Pelvic organ prolapse (POP) is frequently a recurrent condition. There is a lack of information about help-seeking behaviour in women suffering from pelvic organ prolapse recurrence. The aim of this focus group study was to identify factors that determine help-seeking behaviour of women with POP recurrence.

The focus groups were compiled from an observational cohort study, the POP-UP study.1 The POP-UP study reviewed the long-term prevalence of POP after laparoscopic hysterectomy compared with vaginal hysterectomy. Women with a recurrent POP who did not consult a physician were selected. Prior to the focus group discussions, a group of four urogynecologists agreed on seven hypothetical themes for not seeking medical care: ‘personal factors’, ‘previous treatment’, ‘knowledge’, ‘perception of current symptoms’, ‘social environment’, ‘accessibility’ and ‘logistic factors’. Three focus groups were conducted. A funnel design was chosen to moderate the focus group discussions. Focus group discussions were audio-recorded, anonymized and transcribed using Atlas.ti9. A researcher developed a coding scheme and identified the most common themes that were mentioned during the focus group discussions. The coding scheme was based on the themes generated at the expert meeting, and these themes were further refined based on the focus group findings, including adding subcategories. A second researcher reviewed the coding scheme in Atlas.ti9 on any disagreements. Consensus was sought where there were differences between the first and second researcher.

Twenty women with a mean age of 66 years (range 60-80 years) participated in three focus groups.
The most important personal factors were: age, coping style and personal characteristics like postponing, avoiding, minimizing, or serving attitude. The previous treatment experience was important if this was a negative experience. Concerning knowledge, lack of knowledge about treatment options, lack knowledge of general practitioner (GP) and lack of knowledge about right moment to treat, were mentioned most frequently. The perception of current symptoms was mostly less compared to preoperative complaints. Lack of accessibility of the GP mattered and in the social environment taboo on discussing POP symptoms. Logistic factors were hardly mentioned.

This focus group study identified the most common factors influencing the help-seeking behaviour of women experiencing a recurrence of POP symptoms. These are multifactorial and include among others: age, coping style, personal characteristics, lack of knowledge about treatment options, previous treatment experiences, awareness of symptoms and the accessibility to a GP.

Women with POP recurrence, who don’t seek medical care, do this for different reasons. It is important to know the barriers and facilitators in order give optimal care to this group. Further research is needed to confirm the influencing factors for women’s help seeking behaviour and to investigate what adjustments can be made by health professionals to encourage these women to seek help.

Vermeulen, C. K. M., Veen, J., Adang, C., van Leijsen, S. A. L., Coolen, A. L. W. M., & Bongers, M. Y. (2020). Pelvic organ prolapse after laparoscopic hysterectomy compared with vaginal hysterectomy: the POP-UP study. International Urogynecology Journal, 32(4), 841–850. https://doi.org/10.1007/s00192-020-04591-z