Barriers to urogynecological care in a population of gynecological oncology patients.

Introduction And Hypothesis: The objective was to identify barriers to urogynecological evaluation in a population of new patients presenting to a gynecological oncology practice with symptoms of pelvic floor dysfunction.

Methods: A pelvic floor dysfunction screening questionnaire was given to new patients presenting to a university-based gynecological oncology practice between 1 August 2010 and 31 August 2012. Patients indicating symptoms related to pelvic floor dysfunction in the survey were offered urogynecological evaluations. Charts of those patients declining further evaluation were reviewed. Results of the pelvic floor dysfunction questionnaires were assessed. Reasons provided for not desiring further evaluation were extracted from the questionnaire and stratified.

Results: A total of 549 surveys were reviewed. Two hundred and thirty-six patients (42.0 %) of the patients surveyed reported being bothered by pelvic floor dysfunction symptoms. Only 6.7 % (16 out of 236) wanted a referral for an urogynecological evaluation; 93.2 % declined an evaluation. Of patients reporting moderate to severe bother from pelvic floor symptoms, the most frequently cited barrier to care was feeling overwhelmed with the current medical situation (28 %). Other reasons for declining an urogynecological evaluation included a previous evaluation (14 %), financial concerns (6.9 %), and believing that oncological treatment would cure pelvic floor symptoms (6 %).

Conclusions: Quality of life after cancer treatment is important. The ability to provide treatment for gynecological cancer and pelvic floor disorders concomitantly has the potential to improve the quality of life in this patient population. Understanding barriers to care of gynecological oncology patients seeking evaluation for conditions affecting their quality of life is essential in alleviating fears, preventing misconceptions, and for making informed decisions.