Weakness of one or more groups of supporting elements of pelvis leads to pelvic floor dysfunctions and ultimately pelvic organ prolapse. Cross sectional validation study was conducted among 236 study participants at gynaecology unit Teaching Hospital Ragama. Patients with an age of 40 years or above who presented to the gynaecological unit for any reason were included. Sinhala and Tamil Translated versions of Australian Pelvic floor questionnaire was administered to participants to assess the pelvic floor dysfunction. The mean age of the study participant was 55.77 years (SD= 10.18 Years). Considerable number of study participants were not having experience of vaginal deliveries (N=65:27.5). 31.4% of study participants had undergone lower segment cesarean section (N=162). Tamil version of the study instrument Cronbach alpha value was determined as 0.632. The results of the reliability assessment of the Sinhala version of the study tool produced the satisfactorily accepted level (Cronbach alpha=0.610). According to the assessment of pelvic floor dysfunction tool, 56.33% (N=133) were diagnosed as a patient having pelvic floor dysfunction and 24%(N=57) were diagnosed by clinical assessment. Sensitivity of the Sinhala version of the study instrument is 100%. Specificity was calculated as 59.13%. positive predictive value was 41.53 and the negative predictive value was determined as 100%. Sensitivity of the Tamil version of the study instrument is 100%. Specificity was calculated as 55.3%. Positive predictive value was 44.11 and the negative predictive value was determined as 100%. The total statement score has significant predictability of pelvic floor dysfunction (AUC=0.743:95%CI=0.656-0.830). Bladder score alone showed the highest Predictability (AUC=0.888:95%CI=0.839-0.936). Prolapse of pelvic organ score also showed the significant predictability (AUC=0.648:95%CI=0.569-0.727). Reliability of the Sinhala and Tamil versions of the pelvic floor dysfunction assessment tools is at a satisfactory level. Sensitivity and negative predictive ability of the study tool are at a maximum level. Specificity and the positive predictive ability of the study tool are significantly low. Generation of false negative results by the study tool is minimum and tendency to generate false positives is relatively high. All the main components of the study tool have a significant ability to predict Pelvic floor dysfunction. Measures should be taken to publish the questionnaire used for the present study as a screening tool to detect pelvic floor dysfunction. Attention should be paid on developing more simple screening tools by using the identified predictive abilities of each component of the study tool. .
2022-09-01.
Download PDF