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Underlying Factors Contributing to the Delay in Patients Seeking Care for Pelvic Floor Dysfunction

Amos O Adelowo, Ellen O’Neal and Lekha S Hota

Objective: To investigate barriers and variables associated with the delay in seeking urogynecologic care by
women with pelvic floor dysfunction.
Methods: Cross sectional study of 300 new patients presenting for outpatient evaluation of pelvic floor dysfunction from August 2011 through March 2012. Patients were mailed a survey prior to initial visit. Delay in seeking care was defined as 12 months or more from symptom manifestation, persistence or recurrence after prior intervention, or being informed about the condition to time of visit. Data are presented as proportion or mean (±standard deviation). Comparisons were made using chi-square and t tests.
Results: Two hundred and thirty one (77.0%) surveys were returned. Mean age was 55.9 years (± 17.4). Majority (91.3%) were Caucasian, 57.4% sexually active, and 96.1% saw a health care provider annually. Commonly reported causes were child birth (32.6%) and aging (23.4%). Delay was seen in 140 women (61.4%). Of these, 81 (57.9%) had been previously asked about symptoms by their primary care provider. The most common reason reported for delay was “Did not have time to care for myself” (19.8%). There was no statistically significant difference in level of education (p=0.86), annual health care visits (p=0.74), and sexual activity (p=0.28) between women with and without delay. However, women who delayed seeking care were more likely to report increased symptom severity (p=0.005) and to have been asked about symptoms (p=0.01).
Conclusion: There is significant delay in seeking care with an urogynecologist. Additional resources are needed to promote patient and primary care provider awareness.