This document discusses the need to improve diagnostic clinician education about pelvic organ prolapse (POP) by incorporating patient experiences and perspectives. A survey of 139 POP patients found common misconceptions among clinicians that minimized or dismissed POP symptoms. Examples of frustrating patient experiences show clinicians often lacked knowledge to properly diagnose or treat POP. The conclusion is that patient input is essential to evolve diagnostic clinician curriculum and address insufficient perceptions about POP. Enabling patient voices can help establish appropriate screening protocols and awareness of this under-recognized condition.

1. Global Evolution of Pelvic Organ Prolapse Health Directives:
Magnifying Patient Voice to Illuminate Diagnostic Development
Sherrie Palm
Association for Pelvic Organ Prolapse Support
Diagnostic clinicians providing routine pelvic
exams are often insufficiently educated in pelvic
organ prolapse (POP) basics to effectively
screen and refer to specialists. Stigma shrouds
POP in silence; patient embarrassment restricts
effective patient/clinician communication. Patient
voice must be enabled and diagnostic clinician
curriculum evolved to substantiate pelvic organ
prolapse incidence, promote early detection, and
clarify misconceptions.
The investigative intent is to clarify the need for
and path to POP diagnostic clinician
development. Insufficient, unacknowledged, or
misunderstood patient input restricts diagnosis.
Lack of POP core curriculum disables diagnostic
clinician screening technique. Patient comfort is
pivotal to enable vocalization of POP symptoms,
critical to clarify misconceptions. Diagnostic
clinician curriculum must evolve to enable
sufficient POP screening.
 Evolve Diagnostic Clinician
Curriculum
 Enable Patient Voice
 Clarify Misconceptions
 Establish Screening Protocol
 Advance POP Diagnostic
Awareness and Understanding
A 17 item survey measured clinician POP quality of life and best practice misconceptions. APOPS social media, patient email list, and online support forum were the source of
POP diagnosed patient feedback for the survey posted August 2015.
INTRODUCTION
OBJECTIVE
METHOD
PATIENTS, ADVOCACY, HEALTHCARE, ACADEMIA, RESEARCH, AND POLICY MAKERS MUST ALL WORK SIDE BY
SIDE TO GENERATE POP AWARENESS, INCREASE DIAGNOSTIC CLINICIAN UNDERSTANDING, ESTABLISH
APPROPRIATE DIAGNOSTIC SCREENING PROTOCOL, AND OVERCOME POP STIGMA.
RESULTS
139 women responded to the survey. Twelve
POP misconceptions were
presented, patients indicated the three most
frustrating are 1) clinicians indicating women
don’t have to do anything about early stage
POP 55.4%, 2) clinicians indicating POP is
normal after birth and there is no need to
worry 43.9%, 3) clinicians not believing POP
symptoms patients experience 41%.
SURVEY QUESTION: WHAT FRUSTRATED YOU MOST ABOUT THE WAY YOUR PRIMARY CARE PHYSICIAN OR GYNECOLOGIST
DIAGNOSED YOUR POP?
*He told me the symptoms were in my head and to see a therapist.
*Why aren’t gynecologists screening for POP during routine pelvic exams?
*Early referral to a specialist would have been so helpful to me both emotionally and physically.
*He made me feel crazy for saying I wasn’t sure if I was leaking urine.
*The gyne said I had no prolapse even though it was visible at vagina entrance, and if not for APOPS I would not have known to see a
urogynecologist.
*I was undiagnosed for over 10 years.
*That I was overreacting to the symptoms.
*My dr telling me my pain could not be from POP.
*When I asked about running, my doctor said stick a tampon in and keep running.
*I asked him if it would worsen when I reached menopause and he said there wasn’t enough research about that.
*She seemed to have no knowledge of how to deal with POP.
*He said heavy lifting would not affect my POP.
*He did not check me standing up, and totally missed the prolapses.
*My gyne is a good dr, but it’s surprising to me that he didn’t even suspect or check for prolapse when I had a lot of the classic symptoms.
*She said I could try a pessary, but then it became evident she didn’t know how to fit one.
*That it’s a rare diagnosis and only found in elderly women.
*I was passed around to various clinicians and each had a different diagnosis.
*He did not acknowledge my condition so I was prevented from treatable information.
*He felt that it was normal and just part of being a woman that I had to learn to live with.
CONCLUSIONS
Patients typically suffer POP symptoms for years/decades
prior to receiving POP diagnoses. Patient perception varies
considerably from clinician, resulting in copious
misconceptions. Enabling patient share in a secure non-
judgmental environment establishes a source of candid
feedback, substantiating insufficient diagnostic clinician
perception. Patient voice is essential to evolve POP
diagnostic clinician educational curriculum.
ACKNOWLEDGEMENTS
The women Association for Pelvic Organ
Prolapse Support (APOPS) serves
graciously and generously share their
very personal information to enable
forward momentum in the POP arena. In
recognition of the value of patient voice,
APOPS dedicates this academic poster to
the women we serve.Sherrie Palm sherriepalm.apops@gmail.com
APOPS www.pelvicorganprolapsesupport.org
Conflicts of Interest: None
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