Barriers in seeking pelvic floor disorder treatment among ethnic minorities

Treatment seeking attitudes for pelvic floor disorders (PFDs) among ethnic minorities may be inhibited by a lack of understanding about underlying etiology and treatment options, according to a recent study published in the Journal of Urology.¹

Approximately 1 in 4 women in the United States experience pelvic floor disorders that significantly impact their quality of life. However, there is little data about how underrepresented ethnic groups are impacted by PFDs and their understanding of treatment options.

Currently, disorders such as pelvic inflammatory disease (PID) are managed using antibiotic therapy.² However, this treatment does not reverse scarring associated with PID, making immediate care crucial. Immediate care also reduces the risks of severe reproductive organ damage and associated infertility and future ectopic pregnancy.

In the 2021 STI Treatment Guidelines, the Centers for Disease Control and Prevention (CDC) highlighted recommended regimens for PID treatment. Certain cases may require hospitalization for proper treatment, and the need for hospitalization should be decided based on the criteria and judgement of the patient’s health care provider.

Investigators conducted a study with ethnically diverse patients in Miami, Florida, to evaluate the impact of PFDs among these populations.¹ Focus groups included Hispanic English-speaking (HE), Hispanic Spanish-speaking (HS), and African American (AA) women.

The study was conducted in English for HE and AA patients vs in Spanish for HS patients. Participants answered questions about knowledge pertaining to PFDs, including symptom burden and treatment seeking and experiences.

Authors independently performed transcript analysis and coding. There were 6 broad themes encompassing 19 subthemes determined following participant responses.

Major points included noting extremely bothersome outcomes from urinary incontinence and prolapse symptoms, as well as reporting significant impacts on sex life and social life. The third major point indicated impacts on the ability to work from urinary incontinence (UI), while the fourth indicated most patients were able to tell apart stress and urge UI.

Key treatment points included patients mostly being unaware of PFD treatment options, most patients being interested in treatment overall despite different preferences for surgical vs medical treatment, and reported success in most patients with prior treatment.

These results increased understanding of PFD symptom burden, treatment awareness, and treatment seeking among ethically diverse populations. Investigators concluded improvement of treatment awareness among these populations can lead to higher quality of care.

References

1. MP23-16 The impact of pelvic floor disorders, treatment awareness and preference among minority women —A focus group analysis. Journal of Urology. 2024;211(55):e388. doi:10.1097/01.JU.0001008776.99097.8a.16
2. Pelvic inflammatory disease (PID) treatment and care. Centers for Disease Control and Prevention. Accessed May 7, 2021. https://www.cdc.gov/std/pid/treatment.htm#:~:text=Pelvic%20Inflammatory%20Disease%20(PID)%20Treatment%20and%20Care&text=Prompt%20antibiotic%20treatment%20can%20prevent,damage%20to%20the%20fallopian%20tubes.