A New Combined Urogynecology and Colorectal Surgery Pelvic Floor Clinic-1 Year On.

Abstract

Introduction and hypothesis: This study is aimed at characterizing patients seen at a new combined pelvic floor clinic (CPFC) established at a tertiary women's hospital in Singapore. Study goals include identifying patterns of symptom clusters and reviewing management strategies compared with international care standards, improving understanding of complex female pelvic floor dysfunction, and guiding future development of clinical and ancillary support.

Methods: This is a single-center, retrospective cohort study of medical case record review for all patients seen at the CPFC between 1 September 2020 and 31 August 2021. All patients seen at CPFC during this study period were included for analysis. Data were deidentified and aggregated, with analysis performed for descriptive and summary statistics. Institutional Review Board approval was obtained with waiver of informed consent.

Results: Sixty-six referrals were made to the CPFC, with 57 patients seen in 11 clinic sessions across the 12-month period. The most common reasons for referral were fecal or flatus incontinence (30, 52.6%), severe constipation or defecatory dysfunction (21.1%), and rectal prolapse (17.5%). Most patients (78.9%) had multiple symptoms.

Conclusions: Our patient demographic profile aligns with known risk factors for pelvic floor dysfunction, presenting with gastrointestinal symptoms-similar to PFCs worldwide. The new workflow and services were well positioned to address patients' needs, including those left previously untreated, or received uncoordinated care. Conservative approaches were first employed, like with other global PFCs. The combined multidisciplinary model of care resulted in good outcomes for patients managed both conservatively and surgically. Future studies to analyze patient satisfaction are planned.