Multidisciplinary conferences to enhance care for pelvic floor dysfunction: A descriptive study at a tertiary center

Purpose/background

The multidisciplinary approach to pelvic floor disorders has been shown to improve patient care outcomes but remains underutilized. This study aims to assess the utility of multidisciplinary meetings for pelvic floor patients by prospectively evaluating their impact on diagnosis, management, and treatment planning. The specific objectives are to improve diagnostic accuracy, optimize treatment plans, and facilitate efficient resource allocation.

Methods/interventions

This is a descriptive study conducted at a tertiary referral academic center. Multidisciplinary conferences were held monthly by a collaborative clinical team. The meetings aimed to: 1. Comprehensively review radiological findings. 2. Develop individualized care plans. 3. Optimize surgical plans and combined surgery. The patients were identified from the pelvic floor multidisciplinary database. "Utility" will be measured by metrics including: 1) Rate of amendment to radiology reports, indicating improved diagnostic accuracy; 2) Frequency of recommended further assessment or workup, reflecting enhanced care pathway definition; and 3) Documentation of changes to the initial treatment plan based on multidisciplinary discussion, showing impact on management.

Results/outcomes

Nineteen multidisciplinary meetings were conducted between August 2021 and May 2023, discussing 101 cases. The patients were categorized into prolapse (n = 41), functional disorders (n = 38), and miscellaneous (n = 22) groups. The prolapse group was classified into combined rectal and pelvic organ prolapse (n = 22), and isolated rectal prolapse (n = 19). After each case discussion, a comprehensive review note was created and incorporated into the patient's chart, facilitating the initiation of follow-up plans and the coordination of services. Radiology reports were amended in 18 cases (18 %), with the majority of revisions related to rectal prolapse (n = 15, 83 %). Further assessment and workup were recommended in 17 cases (17 %): prolapse (n = 5), miscellaneous (n = 9), and motility (n = 3).

Conclusion/discussion

This study suggests that multidisciplinary meetings are beneficial in complex pelvic health conditions. They correlate clinical assessment with radiological findings and inform individualized treatment plans, as evidenced by the rates of amended radiology reports and recommended further assessment/workup. Further research is needed to quantitatively assess the long-term clinical outcomes and cost-effectiveness of this approach.