Journal of Multidisciplinary Healthcare (Mar 2019)
The impact of pelvic floor multidisciplinary team on patient management: the experience of a tertiary unit
Abstract
Ivilina Pandeva,1 Suzanne Biers,2 Ashish Pradhan,1 Vandna Verma,1 Mark Slack,1 Nikesh Thiruchelvam2 1Department of Urogynecology, Addenbrooke’s Hospital, Cambridge, UK; 2Department of Urology, Addenbrooke’s Hospital, Cambridge, UK Purpose: Pelvic floor dysfunction is a common and heterogenous condition with numerous clinical manifestations, making the optimal management challenging. The traditional single-specialty approach may fail to address its complex nature. Currently, there are no published data on the impact of joint pelvic floor multidisciplinary team (MDT) meetings on patient management.Patients and methods: This study represents a retrospective analysis of prospectively collected data on female patients discussed at a joint pelvic floor MDT over a 12-month period in a tertiary referral center.Results: One hundred fifty-two cases were included with a median age of 55 years (range 18–83) and a BMI of 32 kg/m2 (range 17–58). Lower urinary tract dysfunction was the predominant symptom in 75% (114/152). The pelvic organ prolapse symptom of a vaginal bulge was present in 11% (17/152). All cases of vaginal prolapse were accompanied by either urinary incontinence, 59% (10/17), or obstructive defecation, 41% (7/17). Fecal incontinence was recorded in 10% (15/152). Mesh-related complications were reported in 3% (4/152). The MDT recommended a change in the initial management plan in 20% (31/152) of cases, of whom 80% (25/31) were patients with complex urinary incontinence. The MDT agreed a change in the primary care team in 16% (25/152) of cases.Conclusion: There is an increasing regulatory requirement for patients with pelvic floor dysfunction to be discussed in an MDT setting. Findings demonstrate that joint pelvic floor MDT meetings are feasible and contribute to a change in the management of complex patients. Keywords: MDT, multidisciplinary team, pelvic floor dysfunction, prolapse, incontinence
