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. 2025 Jul 24;14(15):5231.
doi: 10.3390/jcm14155231.

Symptom Burden, Treatment Goals, and Information Needs of Younger Women with Pelvic Organ Prolapse: A Content Analysis of ePAQ-Pelvic Floor Free-Text Responses

Georgina Forshall  1 , Thomas J Curtis  2 , Ruth Athey  3 , Rhys Turner-Moore  1 , Stephen C Radley  3 , Georgina L Jones  1
Affiliations

Symptom Burden, Treatment Goals, and Information Needs of Younger Women with Pelvic Organ Prolapse: A Content Analysis of ePAQ-Pelvic Floor Free-Text Responses

Georgina Forshall et al. J Clin Med. .

Abstract

Background/Objectives: Pelvic organ prolapse (POP) is a common condition that significantly impacts quality of life. Research has focused largely on older women, while experiences of younger women remain relatively underexplored despite challenges unique to this population. Informed by the biopsychosocial model of illness, this study aims to assess the symptom burden, treatment goals, and information needs of younger women complaining of prolapse by analyzing questionnaire responses from an existing electronic Personal Assessment Questionnaire-Pelvic Floor (ePAQ-PF) dataset. Methods: Mixed-methods content analysis was conducted using free-text data from an anonymized multi-site ePAQ-PF dataset of 5717 responses collected across eight UK NHS trusts (2018-2022). A quantitative, deductive approach was first used to identify younger women (≤50 years old) with self-reported prolapse. ePAQ-PF scores for younger women with prolapse were compared with those aged >50 years, using Mann-Whitney tests. Free-text response data were analyzed inductively to qualitatively explore younger women's symptom burden, treatment goals, and information needs. Results: Of the 1473 women with prolapse identified, 399 were aged ≤50 years. ePAQ-PF scores of the younger cohort demonstrated significantly greater symptom severity and bother than those aged >50, particularly in bowel, prolapse, vaginal, body image, and sexual health domains (p < adjusted threshold). Qualitative analysis undertaken to understand women's concerns and priorities produced five health-related themes (physical health; functionality; psychosocial and emotional wellbeing; reproductive and sexual health; and healthcare journeys) and a sixth intersecting theme representing information needs. Conclusions: The findings highlight the substantial symptom burden of younger women with prolapse, as well as treatment goals and information needs specific to this population. The development of age-specific resources is identified as a requirement to support this group.

Keywords: PROMs; patient-reported outcome measures; pelvic floor disorders; pelvic organ prolapse; pre-menopausal; treatment goals.

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Conflict of interest statement

Stephen C. Radley is a director and shareholder of ePAQ Systems Limited, an NHS spin-out technology company (www.epaq.co.uk accessed on 22 July 2025). The other authors declare they have no conflicts of interest. Stephen C. Radley reviewed the coding frameworks but did not collect or analyze the data for this study. The other authors have no financial or commercial interest in ePAQ Systems, Ltd.

Figures

Figure 1
Figure 1
Open-ended questions (extracted from ePAQ-PF General Domain).
Figure 2
Figure 2
Thematic framework representing symptom burden, treatment goals, and information needs of younger women complaining of prolapse.
Figure 3
Figure 3
Information needs of younger women: How does prolapse relate to other health concerns?
See this image and copyright information in PMC

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