Evaluation of the Pelvic Floor Clinic

Sue Ross (UoC), Magali Robert (UoC)

Urinary incontinence, pelvic prolapse and fecal incontinence are three medical conditions known collectively as pelvic floor disorders (PFD). Pelvic floor disorders are common, affecting at least a third of adult women of all ages. Pelvic floor disorders are perceived as affecting only older women, however many younger women are also affected: half of women attending clinics for treatment of pelvic floor disorders are aged between 30 and 60 years, although older women generate more clinic consultations than younger women.

The implications of pelvic floor disorders are enormous for women (including social isolation, sexual inhibition, restricted employment, and potential loss of independence) and the health care system (economic and provision of facilities). In southern Alberta, over 300,000 women have pelvic floor disorders: with an ageing and expanding population, this problem will only worsen. The population served by the Calgary Health Region increased by 22% in the 35 to 64 year old category and by 18% for the over 65 category from 1995 to 2000, and is expected to continue growing. The growth in demand for pelvic floor disorder services is likely to increase at twice the rate of population increase. Calgary Health Region has acknowledged that pelvic health is a major and increasing health problem for the population of Alberta, by highlighting it as a strategic priority, and funding the Calgary Pelvic Floor Disorders Clinic.

This patient-centred system, designed to integrate the work of a number of different health care professionals and enhance communication, seems to have excellent face validity. However it is important to examine the functioning of the system from the patient, the staff, the family physician, and the Calgary Health Region points of view, to ensure that its goals are met. It is also important, that if the Pelvic Floor Disorders Clinic proves to be a useful model of care, an investigation should be carried out to find out if this form of integrated care could prove useful in other areas of obstetrics and gynaecology. The proposed program of work uses a combination of methodologies (including qualitative and quantitative techniques, and retrospective and prospective data collection) to achieve a thorough and rigorous evaluation of the Clinic. For further information, contact Dr Sue Ross by email, sue.ross@albertahealthservices.ca or by phone (403) 944-8458.