The impact of dispositional optimism on symptoms and treatment choices in patients with pelvic floor disorders

Introduction and hypothesis: The objective of this study is to evaluate dispositional optimism, pelvic floor disorder symptoms, and treatment decisions. Methods: Scores of the Life Orientation Test-Revised were used to categorize women seeking clinical treatment for pelvic floor disorders as pessimists (scores in lowest third) or optimists (scores in highest third). Participants also listed their treatment goals and quantified pelvic floor symptom severity by completing the Pelvic Floor Distress Inventory (PFDI-20). We compared symptoms, goals, and treatment choices between optimists and pessimists. Results: Three hundred sixteen patients were included, 31% pessimists and 38% optimists. Pessimists reported more goals and different types of treatment goals. Pessimists were also more likely to elect surgical treatment over more conservative treatment methods, although this trend did not reach statistical significance. Among patients with prolapse (≥stage 2), PFDI-20 prolapse subscale scores were inversely correlated with level of optimism, with pessimists reporting a higher level of bother than optimists. Conclusions: In our study, pessimists reported more treatment goals, were more bothered by prolapse symptoms, and tended to be more likely to choose surgical treatments for their pelvic floor disorders than optimistic women.