Between hope and fear: patient’s expectations prior to pelvic organ prolapse surgery

INTRODUCTION AND HYPOTHESIS: The aim of our study was to analyse the patient's expectations (fears and goals (hopes)) in women who are scheduled for pelvic organ prolapse (POP) surgery. METHODS: All consecutive women awaiting surgery for POP in a tertiary urogynaecological centre were included. A short questionnaire with two open questions on goals and fears with regard to the operation was used. RESULTS: Ninety-six out of 111 distributed questionnaires (86%) were analysed. Goals and fears were categorized into five groups. De novo symptoms (63%), POP recurrence (34%) and surgical complications (29%) were the most important fears. Symptom release (96%), improved lifestyle (physical capabilities; 30%) and improved sexual life (18%) were important goals. CONCLUSIONS: A wide variety of expectations both positive and negative can be found in women before POP surgery and should be an integral part of preoperative counselling. Achieving the individual goals as based on expectations, positive (goals) and negative (fears), should be part of the POP surgery evaluation

Which factors determine subjective improvement following pelvic organ prolapse 1 year after surgery?

Item does not contain fulltextINTRODUCTION AND HYPOTHESIS: The factors influencing a patient's subjective improvement 1 year after pelvic organ prolapse (POP) surgery were studied. METHODS: Women after POP surgery were divided into improved and non-improved group based on their score on the questionnaire Patient Global Impression of Improvement (PGI-I) 1 year after surgery. Anatomical and functional outcomes were assessed as influencing factors for improvement using multivariate logistic regression. RESULTS: Three hundred eighty-six (386) women were included in the study, of whom 40 (10%) had not subjectively improved. First POP operation, symptoms and bother of genital prolapse and overactive bladder, and anterior compartment anatomy were independent factors related to subjective improvement. A threshold needed to be reached in these parameters. CONCLUSIONS: The first operation was more often associated with subjective improvement, and both anatomical and functional outcomes were of importance. The mere finding of a statistical significant improvement was no guarantee for subjective improvement after POP surgery