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Attitudes Toward Hysterectomy in Women Undergoing Evaluation for Uterovaginal Prolapse

Frick, Anna C. MD, MPH; Barber, Matthew D. MD, MHS; Paraiso, Marie Fidela R. MD; Ridgeway, Beri MD; Jelovsek, John Eric MD; Walters, Mark D. MD

Female Pelvic Medicine & Reconstructive Surgery: March/April 2013 - Volume 19 - Issue 2 - p 103–109
doi: 10.1097/SPV.0b013e31827d8667
Original Articles
Journal Club

Objectives: To investigate attitudes toward hysterectomy in women seeking care for pelvic organ prolapse.

Methods: Two hundred twenty women referred for evaluation of prolapse without evidence of previous hysterectomy were surveyed with the Pelvic Organ Prolapse Distress Inventory; the Control Preferences Scale; and questions regarding patients’ perception of the impact of hysterectomy on health, social life, and emotional well-being. Additional items presented hypothetical scenarios. Surveys were distributed in small batches until 100 responses were obtained from patients who met inclusion criteria.

Results: One hundred women with an intact uterus responded. Sixty percent indicated they would decline hysterectomy if presented with an equally efficacious alternative to a hysterectomy-based prolapse repair. The doctor’s opinion, risk of surgical complications, and risk of malignancy were the most important factors in surgical decision making.

Conclusions: Many women with prolapse prefer to retain their uterus at the time of surgery in the absence of a substantial benefit to hysterectomy. These findings should provide further impetus to investigate the efficacy of uterine-sparing procedures to help women make informed decisions regarding prolapse surgery.

Many women undergoing evaluation for pelvic organ prolapse express a strong desire for uterine preservation.

From the Center for Urogynecology and Reconstructive Pelvic Surgery, Obstetrics, Gynecology and Women’s Health Institute, Cleveland Clinic, Cleveland, OH.

Reprints: Anna C. Frick, MD, MPH, Center for Urogynecology and Reconstructive Pelvic Surgery, Obstetrics, Gynecology and Women’s Health Institute, Desk A-81, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195. E-mail:

No financial support was received for this project. The authors have declared that they have no conflicts of interest.

© 2013 by Wolters Kluwer Health | Lippincott Williams & Wilkins