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Female Pelvic Medicine & Reconstructive Surgery:
doi: 10.1097/SPV.0b013e31827d8667
Original Articles

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

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Abstract

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.

© 2013 by Wolters Kluwer Health | Lippincott Williams & Wilkins

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