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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