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Published in: BMC Women's Health 1/2017

Open Access 01-12-2017 | Research article

Are women adequately informed before gynaecological surgery?

Authors: Mojgan Pakbaz, Ewa Rolfsman, Mats Löfgren

Published in: BMC Women's Health | Issue 1/2017

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Abstract

Background

Surgery for pelvic organ prolapse, urinary incontinence, and hysterectomy are the most common gynaecological surgeries that can affect the function of the bladder and bowel as well as one’s sexual life. There is evidence that adequate patient information given preoperatively regarding expected outcomes of surgery is important because well-informed patients are more satisfied with the results of surgery and recover faster. However, there is little known about the amount and quality of information given to women before surgery. This study investigates whether women received information before gynaecological surgery on the effect of surgery with respect to the functioning of the bladder (micturition, ability to stay continent) and the bowel (empty bowel) as well as the surgery’s effect on sexual functioning.

Methods

A prospective, cross-sectional study was conducted. Women undergoing hysterectomy, surgery for vaginal prolapse, or surgery for urinary incontinence (n = 972) and included in the Swedish National Register for Gynaecological Surgery participated in the study. A questionnaire was developed and distributed to the women along with the preoperative questionnaire from the register.

Results

About 50% of the women undergoing prolapse surgery were supplied with information regarding the effect of the surgery with respect to remaining continent, to emptying bowels, micturitaion, and sexual life. One out of four women undergoing hysterectomy received information about the effect of the surgery on the sexual life and bladder function. In the incontinence group, the given information about the surgery’s effect on bladder function and sexual function was 80 and 30%, respectively.

Conclusion

Surgery in the vagina and the genital organs may affect function of the organs close to the surgical area (i.e., bladder and bowel) and may affect sexual function. According to this study, women are inadequately informed before surgery. Access to information via oral and written counselling needs to be improved.
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Literature
3.
go back to reference Pakbaz M, Persson M, Lofgren M, Mogren I. ‘A hidden disorder until the pieces fall into place’--a qualitative study of vaginal prolapse. BMC Womens Health. 2010;10:18.CrossRefPubMedPubMedCentral Pakbaz M, Persson M, Lofgren M, Mogren I. ‘A hidden disorder until the pieces fall into place’--a qualitative study of vaginal prolapse. BMC Womens Health. 2010;10:18.CrossRefPubMedPubMedCentral
4.
go back to reference Maher C, Feiner B, Baessler K, Adams EJ, Hagen S, Glazener CM. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2010;4:CD004014. Maher C, Feiner B, Baessler K, Adams EJ, Hagen S, Glazener CM. Surgical management of pelvic organ prolapse in women. Cochrane Database Syst Rev. 2010;4:CD004014.
5.
go back to reference Jelovsek JE, Barber MD. Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life. Am J Obstet Gynecol. 2006;194(5):1455–61.CrossRefPubMed Jelovsek JE, Barber MD. Women seeking treatment for advanced pelvic organ prolapse have decreased body image and quality of life. Am J Obstet Gynecol. 2006;194(5):1455–61.CrossRefPubMed
6.
go back to reference Forsgren C, Lundholm C, Johansson AL, Cnattingius S, Zetterstrom J, Altman D. Vaginal hysterectomy and risk of pelvic organ prolapse and stress urinary incontinence surgery. Int Urogynecol J. 2012;23(1):43–8.CrossRefPubMed Forsgren C, Lundholm C, Johansson AL, Cnattingius S, Zetterstrom J, Altman D. Vaginal hysterectomy and risk of pelvic organ prolapse and stress urinary incontinence surgery. Int Urogynecol J. 2012;23(1):43–8.CrossRefPubMed
7.
go back to reference Engh MA, Otterlind L, Stjerndahl JH, Lofgren M. Hysterectomy and incontinence: a study from the Swedish national register for gynecological surgery. Acta Obstet Gynecol Scand. 2006;85(5):614–8.CrossRefPubMed Engh MA, Otterlind L, Stjerndahl JH, Lofgren M. Hysterectomy and incontinence: a study from the Swedish national register for gynecological surgery. Acta Obstet Gynecol Scand. 2006;85(5):614–8.CrossRefPubMed
8.
go back to reference de Tayrac R, Chevalier N, Chauveaud-Lambling A, Gervaise A, Fernandez H. Risk of urge and stress urinary incontinence at long-term follow-up after vaginal hysterectomy. Am J Obstet Gynecol. 2004;191(1):90–4.CrossRefPubMed de Tayrac R, Chevalier N, Chauveaud-Lambling A, Gervaise A, Fernandez H. Risk of urge and stress urinary incontinence at long-term follow-up after vaginal hysterectomy. Am J Obstet Gynecol. 2004;191(1):90–4.CrossRefPubMed
9.
go back to reference Rogers GR, Villarreal A, Kammerer-Doak D, Qualls C. Sexual function in women with and without urinary incontinence and/or pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(6):361–5.CrossRefPubMed Rogers GR, Villarreal A, Kammerer-Doak D, Qualls C. Sexual function in women with and without urinary incontinence and/or pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12(6):361–5.CrossRefPubMed
11.
go back to reference Weber AM, Walters MD, Piedmonte MR. Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol. 2000;182(6):1610–5.CrossRefPubMed Weber AM, Walters MD, Piedmonte MR. Sexual function and vaginal anatomy in women before and after surgery for pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol. 2000;182(6):1610–5.CrossRefPubMed
12.
go back to reference Pakbaz M, Rolfsman E, Mogren I, Lofgren M. Vaginal prolapse--perceptions and healthcare-seeking behavior among women prior to gynecological surgery. Acta Obstet Gynecol Scand. 2011;90(10):1115–20.CrossRefPubMed Pakbaz M, Rolfsman E, Mogren I, Lofgren M. Vaginal prolapse--perceptions and healthcare-seeking behavior among women prior to gynecological surgery. Acta Obstet Gynecol Scand. 2011;90(10):1115–20.CrossRefPubMed
13.
go back to reference Bovbjerg VE, Trowbridge ER, Barber MD, Martirosian TE, Steers WD, Hullfish KL. Patient-centered treatment goals for pelvic floor disorders: association with quality-of-life and patient satisfaction. Am J Obstet Gynecol. 2009;200(5):568 e1-6.CrossRefPubMed Bovbjerg VE, Trowbridge ER, Barber MD, Martirosian TE, Steers WD, Hullfish KL. Patient-centered treatment goals for pelvic floor disorders: association with quality-of-life and patient satisfaction. Am J Obstet Gynecol. 2009;200(5):568 e1-6.CrossRefPubMed
14.
16.
go back to reference Thakar R, Chawla S, Scheer I, Barrett G, Sultan AH. Sexual function following pelvic floor surgery. Int J Gynaecol Obstet. 2008;102(2):110–4.CrossRefPubMed Thakar R, Chawla S, Scheer I, Barrett G, Sultan AH. Sexual function following pelvic floor surgery. Int J Gynaecol Obstet. 2008;102(2):110–4.CrossRefPubMed
17.
go back to reference Nguyen JK, Bhatia NN. Resolution of motor urge incontinence after surgical repair of pelvic organ prolapse. J Urol. 2001;166(6):2263–6.CrossRefPubMed Nguyen JK, Bhatia NN. Resolution of motor urge incontinence after surgical repair of pelvic organ prolapse. J Urol. 2001;166(6):2263–6.CrossRefPubMed
18.
go back to reference Digesu GA, Salvatore S, Chaliha C, Athanasiou S, Milani R, Khullar V. Do overactive bladder symptoms improve after repair of anterior vaginal wall prolapse? Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(12):1439–43.CrossRefPubMed Digesu GA, Salvatore S, Chaliha C, Athanasiou S, Milani R, Khullar V. Do overactive bladder symptoms improve after repair of anterior vaginal wall prolapse? Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(12):1439–43.CrossRefPubMed
19.
go back to reference Tunuguntla HS, Gousse AE. Female sexual dysfunction following vaginal surgery: a review. J Urol. 2006;175(2):439–46.CrossRefPubMed Tunuguntla HS, Gousse AE. Female sexual dysfunction following vaginal surgery: a review. J Urol. 2006;175(2):439–46.CrossRefPubMed
20.
go back to reference Helstrom L, Nilsson B. Impact of vaginal surgery on sexuality and quality of life in women with urinary incontinence or genital descensus. Acta Obstet Gynecol Scand. 2005;84(1):79–84.CrossRefPubMed Helstrom L, Nilsson B. Impact of vaginal surgery on sexuality and quality of life in women with urinary incontinence or genital descensus. Acta Obstet Gynecol Scand. 2005;84(1):79–84.CrossRefPubMed
21.
go back to reference Forsgren. Hysterectomy on benign indications and pelvic floor dysfunction - clinical and epidemiological aspects. Stockholm: Karolinska Institutet; 2009. Forsgren. Hysterectomy on benign indications and pelvic floor dysfunction - clinical and epidemiological aspects. Stockholm: Karolinska Institutet; 2009.
22.
go back to reference Goffeng AR, Andersch B, Antov S, Berndtsson I, Oresland T, Hulten L. Does simple hysterectomy alter bowel function? Ann Chir Gynaecol. 1997;86(4):298–303.PubMed Goffeng AR, Andersch B, Antov S, Berndtsson I, Oresland T, Hulten L. Does simple hysterectomy alter bowel function? Ann Chir Gynaecol. 1997;86(4):298–303.PubMed
23.
go back to reference Lashen H, Jones GL, Duru C, Pitsillides C, Radley S, Jacques RM, et al. Bowel dysfunction after total abdominal hysterectomy for benign conditions: a prospective longitudinal study. Eur J Gastroenterol Hepatol. 2013;25(10):1217–22.PubMed Lashen H, Jones GL, Duru C, Pitsillides C, Radley S, Jacques RM, et al. Bowel dysfunction after total abdominal hysterectomy for benign conditions: a prospective longitudinal study. Eur J Gastroenterol Hepatol. 2013;25(10):1217–22.PubMed
24.
go back to reference Nilsson M, Lalos O, Lindkvist H, Lofgren M, Lalos A. Female urinary incontinence: patient-reported outcomes 1 year after midurethral sling operations. Int Urogynecol J. 2012;23(10):1353–9.CrossRefPubMed Nilsson M, Lalos O, Lindkvist H, Lofgren M, Lalos A. Female urinary incontinence: patient-reported outcomes 1 year after midurethral sling operations. Int Urogynecol J. 2012;23(10):1353–9.CrossRefPubMed
25.
go back to reference Nilsson M, Lalos A, Lalos O. The impact of female urinary incontinence and urgency on quality of life and partner relationship. Neurourol Urodyn. 2009;28(8):976–81.CrossRefPubMed Nilsson M, Lalos A, Lalos O. The impact of female urinary incontinence and urgency on quality of life and partner relationship. Neurourol Urodyn. 2009;28(8):976–81.CrossRefPubMed
26.
go back to reference Cholhan HJ, Hutchings TB, Rooney KE. Dyspareunia associated with paraurethral banding in the transobturator sling. Am J Obstet Gynecol. 2010;202(5):481 e1-5.CrossRefPubMed Cholhan HJ, Hutchings TB, Rooney KE. Dyspareunia associated with paraurethral banding in the transobturator sling. Am J Obstet Gynecol. 2010;202(5):481 e1-5.CrossRefPubMed
Metadata
Title
Are women adequately informed before gynaecological surgery?
Authors
Mojgan Pakbaz
Ewa Rolfsman
Mats Löfgren
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Women's Health / Issue 1/2017
Electronic ISSN: 1472-6874
DOI
https://doi.org/10.1186/s12905-017-0426-7

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