Patient-centered surgical outcomes: the impact of goal achievement and urge incontinence on patient satisfaction one year after surgery

Am J Obstet Gynecol. 2006 Mar;194(3):722-8. doi: 10.1016/j.ajog.2005.08.043.

Abstract

Objective: The purpose of this study was to assess factors that influence patient satisfaction 1 year after pelvic reconstructive surgery.

Study design: We previously reported the objective success, goals, and expectations of a cohort of 78 patients 3 months after surgery. A second blinded independent physician investigator contacted the same patients by phone to reassess these items 1 year after surgery. Data were analyzed with the Spearman correlation, the Mann-Whitney test, the chi-squared test of association, and the Friedman test.

Results: Seventy patients (89%) of the original cohort completed the second assessment. Although group satisfaction and goal achievement were stable (P < .01), 70% of patients reported a change in their satisfaction ratings between 3 months and 1 year (rho = 0.3). Reduced satisfaction between 3 and 12 months after surgery was strongly associated with decreased goal achievement (rho = 0.47; P = .006). Fifty-six percent of patients reported urge incontinence symptoms after surgery (44% de novo and 12% persistent). Urge incontinence was the most common reason for patient dissatisfaction after surgery (P = .04).

Conclusion: Symptoms of urge incontinence and reduced achievement of subjective surgical goals are associated with decreased long-term patient satisfaction after reconstructive pelvic surgery.

MeSH terms

  • Achievement*
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Follow-Up Studies
  • Goals*
  • Gynecologic Surgical Procedures / psychology*
  • Humans
  • Middle Aged
  • Patient Satisfaction*
  • Patient-Centered Care
  • Surveys and Questionnaires
  • Time Factors
  • Treatment Outcome
  • Urinary Incontinence* / epidemiology
  • Urinary Incontinence, Stress / surgery
  • Uterine Prolapse / surgery