Colpocleisis for Pelvic Organ Prolapse: A Patient Survey on Reasons for Surgery Selection

• Published in: Obstetrics and gynecology (New York. 1953) Vol. 123 Suppl 1; no. Supplement 1; p. 103S
• Main Authors: Takase-Sanchez, Michelle M, Brooks, Hannah M, Woodman, Patrick J, Hale, Douglass S, Heit, Michael H
• Format: Journal Article
• Language: English
• Published: by The American College of Obstetricians and Gynecologists 01-05-2014
• ISSN: 0029-7844; 1873-233X
• DOI: 10.1097/01.AOG.0000447450.85410.92

INTRODUCTION:The objective of this study was to estimate the prevalence of patient-reported reasons for selecting colpocleisis and determine associations with procedure satisfaction or regret.
METHODS:A retrospective analysis on a surgical cohort was performed with institutional review board approval. A database was created of obliterative procedures performed for prolapse from 2006 to 2013. Women were excluded if they declined, were dead, or had dementia. Participants completed a survey regarding reasons for selecting colpocleisis and validated questionnaires on regret (DRS-PFD; Decision Regret Scale-Pelvic Floor Disorders) and satisfaction (SDS-PFD; Satisfaction Decision Scale-Pelvic Floor Disorders). Parsimonious multivariate linear regression models were constructed to determine if any of the reasons given for choosing colpocleisis were independent predictors of regret and satisfaction after controlling for significant potential confounders identified by univariate analysis.
RESULTS:Seventy-seven women completed the surveys. Doctorsʼ recommendations and lack of sexual activity were the top two reasons for selecting colpocleisis; however, these reasons were not identified as significant independent predictors of regret or satisfaction after controlling for potential confounders. The multivariate linear regression models for regret identified sexual activity status as the only significant independent predictor of more regret. The satisfaction regression models identified reoperation as a significant independent predictor of lower satisfaction (P<.04) and “declined pessary” the reason for surgery selection as a predictor of higher satisfaction (P=.011).
CONCLUSION:Most patients reported doctorsʼ recommendations and lack of sexual activity as making the most difference in their decision-making process. These reasons did not significantly affect overall procedure satisfaction or regret.