Abstract
Objective
To investigate Dutch women’s attitudes and preferences towards hysterectomy or uterus
preservation in surgical treatment of pelvic organ prolapse.
Study design
Women’s attitude was assessed by a structured questionnaire in one university hospital
and one non-university teaching hospital in the Netherlands. Between December 2013
and November 2014, 102 women referred with prolapse complaints, without previous prolapse
surgery, responded to the questionnaire received by mail prior to gynaecological consultation.
Main outcome was the preference for uterus preserving surgery versus hysterectomy.
Furthermore we studied the impact of uterus preservation and hysterectomy on body
image and sexual function and the importance of treatment success, risk of urinary
incontinence after surgery, complication risk, recovery time, length of hospital stay,
costs and the risk of developing endometrial cancer.
Results
Assuming that functional and anatomical outcomes after hysterectomy and uterus preserving
surgery were equal, more women expressed preference for uterus preservation (43%,
44 out of 102 women) compared to hysterectomy (27%, 27 out of 102 women). The majority
of women expected a similar improvement in sexuality and body image after the two
treatment modalities. Treatment success, risk for urinary incontinence after surgery
and complication risk were the most important factors. Taken the future risk of endometrial
cancer into account, 18% of the women preferred hysterectomy because of this risk.
Conclusions
This study demonstrated that women referred with prolapse complaints have a preference
for uterus preservation in case outcomes after both interventions are expected to
be equal. The majority of women expected that body image and sexual function would
equally improve after both interventions.
Keywords
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Article info
Publication history
Published online: November 20, 2017
Accepted:
November 20,
2017
Received in revised form:
October 27,
2017
Received:
February 14,
2017
Identification
Copyright
© 2017 Elsevier B.V. All rights reserved.
