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Patient-centered goals for pelvic floor dysfunction surgery: long-term follow-up
Kathie L Hullfish1, Viktor E Bovbjerg, William D Steers
1Department of Obstetrics and Gynecology, University of Virginia Health System, Charlottesville 22908, USA. khullfish@virginia.edu
American Journal of Obstetrics and Gynecology
|August 6, 2004
Summary
Patients undergoing pelvic floor dysfunction (PFD) surgery reported achieving most of their personal goals 1-3 years post-operation. Goal achievement correlated with quality of life but not with most clinical factors.
Area of Science:
- Urology
- Gynecology
- Pelvic Floor Disorders
Background:
- Pelvic floor dysfunction (PFD) significantly impacts women's quality of life.
- Surgical interventions aim to improve symptoms and restore function.
- Understanding long-term patient-reported outcomes is crucial for evaluating surgical success.
Purpose of the Study:
- To assess the long-term (1-3 years) achievement of subjective, patient-defined goals after PFD surgery.
- To explore the relationship between goal achievement and patient-reported outcome measures.
Main Methods:
- 123 patients undergoing PFD surgery completed preoperative questionnaires detailing personal outcome goals.
- Patients self-assessed goal achievement at 3 months and 1-3 years post-surgery using a 5-point scale.
- Long-term follow-up included the Incontinence Impact Questionnaire (IIQ-7) and Urogenital Distress Inventory (UDI-6).
Main Results:
- Of 194 patient-defined goals, 68% were achieved long-term.
- Goal achievement was high for resuming activities (40.2%) and self-image (9.3%).
- Long-term goal achievement was associated with improved quality of life (UDI-6, IIQ-7) and inversely with surgical complications.
Conclusions:
- Self-reported goal achievement following PFD surgery is sustained 1-3 years postoperatively.
- Goal achievement is linked to, but distinct from, overall measures of PFD impact and symptom distress.
- Preoperative goal assessment can enhance the long-term management of PFD.