Informed consent for sacrocolpopexy: is counseling effective in achieving patient comprehension?

The purpose of the informed consent process is to reinforce a patient's understanding of her condition and treatment alternatives and to thoroughly review the chosen procedure with its risks and benefits. We aimed to evaluate how well women who consented to undergo sacrocolpopexy understood their planned procedure.

We prospectively studied women who had undergone detailed informed consent in preparation for laparoscopic or robotic sacrocolpopexy. A 15-item questionnaire was developed and administered before surgery to assess the patients' comprehension of preoperative counseling.

Fifty women were enrolled. The mean knowledge score was 69.7%. Sixty-four percent of the patients did not recall that they could have a prolapse repair without mesh, 44% did not understand the location of mesh attachment, and 34% believed there was no risk of recurrent prolapse. Women who completed the questionnaire within 3 weeks of signing the surgical consent had a higher mean score (78.5%) than women for whom 3 or more weeks elapsed (66.3%; P=0.02).

Despite detailed preoperative discussion, women had deficiencies in their understanding of sacrocolpopexy. New methods to improve patient education and comprehension should be considered.