Gynecologic surgery and surgical morbidity in mentally handicapped women

A multidisciplinary clinic recognizing the reproductive health concerns of mentally handicapped women was organized in 1985. Thirty-three of the 300 women seen in the clinic required surgery. Thirty-seven operations, including 13 major abdominal and two major vaginal operations, were performed. Uterine leiomyoma and ovarian neoplasm were the most common gynecologic conditions requiring major surgery. No complications developed in women undergoing minor procedures; however, six patients undergoing major abdominal procedures developed significant postoperative complications. Because thorough and complete pelvic examinations are often difficult to accomplish in mentally handicapped women, these patients may have increased risk for the delayed diagnosis of gynecologic conditions that require major abdominal or vaginal surgery. Mentally handicapped women with significant physical handicaps are at increased risk of developing postoperative complications, and the postoperative stay may be prolonged.