Related Experiment Video
Updated: Aug 30, 2025
Author Spotlight: Advancing Pelvic Prolapse Treatment with a Non-Mesh Approach using Laparoscopic Pectopexy
Published on: October 25, 2024
Patient's preference for sacrospinous hysteropexy or modified Manchester operation: A discrete choice experiment
Sascha F M Schulten1,2, Brigitte Essers3, Kim J B Notten4
1Department of Obstetrics and Gynaecology, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands.
Objective:
To investigate women's preference for modified Manchester (MM) or sacrospinous hysteropexy (SH) as surgery for uterine prolapse.
Design:
Labelled discrete choice experiment (DCE).
Setting:
Eight Dutch hospitals.
Population:
Women with uterine prolapse, eligible for primary surgery and preference for uterus preservation.
Methods:
DCEs are attribute-based surveys. The two treatment options were labelled as MM and SH. Attributes in this survey were treatment success ( levels SH: 84%, 89%, 94%; levels MM: 89%, 93%, 96%), dyspareunia (levels: 0%, 5%, 10%), cervical stenosis (levels: 1%, 6%, 11%) and severe buttock pain (levels: 0%, 1%). A different combination of attribute levels was used in each choice set. Women completed nine choice sets, making a choice based on attribute levels. Data were analysed in multinomial logit models.
Main Outcome Measures:
Women's preference for MM or SH.
Results:
137 DCEs were completed (1233 choice sets). SH was chosen in 49% of the choice sets, MM in 51%. Of all women, 39 (28%) always chose the same surgery. After exclusion of this group, 882 choice sets were analysed, in which women preferred MM, likely associated with a labelling effect, i.e. description of the procedure, rather than the tested attributes. In that group, MM was chosen in 53% of the choice sets and SH in 47%. When choosing MM, next to the label, dyspareunia was relevant for decision-making. For SH, all attributes were relevant for decision-making.
Conclusions:
The preference of women for MM or SH seems almost equally divided. The variety in preference supports the importance of individualised healthcare.
