PATIENT SATISFACTION WITH SURGICAL REPAIR OF STAGE 3 AND 4 VAGINAL PROLAPSE

P.Hogston MD, K. Das MD, T Shaw


   Objective: The study was a questionnaire sent to patients at variable times after surgery to assess their symptoms and satisfaction following surgery for severe vaginal prolapse

   Materials and Methods: A questionnaire was sent to 64 patients aged from 46-89 years between nine and forty eight months from their last operation for prolapse. This asked about symptoms of prolapse, and incontinence as well as sexual function along with their general satisfaction with their surgery.

   Results: 59 (92%) patients replied to some or all of the questions. Forty (68%) were very and 11 (19%) fairly satisfied with their surgery. Forty four (75%) could no longer feel a lump but 5 (8%) still felt a lump most of the time. Eight (13%) patients were incontinent of urine most or all of the time and 24 (41%) were never incontinent. Twenty six (44%) had a strong urge to pass urine but in only 7 (12%) was it worse than before surgery. Twelve (20%) patients had their ability to have intercourse adversely affected of whom 7 complained it was a significant problem.

   Conclusion: Overall patient satisfaction was good as far as the correction of prolapse was concerned but was mitigated against by urinary and sexual problems. Although for many patients their bladder symptoms had improved, some had worsened. It is difficult to comment on the cause of the urinary problems as post-operative urodynamics have not been performed to date. Patients with severe prolapse have difficult problems to treat and the effect on the bladder is less than optimal