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Patient preferences for uterine preservation and hysterectomy in women with pelvic organ prolapse.

Abstract：

OBJECTIVE:The purpose of this study was to describe patient preferences for uterine preservation and hysterectomy in women with pelvic organ prolapse symptoms and to describe predictors of preference for uterine preservation. STUDY DESIGN:This multicenter, cross-sectional study evaluated patient preferences for uterine preservation vs hysterectomy in women with prolapse symptoms who were being examined for initial urogynecologic evaluation. Before meeting the physician, the women completed a questionnaire that asked them to indicate their prolapse treatment preference (uterine preservation vs hysterectomy) for scenarios in which the efficacy of treatment varied. Patient characteristics that were associated with preferences were determined, and predictors for uterine preservation preference were identified with multivariable logistic regression. RESULTS:Two hundred thirteen women participated. Assuming outcomes were equal between hysterectomy and uterine preservation, 36% of the women preferred uterine preservation; 20% of the women preferred hysterectomy, and 44% of the women had no strong preference. If uterine preservation was superior, 46% of the women preferred uterine preservation, and 11% of the women preferred hysterectomy. If hysterectomy was superior, 21% of the women still preferred uterine preservation, despite inferior efficacy. On multivariable logistic regression, women in the South had decreased odds of preferring uterine preservation compared with women in the Northeast (odds ratio [OR], 0.17; 95% CI, 0.05-0.66). Women with at least some college education (OR, 2.87; 95% CI, 1.08-7.62) and those who believed that the uterus is important for their sense of self (OR, 28.2; 95% CI, 5.00-158.7) had increased odds for preferring uterine preservation. CONCLUSION:A higher proportion of women with prolapse symptoms who were examined for urogynecologic evaluation preferred uterine preservation, compared with hysterectomy. Geographic region, education level, and belief that the uterus is important for a sense of self were predictors of preference for uterine preservation.

journal_name

Am J Obstet Gynecol

journal_title

American journal of obstetrics and gynecology

authors

Korbly NB,Kassis NC,Good MM,Richardson ML,Book NM,Yip S,Saguan D,Gross C,Evans J,Lopes VV,Harvie HS,Sung VW

doi

10.1016/j.ajog.2013.08.003

subject

Has Abstract

pub_date

2013-11-01 00:00:00

pages

470.e1-6

issue

eissn

0002-9378

issn

1097-6868

pii

S0002-9378(13)00821-1

journal_volume

209

pub_type

杂志文章,多中心研究

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Patient preferences for uterine preservation and hysterectomy in women with pelvic organ prolapse.