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A longitudinal qualitative evaluation of patient perspectives of adverse events after pelvic reconstructive surgery

  • Gena C. DunivanEmail author
  • Brenna L. McGuire
  • Heidi A. Rishel Brakey
  • Yuko M. Komesu
  • Rebecca G. Rogers
  • Andrew L. Sussman
Original Article

Abstract

Introduction and hypothesis

Patient perception of adverse events (AEs) after pelvic floor disorder surgery is incompletely understood and may differ from providers’ views of AEs. Our objective is to describe patient perceptions of AEs related to pelvic floor disorder surgery and how perceptions change over time.

Methods

Mixed-method study of longitudinal patient interviews and surveys. Women planning pelvic floor disorder surgery completed three one-on-one interviews: preoperatively (< 12 weeks before surgery), 6–8 weeks postoperatively, and 6 months postoperatively. Interviews explored the patient experience of surgery and their perception of AEs over time. Participants ranked self-identified AEs by severity. De-identified transcripts of audio recordings were coded and analyzed using an iterative, thematic, team-based process using NVivo software (QSR International).

Results

Twenty women each completed three separate interviews for a total of 60 interviews. Their mean age was 55.3 (± 12.7) years, and 50% were Non-Hispanic white. Women’s perceptions of AEs changed as more time passed from surgery. Women identified potential problems related to surgery such as anesthesia complications, pain, injury, catheter issues, and an unsuccessful surgery as the most concerning AEs preoperatively. Postoperatively (6–8 weeks), women expressed concern about functional outcomes (e.g., performing daily activities, symptom reduction). Late postoperatively (6 months), the majority identified unsuccessful surgery, incontinence, and sexual dysfunction as severe AEs. These findings are consistent with prior work that suggests women perceive functional outcomes as fundamental to their recovery.

Conclusions

These findings contribute to a more nuanced understanding of patient-centered perspectives on AEs. Patients view poor functional outcomes as severe AEs.

Keywords

Pelvic floor disorders Surgical adverse events Qualitative mixed method study Functional outcomes 

Notes

Acknowledgements

Ms. Katherine Mulle, for data collection and research coordination.

Financial support

This project was supported in part by the Dedicated Health Research Funds from the University of New Mexico School of Medicine and the University of New Mexico Clinical and Translational Science Center (UL1TR001449).

Compliance with ethical standards

Conflicts of interest

Gena C Dunivan receives research support from Pelvalon Inc. and Viveve. Rebecca G Rogers, MD, receives royalties from UptoDate and travel and stipend from ACOG, ABOG, and IUGA. Yuko M Komesu, MD, receives research support from Cook Myosite®. All other authors report no disclosures..

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Copyright information

© The International Urogynecological Association 2019

Authors and Affiliations

  • Gena C. Dunivan
    • 1
    Email author
  • Brenna L. McGuire
    • 2
  • Heidi A. Rishel Brakey
    • 3
  • Yuko M. Komesu
    • 1
  • Rebecca G. Rogers
    • 4
  • Andrew L. Sussman
    • 5
  1. 1.Division of Urogynecology, Department of OBGYNUniversity of New MexicoAlbuquerqueUSA
  2. 2.Department of OBGYNUniversity of New MexicoAlbuquerqueUSA
  3. 3.Clinical and Translational Science CenterUniversity of New MexicoAlbuquerqueUSA
  4. 4.Department of Women’ Health, Dell Medical SchoolUniversity of Texas at AustinAustinUSA
  5. 5.Department of Family and Community MedicineUniversity of New MexicoAlbuquerqueUSA

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