BACKGROUND: Prior studies suggest that pelvic organ prolapse (POP) and stress urinary incontinence (SUI) may recur following surgery in 20% or more of patients. Despite these numbers, we have anecdotally found that some surgeons performing pelvic floor reconstruction feel their success rates exceed these figures. Based on our experience, we hypothesized that significant numbers of patients with recurrent POP or SUI following prior surgery do not return or notify their original surgeon of their recurrence. We also aimed to identify reasons why the patient was seeking care elsewhere.
METHODS: We investigated patients presenting to a tertiary referral center urogynecologic practice with recurrence after prior POP or SUI surgery over a 2-year period. Data were collected using an institutional review board-approved 15-item questionnaire and after 2 years were analyzed.
RESULTS: We found that 16 (31%) of 51 patients did not notify their primary surgeon of surgical failure. Of these patients, roughly half (9/16) did not return because of moving to a different area of the country, changing their insurance, or their prior physician retiring. Despite the surgical failures, of all patients presenting to our clinic, very few stated they had a poor relationship with their prior surgeon (6%); however, a large majority (63%) did not think that their primary surgeon could fix their problem.
CONCLUSIONS: Roughly one third of patients who suffer from recurrence after POP or SUI surgery do not notify their original surgeon. This may artificially inflate a clinician's perceived success rate of pelvic floor repair.
Female Pelvic Med Reconstr Surg. 2015 Jul 20. [Epub ahead of print]
Elliott CS1, Sokol ER.
1 From the *Division of Urology, Santa Clara Valley Medical Center, San Jose; Departments of †Urology and ‡Obstetrics and Gynecology, Stanford School of Medicine, Palo, Alto, CA.