Cited by 212Pelvic floor disorders treatmentsUterine Myomas and TreatmentsReproductive Health and Contraception

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

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Korbly, Nicole B., Kassis, Nadine C., Good, Meadow M., Richardson, Monica L., Book, Nicole M., Yip, Sallis, Saguan, Docile, Gross, Carey, Evans, Janelle, Lopes, Vrishali V., Harvie, Heidi S., Sung, Vivian W.·2013·American Journal of Obstetrics and Gynecology

DOI 10.1016/j.ajog.2013.08.003

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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.

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Authors: Korbly, N. B., Kassis, N. C., Good, M. M., Richardson, M. L., Book, N. M., Yip, S., Saguan, D., Gross, C., Evans, J., Lopes, V. V., Harvie, H. S., & Sung, V. W.
Affiliations: Brown University (US)
Indiana University Hospital (US)
Stanford Medicine (US)
Riverside Methodist Hospital (US)
Yale University (US)
Emory University (US)
Cleveland Clinic Florida (US)
Christ Hospital (US)
University of Pennsylvania (US)
Corresponding author: Korbly, Nicole B.
ORCID: Harvie, Heidi S.
Venue: American Journal of Obstetrics and Gynecology
Publisher: Elsevier BV
Published: 2013-11
Volume: 209
Issue: 5
Pages: 470.e1-470.e6
ISSN: 0002-9378 (ISSN-L)
DOI: 10.1016/j.ajog.2013.08.003
OpenAlex: W2043921323
Cited by: 211
References: 15
Citations by year: 2026: 12 · 2025: 22 · 2024: 20 · 2023: 18 · 2022: 21 · 2021: 22 · 2020: 18 · 2019: 20 · 2018: 18 · 2017: 18 · 2016: 9 · 2015: 7 · 2014: 5 · 2013: 1
FWCI: 6.02
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: American Journal of Obstetrics and Gynecology (publishedVersion)
PubMed (publishedVersion)
Funders: Society of Gynecologic Surgeons
Topics: Health Sciences › Medicine › Urology › Pelvic floor disorders treatments
Health Sciences › Medicine › Obstetrics and Gynecology › Uterine Myomas and Treatments
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Health and Contraception
Keywords: pelvic organ prolapse, uterine preservation, hysterectomy, patient preferences, treatment preferences, regional variation, educational attainment, selfhood
MeSH terms: Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Educational Status, Female, Geography, Humans, Hysterectomy, Middle Aged, Surveys and Questionnaires, Self Concept, United States, Uterine Prolapse, Multivariate Analysis, Logistic Models, Odds Ratio, Pelvic Organ Prolapse, Patient Preference, Organ Sparing Treatments

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

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