Pre-operative guided imagery in female pelvic medicine and reconstructive surgery: a randomized trial

The purpose was to determine if pre-operative guided imagery (GIM) would help women to feel more prepared, less anxious, and have higher satisfaction scores 6 weeks after surgery compared with routine care. Eligible women planning to undergo pelvic floor surgery were enrolled and randomized. The GIM group received an institution-specific CD that uses GIM to detail day of surgery (DOS) events and expectations. Participants were asked to listen to the CD once daily during the week before surgery. At three time points (surgical consent visit, DOS, and 6-weeks post-operatively), we measured anxiety using the State and Trait Anxiety Inventory for Adults (STADI), in addition to preparedness for surgery and overall satisfaction (ten-point Likert scales). Data were analyzed in SPSS 23 using two-tailed t tests. A total of 38 out of 44 (86%) enrolled participants completed the study (GIM: 18, control: 20). The GIM self-reported compliance rate was 72%, with an average use of 4.8 times (range = 3-8 times). Women in the GIM group reported a significant increase from baseline in preparedness for surgery on both DOS and 6 weeks post-operatively (7.32 +/- 1.81 vs 9.11 +/- 1.13, p = 0.001) and (7.32 +/- 1.81 vs 9.22 +/- 0.81, p = 0.001) respectively; a change that was not seen in the control group. Satisfaction was high in both the GIM and the control group (9.55 +/- 0.85 and 9.05 +/- 1.70, p = 0.263). In all patients, anxiety increased from baseline to DOS and dropped at 6 weeks post-operatively, and was not significantly different in the two groups. Guided imagery improved patient preparedness for pelvic floor surgery with an overnight stay on their DOS and 6 weeks post-operatively.