Patient-centered surgical outcomes: The impact of goal achievement and urge incontinence on patient satisfaction one year after surgery

Objective: The purpose of this study was to assess factors that influence patient satisfaction 1 year after pelvic reconstructive surgery. Study design: We previously reported the objective success, goals, and expectations of a cohort of 78 patients 3 months after surgery. A second blinded independent physician investigator contacted the same patients by phone to reassess these items 1 year after surgery. Data were analyzed with the Spearman correlation, the Mann-Whitney test, the chi-squared test of association, and the Friedman test. Results: Seventy patients (89%) of the original cohort completed the second assessment. Although group satisfaction and goal achievement were stable (P < 01), 70% of patients reported a change in their satisfaction ratings between 3 months and 1 year (rho = 0.3). Reduced satisfaction between 3 and 12 months after surgery was strongly associated with decreased goal achievement (rho = 0.47; P = .006). Fifty-six percent of patients reported urge incontinence symptoms after surgery (44% de novo and 12% persistent). Urge incontinence was the most common reason for patient dissatisfaction after surgery (P = .04). Conclusion: Symptoms of urge incontinence and reduced achievement of subjective surgical goals are associated with decreased long-term patient satisfaction after reconstructive pelvic surgery. (c) 2006 Mosby, Inc. All rights reserved.