Risk Factors for Impaired Patient-Reported Satisfaction and Increased Length of Hospital Stay Following Hysterectomy on Benign Indications in Premenopausal Women: a Study From the Swedish National Register for Gynecological Surgery

Abstract

Introduction The aims of the study were to evaluate the impact of intra- and postoperative complications on satisfaction one year after hysterectomy for benign conditions, to determine risk factors for low patient satisfaction and to analyze whether complications were associated with the length of hospital stay. Material and Methods A retrospective study of 27 938 women from the Swedish National Register for Gynecological Surgery undergoing hysterectomy for benign conditions between January 2004 and June 2016. Data were obtained from prospectively collected pre-, peri- and postoperative forms. Statistical analyses were performed using multivariable logistic regression models. Crude and adjusted odds ratios and 95% confidence intervals are presented. Results More than 90% were satisfied with the hysterectomy. Dissatisfaction was associated with complications. Pelvic pain as indication, preoperatively having less expectations to get rid of symptoms or being alleviated from surgery, and current smoking were also risk factors for low patient satisfaction. Vaginal and abdominal subtotal hysterectomies were associated with high satisfaction. Occurrence of complications intra- and postoperatively before discharge was associated with increased length of hospital stay, as well as occurrence and severity of complications reported after discharge from hospital. Conclusions Complications were strongly associated with lower patient satisfaction. Preoperative expectations of surgery, indication, mode of surgery and life-style factors had impact on the satisfaction. Patient-centered information to ensure realistic expectations and prevention of complications seem to be essential to gain optimal patient satisfaction with surgery.

Impact of patient‐reported salpingitis on the outcome of hysterectomy and adnexal surgery: A national register‐based cohort study in Sweden

“…Dissatisfaction may of course be explained by many factors and the reason women are dissatisfied is not explained by the data, so no conclusion of a causal relationship can be drawn. In a register‐based study using data from GynOp, Borendal Wodlin found that dissatisfaction correlates with intraoperative and postoperative complications, especially major complications 21 . However, in this report, neither adjustment for complications (overall) nor major complications changed the association between patient‐reported salpingitis and dissatisfaction after 1 year.…”

“…In a registerbased study using data from GynOp, Borendal Wodlin found that dissatisfaction correlates with intraoperative and postoperative complications, especially major complications. 21 However, in this report, neither adjustment for complications (overall) nor major complications changed the association between patient-reported salpingitis and dissatisfaction after 1 year. This suggests that other aspects of salpingitis, not yet identified, are related to the increased risk of dissatisfaction after gynecologic surgery.…”

Hysterectomy after uterus transplantation and detailed analyses of graft failures

“…These hysterectomy surgery durations can be compared with the surgical duration of 100 (±41) min for total abdominal hysterectomy on benign indications reported in a recent Swedish registry study of more than 27 000 hysterectomies. 11 The reasons for the longer durations are most likely related to the presence of adhesions in conjunction with the uterus and the complex dissection of the uterine vessels, with their altered anatomical locations in relation to the ureters and external iliac vessels.…”