Survey on Postponement of Benign Gynecologic Surgery during the COVID-19 Pandemic

Abstract

Study Objective To assess anxiety, satisfaction with interim medical care, and changes in medical status in patients who had benign gynecologic surgery postponed due to COVID. Design Online patient survey. Setting New York City Academic Medical Center. Patients or Participants In Mid-March of 2020 there was a moratorium on elective services due to the COVID-19 pandemic. In our institution, 220 patients were identified who had gynecologic surgery postponed. Of these patients, 150 patients were successfully contacted and invited to participate in the study, and 86 completed the survey. Interventions The research instrument was an online survey, which included a validated anxiety questionnaire. Measurements and Main Results Indications for surgery were fibroids (48%), abnormal bleeding (16%), ovarian mass (16%), endometriosis (12%), incontinence (8%), infertility (7%), prolapse (5%), and dysplasia (2%). On the Zung Self-Rated Anxiety Scale, 92% scored within normal range and 8% scored mild-to-moderate anxiety level. 50% of patients reported feeling more anxious about COVID exposure, 22% were more anxious about waiting for surgery, and 28% were equally anxious about both. Sentiment analysis of an open-ended question about postponement revealed 52% of responses were negative, 27% neutral, and 21% positive. Primary themes within negative responses were “frustrated” or “disappointed” about surgery cancellation. Primary themes within positive responses were “safe” or “relieved.” During the postponement, 60% of patients reported symptoms were the same, 27% worse, and 13% better. 36% of patients reported using alternative therapy while awaiting surgery, the most common being non-opioid pain medication (37%), hormonal therapy (29%), dietary changes (29%), supplements (20%), bladder training exercises (7%), pessary (2%), and pelvic floor physical therapy (2%). 80% reported access to MyChart, and 30% participated in telehealth visits, of which all reported satisfaction with the visit. Conclusion Patients with benign gynecologic surgery postponed due to COVID-19 had a negative impression of this impact on their care.

Is it safe to perform elective gynaecologic surgery during the two peaks of COVID‐19 pandemic?

“…The efficacy of alternative medical treatments evaluated by surveying and the severity of symptoms remained unchanged in 60% of the patients and had worsened in 27%. 17 According to calculations made with modelling, after a 12‐week delay of surgeries, despite a 20% increase in the workforce, the accumulated workload can be compensated in 45 weeks. 16 Based on this modelling, a pandemic that could last up to a year will likely take more than 3 years to eliminate the workload that will arise.…”

“…The postponement of surgery during the COVID‐19 pandemic created the need to use alternative medical treatments. The efficacy of alternative medical treatments evaluated by surveying and the severity of symptoms remained unchanged in 60% of the patients and had worsened in 27% 17 . According to calculations made with modelling, after a 12‐week delay of surgeries, despite a 20% increase in the workforce, the accumulated workload can be compensated in 45 weeks 16 .…”