title: Patient-centered surgical outcomes: the impact of goal achievement and urge incontinence on patient satisfaction one year after surgery.
abstract: OBJECTIVE
  The purpose of this study was to assess factors that influence patient satisfaction 1 year after pelvic reconstructive surgery.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  Symptoms of urge incontinence and reduced achievement of subjective surgical goals are associated with decreased long-term patient satisfaction after reconstructive pelvic surgery.
authors.affiliation: Division of Female Pelvic Medicine and Reconstructive Surgery, Loyola University Medical Center, Maywood, IL, USA. sangeeta.mahajan@uhhs.com
authors.forename: Sangeeta T
authors.initials: ST
authors.lastname: Mahajan
authors.forename: Eman A
authors.initials: EA
authors.lastname: Elkadry
authors.forename: Kimberly S
authors.initials: KS
authors.lastname: Kenton
authors.forename: Susan
authors.initials: S
authors.lastname: Shott
authors.forename: Linda
authors.initials: L
authors.lastname: Brubaker
mesh_terms: D000124:Achievement; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006040:Goals; D013509:Gynecologic Surgical Procedures / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D018802:Patient-Centered Care; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000453:epidemiology; D014550:Urinary Incontinence, Stress / Q000601:surgery; D014596:Uterine Prolapse / Q000601:surgery