title: Are patients' personal goals achieved after pelvic reconstructive surgery?
abstract: OBJECTIVE
  Our goal was to describe patients' personal treatment goals before pelvic floor dysfunction (PFD) surgery and goals achieved and not achieved 12 months after surgery, and to evaluate the association between postoperative symptoms and successful goal achievement.
  
  
  METHODS
  We performed a secondary analysis using a de-identified database from a randomized trial comparing native tissue vs. graft-augmented rectocele repair. In their own words, women listed their top four treatment goals and 12 months after surgery whether those goals were or were not achieved. We categorized goals into symptom improvement (defecatory, bulge, incontinence, pain/discomfort) and functioning (physical, social, emotional, sexual). Women completed symptom questionnaires pre- and postoperatively. Goals were described using simple statistics. The association between defecatory, bulge, and incontinence symptoms and goal achievement was described using the chi-square test.
  
  
  RESULTS
  Of 160 participants in the database, 125 (78 %) met inclusion criteria. The most common preoperative goals were improvement in bulge (26.7 %), defecation (23.9 %), urinary incontinence (18.1 %), and pain/discomfort (6.2 %). Functioning goal categories included: sexual (7 %), emotional (7 %), physical (6.2 %), and social function (3.3 %). Postoperatively, goal categories in which improvement was achieved were urinary continence (70.5 %), sexual function (58.8 %), bulge reduction (56.9 %), defecation (51.7 %), physical (33.3 %), emotional (29.4 %), and social functioning (25 %). Of the women reporting postoperative defecatory or incontinence symptoms, half reported successful improvement in both goals.
  
  
  CONCLUSIONS
  Women predominantly reported symptom-related goals, and those goals are most frequently achieved postoperatively. Of women who reported defecatory and incontinence symptoms postoperatively, many still reported successful goal achievement in those areas.
authors.affiliation: Division of Urogynecology Women and Infants Hospital, Alpert Medical School Brown University, 695 Eddy Street, Providence, RI, 02903, USA, apilzek@wihri.org.
authors.forename: Anna L
authors.initials: AL
authors.lastname: Pilzek
authors.forename: Christina A
authors.initials: CA
authors.lastname: Raker
authors.forename: Vivian W
authors.initials: VW
authors.lastname: Sung
mesh_terms: D000328:Adult; D000368:Aged; D003672:Defecation / Q000502:physiology*; D004644:Emotions; D005260:Female; D006040:Goals; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D010347:Patient Care Planning; D017060:Patient Satisfaction; D059952:Pelvic Floor Disorders / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D017699:Pelvic Pain / Q000209:etiology / Q000601:surgery; D020047:Rectocele / Q000150:complications / Q000601:surgery; D019529:Sexuality / Q000502:physiology*; D058992:Social Participation; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery*
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