title: Might Pelvic Surgeons Be Unaware of Their Surgical Failures? Patient Reporting and Perceptions After Failed Incontinence or Pelvic Organ Prolapse Surgery.
abstract: : Prior studies suggest that pelvic organ prolapse (POP) and stress urinary incontinence (SUI) may recur following surgery in 20% or more of patients. Despite these numbers, we have anecdotally found that some surgeons performing pelvic floor reconstruction feel their success rates exceed these figures. Based on our experience, we hypothesized that significant numbers of patients with recurrent POP or SUI following prior surgery do not return or notify their original surgeon of their recurrence. We also aimed to identify reasons why the patient was seeking care elsewhere.
  
  
  METHODS
  We investigated patients presenting to a tertiary referral center urogynecologic practice with recurrence after prior POP or SUI surgery over a 2-year period. Data were collected using an institutional review board-approved 15-item questionnaire and after 2 years were analyzed.
  
  
  RESULTS
  We found that 16 (31%) of 51 patients did not notify their primary surgeon of surgical failure. Of these patients, roughly half (9/16) did not return because of moving to a different area of the country, changing their insurance, or their prior physician retiring. Despite the surgical failures, of all patients presenting to our clinic, very few stated they had a poor relationship with their prior surgeon (6%); however, a large majority (63%) did not think that their primary surgeon could fix their problem.
  
  
  CONCLUSIONS
  Roughly one third of patients who suffer from recurrence after POP or SUI surgery do not notify their original surgeon. This may artificially inflate a clinician's perceived success rate of pelvic floor repair.
authors.affiliation: From the *Division of Urology, Santa Clara Valley Medical Center, San Jose; Departments of †Urology and ‡Obstetrics and Gynecology, Stanford School of Medicine, Palo, Alto, CA.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Elliott
authors.forename: Eric R
authors.initials: ER
authors.lastname: Sokol
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D012008:Recurrence; D011795:Surveys and Questionnaires; D017211:Treatment Failure; D014550:Urinary Incontinence, Stress / Q000601:surgery*