title: Patient satisfaction and regret with decision differ between outcomes in the composite definition of success after reconstructive surgery.
abstract: OBJECTIVE
  To evaluate patient satisfaction and regret with their decision for reconstructive surgery, and determine if they valued each item equally in the composite definition of success after making the decision for surgery.
  
  
  METHODS
  A list was created including all patients who underwent laparoscopic sacral colpopexy or laparoscopic uterosacrocolpopexy. Patients were placed in mutually exclusive outcome categories (retreatment, symptomatic failure, anatomic failure, and surgical success). Retreatment included any postoperative treatment for urinary incontinence, pelvic organ prolapse including pessary use, or surgery for mesh complications. The validated modified Decision Regret Scale (DRS) and the Satisfaction Decision Scale (SDS) questionnaires were administered by telephone. Higher DRS scores indicate greater regret and higher SDS scores indicate greater satisfaction with the decision for surgery.
  
  
  RESULTS
  Of 715 patients, 197 were successfully contacted by telephone following reconstructive surgery and surveyed as study participants. Composite surgical outcomes were available for 150. Information on the need for retreatment was available for all the study participants. Surgery was successful in 101 (67.3 %) of the study participants. Anatomic failure occurred in 14, symptomatic failure occurred in 10, and retreatment was required in 25 of the study participants. Overall, the study participants were more satisfied than regretful with their decision for reconstructive surgery. Regret and satisfaction with their decision differed between outcomes in the composite definition of success after reconstructive surgery.
  
  
  CONCLUSIONS
  Surgeons and patients should focus on retreatment rates during preoperative outcome discussions because retreatment will result in the least satisfaction and greatest regret with the decision for reconstructive surgery.
authors.affiliation: Indiana University, 1633 N. Capitol Ave., Ste 436, Indianapolis, IN, 46202, USA. Drwkhoder@gmail.com.
authors.forename: Waseem
authors.identifier: http://orcid.org/0000-0002-0909-7174
authors.initials: W
authors.lastname: Khoder
authors.affiliation: Texas A&M University/Scott and White Memorial Hospital, Temple, TX, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Hom
authors.affiliation: School of Medicine, Indiana University, Indianapolis, IN, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Guanzon
authors.affiliation: Obstetrics and Gynecology, Indiana University, Indianapolis, IN, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Rose
authors.affiliation: Indiana University/Methodist Hospital, Indianapolis, IN, USA.
authors.forename: Douglass
authors.initials: D
authors.lastname: Hale
authors.affiliation: Indiana University/Methodist Hospital, Indianapolis, IN, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Heit
mesh_terms: D000368:Aged; D004644:Emotions; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D014549:Urinary Incontinence / Q000601:surgery*
keywords: Pelvic organ prolapse; Reconstructive surgery; Regret; Satisfaction