RESULTS
A total of 300 women participated in this study. Of those, 150 were
patients that presented at our institution during an administrative or a
medical appointment (admission, preoperative evaluation for gynecologic
surgery, or preoperative preparation) prior to undergoing scheduled
hysterectomy. The remaining 150 participants were women that were
approached and interviewed at our institution (companion or passerby),
agreed to participate, and were not undergoing a surgical procedure. All
interviews were included in the analysis. Demographic data of study
participants are shown in Table 1 (Sociodemographic
characteristics of the study population ) .
In the first section of the interview, participants ranked -based on
their preferences- from most to least important 12 items; 6 considered
as advantages of AH, and 6 items considered as advantages of LH. As
shown in Figure 1 (Advantages of abdominal and laparoscopic
hysterectomy ranked and scored by all participants ) , the three most
relevant variables for all interviewed participants were: experiencing
less pain, lower complication rate, and use of a surgical technique that
allows proper visualization of the abdominopelvic cavity. On the other
hand, the least important items were: required training time for
surgeons to safely perform a given technique, cost of procedure, and the
fact that the procedure could be performed using conductive anesthesia.
In the second section of the questionnaire, a total of 10 items –5
advantages of LH, and 5 of VH- were ranked by each participant. As shown
in Figure 2 (Advantages of vaginal and laparoscopic hysterectomy
ranked and scored by all participants) , the three most relevant items
for all interviewed women were: less pain, less bleeding, and proper
visualization of the abdominopelvic cavity during the procedure. On the
other hand, the least important items were: less training time for
surgeons, cost of procedure, and that the technique does not necessarily
require general anesthesia.
Results of the third question of our survey, which listed 7 items that
were selected by the authors as being the most relevant, independently
of the surgical technique they represented, are shown in Figure
3 (Most relevant factors, selected by physicians, ranked and scored by
all participants).
Data collected from the group of women undergoing hysterectomy (n=150)
were analyzed and compared with those from the control group – women
who were not undergoing any surgical procedure ( Table
2.Comparison of scores according to imminence of hysterectomy ). A
median test showed a statistically significant difference (p <
.05) in age of participants between groups. Participants scheduled to
undergo hysterectomy were older, with a mean age of 43 years (SD 6.9),
while participants of the control group exhibited a mean age of 35 years
(SD 10.2). For the younger group, the size of the scar was ranked as the
most important item in question 1 (p = .002) and question 3 (p = .01).
On the other hand, for patients undergoing hysterectomy the fact that
the abdominopelvic cavity could be properly visualized during the
procedure was ranked as most important (p=.008).
Participants were grouped by educational level into two groups:
secondary education or below, and those with technical education or
above (Table 3 . Comparison of scores according to participant
educational level ). Our results show that, when comparing AH with LH,
women with higher education ranked as most important a technique that
resulted in lower complication rates (p=.006), while participants with
lower educational level ranked as most important a faster return to
daily activities (shorter sick leave) (p=.045), a lower cost (p=.037),
and being the most available technique at all levels of care (p=.001).
Regarding advantages of VH and LH, our results show that for women with
lower educational level the lower cost of the procedure (p=.026) was the
most important item.
In regards to question 3, women with higher educational level considered
most important procedure safety (p=.005), while participants with a
lower educational level ranked a faster recovery time as most important
(p=.005).