Introduction and hypothesis We aimed to determine patient recall of specific surgical risks and benefits discussed during consent for midurethral sling (MUS) surgery immediately after consent and at 6 weeks follow-up. Specifically we sought to determine whether or not women recalled specific risks related to the placement of mesh. Methods Surgeons consented patients for MUS in their usual fashion during audio recorded consent sessions. After consent and again at 6 weeks postoperatively, women completed a checklist of risks, benefits, alternatives, and general procedural items covered during consent. In addition, women completed the Decision Regret Scale for Pelvic Floor Disorders (DRS-PFD). Audio files were used to verify specific risks, benefits, alternatives, and procedural items discussed at consent. Recall of specific risks, benefits, and alternatives were correlated with DRS-PFD scores. Results Sixty-three women completed checklists immediately post consent and at 6 weeks postoperatively. Sixweek recall of benefits, alternatives, and description of the operation did not change. Surgical risk recall as measured by the patient checklist deteriorated from 92 % immediately post consent to 72 % at 6 weeks postoperatively (p<.001). Recall of the risk for mesh erosion declined from 91 to 64 % (p<.001). Recall that mesh was placed during the MUS procedure declined from 98 to 84 % (p=.01). DRS-PFD scores were correlated with poorer surgical risk recall and surgical complications (r=.31, p=.02). Conclusions Recall of MUS surgery risks deteriorated over time. Specifically, women forgot that mesh was placed or might erode. Further investigations into methods and measures of adequate consent that promote recall of long-term surgical risks are needed.
|Original language||English (US)|
|Number of pages||6|
|Journal||International Urogynecology Journal and Pelvic Floor Dysfunction|
|State||Published - Dec 2013|
Bibliographical noteFunding Information:
Acknowledgment This study was supported by the American Urogynecologic Society’s Astellas grant. This project was also supported in part by the National Center for Research Resources and the National Center for Advancing Translational Sciences of the National Institutes of Health (NIH) through Grant Number UL1 TR000041. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
- Informed consent
- Midurethral sling