Lisbeth Bonde1,2,3, Mette Calundann Noer4, Lars Alling Møller5, Bent Ottesen4, Helga Gimbel6,7. 1. Department of Obstetrics and Gynecology, Nykoebing Falster Hospital, Nykoebing Falster, Denmark. lisbeth.bonde@dadlnet.dk. 2. University of Southern Denmark, Odense, Denmark. lisbeth.bonde@dadlnet.dk. 3. Department of Gynecology, Juliane Marie Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. lisbeth.bonde@dadlnet.dk. 4. Department of Gynecology, Juliane Marie Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. 5. Department of Obstetrics and Gynecology, Zealand University Hospital, Zealand, Denmark. 6. Department of Obstetrics and Gynecology, Nykoebing Falster Hospital, Nykoebing Falster, Denmark. 7. University of Southern Denmark, Odense, Denmark.
Abstract
INTRODUCTION AND HYPOTHESIS: Several suspension methods are used to try to prevent pelvic organ prolapse (POP) after hysterectomy. We aimed to evaluate agreement on terminology and surgical procedure of these methods. METHODS: We randomly chose 532 medical records of women with a history of hysterectomy from the Danish Hysterectomy and Hysteroscopy Database (DHHD). Additionally, we video-recorded 36 randomly chosen hysterectomies. The hysterectomies were registered in the DHHD. The material was categorized according to predefined suspension methods. Agreement compared suspension codes in DHHD (gynecologists' registrations) with medical records (gynecologists' descriptions) and with videos (reviewers' categorizations) respectively. Whether the vaginal vault was suspended (pooled suspension) or not (no suspension method + not described) was analyzed, in addition to each suspension method. RESULTS: Regarding medical records, agreement on terminology was good among patients undergoing pooled suspension in cases of hysterectomy via the abdominal and vaginal route (agreement 78.7, 92.3%). Regarding videos, agreement on surgical procedure was good among pooled suspension patients in cases of hysterectomy via the abdominal, laparoscopic, and vaginal routes (agreement 88.9, 97.8, 100%). Agreement on individual suspension methods differed regarding both medical records (agreement 0-90.1%) and videos (agreement 0-100%). CONCLUSIONS: Agreement on terminology and surgical procedure regarding suspension method was good in respect of pooled suspension. However, disagreement was observed when individual suspension methods and operative details were scrutinized. Better consensus of terminology and surgical procedure is warranted to enable further research aimed at preventing POP among women undergoing hysterectomy.
INTRODUCTION AND HYPOTHESIS: Several suspension methods are used to try to prevent pelvic organ prolapse (POP) after hysterectomy. We aimed to evaluate agreement on terminology and surgical procedure of these methods. METHODS: We randomly chose 532 medical records of women with a history of hysterectomy from the Danish Hysterectomy and Hysteroscopy Database (DHHD). Additionally, we video-recorded 36 randomly chosen hysterectomies. The hysterectomies were registered in the DHHD. The material was categorized according to predefined suspension methods. Agreement compared suspension codes in DHHD (gynecologists' registrations) with medical records (gynecologists' descriptions) and with videos (reviewers' categorizations) respectively. Whether the vaginal vault was suspended (pooled suspension) or not (no suspension method + not described) was analyzed, in addition to each suspension method. RESULTS: Regarding medical records, agreement on terminology was good among patients undergoing pooled suspension in cases of hysterectomy via the abdominal and vaginal route (agreement 78.7, 92.3%). Regarding videos, agreement on surgical procedure was good among pooled suspension patients in cases of hysterectomy via the abdominal, laparoscopic, and vaginal routes (agreement 88.9, 97.8, 100%). Agreement on individual suspension methods differed regarding both medical records (agreement 0-90.1%) and videos (agreement 0-100%). CONCLUSIONS: Agreement on terminology and surgical procedure regarding suspension method was good in respect of pooled suspension. However, disagreement was observed when individual suspension methods and operative details were scrutinized. Better consensus of terminology and surgical procedure is warranted to enable further research aimed at preventing POP among women undergoing hysterectomy.
Entities:
Keywords:
Medical records; Pelvic organ prolapse; Surgery; Suspension; Vaginal vault; Video
Authors: Stergios K Doumouchtsis; Azar Khunda; Stephen T Jeffery; Anna Virginia M Franco; Michelle M Fynes Journal: Int Urogynecol J Date: 2010-12-02 Impact factor: 2.894
Authors: Charlotte T Hansen; Charlotte Møller; Signe Daugbjerg; Jan Utzon; Henrik Kehlet; Bent Ottesen Journal: Acta Obstet Gynecol Scand Date: 2008 Impact factor: 3.636