Psychological adjustment to and recovery from laparoscopic sterilization and infertility investigation.

One hundred and thirty-one patients undergoing elective laparoscopic surgery for sterilization or infertility investigations were examined in a prospective study. Firstly, the contributions of the reason for undergoing the operation to the patients' psychological adjustment and recovery, is examined. Measures were taken of personality, mood, physical symptoms, vital signs and the patients' speed of returning to normal activities. The reason for laparoscopy does not appear to influence the amount of fear immediately before and after the operation, post-operative physical symptoms, nor the majority of mood states at follow up. There were significant differences between infertility and sterilization patients on state anxiety on the morning of surgery, vital signs, post-operative intramuscular analgesia, and the speed of returning to normal activities. In particular, sterilization patients did not report greater pain but received more analgesia, and returned to their normal activities more rapidly than infertility patients. Secondary infertility patients showed the slowest rate of return to normal activities, and reported more adverse mood states at 1 week follow up. The investigation of patients' attitudes to the operation revealed that patients undergoing sterilization and infertility investigation are concerned about the costs and benefits of the operation which include not only influencing fertility, but influencing menstruation and sexual activity. Patients misunderstood information about surgery, and the majority of patients welcomed additional psychological preparation. Suggestions concerning the management of patients undergoing laparoscopy for different fertility reasons are discussed.