Supplementary Information
Original article: Clinical outcome after laparoscopic and open abdominal myomectomy
Strictly confidencial.ID______
Experiences following myomectomy.
This study is being carried out in order to evaluate the longterm outcome of myomectomy performed by keyhole surgery (laparoscopy) or conventional surgery (laparotomy). For further information, please see the provided “Information and request regarding participation in a survey at The Department of Gynaecology, Ullevaal University Hospital”.
All information that you are able to provide is extremely valuable. Please try to answer all of the sections and feel free to add any further information that you think may be helpful in explaining your experiences.
If you have any queries about the questionnaire, please contact me on phone 22119800,
e mail: , or write to me at the address below.
When you have finished filling in the questionnaire, please return it to me in the pre-paid envelope provided.
Thank you very much for your time and help
Consultant Guri B Majak
Department of Gynaecology
OsloUniversity Hospital, Ullevaal
Kirkeveien 166, 0196 Oslo.
Some of the questions refer to your experiences before surgery and others refer to your experiences the first 2 years after surgery. Please try to answer all questions in the questionnaire.
For the following questions, please think back to the time BEFORE you underwent your myomectomy.
1. What were the main reasons for your myomectomy?(Tick all that apply.)
Infertility
Heavy bleeding
Recommended by physician
Pain
Uncertain
Other reason (Please state): ______
2. Before the myomectomy, did you suffer from menstrual pain?
Yes
No
Do not recall
2b. Please mark the intensity of your menstrual pain before the myomectomy on the scale below.
0 indicates no pain, 5 indicate moderate pain and 10 indicates the worst imaginable pain.
Worst
No pain imaginable
pain
______
0 1 2 3 4 5 6 7 8 9 10
2c. How often did you experience menstrual pain? (Please select one option only).
Never
During some periods
During most periods
During every period
2d. How many days per month did you have to stay home from work or were unable to
perform your usual role because of the menstrual pain?
Days per month
3. How would you describe your usual periods prior to the myomectomy? (Please select one only).
Minimal bleeding
Normal amount of bleeding
Heavy bleeding
Very heavy bleeding
Did not have bleeding
4. Did you use hormone replacement therapybefore you underwent the myomectomy?
Yes
No
Do not recall
5. To what extent did your periodic bleeding give you discomfort before the surgery?
0 indicates no discomfort, 5 indicate moderate discomfort and 10 indicates that the bleeding gave very much discomfort
No discomfort Very much discomfort
______
0 1 2 3 4 5 6 7 8 9 10
6. Had you given birth or been pregnant prior to the myomectomy?
Yes
No
Please state number of births/pregnancies:
The following questions are about the first 1-2 years AFTER THE MYOMECTOMY
7a. After the myomectomy, have you suffered from menstrual/periodic pain?
Yes
No
7b. Please mark the intensity of your menstrual/periodic pain after the myomectomy on the scale below.
0 indicates no pain, 5 indicate moderate pain and 10 indicates the worst imaginable pain.
Worst
No pain imaginable
pain
______
0 1 2 3 4 5 6 7 8 9 10
7c. After myomectomy, how often did you experience menstrual/periodic pain?
Never
During some periods
During most periods
During every period
7d. How many days per month did you have to stay home from work or were unable to
perform your usual role because of the menstrual pain?
Days per month
8. How many days per month did you experience vaginal/menstrual bleeding?
Days per month
8b.How much bleeding did you experience? (Please select one only).
Minimal bleeding/spotting
Less than my normal menstrual bleeding before the myomectomy
About the same as my menstrual bleeding before the myomectomy
Heavier than my menstrual bleeding before the myomectomy
8c.To what extent did these bleedings give you discomfort?
Please mark the extent of discomfort on the scale below. 0 indicates no discomfort at all, 5 indicate moderate discomfort and 10 indicates very much discomfort.
Very much discomfort
No discomfort
______
0 1 2 3 4 5 6 7 8 9 10
8d. Did your periodic bleeding affect your every-day life?
Yes
No
If yes, - which aspects of your life does your bleeding affect? (Tick all that apply).
Aspects of work
Recreation/sport
Sexual relationships
Any other aspects, please state:
______
______
______
9. Was the surgery related to infertility?
Yes
No
10. Have you been pregnant after the surgery?
Yes
No
Number of pregnancies:
11. Have you given birth after the surgery?
Yes
No
Number of births:
12. Did you give birth vaginally or by caesarean section?
Vaginally
Cesarean section
13. Were there complications during your pregnancy or birth?
Yes
No
Please state what kind of complications you had:
14.Have you received any treatment due to bleeding or menstrual pain after the myomectomy? (Tick all that apply).
No Yes, medication
Yes, surgery
15. Have you experienced any new problems or symptoms after the myomectomy?
No
Yes
If yes, please describe:
16. In total, to what extent are you satisfied with the myomectomy you underwent?
(Please select one only).
Very satisfied
Satisfied
Neutral
Dissatisfied
Very dissatisfied
17. To what extent are you satisfied with the information you received prior to your myomectomy?
Very satisfied
Satisfied
Neutral
Dissatisfied
Very dissatisfied
18. Were there anything you would like to have been informed about prior to the myomectomy?
Please describe:
Please return the completed questionnaire in the pre-paid envelope enclosed.
Thank you very much for your great help!
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