Content Validity of a Patient-Reported Measure of Postoperative Recovery

IMPORTANCE: Despite increasing focus on the benefits of expedited recovery after minimally invasive surgery (MIS), urogynecology lacks a validated, simple question to assess recovery. OBJECTIVES: The objectives of this study were to explore how patients evaluate postoperative recovery following MIS for apical pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI), and to confirm understanding of a recovery patient-reported outcome (PRO). STUDY DESIGN: This study enrolled women who underwent MIS for apical POP or an isolated procedure for SUI (midurethral sling placement or urethral bulking) in the past 4 weeks. English and Spanish cognitive interviews were conducted with the goal of identifying components of a participant's perception of recovery and their understanding of the PRO. RESULTS: Sixty-three women recovering from POP procedures (41/63) and SUI procedures (22/63) underwent a cognitive interview at a median time since the index surgery of 3 weeks (range: 0-8). Common factors influencing a participant's report of recovery included activity and/or pain level, ability to participate in regular activities, and resolution of symptoms. Most participants defined recovery as getting back to "normal," and viewed recovery as distinct from symptom resolution; however, some included symptom resolution in their definition. All participants understood the PRO, and the majority (48/63) felt either 75% or "completely" recovered at the time of their interview. CONCLUSIONS: Women undergoing surgical procedures for POP or SUI define recovery as getting back to normal or regular activities. "To what extent do you feel physically recovered after surgery" is understood by both English and Spanish-speaking participants recovering from POP or SUI surgery.