Contraception counselling during gynecology visit - does a questionnaire help?

OBJECTIVES: Women are at risk of unplanned pregnancy and inappropriate choice of contraception if not given effective contraception counselling. We aimed to understand the contraceptive needs of women, improve effective contraception counselling promoting modern contraception methods during gynecology outpatient visit using a contraception counselling questionnaire. MATERIAL AND METHODS: All reproductive-age women over 18 were given Contraception Counselling Project Form to fill in while in the waiting room. The form consisted of 15 questions evaluating patients' characteristics and contraceptive method used. Physicians evaluated these forms during the examination and an appropriate method was chosen. Forms of pregnant, postmenopausal and sexually inactive patients as well as forms with more than one answer missing were excluded. RESULTS: 778 questionnaires were accepted for evaluation. 340 women (43.8%) used modern contraception, 112 (14.4%) used interrupted coitus, 3 (0.4%) used calendar method. 738 women could be given adequate contraception counselling by the physicians. 215 women among 323 women (66.5%) who did not use modern contraception and did not desire pregnancy, were convinced to use modern contraception and 103 (91.9%) among 112 women who used interrupted coitus for contraception were convinced to use modern contraception. There was a significant relationship between age, education, working state, parity, number and type of delivery, previous OCP usage, resources of contraception and the preferred contraception method. CONCLUSIONS: More than half the women preferred to use modern contraception methods by means of contraception counselling questionnaire. Women's backgrounds significantly affected their choice of contraception method.

Improvement in quality of life and pain scores after laparoscopic management of deep endometriosis: a retrospective cohort study.

PURPOSE: This is a retrospective cohort study that evaluates the postoperative pain findings of a consecutive series of laparoscopic surgeries for deep endometriosis (DE). METHODS: This multi-center retrospective cohort study was carried out in university hospitals (Istanbul, Turkey). Sixty-five patients diagnosed through bimanual gynecologic examination, gynecologic ultrasound or magnetic resonance imaging-confirmed endometrioma and DE together; who underwent a laparoscopic surgery between 2013 and 2019 by a team of gynecologists, colorectal surgeons, and a urologist were retrospectively evaluated. The data were collected in a specific database and analyzed for postoperative pain outcomes through a comparison with preoperative symptoms scored using a visual analogue score (VAS), and the British Society of Gynecologic Endoscopy (BSGE) pelvic pain questionnaire. RESULTS: Sixty-five patients who met the criteria were included. The mean age of all patients was 35.0 ± 6.3 (range 22-50) years. The mean operative time was 121.3 ± 50.2 (range, 60-270) minutes. Preoperative and postoperative comparison of VAS scores for dysmenorrhea (8.57 vs. 2.91), dyspareunia (6.62 vs. 1.66), dyschezia (7.46 vs. 2.43), dysuria (5.67 vs. 1.34), chronic pelvic pain (4.11 vs. 1.22), and BSGE score (40.98 vs. 11.00) showed significantly reduced pain scores, respectively (p < 0.01). CONCLUSION: Laparoscopic management of DE is a valid treatment option in terms of reduced postoperative pain and increased quality of life according to pain score outcomes. To have more robust conclusions, a prospective cohort study with a larger sample size which evaluates patients who had segmental bowel resection and those who did not have segmental bowel resection is necessary.