A 28 year old women is scheduled for a bilateral salpingo-oophorectomy, what is the priority concern to be addressed while obtaining informed consent for the surgery
A. Risk of Haemorrhage
B. Acute Pain
C. Chronic lower back pain
D. Loss of child bearing potential
Correct Answer: D. Loss of child bearing potential
Explanation
For a 28-year-old woman scheduled for a bilateral salpingo-oophorectomy, the priority concern to address while obtaining informed consent is:
Permanent loss of fertility
Explanation:
- Bilateral salpingo-oophorectomy involves removal of both ovaries and fallopian tubes.
- This results in irreversible infertility, which is a major life-altering consequence, especially in a young woman of reproductive age.
- The woman must clearly understand that she will not be able to conceive naturally after surgery.
Other important points (but secondary to fertility):
- Immediate surgical menopause
- Hormonal deficiency (estrogen loss) leading to:
- Hot flashes
- Vaginal dryness
- Increased risk of osteoporosis and cardiovascular disease
- Possible need for hormone replacement therapy (HRT)
✅ Priority during informed consent:
Ensuring the patient understands and accepts the permanent loss of reproductive ability.
Other Options Details
Here is a clear description of all the options, in the context of a 28-year-old woman scheduled for bilateral salpingo-oophorectomy:
A. Risk of Haemorrhage
- Haemorrhage refers to excessive bleeding during or after surgery.
- This is a general surgical risk related to damage to blood vessels.
- Although important, it is usually anticipated and managed by the surgical team and is not the main priority during informed consent.
B. Acute Pain
- Acute pain occurs immediately after surgery due to tissue injury.
- It is temporary and can be effectively managed with analgesics and nursing care.
- Patients are routinely informed about postoperative pain, but it is not the most critical long-term concern.
C. Chronic Lower Back Pain
- Chronic lower back pain is not directly related to bilateral salpingo-oophorectomy.
- It is not a typical complication of this surgery.
- Therefore, it is not a priority issue during informed consent.
D. Loss of Child-Bearing Potential
- Bilateral salpingo-oophorectomy involves removal of both ovaries and fallopian tubes.
- This results in permanent infertility and surgical menopause, especially significant in a young woman.
- The loss of reproductive ability has lifelong physical, emotional, and psychological implications.
- This is the most important priority concern to be addressed during informed consent.
✅ Correct Priority Concern: D. Loss of child-bearing potential
This option must be clearly explained so the woman can make an informed and autonomous decision about the surgery.
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Writer: Vandita Singh, Lucknow (GS India Nursing Group