Historical Repeat Surgery Survey

We are doing a survey at Matilda, about the rates of repeat laparoscopic surgery in Australia.

At the end of August, we will draw a winner from the submissions for a $100 Gift Card of your choice.

We appreciate your time and your contributions.

These results will help us close the data gap in endometriosis care, by understanding what types of treatment people are receiving.

How many laparoscopic surgeries have you had in the last 10 years? *

List your surgery dates and any complications due to surgery for each surgery you have had in the last 10 years.

Examples of complications include:

surgical site infections (SSIs), excessive bleeding, urinary tract infections (UTIs), and temporary bowel paralysis (ileus), DVT, re-admission to hospital, adjacent organ injury (bladder/bowel/uterus), medication complication, incontinence, etc.

What month and year was your surgery? *

List complications related to this surgery? *

Were you a private or public patient? *

PrivatePublic

Included in your surgery count above.

Please include all {{number of surgeries}} in the table of surgery dates above.

Have you used the Matilda Program to support any of the above surgeries? *

YesNo

If so, what year was the surgery *

Row Count *

Have you had or are you planning to have a hysterectomy? *

Yes - I have had a hysterectomyYes - I am planning to have a hysterectomy in the next 18 monthsNo

What month and year did you have your hysterectomy *

Did you have any complications due to the hysterectomy surgery? *

Do you want to hear about the results of this survey?

Do you want to be in the running for the $100 gift card?

What is your email? *This is only used if you want to go in the running for the gift card or receive the results of this survey.