Supplementary Table 1 Postoperative complications
Category
Abscess/Haematoma
Anastomotic leak
Ileus
Bowel obstruction
Bowel perforation
Bowel - other
Bladder
Details
Pelvic or abdominal abscess / haematoma
Anastomotic leak: Small bowel
Anastomotic leak: Large bowel
Post op ileus requiring nasogastric tube / Total parental
nutrition
Bowel Obstruction – small bowel confirmed on imaging
Bowel Obstruction – large bowel confirmed on imaging
Small / large bowel
Constipation / Diarrhoea / Faecal incontinence/urgency
Urinary retention requiring catheterisation
Urinary obstruction
Incontinence- stress / urge
Cardiac
Atrial fibrillation, Myocardial infarction, Cardiac failure &
other cardiac problems
Deep vein thrombosis
Pulmonary embolism
Confirmed on imaging / Doppler
Fistula
Hernia
Infection
Lymphocyst/Lymphoedema
Neurological
Psychiatric
Primary haemorrhage
Secondary haemorrhage
Respiratory
Ureteric Obstruction
Wound breakdown
Other
Confirmed on imaging
Enterocutaneous
Enterovaginal
Vesicovaginal
Ureterovaginal
Other types of fistula
Hernia as a result of surgery
Pyrexia (>38.5°C on 2 separate occasions) after 48 hrs post
op requiring antibiotics OR infection confirmed by culture
Lymphoedema
Lymphocyst
Neuropathic pain/ paraesthesia / nerve palsy
Unexpected psychiatric problems postoperatively e.g.
Delirium, Psychosis, Depression and other
Haemorrhage within 24 hrs of surgery requiring
transfusion/packing/embolisation/return to theatre/other
Haemorrhage after 24 hrs of surgery requiring
transfusion/packing/embolisation/return to theatre/other
Pulmonary oedema, Pneumothorax, Atelectasis, Pleural
effusion and other respiratory problems excluding
pneumonia (to be included in infections)
Ureteric obstruction postoperatively
Wound breakdown: Superficial - skin & subcutaneous tissue
Wound breakdown: Deep - involving fascia / muscle
Burst abdomen requiring repair under anaesthesia
Other complications not included in the list
Table 2 Sensitivity of hospital and patient-reporting by type of complication
Complication category
Wound breakdown
Infection
Lymphocyst/Lymphoedema
Bladder
Ileus
Abscess/Haematoma
Bowel - other
Secondary haemorrhage
Cardiac
Bowel obstruction
Fistula
Respiratory
Primary haemorrhage
Pulmonary Embolism
Deep Vein Thrombosis
Neurological
Hernia
Anastomotic leak
Psychiatric
Bowel perforation
Ureteric obstruction
Other
Total
Total
140
126
39
17
16
14
11
10
7
7
7
6
5
5
5
4
4
2
2
2
1
22
452
No. reported
by Hospital
No. reported
by Patient
No
48
51
9
13
13
8
6
7
6
5
5
4
4
2
1
2
0
2
1
1
0
12
200
No
114
86
31
6
6
10
7
6
3
3
5
2
4
3
4
3
4
2
1
1
1
13
315
(%)
34
40
23
76
81
57
55
70
86
71
71
67
80
40
20
50
0
100
50
50
0
55
44
(%)
81
68
79
35
38
71
64
60
43
43
71
33
80
60
80
75
100
100
50
50
100
59
70
Supplementary document 1: Free-text format follow-up letter template
United Kingdom Gynaecological Oncology Surgical Outcomes and Complications (UKGOSOC)
Private and Confidential
Ms «First_Name» «Last_Name»
«Address1»
«Address2»
«Town»
«County»
Date
Dear Ms «Last_Name»,
UKGOSOC Reference number: «UKGOSOC_Ref»
Thank you for participating in this audit.
You might recall your consultant (or one of the members of the team) mentioning that we
would be writing to you following your surgery, to find out if you had any problems
(complications) relating to your operation.
We would be grateful if you could fill in the tear-off slip at the bottom of this letter and return
it to us in the FREE POST envelope provided. We look forward to hearing from you.
Yours sincerely,
(On behalf of the co-ordinating centre team)
If you have any queries, please contact your local hospital on the following phone numbers:
 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - ----------Name: «Patient_Name»
UKGOSOC Ref No:
Please tick as appropriate
 No, I did not have a complication following my gynaecological surgery
 Yes, I had a complication following my gynaecological surgery
If the answer is yes, please describe below the complication you had following your operation.
Please use additional paper if you would like to.
If you are willing to be contacted for any clarification, please enter your telephone number
below. ________________________
Supplementary document 2: Questionnaire format follow-up letter
A surgical complication may be defined as ‘an undesirable and unintended result
of an operation affecting the patient that occurs as a direct result of the operation’.






1
2
Below is a list of 11 common complications experienced by patients.
Even though the list appears long, it should only take approximately five
minutes of your time.
Please choose the complication/s that is most appropriate and indicate the
treatment you required.
You may choose more than one option.
However if your complication is not on the list, please use the free text space
provided.
Please use additional paper if necessary.
Did the wound get infected or did it breakdown?
If the answer is yes, how was this treated?
a. Antibiotics
b. Regular dressing of the wound
c. Required re-admission to hospital
d. Cleaning (debridement) in the operating theatre
e. Re-suturing in the operating theatre
f. Other (please give details)
Yes
No
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
Excluding a wound infection, have you had any other infection
following your surgery?
a. Urine infection
b. Chest Infection or Pneumonia
c. Other (please give details)
Yes
No
Yes
Yes
Yes
No
No
No
Yes
Yes
Yes
No
No
No
Yes
No
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
How was the infection treated?
a. With antibiotics
b. Required re-admission to hospital
c. Required other treatment (please give details)
3
Did you develop an abscess or a haematoma (collection of blood)
in your pelvis or abdomen following surgery?
If so how was this managed
a. Resolved spontaneously
b. Treated with antibiotics
c. Required drainage in the x-ray / radiology department
d. Required drainage in the operating theatre
e. Other (please give details)
4
5
6
7
8
Light vaginal bleeding is common after most gynaecological
procedures. Have you had heavy vaginal bleeding following surgery?
If so, how was this managed?
a. It settled spontaneously
b. It was treated with antibiotics
c. It required re-admission to hospital
d. It required packing of the vagina
e. It required being taken back to the operating theatre
f. Other (please give details)
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
No
No
No
Yes
No
Yes
Yes
Yes
No
No
No
Yes
No
Yes
Yes
Yes
Yes
No
No
No
No
Have you been troubled with constipation after surgery? (please do
not fill this if you had this problem before surgery)
If so how was this managed?
a. Diet
b. Laxatives
c. Required re-admission to hospital for treatment
d. Other (please give details)
Yes
No
Yes
Yes
Yes
Yes
No
No
No
No
Have you had any other problems related to your bowels? (please
do not fill this if you had this problem before surgery)
If so, please give details
Yes
No
Lymphoedema is a build-up of lymph fluid which can occur as a result
of lymph nodes being removed at surgery. It is commonly seen in the
legs.
Have you had lymphoedema following surgery?
If so, how was this managed?
a. With compression stockings
b. Other (please give details)
Lymphocyst is a collection of lymph fluid which occurs in the area
where the lymph node was removed. This usually occurs in the pelvis
or in the groin as a result of surgery.
Have you had a lymphocyst following surgery?
If so, how was this managed?
a. It was left to resolve spontaneously
b. It was drained on the ward / clinic
c. Required re-admission to hospital
d. It was removed / drained under general anaesthesia in the
operating theatre
e. Other (please give details)
9
10
11
12
Have you had any problems with your bladder since the surgery
(please do not fill this if you had this problem before surgery)
a. Difficulty in emptying the bladder
b. Loss of sensation to empty bladder
c. Leaking with coughing / sneezing / walking etc. (Stress
incontinence)
d. An urgent need to pass urine with occasional leakage of urine
(urge incontinence)
e. Inability to pass urine requiring insertion of a catheter (urinary
retention)
f. Required re-admission to hospital for treatment
g. Other (please give details)
Yes
No
Yes
Yes
Yes
No
No
No
Yes
No
Yes
No
Yes
Yes
No
No
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
Did you develop a clot in the lung (pulmonary embolism) following
surgery?
If so, how was this treated?
a. Daily injections for blood thinning (heparin)
b. Blood thinning tablets (Warfarin)
c. Required re-admission to hospital
d. Other (please give details)
Yes
No
Yes
Yes
Yes
Yes
No
No
No
No
If you have had any other complication not listed here, please give
details below regarding the nature of the complication, how this was
treated and whether you required re-admission into hospital for this.
Please use additional paper if necessary.
Yes
No
Did you develop a blood clot in your legs (deep vein thrombosis) after
surgery?
If so, what sort of treatment did you receive?
a. Daily injections for blood thinning (heparin)
b. Blood thinning tablets (Warfarin)
c. Required re-admission to the hospital for treatment
d. Other (please give details)
We would be grateful if you could provide a little more information about yourself.
1. What is the main language spoken in your home?
English
Other, please specify…………………………
2. Is this questionnaire in a language that you can easily understand?
Yes
No
No, I don’t understand the language but I had help from a friend or family member to
fill in this questionnaire
3. What is the highest level of education you have achieved?
Finished school at or before the age of fifteen
Completed GCSEs, O-levels or equivalent
Completed A levels or equivalent
Completed further education but not a degree
Completed a Bachelor’s degree / master’s degree / PhD
Other, please specify………………………………..
4. If you have any suggestions on how we could improve this questionnaire, please write
your comments overleaf. Thank you.