Male Questionnaire
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PAST SURGERIES

This section deals with specific surgeries that you have had.  Any types of surgery not mentioned here can be listed on the final page of this questionnaire, which is coming up soon.  Note that gallbladder surgery is covered elsewhere.

Q863

Have you had any form of transplant surgery?
  • No / don't know
  • Yes, 3 or more years ago
  • Yes, less than 3 years ago

Q864

Have you had a Tonsillectomy and/or Adenoidectomy, a procedure in which the tonsils and/or adenoids are removed?
  • No / don't know
  • Yes, tonsils OR adenoids, before age 20
  • Yes, tonsils AND adenoids, before age 20
  • Yes, tonsils OR adenoids, after age 20
  • Yes, tonsils AND adenoids, after age 20

Q865

Have you had an Appendectomy, a procedure in which the appendix is removed?
  • Don't know
  • No
  • Yes, before age 10
  • Yes, before age 20
  • Yes, after age 20

Q866

Have you had a Splenectomy, a procedure in which the spleen is removed?
  • Don't know
  • No
  • Yes, to treat a separate medical condition
  • Yes, because it was damaged by injury
  • Yes, because of malignancy

Q867

Have you undergone any form of weight loss surgery (Bariatric Surgery)?
  • No / don't know
  • Adjustable gastric banding
  • Gastric bypass surgery
  • Biliopancreatic diversion with/out duodenal switch
  • Sleeve gastrectomy

Q868

Have you had a Small Bowel Resection, a procedure in which a section of the small intestine is removed?
  • No
  • Don't know
  • Less than 50cm (20 inches)
  • More than 50cm (20 inches)

Q869

Have you had a Colectomy, a procedure in which all or part of the colon is removed?
  • Don't know
  • No
  • Yes, a partial colectomy
  • Yes, a total colectomy

Q870

Have you had a Vasectomy, a procedure in which the vas deferens (sperm ducts) are severed?
  • Don't know
  • No
  • Yes, less than 5 years ago
  • Yes, more than 5 years ago
  • Yes, but it has been reversed

Q871

Have you had a Prostatectomy, a procedure in which the prostate is removed?
  • Don't know
  • No
  • Yes, partial prostatectomy
  • Yes, radical prostatectomy
Report by The Analyst™
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  • consent to collect data
  • name, age, and gender

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