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J Minim Invasive Gynecol. 2019 Aug 9. pii: S1553-4650(19)30367-X. doi: 10.1016/j.jmig.2019.08.009. [Epub ahead of print]

Hysterectomy Provides Benefit in Health-Related Quality of Life: A 10-Year Follow-up Study.

Author information

1
Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (Drs. Rahkola-Soisalo, Sjöberg, and Härkki). Electronic address: paivi.rahkola-soisalo@hus.fi.
2
Department of Obstetrics and Gynecology, Østfold Central Hospital, Fredrikstad, Norway (Dr. Brummer).
3
Department of Obstetrics and Gynecology, Central Finland Central Hospital, Jyväskylä, Finland (Dr. Jalkanen).
4
Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland (Drs. Rahkola-Soisalo, Sjöberg, and Härkki).
5
Department of Public Health, University of Helsinki, Helsinki, Finland (Dr. Sintonen).
6
Administration, University of Helsinki and Helsinki University Hospital, Helsinki; Department of Health and Social Management, Research Centre for Comparative Effectiveness and Patient Safety, University of Eastern Finland and Eastern Finland University Hospital, Kuopio, Finland (Dr. Roine).

Abstract

STUDY OBJECTIVE:

This study aims to evaluate short- and long-term effects of hysterectomy on health-related quality of life (HRQoL) and compare that with a representative age-standardized sample from the general population.

DESIGN:

A prospective survey as a part of FINHYST study.

SETTING:

Four Helsinki area hospitals.

PATIENTS:

Eight hundred thirty-six women with hysterectomy because of benign indications during 2006.

INTERVENTIONS:

A change in HRQoL assessed by the 15D instrument at baseline, and after 6 months and 10 years. The HRQoL of women was also compared with that of the age-standardized sample from the general female population.

MEASUREMENTS AND MAIN RESULTS:

Most hysterectomies were performed laparoscopically (41.8%), followed by vaginal (38.2%) and abdominal (20%) approaches. Indications were classified into 6 subgroups; myoma, abnormal uterine bleeding (AUB), endometriosis, pelvic organ prolapse (POP), adnexal mass, and precancerous lesions. The preoperative mean HRQoL in the patients was lower than that of the general population. In the whole study population, hysterectomy provided the greatest improvement in the dimensions of distress, vitality, discomfort and symptoms, and sexual activity, both short- and long-term. Those operated on for myoma, AUB, endometriosis, and POP showed an improved mean HRQoL after 6 months, whereas after 10 years in those operated on for myoma, AUB, and endometriosis, the HRQoL was still better than at baseline. Women with endometriosis never reached HRQoL of the general population. This is right, but the HRQoL of the general population remained lower than that of all other groups.

CONCLUSION:

Hysterectomy provided long-term improvement in HRQoL, especially in women with myoma, AUB, and endometriosis.

KEYWORDS:

Abnormal uterine bleeding; Endometriosis; Myoma; Pelvic organ prolapse

PMID:
31404711
DOI:
10.1016/j.jmig.2019.08.009

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