Patient-Reported Experiences After Hysterectomy: A Cross-Sectional Study of the Views of Over 2300 Women (original) (raw)
Related papers
Self‐reported long‐term outcomes of hysterectomy
… of Obstetrics & …, 1991
To investigate women's perceptions of and satisfaction with the long-term outcomes from a hysterectomy performed between 2 and 10 years ago and to determine whether satisfaction is related to demographic factors, factors associated with the hysterectomy, and the number or type of perceived benefits and problems associated with the hysterectomy. Retrospective survey by telephone interview and postal questionnaire of 236 women who had a hysterectomy between 2 and 10 years ago. Women who had had a hysterectomy were identified from a community survey in the Hunter Region of NSW, Australia. Two hundred and thirty-six women who self-reported having had a hysterectomy between 2 and 10 years ago. Perceived benefits resulting from the hysterectomy; perceived physical and psychological problems caused by the hysterectomy; satisfaction with care. Relief from heavy bleeding was the most frequent benefit (57%) and the most important benefit (32%). Most of the women reported improvements in symptoms experienced before hysterectomy but more than half the women had symptoms which they believed had been worsened or caused by the hysterectomy. Despite this, high levels of satisfaction with the operation were reported. The results highlight the need to examine more closely decision-making about treatment for menstrual symptoms such as heavy bleeding.
Women's Hysterectomy Experiences and Decision-Making
Women & Health, 2003
The goal of the study was to examine women's experiences with gynaecologic symptoms and how they decided to undergo hysterectomy. For this purpose, twenty-nine women were interviewed in hospital within three days of undergoing hysterectomy. The interviews elicited information about the nature of the problem that caused the women to seek medical help, actions taken to solve their problem, their relationship with their gynaecologist, information seeking patterns and decision-making about hysterectomy. Although findings revealed that the symptoms women suffered had a negative impact on their lives, most women delayed seeking medical help and attributed their symptoms to factors other than a physical problem in their reproductive system. Most of the participants' information about the symptoms and possible treatments came from their consulting other women with similar problems. The women reported that their gynaecologist did not initiate a comprehensive discussion about other treatments and their advantages and dis-Ayse K. Uskul is PhD Candidate,
Predictors of Hysterectomy Use and Satisfaction
Obstetrics & Gynecology, 2010
To identify static and time-varying sociodemographic, clinical, health-related quality-of-life and attitudinal predictors of use and satisfaction with hysterectomy for noncancerous conditions. METHODS: The Study of Pelvic Problems, Hysterectomy, and Intervention Alternatives (SOPHIA) was conducted from 1998 to 2008. English-, Spanish-, or Chinesespeaking premenopausal women (n)024,1؍ with intact uteri who had sought care for pelvic pressure, bleeding, or pain from an academic medical center, county hospital, closed-panel health maintenance organization, or one of several community-based practices in the San Francisco Bay area were interviewed annually for up to 8 years. Primary outcomes were use of and satisfaction with hysterectomy. RESULTS: A total of 207 women (14.6%) underwent hysterectomy. In addition to well-established clinical predictors (entering menopause, symptomatic leiomyomas, prior treatment with gonadotropin-releasing hormone agonist, and less symptom resolution), greater symptom impact on sex (P,)100.؍ higher 12-Item Short Form Health Survey mental component summary scores (P,)010.؍ and higher scores on an attitude measure describing "benefits of not having a uterus" and lower "hysterectomy concerns" scores (P<.001 for each) were predictive of hysterectomy use. Most participants who underwent hysterectomy were very (63.9%) or somewhat (21.4%) satisfied in the year after the procedure, and we observed significant variations in posthysterectomy satisfaction across the clinical sites (omnibus P.)630.؍ Other determinants of postsurgical satisfaction included higher pelvic problem impact (P)530.؍ and "benefits of not having a uterus" scores (P)800.؍ before surgery and greater posthysterectomy symptom resolution (P.)100.؍ CONCLUSION: Numerous factors beyond clinical symptoms predict hysterectomy use and satisfaction. Providers should discuss health-related quality of life, sexual function, and attitudes with patients to help identify those who are most likely to benefit from this procedure.
Factors associated with hysterectomy among women in Australia
Health & Place, 2000
This study was to identify hysterectomy prevalence across urban, rural and remote areas of Australia and across states, to separate geographic variation from the effect of sociodemographic influences, and also to compare the quality of life of women who have and have not had hysterectomy. Data were collected from 14,072 women aged 45-50 years participating in the baseline survey of the Australian Longitudinal Study on Women's Health. The estimated prevalence of hysterectomy was 22%. Factors significantly associated with hysterectomy included living in a rural or remote area, state of residence, having private health insurance, lower levels of education, being married and having more than two children, having had other gynaecological and non-gynaecological surgical procedures, and more visits to general practitioners. Compared with women who had not had hysterectomy, women who had had hysterectomy had significantly poorer physical and mental health as measured by the SF-36 quality of life profile (adjusted mean PCS=45.7 vs 49.3, p<0.0001; adjusted mean MCS=46.9 vs 48.2, p<0.0001).
What Matters Most To Women Undergoing Hysterectomy?
2021
Study objective: to gain an understanding of patient preferences regarding choice of surgical approach to hysterectomy. Design: Cross-sectional, analytical study. Setting: Tertiary hospital, referral center for gynecologic surgery in Medellin, Colombia Patients: A total of 300 women, 150 who were scheduled for hysterectomy and 150 women who were not undergoing any surgical procedure. Interventions: A questionnaire listing advantages of laparoscopic, vaginal, and abdominal hysterectomy was designed and applied to all participating women, who were then asked to rank in order of relevance the surveyed items. Answers and demographic variables were collected. Measurements and Main results: Average scores were calculated for each of the listed variables, and the difference of medians between groups (women scheduled to undergo hysterectomy and women who were not undergoing surgery) was analyzed. Difference of medians was also analyzed by grouping participants based on educational level. Pa...
REFLECTION ON HYSTERECTOMIES AND WOMEN HEALTH: A REVIEW OF LITERATURE
International Journal of Multidisciplinary Educational Research , 2022
Hysterectomy as emerging trend in a few societies are associated with premature menopause with the early onset at the age of 40 and before; this has been a growing concern in the field of women health in India (Conway, 2000; Shyamla, 2005; IIPS, 2007). Recently in India, hysterectomy has received increased attention in public health policy debates, where the media reports have highlighted an unusual rise in the number of women undergoing hysterectomy in many parts of the country. A significant number of cases involving young and per-menopausal women from poor families were reported from state of Katakana. The objective of the present study is to review, understand the physical, psychological issues experienced by the women before and after undergoing the hysterectomy. However, the incidence of depression, anxiety and mood disorder are reported in several studies. Hysterectomy includes both physical and psychological health issues. This current paper deals with the arguments based on the existing literature, and the evidences shows that many of the young women are undergoing hysterectomy and they are facing physical and psychological issues in the later stages.
Gynecological Surgery, 2010
Nowadays, an increasing number of minimal invasive treatment alternatives to hysterectomy may be offered to the patient. In determining the appropriate treatment option, the patient has a distinct dilemma if a minimal invasive treatment with lesser effect than hysterectomy should be chosen or if a hysterectomy should be chosen which is a major surgery and requires longer recovery than the minimal invasive alternative. Quality-oflife (QoL) questionnaires that take subjective health perception into account are currently used to assess the treatment effects. The objective of this literature study is to determine and discuss the role of QoL as an outcome in randomized controlled trials (RCT) or systematic reviews of RCTs that study the treatment effect of hysterectomy compared to that of minimal invasive alternatives. A systematic literature search was performed in the PubMed database and in the Cochrane database to find randomized trials and systematic reviews of randomized trials, comparing hysterectomy with minimal invasive or conservative treatment options with sufficient follow-up using satisfac-tion, health status, and quality of life as outcomes. The results were based on nine randomized trials and two systematic reviews. The differences are mostly in favor of hysterectomy. In two out of four studied treatment alternatives, the satisfaction or health status is different in favor of hysterectomy while the QoL is equivalent. After 2 years of follow-up, differences between both groups have disappeared, possibly because of the crossover effect. Possible reasons for the lesser response of QoL compared to satisfaction or health status are discussed. The fundamental question if patients have a better quality of life at all times if they choose for a minimal invasive alternative of hysterectomy remains unresolved. Information, individualization, and freedom of choice before surgery probably best serve the sense of well being and quality of life thereafter.
The Psychosocial Outcomes of Total and Subtotal Hysterectomy: A Randomized Controlled Trial
The Journal of Sexual Medicine, 2006
Introduction. Current controversies involve the adverse effects of hysterectomy on women's psychosocial functioning and whether subtotal as opposed to total hysterectomy mitigates these effects. Aim. To investigate the psychosocial effects of hysterectomy by examining sexual, pain, and psychological outcomes of total vs. subtotal hysterectomy in a randomized controlled trial. Methods. Patients suffering from benign gynecological conditions were randomly assigned to one of two groups: (i) total hysterectomy, that is, laparoscopic assisted vaginal hysterectomy (TOT, N = 32); or (ii) subtotal hysterectomy, that is, supracervical laparoscopic hysterectomy (SUB, N = 31). Both groups were premenopausal and underwent hysterectomy without concurrent oophorectomy. Two premenopausal control groups: (i) minor gynecological surgery (SURG-CON, N = 30); and (ii) healthy nonsurgical controls (NORM-CON, N = 40), were also tested. All surgical groups were assessed 2-3 weeks before surgery and then 6-7 months afterward; the nonsurgical control group was assessed at the time of recruitment and 6-7 months later. Outcome Measures. Assessments included semistructured interviews, standardized questionnaires, and standardized gynecological examinations. Results. For the TOT group, sexual drive, arousal, and sexual behavior significantly improved postoperatively. For the SUB group, sexual behavior and overall sexual functioning significantly improved. For both TOT and SUB groups, unprovoked pain in the abdomen and pain in the abdomen during gynecological examinations was significantly reduced. For both TOT and SUB groups, overall psychological functioning did not significantly change postoperatively. Although between 3% and 16% of women undergoing hysterectomy reported adverse changes in psychosocial well-being after surgery, similar percentages of women in the control groups reported such effects. Conclusions. Hysterectomy resulted in a consistent reduction in abdominal pain, some improvement in sexual functioning, but no change in overall psychological functioning. There was no evidence supporting the idea that subtotal hysterectomy produced more favorable psychosocial outcomes than total hysterectomy nor was there any evidence that either type of hysterectomy resulted in adverse effects. Flory N, Bissonnette F, Amsel RT, and Binik YM. The psychosocial outcomes of total and subtotal hysterectomy: A randomized controlled trial. J Sex Med 2006;3:483-491.
Hysterectomy- “A Boon or Bane”
Objective: Hysterectomy has become one of the commonest surgery, even the general surgeons are doing the surgery by the patient’s wish without surgical indication. The retrospective study was carried out in patients, who had come with complaints after hysterectomy and required admissions. Study also included referred cases of post hysterectomy. Their indications, complications, and follow up period were noted. Analysis done. Material and Methods: 75 patients study with history of hysterectomy were studied and analysed. Results: 60% of patients were operated for benign conditions which could have been treated conservatively. 20% patients had post hysterectomy ovarian tumours followed by infection, urinary symptoms, psychological disturbances and carcinoma of vault /stump accounting for 12 % each. Conclusion: Hysterectomy surgery is not the ultimate treatment for most of conditions.