Endometrial resection versus vaginal hysterectomy for menorrhagia: long-term clinical and quality-of-life outcomes.
OBJECTIVE
Our purpose was to compare patients' satisfaction with the effect of treatment, health-related quality of life, psychologic status, and sexual functioning 2 years after endometrial resection or vaginal hysterectomy for menorrhagia.


METHODS
Menorrhagic women < or = 50 years old with a mobile uterus smaller than a 12-week pregnancy were enrolled in a randomized trial to compare endometrial resection and vaginal hysterectomy. Two years after surgery the women were requested to rate the degree of satisfaction with the effect of the operation and to complete the Short Form 36 general health survey questionnaire, the Hospital Anxiety and Depression Scale, and the revised Sabbatsberg Sexual Rating Scale.


RESULTS
Forty-one subjects underwent endometrial resection and 44 underwent vaginal hysterectomy without major complications. Of the 77 women attending the 2-year follow-up visit, 33 of 38 (86.8%) in the endometrial resection arm were very satisfied or satisfied with the treatment compared with 37 of 39 (94.8%) of those in the hysterectomy arm. According to the Short Form 36 questionnaire, social functioning and vitality scores were significantly better in the hysterectomy group than in the resection group. Significantly lower Hospital Anxiety and Depression Scale anxiety scores were observed in the former than in the latter subjects. The Sabbatsberg Sexual Rating Scale scores were similar in the two groups.


CONCLUSIONS
In patients requiring surgical treatment for menorrhagia vaginal hysterectomy appeared slightly more satisfying and offered a better health-related quality of life than did endometrial resection at 2-year follow-up. Hysterectomy did not adversely affect psychologic status and sexual functioning.
Crosignani
P G
PG
Clinica Ostetrica e Ginecologica Luigi Mangiagalli, Università di Milano, Milan, Italy.
Vercellini
P
P
Apolone
G
G
De Giorgi
O
O
Cortesi
I
I
Meschia
M
M
D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology; D004717:Endometrium / Q000601:surgery*; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000592:standards*; D015907:Hysteroscopy; D015994:Incidence; D008595:Menorrhagia / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D019529:Sexuality; D011795:Surveys and Questionnaires