Effectiveness of hysterectomy.
OBJECTIVE
To measure the effectiveness of hysterectomy in relieving adverse symptoms and to identify factors associated with lack of symptom relief.


METHODS
In a 2-year prospective study, data were collected before and at 3, 6, 12, 18, and 24 months after hysterectomy in 1,299 women who had hysterectomies for benign conditions at 28 hospitals across Maryland. Effectiveness was measured in terms of relief of symptoms such as problematic vaginal bleeding, pelvic pain, and urinary incontinence. Psychologic function and quality of life before and after surgery also were assessed.


RESULTS
Symptom severity, depression, and anxiety levels decreased significantly after hysterectomy and quality of life improved, particularly in the area of social function. However, 8% of women had at least as many symptoms at problematic-severe levels 1 and 2 years after hysterectomy as before. In multiple logistic regression, several presurgical patient characteristics predicted lack of symptom relief, including therapy for emotional or psychologic problems, depression, and household income of $35,000 or less. Bilateral oophorectomy predicted lack of symptom relief at 24 months but not at 12 months after hysterectomy.


CONCLUSIONS
Significant improvements were seen after hysterectomy for all three aspects of health status (symptoms, psychologic function, and quality of life), which persisted or continued to improve throughout the 2 years of follow-up. However, hysterectomy did not relieve symptoms for some women, particularly those who had low incomes or were in therapy at the time of hysterectomy.
Kjerulff
K H
KH
Department of Epidemiology and Preventive Medicine, University of Maryland School of Medicine, Baltimore 21201, USA. kkjerulff@som.umaryland.edu
Langenberg
P W
PW
Rhodes
J C
JC
Harvey
L A
LA
Guzinski
G M
GM
Stolley
P D
PD
D000328:Adult; D000368:Aged; D005260:Female; D006304:Health Status; D006801:Humans; D007044:Hysterectomy / Q000523:psychology; D016015:Logistic Models; D008396:Maryland; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011788:Quality of Life