Hysterectomy improves quality of life and decreases psychiatric symptoms: a prospective and randomised comparison of total versus subtotal hysterectomy.
OBJECTIVE
To conduct a prospective and concurrent evaluation of changes in health status and quality of life and psychological outcome measures over one year in women randomised to total or subtotal abdominal hysterectomy. The concurrent evaluation was the impact of total versus subtotal hysterectomy on bladder, bowel and sexual function.


METHODS
Prospective, randomised, double-blind study.


METHODS
A large UK Teaching Hospital (St George's Hospital, London) and a large District General Hospital (Mayday University Hospital, Croydon). METHODS.


METHODS
Two hundred and seventy-nine women undergoing hysterectomy for benign disease were randomly allocated to total hysterectomy (n= 146) or subtotal hysterectomy (n= 133).


METHODS
Quality of life assessment using the Short-Form-36 health survey (SF-36) and psychological outcome measures using the General Health Questionnaire-28 (GHQ-28) before the operation and 6 and 12 months after.


RESULTS
Quality of life and psychological symptoms were similar in the two groups at baseline. Following surgery, quality of life improved in six of the eight domains, with no significant difference between the groups, with the exception of emotions which showed a greater improvement in subtotal hysterectomy women between baseline and 12 months. When this difference was examined further by looking at change in the GHQ subscales, there were no significant differences between total and subtotal hysterectomy women in the amount of change in anxiety, depression, somatic symptoms or social dysfunction, between baseline and post-operative measurements. All women showed an improvement in psychological symptoms following both operations.


CONCLUSIONS
Hysterectomy, whether total or subtotal, may improve quality of life and psychological outcome.
Thakar
Ranee
R
Department of Obstetrics and Gynaecology, Mayday Hospital, Croydon, UK.
Ayers
Susan
S
Georgakapolou
Alexandra
A
Clarkson
Peter
P
Stanton
Stuart
S
Manyonda
Isaac
I
D000328:Adult; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods* / Q000523:psychology; D001523:Mental Disorders / Q000209:etiology*; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome