Psychosocial effects of hysterectomy: literature review.
OBJECTIVE
With the development of less invasive treatments, the suitability of hysterectomy as a treatment for benign symptoms is being reevaluated. This paper critically and comprehensively reviews the psychosocial outcomes of hysterectomy in areas of sexuality, pain, and psychological functioning.


METHODS
Medline, Pub Med, and PsychLit were searched for studies and reviews pertaining to the psychosocial outcomes of hysterectomy. Over 100 studies and reviews, in English, French, and German language, published in the past 30 years were included. Controversial theories and empirical evidence are discussed in the domains of sexuality, pain, and psychological well-being. Special attention is devoted to design, sampling, and measurement issues as well as different surgical approaches with regard to hysterectomy-oophorectomy.


RESULTS
While hysterectomy appears to reduce pain, there do not appear strong psychosexual or psychosocial effects. Nonetheless, there may be a subgroup of women (10-20%) who report negative psychosocial outcomes such as reduced sexual interest, arousal, and orgasm, as well as elevated depressive symptoms and impaired body image.


CONCLUSIONS
More research is necessary to establish which patients may benefit most and which may not. Directions for future research are discussed.
Flory
Nicole
N
Department of Psychology, McGill University, Montreal, Quebec, Canada.
Bissonnette
François
F
Binik
Yitzchak M
YM
D000328:Adult; D001828:Body Image; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000523:psychology*; D008875:Middle Aged; D010052:Ovariectomy; D010146:Pain / Q000209:etiology; D011183:Postoperative Complications; D011584:Psychology; D011788:Quality of Life / Q000523:psychology; D020018:Sexual Dysfunctions, Psychological / Q000523:psychology*