Health-related quality of life after laparoscopically assisted vaginal hysterectomy: is uterine weight a major factor?
OBJECTIVE
To assess uterine size, symptom severity, and hemoglobin level as determinants of health-related quality of life (HRQOL) in women subsequently undergoing laparoscopically assisted vaginal hysterectomy (LAVH).


METHODS
Sixty-one consecutive women with uterine leiomyoma or adenomyosis undergoing LAVH were studied using a prospective cohort design. The Chinese version of the Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaire was assessed preoperatively. The Taiwan brief version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire and a self-assessment of the perceived health status were assessed preoperatively and 1 day, 1 week, 12 weeks, and 18 months postoperatively.


RESULTS
Women with a greater uterine weight did not report a greater severity of symptoms than those with lower uterine weight. Women with more severe symptoms had lower preoperative hemoglobin levels and were usually younger. Their perceived health status and their scores in physical domain of WHOQOL-BREF were also significantly lower, indicating a poorer HRQOL. The mixed-effects model found that a normal (higher) baseline hemoglobin level and a greater symptom severity were associated with a significant improvement of HRQOL in the physical domain of WHOQOL-BREF following LAVH.


CONCLUSIONS
Preoperative symptom severity, but not uterine weight, was associated with long-term improvement in HRQOL after LAVH. Women with severe symptoms could be considered for LAVH before development of anemia.
Torng
Pao-Ling
PL
Department of Obstetrics and Gynecology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Chang
Wen-Chun
WC
Hwang
Jing-Shiang
JS
Hsu
Wen-Chiung
WC
Wang
Jung-Der
JD
Huang
Su-Cheng
SC
Chen
Chen-Fang
CF
Su
Ta-Chen
TC
D018254:Adenomatoid Tumor / Q000601:surgery; D000328:Adult; D000368:Aged; D002681:China; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D007045:Hysterectomy, Vaginal / Q000379:methods / Q000523:psychology*; D010535:Laparoscopy; D007889:Leiomyoma / Q000601:surgery; D008875:Middle Aged; D009929:Organ Size; D011184:Postoperative Period; D011788:Quality of Life; D014594:Uterine Neoplasms / Q000601:surgery; D014599:Uterus / Q000473:pathology* / Q000601:surgery*