Hysterectomy and women satisfaction: total versus subtotal technique.
BACKGROUND
The impact of different surgical procedures on women's satisfaction after hysterectomy is a topical issue. The aim of this study was to investigate the impact of sub-total and total hysterectomy on women's satisfaction, evaluated with questionnaire assessment of sexual activity, body image, and health status.


METHODS
A prospective, randomized, non-blind study was conducted. In the study period of 3 years, 105 women were enrolled and completed the questionnaires [EuroQol (EQ-5D), body image scale (BIS), sexual activity questionnaire] 2 weeks before and 1 year after surgery.


RESULTS
Both total and sub-total hysterectomy resulted with improvements in the women's sexual satisfaction (1 year after surgery), but no statistically significant differences were reached between the two groups. A highly significant difference (P < 0.001) in the perception of the body image between total and sub-total hysterectomy, at 1 year after surgery, was underlined. The health-related quality of life resulted significantly better in the "sub-total hysterectomy" group 1 year after surgery (P < 0.05).


CONCLUSIONS
Considering these results, why should a total hysterectomy be performed, if the women's satisfaction seems to be higher using the sub-total technique? In our opinion, the woman undergoing hysterectomy for benign conditions must be counseled regarding the differences between the two techniques and, when possible, a choice must be offered to the woman.
Gorlero
Franco
F
Department of Women and Children, Division of Obstetrics and Gynecology, Imperia Hospital, Via Sant'Agata 57, Imperia, Italy.
Lijoi
Davide
D
Biamonti
Mariangela
M
Lorenzi
Paola
P
Pullè
Alberto
A
Dellacasa
Illaria
I
Ragni
Nicola
N
D000328:Adult; D001828:Body Image; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects / Q000379:methods* / Q000523:psychology; D008599:Menstruation Disturbances / Q000209:etiology / Q000523:psychology / Q000601:surgery; D008875:Middle Aged; D010049:Ovarian Diseases / Q000150:complications / Q000523:psychology / Q000601:surgery; D017060:Patient Satisfaction; D017699:Pelvic Pain / Q000209:etiology / Q000523:psychology / Q000601:surgery; D011788:Quality of Life; D012725:Sexual Behavior; D016896:Treatment Outcome; D014591:Uterine Diseases / Q000150:complications / Q000523:psychology* / Q000601:surgery*