Removing the cervix at hysterectomy: an unnecessary intervention?
OBJECTIVE
: To evaluate the long-term outcomes in women who underwent total abdominal hysterectomy (TAH) and subtotal abdominal hysterectomy (sub-TAH).


METHODS
: Two hundred seventy-nine women between 7 and 11 years (mean 9 years) of follow-up who participated in a previously published randomized, double-blind, multicenter trial comparing TAH and sub-TAH were invited to complete questionnaires used in the previous study to assess quality of life and pelvic organ function.


RESULTS
: Sixty-five percent of the women (90 TAH and 91 sub-TAH) completed the study. There were no significant differences in quality of life, mental health, and pelvic organ function between TAH and sub-TAH. Urinary and bowel function variables did not change significantly over time, but significant decreases were found in a range of sexual function parameters, pain, and role limitations due to emotional problems in both the groups.


CONCLUSIONS
: There were no long-term differences in outcomes between TAH and sub-TAH. The lack of a detrimental effect on bowel and urinary function seen at 12 months was maintained. The deterioration in sexual function is likely to be due to the climacteric.


BACKGROUND
: ClinicalTrials.gov, www.clinicaltrials.gov, NCT00750035


METHODS
: I.
Thakar
Ranee
R
From the Department of Obstetrics and Gynecology, Mayday University Hospital, Croydon, United Kingdom; the Department of Health Psychology, University of Sussex, Brighton, United Kingdom; and the Department of Obstetrics and Gynecology, St George's University of London, London, United Kingdom.
Ayers
Susan
S
Srivastava
Rashmi
R
Manyonda
Isaac
I
D000328:Adult; D002584:Cervix Uteri / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods*; D008875:Middle Aged; D011788:Quality of Life; D013995:Time