A 1‐year follow up of psychological wellbeing after subtotal and total hysterectomy—a randomised study

Abstract

Objective To compare subtotal abdominal hysterectomy (SH) and total abdominal hysterectomy (TH) regarding influence on postoperative psychological wellbeing and surgical outcome measurements.Design A prospective, open, randomised multicentre trial.Setting Seven hospitals and one private clinic in the south-east of Sweden.Population Two-hundred women scheduled for abdominal hysterectomy for benign conditions were enrolled in the study; 179 women completed the study (94 SH and 85 TH).Methods Four different psychometric tests were used to measure general wellbeing, depression and anxiety preoperatively, and at 6 and 12 months postoperatively. Statistical analysis of variance and covariance were used.Main outcome measures Effects of operating method on psychological wellbeing postoperatively. Analysis of demographic, clinical and surgical data, including peri-and postoperative complications and complaints at follow up.Results No significant differences were observed between the two groups in any of the psychometric tests. Both surgical methods were associated with a significantly higher degree of psychological wellbeing at 6 and 12 months postoperatively, compared with preoperatively. No significant differences were found in the clinical measures including complications. A substantial number of women experienced persistent cyclic vaginal bleedings after SH. Neither minor or major postoperative complications, nor serum concentration of sex hormones, were associated with general psychological wellbeing 12 months after the operation.Conclusions General psychological wellbeing is equally improved after both SH and TH within 12 months of the operation, and does not seem to be associated with the occurrence of peroperative complications or serum concentration of sex hormones.Keywords Hysterectomy, psychological wellbeing, randomised study, subtotal.Please cite this paper as: Persson P, Brynhildsen J, Kjølhede P on behalf of the Hysterectomy Multicentre Study Group in South-East Sweden. A 1-year follow up of psychological wellbeing after subtotal and total hysterectomy-a randomised study. BJOG 2010;117:479-487.

Pelvic organ prolapse after subtotal and total hysterectomy: a long‐term follow‐up of an open randomised controlled multicentre study

“…15,21 The randomised study was conducted between 1998 and 2004, and the follow-up study was performed between May 2011 and April 2012.…”

“…Besides, we used two validated generic QoL forms (the Psychological General Well-Being and Women's Health Questionnaire) in the primary study, and found no significant difference between the modes of hysterectomy on any occasion of assessment, up to 1 year after surgery. 21 It therefore seems conceivable that even a pelvic floor-specific Table 3. POP-Q measurements and occurrence of pelvic organ prolapse preoperatively, and at a median of 11 years after abdominal subtotal and total hysterectomy…”

“…20 We have previously published a randomised trial comparing SH and TH in order to analyse short-term recovery and psychological wellbeing 1 year after surgery. 15,21 Based on the women participating in that randomised trial we aimed to investigate the development of POP subjectively and objectively in the long term. In addition to the information such a study will provide concerning the association between mode of hysterectomy and later development of prolapse, there are quality-of-life and health-economic aspects of this issue to be considered if one of the hysterectomy methods is found to increase the risk of subsequently developing a prolapse that requires surgery.…”

Pelvic organ prolapse after subtotal and total hysterectomy: a long‐term follow‐up of an open randomised controlled multicentre study

“…A few variables were not normally distributed and consequently we used nonparametric statistical tests for comparison of groups whenever possible. To maintain consistency with our previously published articles 6,7 we chose to use mean and SD in this article. The use of median in the headings of Tables 3 and 4 may be seen as inappropriate from a strictly academic point of view.…”

Psychological Aspects of Hysterectomy & Postoperative Care

“…(Persson et al, 2010b) In addition, they also measured the serum concentration of sex hormones in the patients. The authors failed to find any significant differences between the two groups in any of the psychometric tests.…”