Are the Physiologically and Psychosocially Based Symptoms in Women Suffering from Gynecological Disorders Alleviated by Means of Hysterectomy?

Abstract

Women experiencing gynecological disorders can suffer from a diversity of symptoms and problems. To what extent women are relieved of their physiologically and psychosocially based symptoms by hysterectomy is an important issue. This study aims to evaluate the long-term impact of hysterectomy on such symptoms and to compare the findings with those of a control group. Women with gynecological disorders experienced physiologically based symptoms, such as pelvic pain and urinary incontinence, to a greater degree than did the control group (p < 0.05), whereas bowel function and menopausal symptoms were equally distributed in the two groups. Furthermore, these women experienced psychosocially based symptoms, such as fatigue and insomnia, to a greater degree than the control group (p < 0.05), whereas the groups did not differ in psychological well-being or sexual function. After hysterectomy, however, pelvic pain and sleeping disturbances were alleviated, and the state of energy and urinary function were improved (p < 0.00). Bowel function, menopausal symptoms, psychological well-being, sexual function, and self-perception as a woman were not influenced by the operation. Both 6 and 12 months after hysterectomy, no differences between the patients and the control group were found, except for the tendency of patients not to gain weight after the operation. The symptoms are mostly improved or unchanged after hysterectomy, and additional problems do not seem to follow the operation.

Psychosocial effects of hysterectomy

“….informed consent is of critical importance because not only does this operation carry the operative morbidity and mortality that other surgical procedures have, but also alters the genital anatomy of the patient and in so doing may carry detrimental psychosexual consequences for some patientsQ (p. 41). To date, empirical evidence does not support any broad adverse effects of hysterectomy on women's psychosocial functioning [5]. Positive outcomes of hysterectomy include decreases in chronic pelvic pain and pain during intercourse, as well as the elimination of menstrual pain and dysfunctional uterine bleeding [21,23,54].…”

“…The changes over the past decades in the psychological profile of patients may reflect a reduced tendency of health professionals to treat psychological and psychiatric symptoms with hysterectomy. Studies with control groups suggest no difference in psychological functioning between hysterectomy patients and controls [5,12,54]. Overall, there is no evidence that the uterus or its removal causes or relieves psychopathology (see Tables 1-4).…”

“…While prospective studies suggest significant improvements in sexual functioning overall, postsurgical deterioration of sexual functioning is documented in a subgroup of 10 -22% [7,37,69,82,91]. With regard to controlled studies, only one recent retrospective study suggests a decrease in global sexual functioning following hysterectomy compared with healthy controls [62], while another controlled retrospective study showed no such difference [5]. Two controlled prospective studies included a random assignment of patients with uterine pathology to either hysterectomy or a uterus-preserving intervention and also showed no significant difference between the groups on global sexual functioning [24,92].…”

A brief review of the factors influencing sexuality after hysterectomy

“…In a cross-sectional study, Ferroni and Deeble (1996) reported that women who had undergone hysterectomy for benign gynecological conditions reported less severe depressive symptomatology than women who had not received treatment for similar conditions. Rannestad et al (2001) found no differences in psychosocial well being among three groups: women with current gynecological illness, women who had previously undergone hysterectomy for similar conditions, and a healthy community sample. General life satisfaction among older women who had undergone hysterectomy was similar to or even higher than that among women of similar age who had never undergone hysterectomy (Kritz-Silverstein et al, 2002).…”

Self-assessment and woman’s health control location after gynaecological operations

“…Rannestad et al, after carrying out a study of a group of women who had undergone gynaecological surgery procedures, paid attention to the increase in sleeping disorders presented by the respondents. Nonetheless, no changes of mental health (anxiety disorders or mental disorders) among those respondents were found [32]. On the other hand, according to the results obtained by Wang et al, who studied 105 Chinese women after hysterectomy, only 4.8% of these women were diagnosed with depression after the surgery [33].…”