Returning to work after laparoscopic myomectomy: a prospective observational study

Huff, Keren O.; Aref‐Adib, Mehrnoosh; Magama, Zwelihle; Vlachodimitropoulou, Evangelia; Oliver, Reeba; Odejinmi, Funlayo

doi:10.1111/aogs.13246

Cited by 11 publications

(6 citation statements)

References 14 publications

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“…11,12 However, 1 prior prospective observational study noted that 40% of women returned to work more than 8 weeks after laparoscopic myomectomy, which was associated with how long it took the women to reportedly "feel back to normal." 13 The authors hypothesized that laparoscopic surgery was anticipated to shorten recovery, but the greater complexity of laparoscopic procedures performed now may actually result in longer time for recovery. Open surgical approaches were associated with longer length of stay in hospital, more pain medication use, higher VAS scores, and longer times before return to work.…”

Section: Results In the Context Of What Is Knownmentioning

confidence: 99%

Short-Term Quality of Life After Myomectomy for Uterine Fibroids From the Compare-UF Fibroid Registry

Laughlin-Tommaso

Thomas

et al. 2020

Obstetrical &Amp; Gynecological Survey

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BACKGROUND: Uterine fibroids may decrease quality of life in a significant proportion of affected women. Myomectomy offers a uterinesparing treatment option for patients with uterine fibroids that can be performed abdominally, laparoscopically (with or without robotic assistance), and hysteroscopically. Quality of life information using validated measures for different myomectomy routes, especially hysteroscopic myomectomy, is limited. OBJECTIVE: To compare women's perception of their short-term health-related quality of life measures and reported time to return to usual activities and return to work for different routes of myomectomy. MATERIALS AND METHODS: Comparing Options for Management: Patient-centered Results for Uterine Fibroids (COMPARE-UF) is a prospective nationwide fibroid registry that enrolled premenopausal women seeking treatment for uterine fibroids at 8 clinical sites. For this analysis, we included women undergoing hysteroscopic, abdominal, or laparoscopic myomectomy who completed the postprocedure questionnaire scheduled between 6 and 12 weeks after surgery. Health-related quality of life outcomes, such as pain, anxiety, and return to usual activitie, were assessed for each route. The hysteroscopic myomectomy group had large differences in demographics, fibroid number, and uterine size compared to the other groups; thus, a direct comparison of quality of life measures was performed only for abdominal and laparoscopic approaches after propensity weighting. Propensity weighting was done using 24 variables that included demographics, quality of life baseline measures, and fibroid and uterine measurements. RESULTS: A total of 1206 women from 8 COMPARE-UF sites underwent myomectomy (338 hysteroscopic, 519 laparoscopic, and 349 abdominal). All women had substantial improvement in short-term health-related quality of life and symptom severity scores, which was not different among groups. Average symptom severity scores decreased about 30 points in each group. Return to usual activities averaged 0 days (interquartile range, 0e14 days) for hysteroscopic myomectomy, 21 days (interquartile range, 14e28 days) for laparoscopic myomectomy, and 28 days (interquartile range, 14e35 days) for abdominal myomectomy. After propensity adjustment, quality of life outcomes in the laparoscopic and abdominal myomectomy groups were similar except for more anxiety in the laparoscopic myomectomy group and slightly more pain in the abdominal myomectomy group. After propensity weighting, return to usual activities favored laparoscopic compared to abdominal procedures; median time was the same at 21 days, but the highest quartile of women in the abdominal group needed an additional week of recovery (interquartile range,14.0e28.0 for laparoscopic versus 14.0e35.0 for abdominal, P < .01). Time to return to work was also longer in the abdominal arm (median, 22 days; interquartile range, 14e40 days, versus median, 42; interquartile range, 27e56). CONCLUSION: Women who underwent myomectomy had substantial improvement in health-rel...

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Section: Results In the Context Of What Is Knownmentioning

confidence: 99%

Short-Term Quality of Life After Myomectomy for Uterine Fibroids From the Compare-UF Fibroid Registry

Laughlin-Tommaso

Thomas

et al. 2020

Obstetrical &Amp; Gynecological Survey

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“…2 Kikuchi et al also described that women who underwent operative laparoscopy for benign gynecological condition returned to office work after 12.5 days. 3 A much longer time of 8 weeks or more to return to work after laparoscopic myomectomy found by Aref-Adib et al 4 did not coincide with the earlier studies mentioned above. We are afraid that their results should be justified more elaborately.…”

mentioning

confidence: 76%

“…As Aref-Adib et al themselves pointed out, they did not take any psychosocial factors into consideration when they validated their results. 4 For instance, if patients are allowed to take 8-weeks paid leave when they take surgical operations, it is easy to expect that they will take full length of 8-weeks leave before their return to work even if they are fully recovered within a few weeks. In this sense, the dates when patients actually return to work might not coincide with the date of full QOL recovery.…”

mentioning

confidence: 99%

Response to letter to ‘Recovery of quality of life after laparoscopic myomectomy’

Tsuzuki

Tsuzuki²,

Wada

2019

J of Obstet and Gynaecol

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“…Duration until full return to work (RTW) was chosen as the primary outcome, as this is a well-defined endpoint of recovery [ 21 , 22 ]. The results of this study will help building the evidence base of perioperative care, by enabling the formulation of evidence-based convalescence advice after hysterectomy [ 23 , 24 ]. Moreover, by identifying factors that are modifiable, changes can be made in perioperative care and effective interventions can be designed to target those factors [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Predictive factors of return to work after hysterectomy: a retrospective study

et al. 2022

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Purpose Although hysterectomy is one of the most frequently performed gynaecological surgeries, there is a dearth of evidence on perioperative care. The aim of the current study was to identify sociodemographic, surgical-related and work-related predictors of recovery following different approaches of hysterectomy. Methods Eligible patients for this retrospective cohort study were women who underwent vaginal, abdominal or laparoscopic hysterectomy for both benign and malignant gynaecological disease in 2014 in Máxima Medical Centre in the Netherlands. The main outcome measure was full return to work (RTW). Data were collected using a patient survey. Potential prognostic factors for time to RTW were examined in univariate Cox regression analyses. The strongest prognostic factors were combined in a multivariable model. Results In total 83 women were included. Median time to full return to work was 8 weeks (interquartile range [IQR] 6–12). The multivariable analysis showed that higher age (hazard ratio [HR] 1.053, 95% confidence interval [CI] 1.012–1.095) and same day removal of indwelling catheter (HR 0.122, 95% CI 0.028–0.539) were predictors of shorter duration until full RTW after hysterectomy. Conclusions This study provided insight in the predictors of recovery after hysterectomy. By identifying patient specific factors, pre-operative counselling can be individualized, changes can be made in perioperative care and effective interventions can be designed to target those factors.

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Returning to work after laparoscopic myomectomy: a prospective observational study

Abstract: Time to return to normal activity and BMI significantly influenced the time taken for women to work after laparoscopic myomectomy. Further data would support clinicians in counseling women appropriately and optimizing their postoperative return to employment.

Cited by 11 publications

References 14 publications

Short-Term Quality of Life After Myomectomy for Uterine Fibroids From the Compare-UF Fibroid Registry

Short-Term Quality of Life After Myomectomy for Uterine Fibroids From the Compare-UF Fibroid Registry

Response to letter to ‘Recovery of quality of life after laparoscopic myomectomy’

Predictive factors of return to work after hysterectomy: a retrospective study

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