Changes and Factors Influencing Health-related Quality of Life After Hysterectomy in Premenopausal Women with Benign Gynecologic Conditions

Background/Purpose

A hysterectomy affects a woman's health. This study was performed to identify the factors that affect health-related quality of life (HRQoL) before and after hysterectomy in premenopausal women.

Methods

This prospective follow-up study recruited 38 women (age range, 33-52 years) who underwent abdominal hysterectomy for nonmalignant causes. SF-36 and self-rated health status were used to assess HRQoL before and after hysterectomy. Data were analyzed using descriptive statistics, nonparametric tests and the generalized estimating equation method for modeling the repeatedly measured responses.

Results

Patients' attitudes toward hysterectomy and subsequent sexual activity were influenced by the surgery. All patients showed significant improvements in the physical component summary (PCS) of SF-36 (mean, 42.1-51.0), but there was no significant difference in the mental component summary (MCS). The significant improvements were found from the five repeated measurements of the self-rated health status (mean, 6.0-7.3). Hemoglobin level was the most important predictor of HRQoL before surgery. Women in employment, with more years of education and previous blood transfusion had high MCS scores after surgery.

Conclusion

The overall self-rated health status and PCS showed significant improvements after hysterectomy. Having had a blood transfusion, being educated and employed were positively associated with MCS score after surgery. These findings are vital for preoperative counseling for women undergoing hysterectomy.

Key Words:  abdominal hysterectomy , generalized estimating equation modeling , health-related quality of life , SF-36

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