Study on Quality-of-Life assessment in Women after Hysterectomy

Abstract

Background: Hysterectomy is associated with increased risk of cardiovascular disease, osteoporosis, bone fractures, postoperative adhesions, and potential complications like wound infections, vaginal prolapse, and urinary incontinence.

Objectives: To compare the pre- and postoperative results with patient satisfaction following hysterectomy; and to evaluate the change in quality-of-life following hysterectomy.

Methods: This was a hospital based prospective study conducted in the outpatient department and/or inpatient wards of the Department of Obstetrics and Gynaecology between August 2022 and August 2023.

Results: This study included 50 patients, with a mean age of 53.4 years. Most were from rural areas, and over half were illiterate. Nearly half were of middle socioeconomic status. Heavy menstrual bleeding was the main reason for hysterectomy (70%), followed by pelvic pain and fibroids. Of the patients, 56% had a vaginal hysterectomy and 44% had an abdominal hysterectomy. Most patients (82%) retained at least one ovary, while 18% had bilateral oophorectomy. Post-hysterectomy, pelvic pain significantly reduced from 80% to 30%. However, abdominal pain, hot flushes, vaginal dryness, and urinary symptoms showed no significant changes. Sexual activity remained consistent pre- and post-hysterectomy. Quality of life scores significantly improved in areas such as physical health, emotional wellbeing, and social functioning. Sexual quality of life scores also saw a significant increase. Histopathological examination revealed fibroids (58.3%), adenomyosis (22.2%), ovarian cysts (11.1%), endometrial polyps (5.6%), and endometrial hyperplasia (2.8%).

Conclusion: The positive outcomes challenges historical concerns about potential negative effects on sexual function, providing reassurance to both healthcare providers and women considering the procedure.