Hysterectomy provides benefit in health-related quality of life: A ten-year follow-up study

Abstract Study objective To evaluate short- and long-term effects of hysterectomy on the health-related quality of life (HRQoL), and to compare that for a representative sample of the age-standardized general population. Design A prospective survey as a part of FINHYST Study. Setting Four Helsinki area hospitals. Patients Eight hundred and thirty-six women with hysterectomy due to benign indications during the year 2006. Interventions A change in HRQoL assessed by the 15D instrument at baseline, and after six months and ten years. The HRQoL of women was also compared to that of the age-standardized general female population. Measurements and Main Results The majority of hysterectomies were performed laparoscopically (41.8%), followed by vaginal (38.2%) and abdominal (20%) approaches. Indications were classified into six subgroups; myoma, abnormal uterine bleeding (AUB), endometriosis, pelvic organ prolapse (POP), adnexal mass, and precancerous lesions. The preoperative mean HRQoL was lower in the subjects as compared to the general population. In the whole study population hysterectomy provided the greatest improvement in the dimensions of distress, vitality, discomfort and symptoms, and sexual activity, both short- and long-term. Those operated on for myoma, AUB, endometriosis, and POP showed an improved mean HRQoL after six months, while after ten years in those operated on for myoma, AUB, and endometriosis, the HRQoL was still better than at baseline. The women with endometriosis never reached the HRQoL of the general population, but in all other groups the HRQoL of the general population was exceeded. Conclusions Hysterectomy provided long-term improvement in HRQoL, especially in the women with myoma, AUB, and those with endometriosis.