THE MAINE-WOMENS-HEALTH-STUDY .1. OUTCOMES OF HYSTERECTOMY

Objective: To assess the effect of hysterectomy for nonmalignant condi tions on symptoms and quality of life and to identify adverse effects 1 year after surgery. Methods: The Maine Women's Health Study was a pr ospective cohort study of 418 women ages 25-50 years undergoing hyster ectomy for any nonmalignant condition. Patients recruited from the pra ctices of 63 physicians performing hysterectomy throughout Maine were interviewed at the time of surgery and 3, 6, and 12 months later. Clin ical and hospitalization data were obtained from physician reports and from a statewide hospital discharge data base. The primary outcomes o f interest were symptom relief, changes in quality of life, and the de velopment of new symptoms or problems during the year following surger y. Results: The most frequent indications for hysterectomy were leiomy omas (35%), abnormal bleeding (22%), and chronic pelvic pain (18%). Fo r these indications, hysterectomy resulted in marked improvements in a range of symptoms, including pelvic pain, urinary symptoms, fatigue, psychological symptoms, and sexual dysfunction. Significant improvemen ts in scores for indices of mental health, general health, and activit y were evident at 6 months and sustained at 1 year. New problems after hysterectomy (measured in those free of the symptom preoperatively) i ncluded hot flashes (13%), weight gain (12%), depression (8%), and lac k of interest in sex (7%). Conclusions: Hysterectomy is highly effecti ve for relief of symptoms associated with common nonmalignant gynecolo gic conditions. Symptom relief following hysterectomy is associated wi th a marked improvement in quality of life. New problems are reported after hysterectomy by a limited number of women.