Quality of life among women undergoing hysterectomies

Objective: To measure the association between gynecologic conditions and qu ality of life in women before hysterectomy. Methods: We retrospectively identified 482 women who had hysterectomies for nononcologic and nonemergency indications in one of nine capitated medical groups in Southern California between 1993 and 1995. Their symptoms and qu ality of life before hysterectomy were assessed by medical record review an d telephone interview. Women were placed into four symptom-based groups (pa in, bleeding, pelvic discomfort, and asymptomatic groups) and compared acro ss six quality-of-life scales. Results: Women with primary pain conditions reported the highest average ro le impairment compared with women with primary bleeding, pelvic discomfort, or asymptomatic conditions (8.6 days/month versus 5.0, 2.5, and 1.9 days/m onth, respectively; P < .05). On the five 0 to 100-point quality-of-life sc ales, women with primary pain conditions, compared with women with bleeding , pelvic discomfort, or asymptomatic conditions, had the highest mean level s of sexual impairment (71.5 versus 54.1, 29.6, and 17.9, respectively; P < .05) and mood impairment (55.2 versus 45.2, 34.6, and 38.1, respectively; P < .05), the poorest perception of general health (74.4 versus 60.7, 44.1, and 49.4, respectively; P < .05), and the greatest increase in severity of symptoms before hysterectomy (77.2 versus 68.7, 61.5, and 57.1, respective ly; P < .05). Conclusion: Women's primary symptoms before hysterectomy are associated dif ferentially with varying levels of impairment. Standardized measurement of quality of life among women with gynecologic complaints that lead to hyster ectomy might help in the development of treatment guidelines and in the ass essment of appropriateness and outcomes of care for those women. (Obstet Gy necol 1999;93: 915-21. (C) 1999 by The American College of Obstetricians an d Gynecologists.)