ENDOMETRIAL RESECTION VERSUS VAGINAL HYSTERECTOMY FOR MENORRHAGIA - LONG-TERM CLINICAL AND QUALITY-OF-LIFE OUTCOMES

OBJECTIVE: Our purpose was to compare patients' satisfaction with the effect of treatment, health-related quality of life, psychologic statu s, and sexual functioning 2 years after endometrial resection or vagin al hysterectomy for menorrhagia. STUDY DESIGN: Menorrhagic women less than or equal to 50 years old with a mobile uterus smaller than a 12-w eek pregnancy were enrolled in a randomized trial to compare endometri al resection and Vaginal hysterectomy. Two years after surgery the wom en were requested to rate the degree of satisfaction with the effect o f the operation and to complete the Short Form 36 general health surve y questionnaire, the Hospital Anxiety and Depression Scale, and the re vised Sabbatsberg Sexual Rating Scale. RESULTS: Forty-one subjects und erwent endometrial resection and 44 underwent vaginal hysterectomy wit hout major complications. Of the 77 women attending the 2-year follow- up visit, 33 of 38 (86.8%) in the endometrial resection arm were very satisfied or satisfied with the treatment compared with 37 of 39 (94.8 %) of those in the hysterectomy arm. According to the Short Form 36 qu estionnaire, social functioning and vitality scores were significantly better in the hysterectomy group than in the resection group. Signifi cantly lower Hospital Anxiety and Depression Scale anxiety scores were observed in the former than in the latter subjects. The Sabbatsberg S exual Rating Scale scores were similar in the two groups. CONCLUSIONS: In patients requiring surgical treatment for menorrhagia vaginal hyst erectomy appeared slightly more satisfying and offered a better health -related quality of life than did endometrial resection at 2-year foll ow-up. Hysterectomy did not adversely affect psychologic status and se xual functioning.