1
|
Reddington C, Dior UP, Stafford L, McNamara HC, Rasaratnam P, Karri R, Karahalios A, Healey M, Cheng C. The impact of age and parity on the experience of relief and regret in women who have undergone hysterectomy for benign disease: A cross sectional survey. BJOG 2024; 131:1102-1110. [PMID: 38212141 DOI: 10.1111/1471-0528.17745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/18/2023] [Accepted: 12/08/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVE To investigate the impact of age and parity on the experience on relief and regret following elective hysterectomy for benign disease, and to explore the factors that impact relief and regret. DESIGN Retrospective cross-sectional survey of a cohort. SETTING Single-centre tertiary hospital in Melbourne, Australia. POPULATION Patients who underwent elective hysterectomy for benign indications from 01 January 2008 - 31 July 2015 (inclusive) with age <51 years at time of admission. METHODS Eligible participants completed a retrospective survey regarding their experience of relief and regret following hysterectomy. MAIN OUTCOME MEASURES Regret was defined as a positive response to "Do you regret the decision to have a hysterectomy?". Relief was defined as responding "agree/strongly agree" to "I feel relieved I had a hysterectomy". RESULTS 268 of 1285 (21%) eligible participants completed the study questionnaire. Of these, 29 were aged <36 years at the time of hysterectomy. Seven percent (n=18/262) reported regretting having a hysterectomy and 88% (n=230/262) reported experiencing relief. We did not observe associations between age at hysterectomy and regret (aOR 0.93; 95% CI 0.85, 1.03), age at hysterectomy and relief (aOR 1.01; 95% CI 0.93, 1.09), nulliparity and regret (aOR 0.32; 95% CI 0.06, 1.59) or nulliparity and relief (aOR 2.37; 95% CI 0.75, 7.51). Desire for future pregnancy at the time of hysterectomy was more frequently reported in those who experienced regret vs no regret (46.7% vs 12.1%, OR: 6.33; 95% CI: 2.12, 18.90; p=0.001). CONCLUSIONS Age and parity are not associated with relief nor regret following elective hysterectomy for benign disease.
Collapse
Affiliation(s)
- Charlotte Reddington
- Gynaecology Unit 2, The Royal Women's Hospital, Parkville, Victoria, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Uri P Dior
- Gynaecology Unit 2, The Royal Women's Hospital, Parkville, Victoria, Australia
- Department of Obstetrics and Gynaecology, Hadassah Medical Centre, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Lesley Stafford
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Helen C McNamara
- Gynaecology Unit 2, The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Prakashini Rasaratnam
- Gynaecology Unit 2, The Royal Women's Hospital, Parkville, Victoria, Australia
- Oceania University of Medicine, Brisbane, Queensland, Australia
| | - Roshan Karri
- Gynaecology Unit 2, The Royal Women's Hospital, Parkville, Victoria, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Amalia Karahalios
- Centre for Epidemiology and Biostatistics, Melbourne School of Population Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Martin Healey
- Gynaecology Unit 2, The Royal Women's Hospital, Parkville, Victoria, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Claudia Cheng
- Gynaecology Unit 2, The Royal Women's Hospital, Parkville, Victoria, Australia
- Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
2
|
Zimmermann JSM, Sima RM, Radosa MP, Radosa CG, Ples L, Wagenpfeil S, Solomayer EF, Radosa JC. Quality of life and sexual function in patients aged 35 years or younger undergoing hysterectomy for benign gynecologic conditions: A prospective cohort study. Int J Gynaecol Obstet 2023; 160:548-553. [PMID: 35965372 DOI: 10.1002/ijgo.14400] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 07/25/2022] [Accepted: 08/05/2022] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate how hysterectomy performed for benign gynecologic pathologies affects the quality of life and sexual function of patients aged 35 years or younger, and if outcomes differ according to the surgical technique. METHODS Seventy-three patients who underwent total laparoscopic hysterectomy (TLH), supracervical laparoscopic hysterectomy (SLH), or vaginal hysterectomy (VH) for benign uterine disorders between April 2014 and June 2020 at the Department of Gynecology and Obstetrics, Saarland University Hospital, Homburg, Germany, were enrolled in this prospective observational cohort study. Quality of life and sexual function were assessed preoperatively and 6 months postoperatively using standardized validated questionnaires: the European Quality of Life Five-Dimension Scale (EQ-5D) and the Female Sexual Function Index (FSFI). RESULTS Thirty-three (45%) patients underwent TLH, 25 (34%) underwent SLH, and 15 (21%) patients underwent VH. The median preoperative EQ-5D score, FSFI score, and EQ-5D visual analog scale were 0.9 (range 0.62-1), 19.25 (range 2.4-27.4), and 50 (range 0-100); postoperative scores were 1 (range 0.61-1), 24.15 (range 3.9-29.3), and 90 (range 30-100), respectively (P ≤ 0.001). Postoperative scores were significantly higher than preoperative scores, with no significant difference according to the surgical technique. CONCLUSION Hysterectomy for benign indication in women aged 35 years or less significantly improved the patients' quality of life and sexual function with no differences regarding the surgical technique. CLINICAL TRIAL REGISTRATION The study was registered in the German trial registry (no. DRKS00005622).
Collapse
Affiliation(s)
- Julia S M Zimmermann
- Department of Gynecology and Obstetrics, Saarland University Hospital, Homburg, Germany
| | - Romina-Marina Sima
- Department of Gynecology and Obstetrics, Saarland University Hospital, Homburg, Germany
| | - Marc P Radosa
- Department of Gynecology and Obstetrics, Klinikum Bremen-Nord, Bremen, Germany
| | - Christoph G Radosa
- Institute and Policlinic of Diagnostic and Interventional Radiology, Medical University, TU Dresden, Dresden, Germany
| | - Liana Ples
- Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Stefan Wagenpfeil
- Institute of Medical Biometry, Epidemiology & Medical Informatics, Saarland University Hospital, Homburg, Germany
| | - Erich-Franz Solomayer
- Department of Gynecology and Obstetrics, Saarland University Hospital, Homburg, Germany
| | - Julia C Radosa
- Department of Gynecology and Obstetrics, Saarland University Hospital, Homburg, Germany
| |
Collapse
|
3
|
Gan ZS, Roberson DS, Smith AL. Role of Hysteropexy in the Management of Pelvic Organ Prolapse. Curr Urol Rep 2022; 23:175-183. [PMID: 35789456 DOI: 10.1007/s11934-022-01101-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW To discuss considerations for hysteropexy for apical pelvic organ prolapse (POP) and summarize available literature comparing various hysteropexy techniques to analogous procedures involving hysterectomy. RECENT FINDINGS Hysteropexy for apical POP has increased in popularity in recent years, although anatomic factors and gynecologic cancer risk must be taken into account. Native tissue hysteropexy options include the LeFort colpocleisis, sacrospinous hysteropexy, and uterosacral hysteropexy. Although vaginal mesh was banned by the Food and Drug Administration in 2019, abdominal mesh sacrohysteropexy done either open or laparoscopically remains an option in the USA. Overall, short-term prolapse outcomes appear to be comparable between uterus-sparing approaches and hysterectomy, with less blood loss and shorter operating room time observed with the uterine-sparing approaches, although long-term outcome data remains variable and limited. Uterine-sparing apical POP repair may be offered to appropriate patients without certain risk factors, although longer-term data will be required to evaluate durability.
Collapse
Affiliation(s)
- Zoe S Gan
- Division of Urology, Department of Surgery, University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Blvd, PCAM 3-334W, Philadelphia, PA, 19104, USA.
| | - Daniel S Roberson
- Division of Urology, Department of Surgery, University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Blvd, PCAM 3-334W, Philadelphia, PA, 19104, USA
| | - Ariana L Smith
- Division of Urology, Department of Surgery, University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Blvd, PCAM 3-334W, Philadelphia, PA, 19104, USA
| |
Collapse
|
4
|
Savard C, Yan E, Plante AS, Bégin C, Robitaille J, Michaud A, Lemieux S, Provencher V, Morisset AS. Positive attitudes toward weight gain in late pregnancy are associated with healthy eating behaviours. Eat Weight Disord 2021; 26:2051-2058. [PMID: 33128720 DOI: 10.1007/s40519-020-01057-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/15/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE This cross-sectional study examined the associations between 3rd trimester attitudes toward weight gain and (1) pre-pregnancy BMI, (2) gestational weight gain (GWG) and (3) eating behaviours assessed in the 3rd trimester. METHODS Seventy-nine (79) pregnant women completed the French version of the Pregnancy Weight Gain Attitude Scale (PWGAS), the Three-Factor Eating Questionnaire (TFEQ) and the Intuitive Eating Scale-2 (IES-2) in their 3rd trimester. Total GWG was calculated as the difference between the weight recorded before delivery and self-reported pre-pregnancy weight. RESULTS Most (55.6%) women gained weight above the Institute of Medicine's (IOM) recommendations, but there was no association between PWGAS scores and total or 3rd trimester GWG. Women with obesity had lower PWGAS total scores compared to women with overweight (3.48 ± 0.6 vs. 3.99 ± 0.3, p = 0.005), indicating more negative attitudes in women with obesity vs. overweight. Higher total PWGAS scores were positively correlated with intuitive eating scores (r = 0.28, p < 0.05), and inversely associated with unfavourable eating behaviours such as dietary restraint (r = - 0.42, p < 0.01). CONCLUSION Women with positive attitudes toward weight gain reported healthier eating behaviours in late pregnancy, which remains to be confirmed in prospective studies. Interventions addressing body image issues during pregnancy may positively influence pregnant women's health, including eating behaviours. LEVEL OF EVIDENCE Level III, case-control analytic study.
Collapse
Affiliation(s)
- Claudia Savard
- School of Nutrition, Laval University, Québec City, Canada
- Institute of Nutrition and Functional Foods, NUTRISS Research Center, Laval University, Québec City, Canada
- Endocrinology and Nephrology Unit, CHU of Québec-Université Laval Research Center, Québec City, Canada
| | - Emmanuelle Yan
- Biology's Formation and Research Unit, Clermont-Auvergne University, Clermont-Ferrand, France
| | - Anne-Sophie Plante
- Endocrinology and Nephrology Unit, CHU of Québec-Université Laval Research Center, Québec City, Canada
| | - Catherine Bégin
- School of Nutrition, Laval University, Québec City, Canada
- School of Psychology, Laval University, Québec City, Canada
| | - Julie Robitaille
- School of Nutrition, Laval University, Québec City, Canada
- Institute of Nutrition and Functional Foods, NUTRISS Research Center, Laval University, Québec City, Canada
- Endocrinology and Nephrology Unit, CHU of Québec-Université Laval Research Center, Québec City, Canada
| | - Andréanne Michaud
- School of Nutrition, Laval University, Québec City, Canada
- Institute of Nutrition and Functional Foods, NUTRISS Research Center, Laval University, Québec City, Canada
- Québec Heart and Lung Institute Research Center, Laval University, Québec City, Canada
| | - Simone Lemieux
- School of Nutrition, Laval University, Québec City, Canada
- Institute of Nutrition and Functional Foods, NUTRISS Research Center, Laval University, Québec City, Canada
| | - Véronique Provencher
- School of Nutrition, Laval University, Québec City, Canada
- Institute of Nutrition and Functional Foods, NUTRISS Research Center, Laval University, Québec City, Canada
| | - Anne-Sophie Morisset
- School of Nutrition, Laval University, Québec City, Canada.
- Institute of Nutrition and Functional Foods, NUTRISS Research Center, Laval University, Québec City, Canada.
- Endocrinology and Nephrology Unit, CHU of Québec-Université Laval Research Center, Québec City, Canada.
| |
Collapse
|
5
|
Bole R, Jimbo M, Parikh N, Britton C, Gopalakrishna A, Yang D, Trost L, Helo S, Kohler T, Ziegelmann M. Patient Attitudes Towards Surgical Management of Peyronie's Disease Prior to Men's Health Consultation. Urology 2021; 153:199-203. [PMID: 33676956 DOI: 10.1016/j.urology.2021.02.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/28/2021] [Accepted: 02/23/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate clinical characteristics associated with patient attitudes toward surgical treatment of Peyronie's disease (PD) prior to consultation in a high-volume male sexual health clinic. METHODS From 2014-2018 a prospective database was created of patients presenting to the sexual health clinic at our institution. Multivariable regression analysis was conducted to determine factors associated with pre-visit consideration of surgery. RESULTS Of 1359 men presenting to clinic, 342 had a chief complaint of PD. Prior to consultation, 79% of patients (n = 270) stated they were willing to consider surgery to correct their PD symptoms. Factors associated with consideration of surgery included younger patient age (mean 55.8 vs 60.0 years; P = .008), history of depression/anxiety (21% vs 8%, P = .01), greater penile curvature (43.3 vs 34.6 degrees; P = .002), penile shortening (64% vs 44%; P = .003), pain with erections (46% vs 33%; P = .05) and decreased ability to have penetrative intercourse (51.9% vs 65.3%, P = .04). On multivariable analysis, age, history of depression, penile shortening, and mean curvature remained significantly associated. Symptom duration and relationship factors were not associated with a difference in the stated preference to consider surgery prior to consultation (P >.05 for all). CONCLUSION Nearly 4 out of 5 patients reported willingness to consider surgical intervention for their PD-related symptoms prior to urologic consultation. On multivariable analysis, younger age, history of depression/anxiety, penile shortening, and curvature were associated with a greater likelihood of considering surgery. This information provides important insight into patient attitude toward undergoing surgery and will help drive patient counseling for men with PD.
Collapse
Affiliation(s)
- Raevti Bole
- Department of Urology, Mayo Clinic, Rochester, MN.
| | - Masaya Jimbo
- Department of Urology, Mayo Clinic, Rochester, MN
| | - Niki Parikh
- Department of Urology, Mayo Clinic, Rochester, MN
| | | | | | - David Yang
- Department of Urology, Mayo Clinic, Rochester, MN
| | - Landon Trost
- Department of Urology, Mayo Clinic, Rochester, MN
| | - Sevann Helo
- Department of Urology, Mayo Clinic, Rochester, MN
| | | | | |
Collapse
|
6
|
|
7
|
Surgical Decision Regret in Women Pursuing Surgery for Endometriosis or Chronic Pelvic Pain. J Minim Invasive Gynecol 2020; 28:1343-1350. [PMID: 32979533 DOI: 10.1016/j.jmig.2020.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/02/2020] [Accepted: 09/19/2020] [Indexed: 12/27/2022]
Abstract
STUDY OBJECTIVE To identify incidence of decision regret associated with surgery for endometriosis or chronic pelvic pain (CPP). DESIGN Survey study. SETTING Academic medical center. PATIENTS All patients undergoing excisional surgery for endometriosis or CPP between January 2016 and June 2019. INTERVENTIONS The women were contacted to complete 2 validated questionnaires: the Decision Regret and Patient Global Impression of Improvement scales. MEASUREMENTS AND MAIN RESULTS A total of 253 patients were contacted, and 154 patients responded (60.8% response rate) to the survey. A total of 137 women (90%) agreed or strongly agreed that having excisional surgery was the right decision; 134 women (87%) indicated that they would choose to have surgery again. The survey responders did not differ from nonresponders in age (years, 33.9 vs 35; p = .25), robotic route of surgery (83.1% vs 78.8%; p = .66), or performance of hysterectomy (27.3% vs 26.3%; p = .85). The responders were more likely to have stage III/IV endometriosis (50.6% vs 29.3%; p <.01), more previous surgeries for endometriosis (median surgeries, 1 vs 0; p = .01), higher complication rate (8.4% vs 2.0%; p = .03), and pathology test results more frequently positive for endometriosis (87.7% vs 77.8%; p = .03). Overall, 25 patients (16.3%) reported some level of regret after excisional surgery for endometriosis or CPP. Regret was not associated with a lower Patient Global Impression of Improvement score (odds ratio [OR] 4.37; 95% confidence interval [CI], 0.81-23.7), age (OR 0.98; 95% CI, 0.93-1.04), time since surgery (OR 1; 95% CI, 0.97-1.04), number of previous surgeries (OR 1.08; 95% CI, 0.9-1.31), negative pathology test results (OR 2.82; 95% CI, 0.95-8.32), hysterectomy (OR 1.23; 95% CI, 0.45-3.32), or complications (OR 1.07; 95% CI, 0.22-5.16). CONCLUSION Most women who pursue excisional surgery for endometriosis or CPP are satisfied with their decision. Regret was not associated with patient-reported lack of improvement, negative pathology test results, hysterectomy, or complications. Gynecologic surgeons should engage in shared decision-making with patients and feel comfortable offering surgical evaluation and management to patients with endometriosis or CPP when clinically indicated.
Collapse
|
8
|
Afiyah RK, Wahyuni CU, Prasetyo B, Dwi Winarno D. Recovery time period and quality of life after hysterectomy. J Public Health Res 2020; 9:1837. [PMID: 32728576 PMCID: PMC7376450 DOI: 10.4081/jphr.2020.1837] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 06/13/2020] [Indexed: 11/23/2022] Open
Abstract
Background: Women who had undergone hysterectomy have to overcome problems related to sexual and reproductive health. They often suffer a decline in self-esteem due to sexual dysfunction and the inability to give birth, along with their quality of recovery. This study aims to describe the relationships between recovery time and the components of quality of life after hysterectomy. D esign and methods: 103 women post-hysterectomy from several community-integrated health center in Surabaya were selected using the total sampling technique. Results: Findings show that there is relationship between recovery time period and sexual activity (P=0.000). However, no significant relationship exists between recovery time period personal relationships and social support. Conclusions: It is recommended that nurses should improve their social support for women and families during recovering, to avoid pathological stress and improve quality of life. Significance for public health Hysterectomy has several impacts on women, affecting their quality of life. Different length of recovery time period may affect quality of life after hysterectomy. Adequate help and support from friends, family and health care professionals, could improve their quality of life after surgery. Three components of quality of life are discussed, namely personal relationships, social support, and sexual activity. This study describes the relationships between recovery time period and the components of quality of life after hysterectomy
Collapse
Affiliation(s)
| | | | - Budi Prasetyo
- Department of Obstetrics and Gynecology, Faculty of Medicine
| | - Didik Dwi Winarno
- Master Student, Faculty of Public Health, Universitas Airlangga, Mulyorejo, Surabaya, Indonesia
| |
Collapse
|