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 status, and sexual functioning 2 years after endometrial resection or vaginal hysterectomy for menorrhagia. STUDY DESIGN: Menorrhagic women ≤50 years old with a...

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Published in:American journal of obstetrics and gynecology 1997-07, Vol.177 (1), p.95-101
Main Authors: Crosignani, Pier Giorgio, Vercellini, Paolo, Apolone, Giovanni, De Giorgi, Olga, Cortesi, Ilenia, Meschia, Michele
Format: Article
Language:English
Subjects:
Adult
anxiety
Anxiety - epidemiology
Biological and medical sciences
depression
Depression - epidemiology
endometrial resection
Endometrium - surgery
Female
Humans
hysterectomy
Hysterectomy, Vaginal - standards
Hysteroscopy
Incidence
Medical sciences
Menorrhagia
Menorrhagia - surgery
Middle Aged
Patient Satisfaction
Quality of Life
sexual functioning
Sexuality
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the genital tract and mammary gland
Surveys and Questionnaires
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Summary:OBJECTIVE: Our purpose was to compare patients' satisfaction with the effect of treatment, health-related quality of life, psychologic status, and sexual functioning 2 years after endometrial resection or vaginal hysterectomy for menorrhagia. STUDY DESIGN: Menorrhagic women ≤50 years old with a mobile uterus smaller than a 12-week pregnancy were enrolled in a randomized trial to compare endometrial resection and vaginal hysterectomy. Two years after surgery the women were requested to rate the degree of satisfaction with the effect of the operation and to complete the Short Form 36 general health survey questionnaire, the Hospital Anxiety and Depression Scale, and the revised Sabbatsberg Sexual Rating Scale. RESULTS: Forty-one subjects underwent endometrial resection and 44 underwent vaginal hysterectomy without 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 questionnaire, social functioning and vitality scores were significantly better in the hysterectomy group than in the resection group. Significantly lower Hospital Anxiety and Depression Scale anxiety scores were observed in the former than in the latter subjects. The Sabbatsberg Sexual Rating Scale scores were similar in the two groups. CONCLUSIONS: In patients requiring surgical treatment for menorrhagia vaginal hysterectomy appeared slightly more satisfying and offered a better health-related quality of life than did endometrial resection at 2-year follow-up. Hysterectomy did not adversely affect psychologic status and sexual functioning. (Am J Obstet Gynecol 1997;177:95-101)
ISSN:0002-9378
1097-6868
DOI:10.1016/S0002-9378(97)70445-9