INTRODUCTION:Uterine fibroids are highly prevalent and associated with significant effect on quality of life (QOL). The current study compares QOL scores in patients that underwent myomectomy or hysterectomy for management of fibroids.METHODS:After obtaining approval from the Cleveland Clinic IRB, we conducted a retrospective cohort study for patients that underwent hysterectomy or myomectomy for uterine fibroids. Eligible patients were sent validated surveys: 36-Item Short Form Health Survey (SF-36) and Uterine Fibroid Symptom and QOL questionnaire (UFS-QOL). Standard bivariate analyses were used to compare differences in QOL scores between groups, adjusting for age and race.RESULTS:Of the 142 survey respondents, 37 underwent myomectomy and 105 underwent hysterectomy. The median number of days between surgery and survey completion was 1,652 (1,142, 2,328) for myomectomy and 1,022 (740, 1,317) for hysterectomy. For SF-36, hysterectomy patients reported significantly less energy (P=.006) compared to myomectomy. Significant differences were not observed in postoperative physical functioning, role limitations, pain, health perceptions, vitality, social functioning, or mental health. Although there was no statistically significant difference in UFS-QOL scores, patients who underwent hysterectomy experienced significantly lower symptom severity (P=.009) and levels of concern (P<.001), and increased activity tolerance (P=.005) and sense of control (P=.029).CONCLUSION:While patients who underwent hysterectomy reported more fatigue, they experienced lower symptom severity, lower levels of concern, higher activity tolerance, and increased sense of control compared to myomectomy. These findings may help guide counseling for surgical fibroid treatment.
Importance There is currently a paucity of data describing the outcomes of women with pelvic organ prolapse (POP) and/or urinary incontinence (UI) who present with pessary-related complications. Objective This study aimed to describe outcomes in women with POP and UI managed with a pessary who present with pessary-related complications. Study Design This was a retrospective cohort study of women with POP and/or UI who elected for management with a pessary from January 1, 2016, to December 31, 2020. Patients were included if they had used a pessary for at least 1 year and had a documented pessary-related complication. Complications were defined a priori, and patient charts were abstracted using International Classification of Diseases, Ninth and Tenth Revisions codes associated with pessary use. Results Of 2,088 of women receiving pessary care, 444 (21%) experienced a complication. Of 154 of women, 34.6% experienced 2 pessary-related complications during the study period, whereas 12.6% (56) experienced 3, 4.5% (20) experienced 4, and 1.8% (8) experienced 5. One hundred fifty-two patients (34.2%) underwent surgery during the study period to manage their POP and/or UI. Patients who were older were less likely to have surgery (adjusted odds ratio, 0.70 [95% confidence interval, 0.20–0.90]; P = 0.002), and patients who had an indication of pessary use for both POP and UI were more likely to undergo surgery during the study period (adjusted odds ratio, 2.12 [95% confidence interval, 1.29–3.48]; P = 0.003). Conclusions Our results suggest that 1 in 5 patients has a documented complication associated with pessary use of greater than 1 year. Of these patients, one third will eventually undergo surgery for management of their POP and/or UI.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.