A randomized trial comparing changes in psychological well‐being and sexuality after laparoscopic and abdominal hysterectomy

Ellström, Marie; Åström, Maria; Möller, Anders; Olsson, Jan‐Edvin; Hahlin, Mats

doi:10.1034/j.1600-0412.2003.00216.x

Cited by 33 publications

(44 citation statements)

References 30 publications

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“…For PGWB and WHQ we used the median total score values of the study population. These scores are similar to the mean total score values of other populations in studies of benign hysterectomy or perimenopausal women 20,22,32,33 . We excluded women with severe psychiatric disorders in our study to avoid the bias of psychiatric disease on psychological recovery after hysterectomy.…”

Section: Discussionsupporting

confidence: 63%

Short‐term recovery after subtotal and total abdominal hysterectomy—a randomised clinical trial

Persson

Brynhildsen

Kjølhede

2010

BJOG

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Objective To determine whether the day-by-day postoperative recovery differs between women undergoing subtotal and total abdominal hysterectomy, and to analyse factors associated with postoperative recovery and sick leave.Design A prospective, open, randomised multicentre trial.Setting Seven hospitals and one private clinic in the south-east of Sweden.Population Two-hundred women scheduled for hysterectomy for benign conditions were enrolled in the study, and 178 women completed the study. Ninety-four women were randomised to subtotal abdominal hysterectomy; 84 women were randomised to total abdominal hysterectomy.Methods The day-by-day recovery of general wellbeing was measured on a visual analogue scale in a diary 7 days preoperatively and 35 days postoperatively. Psychometric measurements included depression, anxiety and general psychological wellbeing.Main outcome measures Effects of operating method and preoperative wellbeing on the day-by-day recovery and duration of sick leave.Results No significant difference was found in the day-by-day recovery between operating methods. The day-by-day recovery of general wellbeing and duration of sick leave was strongly associated with the occurrence of minor complications, but not with major complications. The level of psychological wellbeing preoperatively was strongly associated with the day-by-day recovery of general wellbeing and duration of sick leave.Conclusions Day-by-day recovery of general wellbeing is no faster in subtotal versus total abdominal hysterectomy. Independent of operation method there is an interaction between preoperative psychological wellbeing, postoperative recovery of general wellbeing and the duration of sick leave. Postoperative complications and preoperative psychological wellbeing are strong determinants for the duration of sick leave. There is a need for intervention studies with a focus on complications and preoperative wellbeing.Keywords Hysterectomy, randomised study, recovery, subtotal.Please cite this paper as: Persson P, Brynhildsen J, Kjølhede P on behalf of the Hysterectomy Multicentre Study Group in South-East Sweden. Short-term recovery after subtotal and total abdominal hysterectomy-a randomised clinical trial. BJOG 2010;117:469-478.

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Section: Discussionsupporting

confidence: 63%

Short‐term recovery after subtotal and total abdominal hysterectomy—a randomised clinical trial

Persson

Brynhildsen

Kjølhede

2010

BJOG

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“…While theoretical arguments and observational data suggested that laparoscopic surgery produced better psychosocial outcomes than abdominal or vaginal hysterectomy [8,11], Ellstrom et al. 's [41] randomized controlled study did not support such a difference.…”

Section: Discussionmentioning

confidence: 99%

The Psychosocial Outcomes of Total and Subtotal Hysterectomy: A Randomized Controlled Trial

Flory

Bissonnette

Amsel

et al. 2006

The Journal of Sexual Medicine

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Introduction Current controversies involve the adverse effects of hysterectomy on women's psychosocial functioning and whether subtotal as opposed to total hysterectomy mitigates these effects. Aim To investigate the psychosocial effects of hysterectomy by examining sexual, pain, and psychological outcomes of total vs. subtotal hysterectomy in a randomized controlled trial. Methods Patients suffering from benign gynecological conditions were randomly assigned to one of two groups: (i) total hysterectomy, that is, laparoscopic assisted vaginal hysterectomy (TOT, N = 32); or (ii) subtotal hysterectomy, that is, supracervical laparoscopic hysterectomy (SUB, N = 31). Both groups were premenopausal and underwent hysterectomy without concurrent oophorectomy. Two premenopausal control groups: (i) minor gynecological surgery (SURG-CON, N = 30); and (ii) healthy nonsurgical controls (NORM-CON, N = 40), were also tested. All surgical groups were assessed 2–3 weeks before surgery and then 6–7 months afterward; the nonsurgical control group was assessed at the time of recruitment and 6–7 months later. Outcome Measures Assessments included semistructured interviews, standardized questionnaires, and standardized gynecological examinations. Results For the TOT group, sexual drive, arousal, and sexual behavior significantly improved postoperatively. For the SUB group, sexual behavior and overall sexual functioning significantly improved. For both TOT and SUB groups, unprovoked pain in the abdomen and pain in the abdomen during gynecological examinations was significantly reduced. For both TOT and SUB groups, overall psychological functioning did not significantly change postoperatively. Although between 3% and 16% of women undergoing hysterectomy reported adverse changes in psychosocial well-being after surgery, similar percentages of women in the control groups reported such effects. Conclusions Hysterectomy resulted in a consistent reduction in abdominal pain, some improvement in sexual functioning, but no change in overall psychological functioning. There was no evidence supporting the idea that subtotal hysterectomy produced more favorable psychosocial outcomes than total hysterectomy nor was there any evidence that either type of hysterectomy resulted in adverse effects.

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“…Three of these studies demonstrated no difference in comparison with open surgery (Lumsden et al. 2000, Ellström et al. 2003, Persson et al.…”

Section: Introductionmentioning

confidence: 97%

Laparoscopic surgery for endometrial cancer: a phenomenological study

Hughes

Knibb

Allan

2010

Journal of Advanced Nursing

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A randomized trial comparing changes in psychological well‐being and sexuality after laparoscopic and abdominal hysterectomy

Abstract: This study implies that psychological well-being and sexuality after hysterectomy are not influenced by surgical technique.

Cited by 33 publications

References 30 publications

Short‐term recovery after subtotal and total abdominal hysterectomy—a randomised clinical trial

Short‐term recovery after subtotal and total abdominal hysterectomy—a randomised clinical trial

The Psychosocial Outcomes of Total and Subtotal Hysterectomy: A Randomized Controlled Trial

Laparoscopic surgery for endometrial cancer: a phenomenological study

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