Body Image and Sexual Function Improve after Both Myomectomy and Hysterectomy for Symptomatic Fibroids

Abstract

Objectives: To determine the factors that influence the choice of myomectomy, uterine fibroid embolization (UFE), or hysterectomy in women with symptomatic uterine fibroids and to assess women's perception of body image and sexual functioning before and after treatment. Methods:In this prospective observational cohort pilot study, women scheduled to undergo hysterectomy, myomectomy, or UFE were surveyed before surgery and again at 3 to 6 months after their procedure to assess body image and sexual function using the validated 10-item Body Image Scale and 19-item Female Sexual Function Index. Logistic regression was used to determine predictive factors for surgery choice and paired t tests were used to determine changes in perceived sexual function and body image.Results: Of the 71 women surveyed, 69 underwent their scheduled procedure and 68 participants completed the preoperative questionnaire completely (98%). A total of 33 participants completed the postoperative questionnaire (49%). The predictive factor for hysterectomy versus myomectomy/UFE was older age (odds ratio 1.13, P = 0.017, 95% confidence interval [CI] 1.02-1.24). Regardless of surgery type, there were significant improvements in perceived body image and sexual function, including an increase in the overall sexual satisfaction of the participant (mean difference 0.50, P = 0.021, 95% CI 0.92-0.08) and less likely to feel less sexually attractive because of their menstrual bleeding problem (P < 0.0001, 95% CI 0.637-1.675).Conclusions: Women of older age are more likely to choose hysterectomy over myomectomy or UFE for the treatment of symptomatic uterine fibroids. In addition, women who underwent any treatment for fibroids have increases in perception of body image and sexual functioning after their procedure.

Analysis of the Relationship between Socioeconomic Status and Incidence of Hysterectomy Using Data of the Korean Genome and Epidemiology Study (KoGES)

“…Furthermore, laparoscopic myomectomy is an alternative treatment for fibroids in women who want to preserve the uterus. In addition, the perception of hysterectomy has recently changed [ 31 ]. Nevertheless, women with lower incomes prefer hysterectomy because it is cheaper and safer without the risk of recurrence.…”

Clinical-Psychological Aspects Involved in Gynecological Surgery: Description of Peri-Operative Psychopathological Symptoms and Illness Behavior

“…Furthermore, the opinions among researchers are also conflicting (Birsen et al, 2018;Ferrandina et al, 2020;Frumovitz et al, 2020;Hartmann et al, 2004;Helström & Nilsson, 2005;Mann et al, 2020). Some studies have suggested that hysterectomy could reduce symptoms of depression and anxiety, increase general well-being (Aziz et al, 2005;Mattsson et al, 2020;Persson et al, 2010), and improve their interpersonal functioning in terms of a better perception of the body image and sexual functioning (Klock et al, 2021;Pauls, 2010). However, other researchers found evidence of a decrease in well-being and in the quality of life (Darwish et al, 2014;Khastgir et al, 2000;McPherson et al, 2005).…”