This study measured the association between gynecologic conditions and quality of life in women before hysterectomy. The researchers retrospectively identified 482 women who had hysterectomies for nononcologic and nonemergency indications in one of nine capitated medical groups in Southern California between 1993 and 1995. Their symptoms and quality of life before hysterectomy were assessed by medical record review and telephone interview. Women were placed into four symptom-based groups (pain, bleeding, pelvic discomfort, and asymptomatic groups) and compared across six quality-of-life scales. Women with primary pain conditions reported the highest average role impairment compared with women with primary bleeding pelvic discomfort, or asymptomatic conditions. On the five 0 to 100 -point quality-of-life scales, women with primary pain conditions, compared with women with bleeding pelvic discomfort, or asymptomatic conditions, had the highest mean levels of sexual and mood impairment, the poorest perception of general, and the greatest increase in severity of symptoms before hysterectomy. The study concludes that women's primary symptoms before hysterectomy are associated differentially with varying levels of impairment. Standardized measurement of quality of life among women with gynecologic complaints that lead to hysterectomy might help to develop treatment guidelines and assess appropriateness and outcomes of care for those women.
Originally published in: Obstetrics and Gynecology, v. 93, no. 6, 1999, pp. 915-920.
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