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22-12-2022

A comparison of patient-reported outcomes among Canadian women having hysterectomies

Auteurs: Maria Saleeb, Fariba Mohtashami, Anne Gadermann, Rachel Murphy, Alana Flexman, Trafford Crump, Guiping Liu, Jason M. Sutherland

Gepubliceerd in: Quality of Life Research | Uitgave 3/2023

Abstract

Purpose

Many indications for hysterectomy can negatively affect patients’ quality of life. This study uses patient-reported outcomes to measure changes in self-reported health among hysterectomy patients.

Method

A prospective cohort of 294 hysterectomy patients completed patient-reported outcomes preoperatively and six months postoperatively in Vancouver, Canada. Patient-reported outcomes measured pelvic health, sexual function, pain, and depression. Changes in health were compared with paired t-tests, and multi-variable regression analysis measured associations between patient and clinical factors with postoperative outcomes

Results

Many patients reported improvements in health. Unadjusted analysis found that 65% of participants reported less pelvic distress, 55% reported less pain, and 47% reported less depression symptoms postoperatively. Multivariable regression analysis found that poorer preoperative health was associated with poorer postoperative outcomes in all domains of health measured (p-value < 0.01). Postoperative pain scores were lower (less pain) by 0.78 among residents of the most affluent neighborhoods (p-value = 0.02) compared to those in less affluent neighborhoods. Postoperative depression scores were 1.58 points worse among participants with endometriosis (p-value = 0.03) and 1.02 points worse among participants having abdominal surgery (p-value = 0.02).

Conclusion

Many participants reported improvements in pelvic symptoms, pain, and depression after hysterectomy. Lower socioeconomic status patients may be at risk for reporting higher pain after surgery, and endometriosis patients may report higher depression. Further investigation is needed to determine effective interventions for the higher postoperative pain observed in this study for residents of less affluent neighborhoods.

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Hammer, A., Rositch, A. F., Kahlert, J., Gravitt, P. E., Blaakaer, J., & Søgaard, M. (2015). Global epidemiology of hysterectomy: Possible impact on gynecological cancer rates. American Journal of Obstetrics and Gynecology, 213(1), 23–29. https://doi.org/10.1016/J.AJOG.2015.02.019CrossRefPubMed

Committee Opinion No. (2017). 701 Summary: Choosing the route of hysterectomy for benign disease. Obstetrics and Gynecology, 129(6), 1149–1150. https://doi.org/10.1097/AOG.0000000000002108CrossRef

Mbongo, J. A., Mouanga, A., Miabaou, D. M., Nzelie, A., & Iloki, L. H. (2016). Evaluation of quality of life and subjective experience of the disease before and after vaginal hysterectomy among women admitted to the university hospital in Brazzaville. The Pan African Medical Journal. https://doi.org/10.11604/pamj.2016.25.79.10085CrossRefPubMedPubMedCentral

Rahkola-Soisalo, P., Brummer, T., Jalkanen, J., et al. (2020). Hysterectomy provides benefit in health-related quality of life: A 10-year follow-up study. Journal of Minimally Invasive Gynecology, 27(4), 868–874. https://doi.org/10.1016/J.JMIG.2019.08.009CrossRefPubMed

Humalajärvi, N., Aukee, P., Kairaluoma, M. V., et al. (2014). Quality of life and pelvic floor dysfunction symptoms after hysterectomy with or without pelvic organ prolapse. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 182, 16–21. https://doi.org/10.1016/J.EJOGRB.2014.08.032CrossRefPubMed

Hartmann, K. E., Ma, C., Lamvu, G. M., Langenberg, P. W., Steege, J. F., & Kjerulff, K. H. (2004). Quality of life and sexual function after hysterectomy in women with preoperative pain and depression. Obstetrics and Gynecology, 104(4), 701–709. https://doi.org/10.1097/01.AOG.0000140684.37428.48CrossRefPubMed

Vandyk, A. D., Brenner, I., Tranmer, J., & Van Den Kerkhof, E. (2011). Depressive symptoms before and after elective hysterectomy. Journal of Obstetric, Gynecologic & Neonatal Nursing, 40(5), 566–576. https://doi.org/10.1111/j.1552-6909.2011.01278.xCrossRef

Darwish, M., Atlantis, E., & Mohamed-Taysir, T. (2014). Psychological outcomes after hysterectomy for benign conditions: A systematic review and meta-analysis. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 174(1), 5–19. https://doi.org/10.1016/j.ejogrb.2013.12.017CrossRefPubMed

Miller, B. E., Pittman, B., Case, D., & McQuellon, R. P. (2002). Quality of life after treatment for gynecologic malignancies: A pilot study in an outpatient clinic. Gynecologic Oncology, 87(2), 178–184. https://doi.org/10.1006/GYNO.2002.6812CrossRefPubMed

10.

Tabassum, F., Jyoti, C., Sinha, H. H., Dhar, K., & Akhtar, M. S. (2021). Impact of polycystic ovary syndrome on quality of life of women in correlation to age, basal metabolic index, education and marriage. PLoS ONE, 16(3), e0247486. https://doi.org/10.1371/JOURNAL.PONE.0247486CrossRefPubMedPubMedCentral

11.

Traylor, J., Koelper, N., Kim, S. W., Sammel, M. D., & Andy, U. U. (2020). Impact of surgical wait time to hysterectomy for benign gynecologic disease. Journal of Minimally Invasive Gynecology. https://doi.org/10.1016/j.jmig.2020.08.486CrossRefPubMedPubMedCentral

12.

Johnston, B. C., Ebrahim, S., Carrasco-Labra, A., et al. (2015). Minimally important difference estimates and methods: A protocol. British Medical Journal Open, 5(10), 7953. https://doi.org/10.1136/bmjopen-2015-007953CrossRef

13.

Guidance for Industry Patient-Reported Outcome Measures: Use in Medical Product Development to Support Labeling Claims. U.S Department of Health and Human Services Food and Drug Adminstration December 2009 https://www.fda.gov/media/77832/download

14.

Wyrwich, K. W., Tierney, W. M., & Wolinsky, F. D. (1999). Further evidence supporting an SEM-based criterion for identifying meaningful intra-individual changes in health-related quality of life. Journal of Clinical Epidemiology, 52(9), 861–873. https://doi.org/10.1016/S0895-4356(99)00071-2CrossRefPubMed

15.

Donoghue, A. P., Jackson, H. J., & Pagano, R. (2003). Understanding pre- and post-hysterectomy levels of negative affect: A stress moderation model approach. Journal of Psychosomatic Obstetrics and Gynecology, 24(2), 99–109. https://doi.org/10.3109/01674820309042807CrossRefPubMed

16.

Kjerulff, K., Patricia, L., Rhodes, J., Harvey, L., Guzinski, G., & Stolley, P. (2000). Effectiveness of hysterectomy. Obstetrics & Gynecology, 95(3), 319–326.

17.

Theunissen, M., Peters, M. L., Schepers, J., Schoot, D. C., Gramke, H. F., & Marcus, M. A. (2017). Prevalence and predictors of depression and well-being after hysterectomy: An observational study. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 217, 94–100. https://doi.org/10.1016/j.ejogrb.2017.08.017CrossRefPubMed

18.

Grundström, H., Alehagen, S., Berterö, C., Kjölhede, P., Hanna Grundström, B., & Kjølhede, P. (2004). Impact of pelvic pain and endometriosis on patient-reported outcomes and experiences of benign hysterectomy: A study from the swedish national register for gynecological surgery. Journal of Women’s Health. https://doi.org/10.1089/jwh.2017.6546CrossRef

19.

Kocaay, A. F., Oztuna, D., Su, F. A., Elhan, A. H., & Kuzu, M. A. (2017). Effects of hysterectomy on pelvic floor disorders: A longitudinal study. Diseases of the Colon and Rectum, 60(3), 303–310. https://doi.org/10.1097/DCR.0000000000000786CrossRefPubMed

20.

Forsgren, C., Lundholm, C., Johansson, A. L. V., Cnattingius, S., Zetterström, J., & Altman, D. (2012). Vaginal hysterectomy and risk of pelvic organ prolapse and stress urinary incontinence surgery. International Urogynecology Journal, 23(1), 43–48. https://doi.org/10.1007/s00192-011-1523-zCrossRefPubMed

21.

Danesh, M., Hamzehgardeshi, Z., Moosazadeh, M., & Shabani-Asrami, F. (2015). The effect of hysterectomy on women’s sexual function: A narrative review. Medical Archives, 69(6), 387–392. https://doi.org/10.5455/medarh.2015.69.387-392CrossRefPubMedPubMedCentral

22.

Geller, E. J., Bretschneider, C. E., Wu, J. M., Kenton, K., & Matthews, C. A. (2021). Sexual function after minimally invasive total hysterectomy and sacrocolpopexy. Journal of Minimally Invasive Gynecology, 28(9), 1603–1609. https://doi.org/10.1016/j.jmig.2021.01.021CrossRefPubMed

23.

Barber, M. D., Walters, M. D., & Bump, R. C. (2005). Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). American Journal of Obstetrics and Gynecology, 193(1), 103–113. https://doi.org/10.1016/j.ajog.2004.12.025CrossRefPubMed

24.

Yali, M., Rong, Z., & Jianliu, W. (2012). Investigation of long-term pelvic floor function and sexual life after total hysterectomy]. Chinese Journal of Obstetrics & Gynaecology, 07, 496–499.

25.

Mamik, M. M., Rogers, R. G., Qualls, C. R., & Morrow, J. D. (2014). The minimum important difference for the pelvic organ prolapse-urinary incontinence sexual function questionnaire. International Urogynecology Journal, 25(10), 1321–1326. https://doi.org/10.1007/s00192-014-2342-9CrossRefPubMed

26.

Volonte, S., Barba, M., Cola, A., Marino, G., & Frigerio, M. (2022). Italian validation of the short form of the pelvic organ prolapse/urinary incontinence sexual questionnaire (PISQ-12). International Urogynecology Journal, 33(11), 3171–3175. https://doi.org/10.1007/S00192-022-05235-0/TABLES/3CrossRefPubMedPubMedCentral

27.

Kamińska, A., Skorupska, K., Kubik-Komar, A., Futyma, K., Filipczak, J., & Rechberger, T. (2021). Reliability of the polish pelvic organ prolapse/urinary incontinence sexual questionnaire (PISQ-12) and assessment of sexual function before and after pelvic organ prolapse reconstructive surgery—a prospective study. Journal of Clinical Medicine, 10(18), 4167. https://doi.org/10.3390/JCM10184167CrossRefPubMedPubMedCentral

28.

Krebs, E. E., Bair, M. J., Damush, T. M., Tu, W., Wu, J., & Kroenke, K. (2010). Comparative responsiveness of pain outcome measures among primary care patients with musculoskeletal pain. Medical Care, 48(11), 1007. https://doi.org/10.1097/MLR.0B013E3181EAF835CrossRefPubMedPubMedCentral

29.

Krebs, E. E., Lorenz, K. A., Bair, M. J., et al. (2009). Development and Initial validation of the peg, a three-item scale assessing pain intensity and interference. Journal of General Internal Medicine, 24(6), 733–738. https://doi.org/10.1007/s11606-009-0981-1CrossRefPubMedPubMedCentral

30.

Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.xCrossRefPubMedPubMedCentral

31.

Ribeiro, A. I., Fraga, S., Severo, M., et al. (2022). Association of neighbourhood disadvantage and individual socioeconomic position with all-cause mortality: A longitudinal multicohort analysis. Lancet Public Heal., 7(5), e447–e457. https://doi.org/10.1016/S2468-2667(22)00036-6CrossRef

32.

Rautava, S., Turta, O., Vahtera, J., et al. (2022). Neighborhood socioeconomic disadvantage and childhood body mass index trajectories from birth to 7 years of age. Epidemiology, 33(1), 121–130. https://doi.org/10.1097/EDE.0000000000001420CrossRefPubMed

33.

Meijer, M., Röhl, J., Bloomfield, K., & Grittner, U. (2012). Do neighborhoods affect individual mortality? A systematic review and meta-analysis of multilevel studies. Social Science and Medicine, 74(8), 1204–1212. https://doi.org/10.1016/J.SOCSCIMED.2011.11.034CrossRefPubMed

34.

Dalton, J. E., Pfoh, E. R., Dawson, N. V., et al. (2022). Evaluating and modeling neighborhood diversity and health using electronic health records. Medical Decision Making, 42(8), 1027–1040. https://doi.org/10.1177/0272989X221123569CrossRefPubMedPubMedCentral

35.

Statistics Canada. The Canadian Index of Multiple Deprivation - User Guide. Statistics Canada Catalogue no. 45–20–0001. 2019 https://publications.gc.ca/collections/collection_2019/statcan/452000012019002-eng.pdf

36.

Austin, S. R., Wong, Y. N., Uzzo, R. G., Beck, J. R., & Egleston, B. L. (2015). Why summary comorbidity measures such as the charlson comorbidity index and elixhauser score work. Medical Care, 53(9), e65. https://doi.org/10.1097/MLR.0B013E318297429CCrossRefPubMedPubMedCentral

37.

Barua B, Moir M. Waiting Your Turn: Wait Times for Health Care in Canada 2019 Report 2019 https://www.fraserinstitute.org/sites/default/files/waiting-your-turn-2019-rev17dec.pdf

38.

Little, R. J. A. (1988). A test of missing completely at random for multivariate data with missing values. Journal of American Statistical Association, 83(404), 1198–1202. https://doi.org/10.1080/01621459.1988.10478722CrossRef

39.

R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. Published 2021 https://www.r-project.org/ Accessed 16 March, 2022

40.

Merali, K., Karimuddin, A., Crump, T., et al. (2022). The relationship between perceptions of shared decision-making and patient-reported outcomes in a cross-sectional cohort of haemorrhoidectomy patients. Colorectal Disease. https://doi.org/10.1111/CODI.16039CrossRefPubMed

41.

Chen, V., Shackelford, L., & Spain, M. (2021). Pelvic floor dysfunction after hysterectomy: moving the investigation forward. Cureus. https://doi.org/10.7759/CUREUS.15661CrossRefPubMedPubMedCentral

42.

Bird, Y., Lemstra, M., Rogers, M., & Moraros, J. (2015). The relationship between socioeconomic status/income and prevalence of diabetes and associated conditions: A cross-sectional population-based study in Saskatchewan. International Journal for Equity in Health, 14(1), 1–8. https://doi.org/10.1186/S12939-015-0237-0/TABLES/6CrossRef

43.

Pampel, F. C., Denney, J. T., & Krueger, P. M. (2012). Obesity, SES, and economic development: A test of the reversal hypothesis. Social Science and Medicine, 74(7), 1073–1081. https://doi.org/10.1016/J.SOCSCIMED.2011.12.028CrossRefPubMed

44.

Leeds, I. L., Alimi, Y., Hobson, D. R., et al. (2017). Racial and socioeconomic differences manifest in process measure adherence for enhanced recovery after surgery pathway. Diseases of the Colon and Rectum, 60(10), 1092–1101. https://doi.org/10.1097/DCR.0000000000000879CrossRefPubMedPubMedCentral

45.

Daugbjerg, S. B., Cesaroni, G., Ottesen, B., Diderichsen, F., & Osler, M. (2014). Effect of socioeconomic position on patient outcome after hysterectomy. Acta Obstetricia et Gynecologica Scandinavica, 93(9), 926–934. https://doi.org/10.1111/aogs.12444CrossRefPubMed

46.

Moradi, M., Parker, M., Sneddon, A., Lopez, V., & Ellwood, D. (2014). Impact of endometriosis on women’s lives: A qualitative study. BMC Women’s Health, 14(1), 123. https://doi.org/10.1186/1472-6874-14-123CrossRefPubMedPubMedCentral

47.

Soliman, A. M., Fuldeore, M., & Snabes, M. C. (2017). Factors associated with time to endometriosis diagnosis in the United States. Journal of women’s health, 26(7), 788–797. https://doi.org/10.1089/JWH.2016.6003/SUPPL_FILE/SUPP_TABLE1.PDFCrossRefPubMed

48.

Rizk, B., Fischer, A. S., Lotfy, H. A., et al. (2014). Recurrence of endometriosis after hysterectomy. Facts, views & vision in ObGyn, 6(4), 219.

49.

Clayton, R. D. (2006). Hysterectomy. Best Practice & Research. Clinical Obstetrics & Gynaecology, 20(1), 73–87. https://doi.org/10.1016/j.bpobgyn.2005.09.007CrossRef

50.

Brito, L. G. O., Panobianco, M. S., Sabino-De-Freitas, M. M., et al. (2014). Uterine leiomyoma: Understanding the impact of symptoms on womens’ lives. Reproductive Health, 11(1), 1–5. https://doi.org/10.1186/1742-4755-11-10/TABLES/1CrossRef

51.

Ghetti, C., Skoczylas, L. C., Oliphant, S. S., Nikolajski, C., & Lowder, J. L. (2015). The emotional burden of pelvic organ prolapse in women seeking treatment: A qualitative study. Female Pelvic Medicine & Reconstructive Surgery, 21(6), 332. https://doi.org/10.1097/SPV.0000000000000190CrossRef

52.

Mettler, L., Schollmeyer, T., Tinelli, A., Malvasi, A., & Alkatout, I. (2012). Complications of uterine fibroids and their management, surgical management of fibroids, laparoscopy and hysteroscopy versus hysterectomy, haemorrhage, adhesions, and complications. Obstetrics and Gynecology International, 2012, 1–8. https://doi.org/10.1155/2012/791248CrossRef

Titel: A comparison of patient-reported outcomes among Canadian women having hysterectomies
Auteurs: Maria Saleeb
Fariba Mohtashami
Anne Gadermann
Rachel Murphy
Alana Flexman
Trafford Crump
Guiping Liu
Jason M. Sutherland
Publicatiedatum: 22-12-2022
Uitgeverij: Springer International Publishing
Gepubliceerd in: Quality of Life Research / Uitgave 3/2023
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-022-03326-5

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