Gynecology & Reproductive Medicine

Abstract

Post-operative Quality of Life Assessment after Total Abdominal Hysterectomy

Jayasundara Chandana, Gunasena Asanka, Gihan Champika, Bandara Sajith, Dissanayake Kushangi.

Rationale: Hysterectomy is one of the commonest major gynecological surgeries carried out in Sri Lanka for benign gynaecological conditions. As a definitive treatment method, it is important to assess whether total abdominal hysterectomy improves the domains of patient’s quality of life.

Objective: The main objective was to assess the improvement in quality of life after total abdominal hysterectomy (TAH).

Method: This was a descriptive cross sectional study, carried out in two centres; a teaching hospital and a peripheral hospital at central province, Sri Lanka. Data were collected from a total of 46 patients who underwent TAH. The health related quality of life (HRQoL) was assessed by using a pre-tested, interviewer guided questionnaire based on the Standard Form-36 (SF-36) prior to surgery and six months after the surgery.

Results: Majority of patients had TAH for non-malignant conditions (89%). Out of 46 patients, 38 (82.6%) reported an improvement in their general health while 8 (17.4%) did not experience any improvement. Those who had limitations in their routine activities reported a notable improvement; travelling by 90.7%, dressing by 93.7% and bathing by 96.2%. On a scale of 1 to 10, mean improvement in psychological status was 9.15 (±1.93). Improvement in women’s participation in social gatherings was 21.5%. Impact on work attendance was shown by a reduction in number of women taking leave being dropped to zero from 15.2%. There was no significant improvement in sexual frequency, dyspareunia and interaction with the sexual partner. The mean level of post-surgical satisfaction, which was assessed by a scale of 1 to 10, was 9.2 (±1.2).

Conclusion: In symptomatic women with poor response to conservative treatment, total abdominal hysterectomy may improve quality of life and reduce psychiatric symptoms.