A retrospective review of patient-reported outcomes on the impact on quality of life in patients undergoing total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis

Tan BK, Bee K. Tan, Maillou K, Kate Maillou, R. S. Mathur, Raj Mathur, Rajneesh S Mathur, Prentice A, Andrew Prentice
European journal of obstetrics, gynecology, and reproductive biology · 2013 · vol. 170(2) , pp. 533–538 · doi:10.1016/j.ejogrb.2013.07.030 · PMID:23937796 · W1987221810
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This retrospective review analyzed patient-reported outcomes to assess the impact of total abdominal hysterectomy and bilateral salpingo-oophorectomy on quality of life in endometriosis patients.

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Abstract

ObjectiveThe Endometriosis Health Profile-30 (EHP-30), an endometriosis-specific health-related quality of life (HRQoL) questionnaire, forms part of our service evaluation of all women undergoing total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis in our reproductive medicine unit. We used the EHP-30 to investigate patient-reported outcomes in all patients undergoing this procedure.Study designRetrospective review of 16 women with endometriosis undergoing total abdominal hysterectomy and bilateral salpingo-oophorectomy for debilitating symptoms after other modalities of treatment had failed. Patients completed EHP-30 questionnaires before the operation and again three months after surgery.ResultsTotal abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis results in a significant improvement in HRQoL. The impact was greatest in the core domains--control and powerlessness, emotional wellbeing and social support. There was a 100% response rate for the core domains whereas in the modular domains, missing response rates ranged from 12.5% to 62.5%, with the percentage of missing data being greatest in the concern on infertility and relationship with children domains. Pain was significantly positively correlated with control and powerlessness, emotional wellbeing, work life and relationship with children. After multiple regression analyses, only control and powerlessness and emotional wellbeing were found to be predictive of pain. Additionally, changes in pain before and after total abdominal hysterectomy and bilateral salpingo-oophorectomy were significantly positively correlated with the changes in the core domains--control and powerlessness, emotional wellbeing and self image. After multiple regression analyses, change in pain was found to be predictive of ΔControl and powerlessness in our study subjects.ConclusionTotal abdominal hysterectomy and bilateral salpingo-oophorectomy significantly improves HRQoL in patients debilitated by symptoms attributable to endometriosis and in whom other modalities of treatment have failed.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Hysterectomy Hysterectomy Ovariectomy Ovariectomy Quality of Life Adult Endometriosis Endometriosis Female Humans Middle Aged Regression Analysis Retrospective Studies Salpingectomy Salpingectomy Treatment Outcome

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