Health-related quality of life after laparoscopically assisted vaginal hysterectomy: is uterine weight a major factor?

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This study found that preoperative symptom severity, not uterine weight, was associated with improved health-related quality of life after laparoscopically assisted vaginal hysterectomy.

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This prospective cohort study followed 61 consecutive women with uterine leiomyoma or adenomyosis undergoing laparoscopically assisted vaginal hysterectomy, assessing preoperative symptom severity and hemoglobin and measuring health-related quality of life (HRQOL) with UFS-QOL and WHOQOL-BREF at multiple time points through 18 months. Women with greater uterine weight reported no greater symptom severity, while those with more severe symptoms had lower preoperative hemoglobin and tended to be younger, with worse baseline perceived health and physical HRQOL. Mixed-effects modeling showed that higher baseline hemoglobin and greater symptom severity were associated with significant improvement in the physical domain HRQOL after LAVH. The authors limited interpretation by focusing on HRQOL changes after a single surgical approach and noting the cohort size and observational design. Relevance to endometriosis: the paper includes adenomyosis among enrolled uterine conditions and therefore relates to endometriosis-spectrum disease via adenomyosis, though its main question is uterine weight versus symptom severity for HRQOL after LAVH.

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Abstract

OBJECTIVE: To assess uterine size, symptom severity, and hemoglobin level as determinants of health-related quality of life (HRQOL) in women subsequently undergoing laparoscopically assisted vaginal hysterectomy (LAVH). METHODS: Sixty-one consecutive women with uterine leiomyoma or adenomyosis undergoing LAVH were studied using a prospective cohort design. The Chinese version of the Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaire was assessed preoperatively. The Taiwan brief version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire and a self-assessment of the perceived health status were assessed preoperatively and 1 day, 1 week, 12 weeks, and 18 months postoperatively. RESULTS: Women with a greater uterine weight did not report a greater severity of symptoms than those with lower uterine weight. Women with more severe symptoms had lower preoperative hemoglobin levels and were usually younger. Their perceived health status and their scores in physical domain of WHOQOL-BREF were also significantly lower, indicating a poorer HRQOL. The mixed-effects model found that a normal (higher) baseline hemoglobin level and a greater symptom severity were associated with a significant improvement of HRQOL in the physical domain of WHOQOL-BREF following LAVH. CONCLUSIONS: Preoperative symptom severity, but not uterine weight, was associated with long-term improvement in HRQOL after LAVH. Women with severe symptoms could be considered for LAVH before development of anemia.
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Abstract

Objective To assess uterine size, symptom severity, and hemoglobin level as determinants of health-related quality of life (HRQOL) in women subsequently undergoing laparoscopically assisted vaginal hysterectomy (LAVH).

Methods

Sixty-one consecutive women with uterine leiomyoma or adenomyosis undergoing LAVH were studied using a prospective cohort design. The Chinese version of the Uterine Fibroid Symptom and Quality of Life (UFS-QOL) questionnaire was assessed preoperatively. The Taiwan brief version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire and a self-assessment of the perceived health status were assessed preoperatively and 1 day, 1 week, 12 weeks, and 18 months postoperatively.

Results

Women with a greater uterine weight did not report a greater severity of symptoms than those with lower uterine weight. Women with more severe symptoms had lower preoperative hemoglobin levels and were usually younger. Their perceived health status and their scores in physical domain of WHOQOL-BREF were also significantly lower, indicating a poorer HRQOL. The mixed-effects model found that a normal (higher) baseline hemoglobin level and a greater symptom severity were associated with a significant improvement of HRQOL in the physical domain of WHOQOL-BREF following LAVH.

Conclusions

Preoperative symptom severity, but not uterine weight, was associated with long-term improvement in HRQOL after LAVH. Women with severe symptoms could be considered for LAVH before development of anemia. Similar content being viewed by others

References

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Acknowledgements

This work was supported by grant NHRI-EX94-9204PP from the National Health Research Institutes and grant NTUH095-000400 from National Taiwan University Hospital. Author information Authors and Affiliations Corresponding authors Rights and permissions About this article Cite this article Torng, PL., Chang, WC., Hwang, JS. et al. Health-related quality of life after laparoscopically assisted vaginal hysterectomy: Is uterine weight a major factor?. Qual Life Res 16, 227–237 (2007). https://doi.org/10.1007/s11136-006-9123-y Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s11136-006-9123-y

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Condition tags

adenomyosis

MeSH descriptors

Health Status Indicators Hysterectomy, Vaginal Quality of Life Uterus Uterus Adenomatoid Tumor Adenomatoid Tumor Adult Aged China Female Humans Hysterectomy, Vaginal Hysterectomy, Vaginal Laparoscopy Leiomyoma Leiomyoma Middle Aged Organ Size Postoperative Period

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