Health-Related Quality of Life After Hysterectomy

Hysterectomy is the second most common major surgical procedure performed in the United States each year.1 The primary indications for hysterectomy are leiomyomas, unexplained uterine bleeding, uterine prolapse, chronic pelvic pain, and endometriosis. Cancerous conditions account for only 10% of all hysterectomies performed. The appropriateness of hysterectomy to treat nonmalignant conditions has been debated increasingly in recent years. This is, in part, because of rising health care costs and reports of negative outcomes after hysterectomy, such as pelvic pain, reduced sexual functioning, urinary symptoms, and psychological distress. The effects of hysterectomy on patients' health-related quality of life are important factors in the management of uterine-related conditions. Knowing what aspects may and may not be alleviated by hysterectomy for particular patient groups can assist in clinical decision making about treatment options. Assessments of the effects of hysterectomy on quality of life, however, have not always been conducted systematically with validated instruments. The purpose of this article is to provide a brief overview of the assessment of health-related quality of life and to review the published research on the effects of hysterectomy on the daily lives of hysterectomized patients.