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

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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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Data availability

Anonymized data can be obtained from the corresponding author.

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Acknowledgements

This research will constitute one component of the thesis prepared by Ms. M. Saleeb in partial fulfillment of the requirements of the Master of Science degree at the University of British Columbia.

Funding

This study was funded through in-kind support of Vancouver Coastal Health (VCH) Authority and Providence Health Care (PHC; Vancouver). Dr. Rachel Murphy was supported through the Michael Smith Foundation for Health Research (Grant Number: 17644).

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Authors and Affiliations

  1. Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, 201-2206 East Mall, Vancouver, V6T 1Z3, Canada

    Maria Saleeb, Guiping Liu & Jason M. Sutherland

  2. Obstetrics & Gynecology, Faculty of Medicine, University of British Columbia, Vancouver, Canada

    Fariba Mohtashami

  3. Centre for Health Evaluation and Outcome Sciences, School of Population and Public, Health University of British Columbia, Vancouver, Canada

    Anne Gadermann

  4. Cancer Control Research, British Columbia Cancer, School of Population and Public Health, University of British Columbia, Vancouver, Canada

    Rachel Murphy

  5. Department of Anesthesiology, Faculty of Medicine and St. Paul’s Hospital/Providence Health Care, University of British Columbia, Vancouver, BC, Canada

    Alana Flexman

  6. Department of Surgery, University of Calgary, Calgary, Canada

    Trafford Crump

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  1. Maria Saleeb
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  2. Fariba Mohtashami
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  8. Jason M. Sutherland
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Contributions

All authors contributed to study conception and design. Manuscript writing and data analysis were conducted by MS and JS. AG, RM, AFl, TC, and FM all edited and approved the final manuscript. Data collection, and material preparation were done by GL

Corresponding author

Correspondence to Jason M. Sutherland.

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Conflict of interest

R Murphy has received consulting fees from Pharmavite LLC. Pharmavite had no role in developing the methods, data analyses, interpreting the results or manuscript preparation. All other authors report no conflict of interest.

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Ethics approval for this study was granted by the University of British Columbia’s Behavioural Research Ethics Board (H12-02062-A013).

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Informed consent was obtained from all individual participants included in the study.

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Saleeb, M., Mohtashami, F., Gadermann, A. et al. A comparison of patient-reported outcomes among Canadian women having hysterectomies. Qual Life Res 32, 759–768 (2023). https://doi.org/10.1007/s11136-022-03326-5

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