Effect of Hysterectomy vs Medical Treatment on Health-Related Quality of Life and Sexual Functioning

The Medicine or Surgery (Ms) Randomized Trial

Miriam Kuppermann, R. Edward Varner, Robert L. Summitt, Lee A. Learman, Christine Ireland, Eric Vittinghoff, Anita L. Stewart, Feng Lin, Holly E. Richter, Jonathan Showstack, Stephen B. Hulley, A. Eugene Washington

Research output: Contribution to journalArticle

110 Citations (Scopus)

Abstract

Context: Although a quarter of US women undergo elective hysterectomy before menopause, controlled trials that evaluate the benefits and harms are lacking. Objective: To compare the effect of hysterectomy vs expanded medical treatment on health-related quality of life. Design, Setting, and Participants: A multicenter, randomized controlled trial (August 1997-December 2000) of 63 premenopausal women, aged 30 to 50 years, with abnormal uterine bleeding for a median of 4 years who were dissatisfied with medical treatments, including medroxyprogesterone acetate. The participants, who were patients at gynecology clinics and affiliated practices of 4 US academic medical centers, were followed up for 2 years. Interventions: Participants were randomly assigned to undergo hysterectomy or expanded medical treatment with estrogen and/or progesterone and/or a prostaglandin synthetase inhibitor. The hysterectomy route and medical regimen were determined by the participating gynecologist. Main Outcome Measures: The primary outcome was mental health measured by the Mental Component Summary (MCS) of the 36-item Short-Form Health Survey (SF-36). Secondary outcomes included physical health measured by the Physical Component Summary (PCS), symptom resolution and satisfaction, body image, and sexual functioning, as well as other aspects of mental health and general health perceptions. Results: At 6 months, women in the hysterectomy group had greater improvement in MCS scores than women in the medicine group (8 vs 2, P=.04). They also had greater improvement in symptom resolution (75 vs 29, P

Original languageEnglish (US)
Pages (from-to)1447-1455
Number of pages9
JournalJournal of the American Medical Association
Volume291
Issue number12
DOIs
StatePublished - Mar 24 2004
Externally publishedYes

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Hysterectomy
Quality of Life
Medicine
Mental Health
Therapeutics
Prostaglandin Antagonists
Medroxyprogesterone Acetate
Uterine Hemorrhage
Body Image
Health
Prostaglandin-Endoperoxide Synthases
Menopause
Health Surveys
Gynecology
Progesterone
Estrogens
Randomized Controlled Trials
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effect of Hysterectomy vs Medical Treatment on Health-Related Quality of Life and Sexual Functioning : The Medicine or Surgery (Ms) Randomized Trial. / Kuppermann, Miriam; Varner, R. Edward; Summitt, Robert L.; Learman, Lee A.; Ireland, Christine; Vittinghoff, Eric; Stewart, Anita L.; Lin, Feng; Richter, Holly E.; Showstack, Jonathan; Hulley, Stephen B.; Washington, A. Eugene.

In: Journal of the American Medical Association, Vol. 291, No. 12, 24.03.2004, p. 1447-1455.

Research output: Contribution to journalArticle

Kuppermann, M, Varner, RE, Summitt, RL, Learman, LA, Ireland, C, Vittinghoff, E, Stewart, AL, Lin, F, Richter, HE, Showstack, J, Hulley, SB & Washington, AE 2004, 'Effect of Hysterectomy vs Medical Treatment on Health-Related Quality of Life and Sexual Functioning: The Medicine or Surgery (Ms) Randomized Trial', Journal of the American Medical Association, vol. 291, no. 12, pp. 1447-1455. https://doi.org/10.1001/jama.291.12.1447
Kuppermann, Miriam ; Varner, R. Edward ; Summitt, Robert L. ; Learman, Lee A. ; Ireland, Christine ; Vittinghoff, Eric ; Stewart, Anita L. ; Lin, Feng ; Richter, Holly E. ; Showstack, Jonathan ; Hulley, Stephen B. ; Washington, A. Eugene. / Effect of Hysterectomy vs Medical Treatment on Health-Related Quality of Life and Sexual Functioning : The Medicine or Surgery (Ms) Randomized Trial. In: Journal of the American Medical Association. 2004 ; Vol. 291, No. 12. pp. 1447-1455.
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