Predictors of hysterectomy use and satisfaction

Miriam Kuppermann, Lee A. Learman, Michael Schembri, Steven E. Gregorich, Rebecca Jackson, Alison Jacoby, James Lewis, A. Eugene Washington

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

Objective: To identify static and time-varying sociodemographic, clinical, health-related quality-of-life and attitudinal predictors of use and satisfaction with hysterectomy for noncancerous conditions. Methods: The Study of Pelvic Problems, Hysterectomy, and Intervention Alternatives (SOPHIA) was conducted from 1998 to 2008. English-, Spanish-, or Chinese-speaking premenopausal women (n=1,420) with intact uteri who had sought care for pelvic pressure, bleeding, or pain from an academic medical center, county hospital, closed-panel health maintenance organization, or one of several community-based practices in the San Francisco Bay area were interviewed annually for up to 8 years. Primary outcomes were use of and satisfaction with hysterectomy. Results: A total of 207 women (14.6%) underwent hysterectomy. In addition to well-established clinical predictors (entering menopause, symptomatic leiomyomas, prior treatment with gonadotropin-releasing hormone agonist, and less symptom resolution), greater symptom impact on sex (P=.001), higher 12-Item Short Form Health Survey mental component summary scores (P=.010), and higher scores on an attitude measure describing "benefits of not having a uterus" and lower "hysterectomy concerns" scores (P<.001 for each) were predictive of hysterectomy use. Most participants who underwent hysterectomy were very (63.9%) or somewhat (21.4%) satisfied in the year after the procedure, and we observed significant variations in posthysterectomy satisfaction across the clinical sites (omnibus P=.036). Other determinants of postsurgical satisfaction included higher pelvic problem impact (P=.035) and "benefits of not having a uterus" scores (P=.008) before surgery and greater posthysterectomy symptom resolution (P=.001). Conclusion: Numerous factors beyond clinical symptoms predict hysterectomy use and satisfaction. Providers should discuss health-related quality of life, sexual function, and attitudes with patients to help identify those who are most likely to benefit from this procedure.

Original languageEnglish (US)
Pages (from-to)543-551
Number of pages9
JournalObstetrics and gynecology
Volume115
Issue number3
DOIs
StatePublished - Mar 1 2010

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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    Kuppermann, M., Learman, L. A., Schembri, M., Gregorich, S. E., Jackson, R., Jacoby, A., Lewis, J., & Washington, A. E. (2010). Predictors of hysterectomy use and satisfaction. Obstetrics and gynecology, 115(3), 543-551. https://doi.org/10.1097/AOG.0b013e3181cf46a0