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 Citations (Scopus)

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
Pages (from-to)543-551
Number of pages9
JournalObstetrics and Gynecology
Volume115
Issue number3
DOIs
StatePublished - Mar 2010

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Hysterectomy
Uterus
Quality of Life
County Hospitals
San Francisco
Health Maintenance Organizations
Leiomyoma
Menopause
Health Surveys
Gonadotropin-Releasing Hormone
Hemorrhage
Pressure
Pain

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

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

Predictors of hysterectomy use and satisfaction. / Kuppermann, Miriam; Learman, Lee A.; Schembri, Michael; Gregorich, Steven E.; Jackson, Rebecca; Jacoby, Alison; Lewis, James; Washington, A. Eugene.

In: Obstetrics and Gynecology, Vol. 115, No. 3, 03.2010, p. 543-551.

Research output: Contribution to journalArticle

Kuppermann, M, Learman, LA, Schembri, M, Gregorich, SE, Jackson, R, Jacoby, A, Lewis, J & Washington, AE 2010, 'Predictors of hysterectomy use and satisfaction', Obstetrics and Gynecology, vol. 115, no. 3, pp. 543-551. https://doi.org/10.1097/AOG.0b013e3181cf46a0
Kuppermann M, Learman LA, Schembri M, Gregorich SE, Jackson R, Jacoby A et al. Predictors of hysterectomy use and satisfaction. Obstetrics and Gynecology. 2010 Mar;115(3):543-551. https://doi.org/10.1097/AOG.0b013e3181cf46a0
Kuppermann, Miriam ; Learman, Lee A. ; Schembri, Michael ; Gregorich, Steven E. ; Jackson, Rebecca ; Jacoby, Alison ; Lewis, James ; Washington, A. Eugene. / Predictors of hysterectomy use and satisfaction. In: Obstetrics and Gynecology. 2010 ; Vol. 115, No. 3. pp. 543-551.
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