1. Comparative effectiveness of hysterectomy versus myomectomy on one-year health-related quality of life in women with uterine fibroids.
- Author
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Wallace K, Zhang S, Thomas L, Stewart EA, Nicholson WK, Wegienka GR, Wise LA, Laughlin-Tommaso SK, Diamond MP, Marsh EE, Jacoby VL, Anchan RM, Venable S, Larry GM, Lytle B, Wang T, and Myers ER
- Subjects
- Adult, Cohort Studies, Comparative Effectiveness Research, Female, Follow-Up Studies, Humans, Leiomyoma epidemiology, Leiomyoma psychology, Middle Aged, Pregnancy, Prospective Studies, Surveys and Questionnaires, Treatment Outcome, Uterine Artery Embolization adverse effects, Uterine Artery Embolization rehabilitation, Uterine Artery Embolization statistics & numerical data, Uterine Neoplasms epidemiology, Uterine Neoplasms psychology, Hysterectomy adverse effects, Hysterectomy rehabilitation, Hysterectomy statistics & numerical data, Leiomyoma surgery, Quality of Life, Uterine Myomectomy adverse effects, Uterine Myomectomy rehabilitation, Uterine Myomectomy statistics & numerical data, Uterine Neoplasms surgery
- Abstract
Objective: To compare long-term health-related quality of life (HRQOL) 1 year after hysterectomy or myomectomy for treatment of uterine fibroids (UFs) and to determine whether route of procedure, race, or age affected improvements in HRQOL., Design: Prospective cohort study., Setting: Eight clinical sites throughout the United States., Patient(s): A total of 1,113 premenopausal women with UFs who underwent hysterectomy or myomectomy as part of Comparing Options for Management: Patient-Centered Results for Uterine Fibroids., Intervention(s): None., Main Outcome Measure (s): Self-reported HRQOL measures including Uterine Fibroid Symptom Quality of Life, the European QOL 5 Dimension Health Questionnaire, and the visual analog scale at baseline and 1-year after hysterectomy or myomectomy., Result (s): Hysterectomy patients were older with a longer history of symptomatic UF compared with myomectomy patients. There were no differences in baseline HRQOL. After adjustment for baseline differences between groups, compared with myomectomy, patients' HRQOL (95% confidence interval [CI], 5.4, 17.2) and symptom severity (95% CI, -16.3, -8.8) were significantly improved with hysterectomy. When stratified across race/ethnicity and age, hysterectomy had higher HRQOL scores compared with myomectomy. There was little difference in HRQOL (95% CI, 0.1 [-9.5, 9.6]) or symptom severity (95% CI, -3.4 [-10, 3.2]) between abdominal hysterectomy and abdominal myomectomy., Conclusion (s): HRQOL improved in all women 1 year after hysterectomy or myomectomy. Hysterectomy patients reported higher HRQOL summary scores compared with myomectomy patients. When stratified by route, minimally invasive hysterectomy had better HRQOL scores than minimally invasive myomectomy. There was little difference in scores with abdominal approaches., (Copyright © 2020 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
- Published
- 2020
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