According to recent research published in the March issue of the journal Obstetrics & Gynecology, women who have a hysterectomy in Maryland for a non-cancerous condition normally obtain relief from the symptoms that made them seek the procedure. Hysterectomies for cancerous conditions have not been researched so far.
According to Kristen H. Kjerulff, MS, PhD, the lead author of the research, the research applies greatly to women who reveal symptoms such as bleeding, bloating, and/or pelvic pain - symptoms that a hysterectomy has the potential to help address. Kjerulff is associate professor of epidemiology and preventive medicine at the University of Maryland School of Medicine in Baltimore.
But don’t make that appointment with your ob/gyn just yet. Kjerulff tells WebMD that this finding may not prove to be important in states where physicians overuse hysterectomy. Maryland has one of the lowest rates of hysterectomy in the United States.
"Women do feel better [and] observe significant improvements that are maintained for the period of two years out," claims Kjerulff. "We thought that there might be a honeymoon period, but these benefits held up two years after the surgery." However, she stopped short of saying the research recommends performing hysterectomy for all women due to the fact that there is a wide variation in how and when healthcare providers perform hysterectomies. "I don’t know if these results are replicable in places where hysterectomies are more common," she claims.
In the research, the investigators observed for two years almost 1,300 women who were scheduled to have a hysterectomy for a non-cancerous condition at twenty-eight hospitals across Maryland. The authors evaluated the symptoms of vaginal bleeding, pelvic pain, fatigue, back pain, abdominal bloating, sleep problems, urinary incontinence, and activity reduction before surgery at different intervals within the two years after surgery.
However, hysterectomy did not alleviate symptoms for some women, particularly those women with lower incomes, women in psychological therapy, and women having children under the age of 18 living in their home. Speculating on why low-income women might do worse, Kjerulff claims that "they are frequently in very disorganized and uncertain life situations," with poverty being a tremendous stress in their lives.
Based on her findings, Kjerulff claims, "women who are clinically depressed may not be proper candidates for hysterectomy. Symptoms might result from distress rather than gynecological problems." Still though, the research revealed that approximately 25 per cent of women assessed before having a hysterectomy expressed evidence of clinical depression.
The research was not aiming at determining whether the depression was long term or just in anticipation of the surgery. And the authors did not look at whether women were taking antidepressant medications or not. However, one variable that stood out was that women in psychological therapy usually reported less symptom ease.
Another crucial observation is that women who had their ovaries removed during the hysterectomy had worse outcomes within the next two years, a finding that Kjerulff claims "could not be explained."
In an interview with WebMD, Judy Levison, MD, states that based on the research and her own clinical experience, patients with chronic pelvic pain are among the most difficult patients to evaluate for a hysterectomy due to the fact that there are so many possible causes of the pain. Levison, an obstetrician/gynecologist in Houston, claims that the research lumped several various sorts of pain into one category, and therefore did not give a satisfactory answer about how best to manage each type of chronic pelvic pain.
Levison is particularly concerned about depressed women who consider hysterectomy to alleviate symptoms. "They should be counseled appropriately due ti the fact that a hysterectomy may not cure them," she claims.
Kjerulff also claims "Women who observe symptoms should try every potential therapy before they resort to hysterectomy. Hysterectomy is still the main surgery and involves a long recovery. If they have tried everything and they still feel their symptoms influence their quality of life," she claims it is sensible to consider hysterectomy.
Very important Information:
* In research conducted in Maryland, women who underwent hysterectomy for noncancerous conditions reported significant improvements in symptom alleviation and quality of life.
* The rate of hysterectomy in Maryland is relatively low, hence the scientists can not say that the results can be applied to other regions where the procedure may be overused.
* Women who have the symptoms ought to try every potential therapy before considering hysterectomy, and those who are depressed may not be proper candidates for the surgery.
