Comparison of Postoperative Quality of Life Scores in Women Who Underwent Myomectomy Versus Hysterectomy for Uterine Fibroids [ID: 1379414

Abstract

INTRODUCTION: Uterine fibroids are highly prevalent and associated with significant effect on quality of life (QOL). The current study compares QOL scores in patients that underwent myomectomy or hysterectomy for management of fibroids. METHODS: After obtaining approval from the Cleveland Clinic IRB, we conducted a retrospective cohort study for patients that underwent hysterectomy or myomectomy for uterine fibroids. Eligible patients were sent validated surveys: 36-Item Short Form Health Survey (SF-36) and Uterine Fibroid Symptom and QOL questionnaire (UFS-QOL). Standard bivariate analyses were used to compare differences in QOL scores between groups, adjusting for age and race. RESULTS: Of the 142 survey respondents, 37 underwent myomectomy and 105 underwent hysterectomy. The median number of days between surgery and survey completion was 1,652 (1,142, 2,328) for myomectomy and 1,022 (740, 1,317) for hysterectomy. For SF-36, hysterectomy patients reported significantly less energy (P=.006) compared to myomectomy. Significant differences were not observed in postoperative physical functioning, role limitations, pain, health perceptions, vitality, social functioning, or mental health. Although there was no statistically significant difference in UFS-QOL scores, patients who underwent hysterectomy experienced significantly lower symptom severity (P=.009) and levels of concern (P<.001), and increased activity tolerance (P=.005) and sense of control (P=.029). CONCLUSION: While patients who underwent hysterectomy reported more fatigue, they experienced lower symptom severity, lower levels of concern, higher activity tolerance, and increased sense of control compared to myomectomy. These findings may help guide counseling for surgical fibroid treatment.