A woman who suffers from pelvic pain (search) and depression at the time of her hysterectomy (search) may experience improvement in depression, pelvic pain, quality of life, and sexual function after surgery, according to a new study.
In the U.S., more than 600,000 women per year have hysterectomies. Common reasons for the surgery include vaginal bleeding, endometriosis (search), chronic pelvic pain (search), uterine fibroids (search), uterine prolapse (search), and cancer of the uterus or cervix.
However, studies have shown that as many as 22 percent of women with pelvic pain prior to surgery continue to have pain after surgery. Emotional factors can play a role in the tolerance of pain and how an individual is able to cope with pain. Depression is the most common condition known to accompany pain, write the authors.
The new study was conducted by experts including Katherine Hartmann, MD, PhD, of the obstetrics and gynecology department of the University of North Carolina.
Reporting their findings in a recent issue of the journal Obstetrics & Gynecology, Hartmann and colleagues studied more than 1,200 Maryland women who had hysterectomies. The two most common reasons for the surgery were fibroids and menstrual problems.
The women were interviewed shortly before surgery and again at 3, 6, 12, 18, and 24 months after their hysterectomy. The researchers asked the women about topics including depression, pelvic pain, quality of life, and sexual function.
Before surgery, 14 percent of the women had depression only, 19 percent had pelvic pain only, 13 percent had both depression and pelvic pain, and most (54 percent) had neither pain nor depression.
Women with both pelvic pain and depression fared less well 24 months after their surgery than women who had either disorder or neither, say the researchers.
Yet women with pelvic pain and/or depression substantially improved after surgery in areas of quality of life and sexual function.
Two years after the surgery, the three groups with one or both conditions improved, although they still had more depression and pain than women without depression, pelvic pain, or both problems.
Quality of Life, Sexual Function Improvements
For instance, in women with both depression and pain, pelvic pain decreased from 97 percent of women to 19 percent of women at two years. The same group also had fewer mental health problems at two years, dropping from 93 percent of women to 38 percent.
In women with pelvic pain only, pelvic pain reduced from 95 percent of women to 9 percent. In those with depression only, impaired mental health was reduced from 85 percent of women to 33 percent of women.
“We were pleasantly surprised to find that the majority of participants with pain, depression, or both report their symptoms, quality of life, and sexual function improved substantially,” write the researchers.
However, hysterectomy shouldn’t be viewed as a cure for those problems.
The researchers want women considering hysterectomy to get a realistic view of the procedure and its recovery. One quarter of participants with both pain and depression thought that their recovery was slow, compared to 15 percent with pain or depression only and 12 percent with neither problem.
“Those providing care for women with pain and/or depression who are seeking hysterectomies may wish to explicitly describe surgery as just one step in a more broadly based treatment and rehabilitation plan focused on restoring their overall quality of life to mitigate the perception that surgery will be a panacea,” the researchers write.
SOURCES: Hartmann, K., Obstetrics & Gynecology, October 2004; vol 104: pp 701-709. WebMD Medical Reference from Healthwise: “Hysterectomy: Topic Overview.” WebMD Medical Reference from Healthwise: “Hysterectomy: Why It Is Done.” News release, University of North Carolina at Chapel Hill.