Few studies have evaluated quality of life as a primary outcome after hysterectomy performed with different types of surgical approaches. Two studies reported that quality of life was higher up to 12 weeks postoperatively after LH as compared with AH. Because the longest follow-up study has been 1 year, it is unclear whether this improvement in quality of life would be maintained in the long term.
This study reports the results of a 4-year follow-up quality-of-life data of a previously published randomized controlled trial that compared the quality of life among patients with benign gynecologic disease treated with AH and those treated with LH. The aim of this study was to determine whether any difference in quality of life would persist in the long term. Between 2002 and 2005, women scheduled for hysterectomy were randomized between LH and AH. At a median follow-up of 4 years, the Dutch version of the Short Form 36 questionnaire was mailed to patients to assess short-term quality of life, the primary outcome measure. The Short Form 36 contains 8 domains; a score of 100 points can be obtained on each domain. Higher scores indicate a higher quality of life. Differences between the 2 groups were assessed with a linear mixed model for each of the domains and the total Short Form 36 score separately.
A total of 59 patients were randomized to receive LH (n = 27) or AH (n = 32). Median follow-up was 243 weeks, with a range of 188 to 303 weeks. The overall response rate after 4 years for the Short Form 36 questionnaire was 83% (49/59 patients). The mean total Short Form 36 score was significantly higher in patients after LH compared with AH up to 4 years after surgery; the improvement was 50.4 points, with a 95% confidence interval of 1.0 to 99.7. Similarly, higher scores for LH were found on the domains vitality, physical role functioning, and social role functioning.
These findings show that at 4 years after surgery, LH provides a better quality of life than AH.
From the Departments of Obstetrics and Gynecology and Epidemiology and Biostatistics, Radboud University Nijmegen Medical Center; and Department of Obstetrics and Gynecology, Maxima Medical Centre, Veldhoven, the Netherlands