Psychosocial effects of hysterectomy: Literature review
Nicole Flory, François Bissonnette, Yitzchak M. Binik
Journal of Psychosomatic Research
September 2005 (Vol. 59, Issue 3, Pages 117-129) Abstract |
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In the September issue of the Journal of Psychosomatic Research (volume 59, number 3), errors appeared in Table 4 of the 2005 article “Psychosocial effects of hysterectomy: literature review” (pages 117–29). The correct table is printed on the next page. In addition, the corresponding author's contact information was printed incorrectly, the correct information for Nicole Flory is:
2?, 8, 9/only 319 patients were randomly assigned to Tot vs. Sub
Roovers 2003, Netherlands
310
Conven
44
Tot/Sub
Abdom/vagin
?
0.5 year
ASQ
?
nd
nd
nd
nd
nd
?
?
?
?
2?, 7, 8/post-op: sexual difficulties in 40%; no significant difference vagin vs. abdom and Tot vs. Sub
Ellstrom 2003, Sweden
74
Conven
50
Tot
Abdom/vagin
Mixed
1 year
SSQ ?
nd
nd
nd
nd
nd
nd
?
nd
?
nd
7/first study with random assignment to abdom/vagin; no significant difference between/within groups
Gutl et al. 2002, Austria
90
Conven
52
?
Abdom/vagin
PreM HRT
2 years
SSQ, ASQ interv, phone, mail
nd
?
?
nd
nd
nd
nd
?
⇐
?
2, 5/40% drop-out rate; no random assignment
Thakar 2002, GB
279
Conven
43
Tot/Sub
Abdom
Mixed
1 year
ASQ ?
nd
?
nd
nd
nd
?
nd
?
?
?
7, 8?/1st study with random assignment to Tot vs. Sub; 10–20% stopped having sex post-op
Rannestad 2001, Norway
284
Conven probab
45
?
Abdom
?
1 year
SSQ, ASQ ?
?
?
?
?
nd
?
nd
?
?
nd
2?, 5, 7/controls were a probability sample of women with intact uteri
Alexander 1995, GB
202
Conven
40
?
Abdom/vagin
?
1 year
SSQ interv
nd
?
?
?
nd
?
?
nd
nd
?
2, 5, 6, 7/first study with random assignment to uterus sparing surgery
Carlson et al.
691
Probab
41
?
Abdom/vagin
?
1 year
ASQ face, phone, mail
nd
?
?
?
?
?
nd
nd
nd
?
1, 5, 6, 7/controls had conservative surgery; women of lower SES choose hys
Bhatia 1990, India
75
Conven
46
Mixed
Abdom
?
4 weeks
SSQ ASQ ?
?
?
?
?
?
?
?
nd
?
nd
5, 6, 7/controls had minor gynecological surgeries
Kilkku 1983, Finland
212
Conven
46
Mixed
Abdom
Mixed
1 year
ASQ interv
nd
?
⇐
?
?
⇒
?
?
?
?
7/controls had Sub; no random assignment
Abbreviations: FU: follow-up; probab: probability sample; conven: convenience sample; volun: volunteer sample; hys: hysterectomy/hysterectomy group; pre-op: before Hys; post-op: after Hys; SES: socioeconomic status.
Hysterectomy and surgery type: Tot: total Hys; Sub: subtotal Hys; abdom: abdominal Hys; vagin: vaginal Hys; lapar: laparoscopic Hys; LAVH: laparoscopic assisted vaginal Hys.
Hormonal status: PreM: premenopausal women with intact ovaries; HRT: menopausal or oophorectomized patients on HRT.
Data collection: SSQ: Standardized structured questionnaire; ASQ: ad hoc structured questionnaire/interview; PHYS: physiological measurement; interv: face-to-face interview; phone: phone interview; mail: mailed questionnaire; med. record: medical records.
Outcomes:
↑: significantly increased post-op as compared with pre-op; ↓: significantly decreased post-op as compared with pre-op; ⇒: significantly more in Group I (Hys) compared with controls; ⇐: significantly less in Group I (Hys) compared with controls; nd: no significant difference; ?: unspecified/not clear/missing/mixed
Methodological problems:
1. Included cervical carcinomas/cancer patients; 2. Postoperative functioning compared with functioning at day/time of surgery; 3. More than 50% drop-out; 4. No or rudimentary data analysis; 5. No analysis/presentation of data for different types of hysterectomy; 6. No analysis/presentation of data for different types of surgery; 7. No analysis/presentation of data for different types of hormonal status; 8. Assesses patients at inconsistent times before and/or after hysterectomy; 9. Asks patients to recall psychosexual functioning for time periods longer than 6 months; 10. Systematic drop-out of women with lower sexual functioning, depression, and SES
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