Effect of Hysterectomy vs Medical Treatment on Health-Related Quality of Life and Sexual Functioning The Medicine or Surgery (Ms) Randomized Trial.

Hysterectomy is the most common major surgical procedure performed in the United States for nonobstetric reasons. In 2000, approximately 633,000 hysterectomies were performed, and US women have an estimated 25% risk of having their uterus removed. Ninety percent of hysterectomies are elective and performed before menopause for abnormal uterine bleeding and other non-life-threatening reasons. Women (aged 30-50 yrs.) enrolled in the Medicine or Surgery (Ms) trial and under care for abnormal uterine bleeding were randomly assigned to receive either a hysterectomy or expanded medical treatment. Results showed clear benefits for hysterectomy over expanded medical treatment after 6 months. Women in the hysterectomy group demonstrated a consistent pattern of improvement in all but 1 of the health-related quality-of-life outcomes. Significant improvements were found in overall mental health, symptom resolution, satisfaction with symptoms, sexual functioning, health distress, sleep problems, and general health perceptions, underscoring the value of this procedure when resolution is not obtained with medroxyprogesterone. The superiority of hysterectomy over medical treatment was no longer statistically significant at 2-yrs. (PsycINFO Database Record (c) 2019 APA, all rights reserved)