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Hysterectomy improves quality of life and decreases psychiatric symptoms: a prospective and randomized comparison of total versus subtotal hysterectomy

journal contribution
posted on 2023-06-07, 18:40 authored by Ranee Thakar, Susan Ayers, Alexandra Georgakapolou, Peter Clarkson, Stuart Stanton, Isaac Manyonda
Objective To conduct a prospective and concurrent evaluation of changes in health status and quality of life and psychological outcome measures over one year in women randomised to total or subtotal abdominal hysterectomy. The concurrent evaluation was the impact of total versus subtotal hysterectomy on bladder, bowel and sexual function. Design Prospective, randomised, double-blind study. Setting A large UK Teaching Hospital (St George's Hospital, London) and a large District General Hospital (Mayday University Hospital, Croydon). Methods Sample Two hundred and seventy-nine women undergoing hysterectomy for benign disease were randomly allocated to total hysterectomy (n= 146) or subtotal hysterectomy (n= 133). Main outcome measures Quality of life assessment using the Short-Form-36 health survey (SF-36) and psychological outcome measures using the General Health Questionnaire-28 (GHQ-28) before the operation and 6 and 12 months after. Results Quality of life and psychological symptoms were similar in the two groups at baseline. Following surgery, quality of life improved in six of the eight domains, with no significant difference between the groups, with the exception of emotions which showed a greater improvement in subtotal hysterectomy women between baseline and 12 months. When this difference was examined further by looking at change in the GHQ subscales, there were no significant differences between total and subtotal hysterectomy women in the amount of change in anxiety, depression, somatic symptoms or social dysfunction, between baseline and post-operative measurements. All women showed an improvement in psychological symptoms following both operations. Conclusion Hysterectomy, whether total or subtotal, may improve quality of life and psychological outcome.


Publication status

  • Published


British Journal of Obstetrics and Gynaecology







Page range

1115 - 1120

Department affiliated with

  • Psychology Publications

Full text available

  • No

Peer reviewed?

  • Yes

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