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Obstetrics & Gynecology 2007;109:347-354
© 2007 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Oophorectomy in Premenopausal Women

Health-Related Quality of Life and Sexual Functioning

Vanessa Teplin, MD1,2, Eric Vittinghoff, PhD3, Feng Lin, MS3, Lee A. Learman, MD, PhD2,3, Holly E. Richter, PhD, MD4 and Miriam Kuppermann, PhD, MPH2,3,5

From the 1Veterans Administration Medical Center, San Francisco, California; the Departments of 2Obstetrics, Gynecology & Reproductive Sciences and 3Epidemiology & Biostatistics, University of California, San Francisco, California; the 4Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, Alabama; and the 5Medical Effectiveness Research Center for Diverse Populations, University of California, San Francisco, California.

OBJECTIVE: To compare health-related quality-of-life outcomes and sexual functioning among premenopausal women who underwent bilateral salpingo-oophorectomy (BSO) versus ovarian conservation at the time of hysterectomy.

METHODS: This is a secondary data analysis of premenopausal women who underwent hysterectomy for benign gynecologic disease in the Medicine or Surgery and the Total or Supracervical Hysterectomy randomized trials. Bilateral salpingo-oophorectomy was performed at the patients' requests or to treat intraoperative ovarian pathology. Health-related quality-of-life outcomes and sexual functioning were assessed using the Medical Outcomes Study SF-36, Sexual Problems Scales, and several other measures at 4 weeks, 6 months, and 2 years after hysterectomy.

RESULTS: Mean age at hysterectomy was higher for the 49 women who underwent BSO compared with the 112 women with ovarian conservation (45 versus 40, P<.001). At 6 months, the BSO group demonstrated less improvement than women with ovarian conservation on scales for body image (2 versus 14, P=.01), sleep problems (4 versus 16, P<.01), and the SF-36 Mental Component Summary (4 versus 10, P=.03). There were no differences in any measure of sexual functioning between the groups. Hot flushes, urinary incontinence, and pelvic pain were similar in both groups. At 2-year follow-up, all measures of health-related quality-of-life and sexual functioning appeared similar by BSO status.

CONCLUSION: Women who underwent BSO had less improvement in some aspects of health-related quality of life within the first 6 months following hysterectomy compared to women with ovarian conservation. However, these differences were not apparent 2 years after surgery.

LEVEL OF EVIDENCE: II




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