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Postoperative Fatigue Negatively Impacts the Daily Lives of Patients Recovering From Hysterectomy

From the UCLA Medical Center, Los Angeles, California; Robert Wood Johnson Medical School, New Brunswick, New Jersey; Massachusetts General Hospital, Boston, Massachusetts; and University of Louisville, Louisville, Kentucky.

Address reprint requests to: Alan H. DeCherney, MD, UCLA School of Medicine, Department of Obstetrics and Gynecology, 27-117 CHS, 10833 Le Conte Avenue, Los Angeles, CA 90095-1740; E-mail: adechern{at}mednet.ucla.edu.

OBJECTIVE: To assess, from the patient’s perspective, the prevalence and impact of postoperative fatigue after hysterectomy and to increase understanding of physician–patient communications before and after surgery regarding recovery and diminished postoperative energy level.

METHODS: We completed a telephone survey of 300 women aged 25–50 who had undergone a hysterectomy or myomectomy within the past 2 years. The patients were recruited randomly from two national, random samples of households: 1) women aged 25–50, and 2) women taking hormone replacement therapy in the target age range. Patients were asked a series of questions about their postoperative fatigue after surgery.

RESULTS: Overall, 74% of patients experienced moderate-to-severe fatigue within the first few weeks after surgery. Fatigue occurred more frequently and persisted twice as long as pain, the next most frequent symptom, which was experienced by 63% of patients overall. Fatigue was the symptom that most interfered with daily activities (37%) and also contributed to feelings of frustration (52%), to depression (37%), and to difficulty in concentrating (42%). Patients employed at the time of surgery missed an average of 5.8 weeks of work; 69% of those surveyed required 2 or more weeks of caregiver assistance. Postoperative fatigue was discussed by 68% of patients’ physicians before surgery, and 57% of patients discussed postoperative fatigue with their physicians after surgery. Oral iron therapy and dietary supplements were the most frequently recommended treatments; 52% of patients were not offered any treatments or recommendations to alleviate their fatigue.

CONCLUSIONS: Fatigue is a highly prevalent posthysterectomy and myomectomy symptom and has substantial negative physical, psychosocial, and economic effects on patients during recovery.

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