Does health-related quality of life improve in women following gynaecological surgery?

Objectives: To measure the change in health-related quality of life (HRQOL) before and after gynaecologic surgery and to compare HRQOL to age-matched Canadian normative data.

Methods: This prospective observational cohort study consisted of a convenience sample of 460 women scheduled for elective gynaecologic surgery. Women underwent surgery for a variety of reasons, including cancer, menorrhagia/dysfunctional uterine bleeding, benign uterine masses, prolapse or urinary incontinence, and chronic pelvic pain syndromes. Women were recruited preoperatively and followed for six months after surgery. HRQOL questionnaires were completed preoperatively and at six weeks and six months postoperatively, using the SF-36, and compared between time points and against normative data. Analysis included univariate statistics, repeated measures ANOVA, paired t tests, and independent samples t tests.

Results: The mean age of women in the study cohort was 49 years (± 11); the majority were married, employed, had an education beyond high school, were overweight or obese, had a hysterectomy, and had an abdominal incision. Twenty-eight percent underwent surgery for cancer. General and mental health domains showed significant improvement between the preoperative and six-week postoperative assessments, while the remaining domains showed statistically significant declines. All but one (general health) of 10 outcomes saw significant improvements from the preoperative to the six-month follow-up assessment. Preoperatively, the surgical sample scored worse on all but one (role emotional) outcome than the normative data. By six months, domain scores were much closer to normative values.

Conclusion: Health-related quality of life improved considerably from the preoperative period to six months postoperative in women who underwent gynaecologic surgery. When compared with normative data from age-matched women, the surgical sample reported significantly reduced HRQOL preoperatively and at six weeks following surgery, but by six months after surgery HRQOL had rebounded to the point of being comparable to age-matched peers.