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Evaluating the Prevalence of Regret With the Decision to Proceed With a Hysterectomy in Women Younger than Age 35

Published:November 14, 2019DOI:https://doi.org/10.1016/j.jogc.2019.08.006

      Abstract

      Objective

      This study sought to evaluate prevalence of regret with the decision to undergo a hysterectomy at a young age.

      Methods

      A retrospective cohort study was performed at two centres and included patients who underwent an elective hysterectomy for benign indications under age 35, between January 1, 2008 and December 31, 2015. Eligible patients were contacted and completed a validated decision regret survey and patient health questionnaire.

      Results

      A total of 189 patients met the study criteria. Of the 95 patients who could be contacted, 71 consented to participate (response rate, 75%). The most common indications for surgery were menorrhagia (35.2%), uterine fibroids (22.5%), endometriosis (19.7%), and pain (15.5%). Overall, 91.5% of patients agreed that having this surgery was the right decision for them, and 90% said that they would make the same choice in the future. A total of 2.8% regretted the choice that they made, and 14% responded that this caused them harm. Over 95% of patients reported that the decision was either mostly patient driven or shared with the physician.

      Conclusion

      This is the first evaluation of regret after hysterectomy specifically examining a younger patient population. The study results suggest that patients who are appropriately counselled do not regret their decision to proceed with hysterectomy.

      Résumé

      Objectif

      Les auteurs de cette étude cherchaient à évaluer la fréquence du regret d'avoir choisi de subir une hystérectomie à un jeune âge.

      Méthodologie

      Une étude de cohorte rétrospective a été réalisée dans deux centres et comprenait des patientes ayant subi une hystérectomie planifiée en raison d'une indication bénigne avant l'âge de 35 ans, entre le 1er janvier 2008 et le 31 décembre 2015. On a communiqué avec les patientes admissibles; celles-ci ont répondu à un sondage validé sur le regret de la décision ainsi qu'à un questionnaire sur leur état de santé.

      Résultats

      Un total de 189 patientes répondaient aux critères de l'étude. Des 95 patientes jointes, 71 ont accepté de participer (taux de réponse de 75 %). Les indications les plus fréquentes de l'hystérectomie étaient la ménorragie (35,2 %), les fibromes utérins (22,5 %), l'endométriose (19,7 %) et les douleurs (15,5 %). Dans l'ensemble, 91,5 % des patientes ont indiqué que l'hystérectomie avait été la bonne décision pour elles, et 90 % ont dit qu'elles feraient encore le même choix. Au total, 2,8 % des patientes ont indiqué regretter leur choix, et 14 % ont répondu que l'hystérectomie leur avait fait du tort. Plus de 95 % des patientes ont rapporté que la décision venait surtout d'elles-mêmes ou qu'elle était partagée avec le médecin.

      Conclusions

      Il s'agit de la première évaluation du regret après l'hystérectomie spécifiquement chez une population de jeunes patientes. Les résultats de cette étude portent à croire que les patientes qui reçoivent un accompagnement et des conseils adéquats ne regrettent pas leur décision de subir une hystérectomie.

      Key Words

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