Partial Or Total?

A new study has found that women who undergo a hysterectomy for conditions that are non-cancerous do well whether they have all or only a part of their uterus removed. Earlier studies suggest that partial hysterectomies are on the rise as a treatment option and have been so since the 1990’s in the U.S. and other parts of the world. While a total hysterectomy entails removal of the entire uterus, the partial hysterectomy leaves the lower part of the uterus, the cervix, untouched.

The most frequent reason for performing a hysterectomy, whether partial or total is to treat uterine fibroids. These benign growths can cause some unpleasant symptoms and complications such as heavy, persistent bleeding, infertility, and chronic pressure or pelvic pain.

Prevalent Belief

Why the growing demand for the partial hysterectomy as opposed to the total removal of the uterus? The popularity of the abbreviated form of the surgery may be due to the prevalent belief of women that they will have better quality of life should they choose a partial rather than a total hysterectomy. Also, two Scandinavian studies dating back to the 1980’s suggest that since a partial hysterectomy is less invasive, women might have improved sexual and psychological outcomes in the long-term. These study results were cited by the current study’s author, Dr. Par Persson of Sweden’s Uppsala University Hospital.

However, partial hysterectomies may not be as successful in treating uterine fibroids as the total removal of the uterus, since leaving the cervix means that fibroid-related bleeding remains a risk. Because of this fact, Persson and his colleagues decided to explore whether the partial hysterectomy has any true advantages over the other type of procedure. To this end, the team watched 179 hysterectomy patients over the course of a year and found that the psychological well-being of the patients improved as time elapsed no matter whether they had undergone the partial or the total hysterectomy procedure. This is according to the study report published in the British Journal of Obstetrics and Gynaecology (BJOG).

Psychological Well-Being

There were 94 study participants in the partial hysterectomy group and 85 participants who had their entire uterus removed. The women were examined before surgery, at 6 months post-surgery, and one year after surgery. During these examinations, the women were administered four tests to measure their psychological well-being. These tests included questions intended to measure symptoms of depression and anxiety.

The scientists found that the two groups had comparable scores before their surgeries, and these scores improved to the same extent in both groups during the year after surgery.

The only major difference between the two groups was a complaint of regular bleeding a year after surgery for some women in the partial hysterectomy group, as compared to only one woman with this complaint from the total hysterectomy group.