Body Image and Sexual Function Improve after Both Myomectomy and Hysterectomy for Symptomatic Fibroids. Issue 12 (December 2021)

• Record Type: Journal Article
• Authors: Klock, Julie; Radakrishnan, Ankitha; Runge, Megan Ada; Aaby, David; Milad, Magdy P.
• Is Part Of: Southern medical journal. Volume 114:Issue 12(2021)
• Page Start: 733
• Page End: 738
• Publication Date: 2021-12
• Subjects: fibroids -- hysterectomy -- leiomyoma -- myomectomy -- uterine fibroid embolization (UFE); Medicine -- Periodicals; 610.5
• DOI: 10.14423/SMJ.0000000000001326
• Languages: English
• ISSNs: 0038-4348

Abstract

Abstract : Uterine leiomyomas are a common occurrence in women. Although some women are asymptomatic, others may develop symptoms and seek treatment with myomectomy, uterine fibroid embolization, or hysterectomy. This pilot study explored demographic factors that predict the choice of uterine-conserving procedures versus hysterectomy for symptomatic uterine fibroids and how treatment of fibroids affects perceived body image and sexual function. Supplemental digital content is available in the text. Abstract: Objectives: To determine the factors that influence the choice of myomectomy, uterine fibroid embolization (UFE), or hysterectomy in women with symptomatic uterine fibroids and to assess women's perception of body image and sexual functioning before and after treatment. Methods: In this prospective observational cohort pilot study, women scheduled to undergo hysterectomy, myomectomy, or UFE were surveyed before surgery and again at 3 to 6 months after their procedure to assess body image and sexual function using the validated 10-item Body Image Scale and 19-item Female Sexual Function Index. Logistic regression was used to determine predictive factors for surgery choice and paired t tests were used to determine changes in perceived sexual function and body image. Results: Of the 71 women surveyed, 69 underwent their scheduled procedure and 68 participants completed the preoperative questionnaire completely (98%). A total of 33 participants completed the postoperative questionnaire (49%). The predictive factor for hysterectomy versus myomectomy/UFE was older age (odds ratio 1.13, P = 0.017, 95% confidence interval [CI] 1.02–1.24). Regardless of surgery type, there were significant improvements in perceived body image and sexual function, including an increase in the overall sexual satisfaction of the participant (mean difference 0.50, P = 0.021, 95% CI 0.92–0.08) and less likely to feel less sexually attractive because of their menstrual bleeding problem ( P < 0.0001, 95% CI 0.637–1.675). Conclusions: Women of older age are more likely to choose hysterectomy over myomectomy or UFE for the treatment of symptomatic uterine fibroids. In addition, women who underwent any treatment for fibroids have increases in perception of body image and sexual functioning after their procedure.