More Young Patients Regret Having a Hysterectomy Than Older Ones

The proportion of younger patients regretting having had a hysterectomy is higher compared to older patients

Key Points

Highlights: 

• More patients, ages 30 and younger regret undergoing a hysterectomy compared to older patients.
• Patients regret both having had the surgery and having lost their fertility.

Importance:

• These findings can help decision-making about undergoing a hysterectomy.

What’s done here:

• Researchers conducted a matched retrospective cohort study in 241 patients who underwent a laparoscopic hysterectomy between 2009 and 2016. 
• The number of patients who completed the survey was 241,  77 were aged 30 years or younger, and 164 were aged 31-49.
• Two validated decision regret scales, including surgical decision regret and loss-of-fertility regret were completed by respondents.

Key results:

• Among patients ages 30 and younger, 32.5% regretted undergoing a hysterectomy and 39% regretted losing their fertility.
• Among patients ages, 31 to 49, 9.1% regretted undergoing a hysterectomy and 13.4% regretted losing their fertility.
• 83.1% of younger patients and 97% of older patients agreed that hysterectomy was the right choice.
• The rate of regret was higher among patients who had self-reported pelvic pain, endometriosis diagnosis before surgery, and complications following the surgery.
• The time of surgery did not affect the rate of surgery regret but it affected the rate of loss-of-fertility regret with those who had the surgery longer ago having lower rates of regret. 
• The age of the patient was associated with the rate of regret on multivariable logistic regression analysis. 

Lay Summary

A study published inObstetrics & Gynecology found that patients aged 30 or younger were more likely to regret their decision to undergo a hysterectomy compared to those aged 31 to 49, regardless of factors such as parity, prior sterilization, or previous treatments

To assess long-term regret following hysterectomy, researchers led by Dr. Christine E. Foley conducted a matched retrospective cohort study. The study compared patients aged 30 and younger with those aged 31 to 49 who underwent laparoscopic hysterectomy for benign conditions, including endometriosis, between 2009 and 2016.

Among the 241 respondents out of 287, 77 were aged 30 or younger, and 164 were between 31 and 49 years old. The time since surgery ranged between 3.7 and 12.1 years. 

The results revealed that 32.5% of younger patients regretted the surgery, and 39% regretted losing fertility, compared to 9.1% and 13.4% in older patients, respectively Overall, 83.1% of patients aged 30 and under believed hysterectomy was the right choice, compared to 97% of patients aged 31 to 49.

Regret regarding surgery and loss of fertility was higher in patients with self-reported pelvic pain, a prior endometriosis diagnosis, and post-surgical complications. The researchers also reported that the time elapsed since hysterectomy did not affect the rate of surgical regret. However, participants who had a hysterectomy a long time ago had lower rates of losing their fertility. 

On multivariable logistic regression analysis, the age of the patients remained significantly associated with both surgical and loss-of-fertility regret.

Research Source: https://pubmed.ncbi.nlm.nih.gov/39601703/