Department of Reproductive Medicine, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK.
Eur J Obstet Gynecol Reprod Biol. 2013 Oct;170(2):533-8. doi: 10.1016/j.ejogrb.2013.07.030. Epub 2013 Aug 12.
The Endometriosis Health Profile-30 (EHP-30), an endometriosis-specific health-related quality of life (HRQoL) questionnaire, forms part of our service evaluation of all women undergoing total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis in our reproductive medicine unit. We used the EHP-30 to investigate patient-reported outcomes in all patients undergoing this procedure.
Retrospective review of 16 women with endometriosis undergoing total abdominal hysterectomy and bilateral salpingo-oophorectomy for debilitating symptoms after other modalities of treatment had failed. Patients completed EHP-30 questionnaires before the operation and again three months after surgery.
Total abdominal hysterectomy and bilateral salpingo-oophorectomy for endometriosis results in a significant improvement in HRQoL. The impact was greatest in the core domains--control and powerlessness, emotional wellbeing and social support. There was a 100% response rate for the core domains whereas in the modular domains, missing response rates ranged from 12.5% to 62.5%, with the percentage of missing data being greatest in the concern on infertility and relationship with children domains. Pain was significantly positively correlated with control and powerlessness, emotional wellbeing, work life and relationship with children. After multiple regression analyses, only control and powerlessness and emotional wellbeing were found to be predictive of pain. Additionally, changes in pain before and after total abdominal hysterectomy and bilateral salpingo-oophorectomy were significantly positively correlated with the changes in the core domains--control and powerlessness, emotional wellbeing and self image. After multiple regression analyses, change in pain was found to be predictive of ΔControl and powerlessness in our study subjects.
Total abdominal hysterectomy and bilateral salpingo-oophorectomy significantly improves HRQoL in patients debilitated by symptoms attributable to endometriosis and in whom other modalities of treatment have failed.
子宫内膜异位症健康状况问卷-30（EHP-30）是一种子宫内膜异位症特异性健康相关生活质量（HRQoL）问卷，是我们对生殖医学部门所有因子宫内膜异位症接受全子宫切除术和双侧输卵管卵巢切除术的女性进行服务评估的一部分。我们使用 EHP-30 调查了所有接受这种手术的患者的患者报告结果。
对 16 名因其他治疗方法失败而出现严重症状的子宫内膜异位症患者进行回顾性研究，这些患者接受全子宫切除术和双侧输卵管卵巢切除术。患者在手术前和手术后三个月完成 EHP-30 问卷。
全子宫切除术和双侧输卵管卵巢切除术治疗子宫内膜异位症可显著改善 HRQoL。影响最大的是核心领域——控制和无力感、情绪健康和社会支持。核心领域的响应率为 100%，而在模块化领域，缺失响应率范围为 12.5%至 62.5%，与不孕和与孩子的关系领域的缺失数据百分比最大。疼痛与控制和无力感、情绪健康、工作生活和与孩子的关系呈显著正相关。多元回归分析后，只有控制和无力感以及情绪健康被发现是疼痛的预测因素。此外，全子宫切除术和双侧输卵管卵巢切除术前和术后疼痛的变化与核心领域——控制和无力感、情绪健康和自我形象的变化呈显著正相关。多元回归分析后，疼痛的变化被发现是研究对象中 Δ控制和无力感的预测因素。
全子宫切除术和双侧输卵管卵巢切除术显著改善了因子宫内膜异位症症状而衰弱且其他治疗方法失败的患者的 HRQoL。
