Quality of life and factors affecting the response to hysterectomy .

Hysterectomy is the most commonly performed major surgery in the United States. A hysterectomy does not produce significant psychopathology in a psychologically mature woman. Yet a mourning process occurs as a woman reintegrates her gender identity. Organic pathology, age, socioeconomic class, types of significant relationships, meaning given menses, coitus, childbearing, children, and vocational and avocational involvements are variables affecting every woman's attitudes toward, decision to have, and reactions to a hysterectomy. Each woman's characteristic coping pattern in a personally threatening situation is apparent during her hospitalization. In the process of reorganizing her gender identity, other interests (vocational and avocational) and intimate interpersonal relationships will assume new significance. The most frequent psychopathological reaction is depression. A woman's potential for depression is increased with malignancy, predisposing personality features, a history of depressive responses to stress, and concurrent marital disruption. Data support a higher incidence of depression in posthysterectomy than in other postsurgical female patients.