Strauss B, Jäkel I, Koch-Dörfler M, Lehmann-Willenbrock E, Giese K P, Semm K
Klinik für Psychotherapie und Psychosomatik, Universität Kiel.
Geburtshilfe Frauenheilkd. 1996 Sep;56(9):473-81. doi: 10.1055/s-2007-1022290.
Comparison of Different Surgical Methods: The cardinal question of this prospective longitudinal study was whether different surgical methods of hysterectomy correlate with differences in adaptation and in respect of psychological as well as sexual consequences. A total of 83 patients were investigated immediately prior to surgery as well as 6 weeks later. 61 resp. 58 patients participated in follow-up investigations 6 months and 1 year following surgery. Total hysterectomy was performed vaginally in 16 females, abdominally in 22 patients. 23 patients underwent subtotal C.I.S.H. hysterectomy. 23 females indicated for myoma enucleation formed another group of this study. Besides several psychological variables of potential influence such as personality characteristics, coping, sexual attitudes and partner satisfaction, the study covered psychological as well as physical complaints, life satisfaction and differential characteristics of sexual experiences and behaviour longitudinally. The results indicate that single subgroups differ from each other in several respects. There were no indications of different psychological as well as sexual consequences depending on the surgical method. These findings support the view that consequences of hysterectomies are more likely to be predicted on the basis of psychological traits that existed before the operation, rather than from a medico-technical point of view.
这项前瞻性纵向研究的核心问题是子宫切除术的不同手术方法是否与适应差异以及心理和性方面的后果存在关联。共有83名患者在手术前及术后6周接受了调查。分别有61名和58名患者在术后6个月和1年参与了随访调查。16名女性接受了经阴道全子宫切除术，22名患者接受了经腹全子宫切除术。23名患者接受了次全腹腔镜下子宫切除术（C.I.S.H.）。23名因子宫肌瘤剥除术而入选的女性构成了本研究的另一组。除了一些可能有影响的心理变量，如人格特征、应对方式、性态度和伴侣满意度外，该研究还纵向涵盖了心理和身体不适、生活满意度以及性经历和行为的差异特征。结果表明，各个亚组在几个方面存在差异。没有迹象表明手术方法不同会导致心理和性方面的后果有所不同。这些发现支持了这样一种观点，即子宫切除术的后果更有可能基于手术前存在的心理特征来预测，而不是从医学技术角度来预测。
