The effect of hysterectomy on pelvic floor symptoms

Abstract

Aims Pelvic floor functioning is a major concern for women requiring a hysterectomy for endometrial cancer and for benign conditions. This study reports the effect of hysterectomy on pelvic floor symptoms preformed using an open abdominal (TAH) or total laparoscopic approach (TLH). Method 381 women who participated in the Laparoscopic Approach to Cancer of the Endometrium (LACE) trial and required surgery for stage 1 endometrial cancer, were asked to complete the Pelvic Floor Distress Inventory (PFDI-20) before surgery, 6-months post-surgery, and yearly thereafter until 54 months follow-up. The mean change in scores in the TAH and TLH groups were compared using student t-test. Results At baseline, women were on average 63 years (SD 10 years), and 88% were overweight or obese. The mean PFDI-20 score was 13.5 (13.8) at baseline, indicating a low level of pelvic floor concerns among the women. Six months after surgery, women in both treatment groups reported better pelvic floor quality of life compared to baseline. Women who received a TAH reported a score of 11.01 (12.71), and women who received TLH 8.95 (11.77). The mean change in PFDI-20 score from baseline to 6-months post-surgery was not significantly different between TAH and TLH groups (0.06 (95% CI -3.18, 3.31); p=0.97). Conclusion Prevalence of pelvic floor symptoms in this trial was comparatively low. Surgical treatment of stage 1 endometrial cancer led to improvements in pelvic floor quality of life six months after surgery regardless of whether the surgery was performed via TAH or TLH.L619745821 <br />