Psychological Functioning after Non-Cancer Hysterectomy: A Review of Methods and Results

Abstract

This article gives a review of the literature on psychological, sexual and physical functioning after hysterectomy, published since 1950 in the English, German and Dutch languages with a detailed documentation of methods and results. The publications are classified into 3 groups according to the methods used: (1) file studies; (2) post-treatment studies; and (3) pre-post-treatment studies. The results are qualified for these groups respectively as: (1) ‘hypothetical;’ (2) ‘ndicative;’ and (3) ‘informative.’ Following the results of the pre-post-treatment studies, a more detailed analysis of psychological functioning after hysterectomy is given. Improvement as well as deterioration of psychological functioning after hysterectomy has been observed. It is suggested that worsened psychological functioning after hysterectomy is associated with mental health problems in the history, or with psychological problems and/or dysfunctioning already existing before the operation. The reviewed studies show a discongruent picture of postoperative changes in sexual and physical functioning. Because psychological functioning after hysterectomy has been measured in a rather crude way in most studies, only preliminary and tentative conclusions can be drawn. There is still a need for research in which the terms of investigation are operationalized in a more reliable and valid way.