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Health-Related Quality of Life After Hysterectomy Performed for Benign Conditions in Tertiary Hospitals, Rwanda

Corneille Killy Ntihabose*, Bonaventure Twahirwa*

Objective: Hysterectomy is the most common major surgical procedure performed by gynaecologists. Most studies reporting on surgical procedures emphasize surgical outcomes such as operation time, surgical complications and hospital stay. Most women undergo hysterectomy to relieve symptoms and improve their health-related quality of life (HRQoL). It is an important outcome variable in clinical research for benign gynaecological conditions. The objective of this study was to assess the HRQoL in women after hysterectomy performed for benign gynaecological conditions in Rwanda.

Methods: A prospective longitudinal study was conducted in three tertiary hospitals in Rwanda over 10 months. A total of 110 women were enrolled in the study. Health Related Quality of Life was measured using the Short-Form-36 Health Survey (SF-36) questionnaire. HRQoL scores before surgery and at 3 months postoperative were compared using nonparametric tests.

Results: The mean age of patients was 51 ± 9 years. Most of the women were premenopausal (64.1%). The most common indications for hysterectomy were fibroids (52.2%) and uterine prolapse (22.8%). Most of the hysterectomies (76.1%) were performed transabdominally. The average length of hospital stay was 6 ± 4 days. All domains showed significant improvement in HRQoL scores after hysterectomy (p<0.001). The Physical Health component summary improved from 28.8 to 61.3 (p<0.001) and the Mental Health component summary improved from 35.8 to 67.0 (p<0.001).

Conclusion: Health related quality of life significantly improve after hysterectomy performed for benign gynaecological conditions in Rwanda. These findings are vital and may be useful to patients and health care providers in counselling women before hysterectomy.