Quality of Life and Individual-Psychological Features as an Integral Criterion of Efficiency of Surgical Treatment in Patients with Uterine Fibroids
The ultimate goal of any treatment is not only to restore physical health, but also to ensure quality of life. The aim of the study was to examine the severity of psychoemotional and neuro-vegetative symptoms, anxiety, depression and quality of life parameters in women with uterine fibroids after radical surgery using various surgical techniques and approaches. A comprehensive assessment of the long-term consequences of hysterectomy, characterization of psychoemotional manifestations, urogenital disorders, levels of depression and anxiety, psychological portrait and quality of life scales in 160 women of reproductive age after hysterectomy. In the first year after surgery, 105 women (66.7%) are dominated by neurovegetative disorders, in the first two years after surgery, 72% are dominated by neurovegetative disorders, 38 (23.8%) - psycho-emotional disorders and only 17 (10, 6%) - metabolic and endocrine. By 24 months after surgery, the proportion of psychoemotional disorders progressively increases - up to 94 observations (58.7%), remaining long, a slightly larger share in the structure and metabolic and endocrine disorders - up to 38 (23.8%), neurovegetative manifestations are leveled. Testing has shown that patients with fibroids before surgery suffer from a psychological component of health, significantly limited indicators of vital activity, social and role functioning due to emotional state and mental health, characterized by the presence of anxiety and depression compared with control data (p<0.05). After surgical treatment, the evaluation of these indicators during 24 months of monitoring, characterizing the mental component of health, showed a tendency to improve compared with preoperative parameters (p<0.05). The best parameters of quality of life scales were observed in patients after the use of vaginal techniques. The tension of psycho-emotional status, the manifestation of anxiety and depression in patients after hysterectomy in the postoperative period depended on age, social characteristics and marital status, had its own specific features that were associated with hormonal imbalances, metabolic disorders and was manifested by a high level of psycho-emotional stress and the dominance of vegetative-vascular symptoms of moderate and severe severity. The study found higher quality of life after laparoscopically assisted vaginal hysterectomy, which allows us to recommend this approach as a choice in patients of reproductive age and as the most effective in terms of quality of life in fulfilling all criteria for selecting patients for use and depending on the index. somatic health.