자궁적출술 후의 정신의학적 후유증

Psychiatric Complications after Hysterectomy

Authors studied the psychosomatic complications and changes in sexual life after hysterectomy and examined the possible causes that had precipitated those complications. Among 1,004 patients who had undergone hysterectomy with or without oophorectomy because of benign gynecological diseases at Sevrance Hospital during the period of July, 1982 to July, 1985，242 patients answered the mailed questionaire including self-rating anxiety and depression scales. Two hundred and eight patients were finally included in the study. The results were as follows; 1) The educational level is the only significant factor among the demographic factors in relation to complications; the higher educational level, the less number of somatic symptoms, scores of depression and anxiety scale and scores in a scale of significance for uterus and ovary after hysterectomy. 2) The scores of depression and anxiety scale was negatively correlated with the frequencies of past pregnancy, delivery and abortion. Number of somatic symptoms was negatively correlated with the postoperative duration. The patients with uterine atony showed highest score of depression and anxiety compared to other diagnostic groups. 3) Number of somatic and psychological symptoms and scores of anxiety and depression scale were positively correlated with scores of scale of significance for uterus and ovary. 4) Frequency of sexual intercourse and satisfaction in sexual life significantly decreased after hysterectomy. Number of somatic and psychological symptoms, scores of anxiety and depression scale and scores in scale of significance for uterus and ovary were all significantly higher in the patients who experienced decreased sexual desire and were dissatisfied in marital life. 5) Number of somatic and psychological symptoms, scores of depression and anxiety scale and scores of scale of significance for uterus and ovary were all significantly higher in the patients who regreted for the hysterectomy than those who were satisfied. The patients who thought present problems was due to the operation showed the higher number of somatic symptoms and scores of significance for uterus and ovary. The patients who were given previous explanation about post-operative prognosis by surgeons or nurses showed the higher numbers of somatic and psychological symptoms. 6) Self-evaluation on their own femininity was rated lower significantly after hysterectomy. Scores of scale of significance for uterus and ovary was significantly higher in the patients who believed their femininity to be lost after hysterectomy.