Qualité de vie et vécu de la maladie, avant et après hystérectomie vaginale, chez les femmes admises au Centre Hospitalier Universitaire de Brazzaville

Any illness is viewed as inherently evil, so it must be eradicated because it often significantly affect the quality of life. Vaginal hysterectomy is indicated in patients with some severe gynecological conditions; it is beneficial but can also have a detrimental impact on women’s quality of life. The aim of our study was to explore subjective experience of the disease and vaginal hysterectomy (VH) among women before and after surgery. We conducted a qualitative prospective study based on clinical data collection over a period of 12 months; it involved women who had undergone vaginal hysterectomy. Those who decided not to take part in this study or lack of phone contact were not enrolled. During their disease, women experienced: discomfort during sex 26/40 (65%); vaginal bleeding 12/40 (30%); 13/40 pelvic pain (32.5%). Postoperatively, transient dyspareunia 30/40 (75%); headache after anesthesia 4/40 (10%) were noted. Women’s psychological experience before VH was dominated by surgery fear in all patients, sleep disorders 38/40 (95%), anxiety 30/40 (75%), feelings of shame related to difficulty in performing the sexual intercourse because of prolapse 26/40 (65%) and/or because of genital bleeding due to uterine fibroids 14/40 (35%). The feeling of loss of femininity was reported in 26/40 women with uterine prolapse (65%), changes in self-esteem in 26/40 (65%). These subjective assessments were improved in women undergoing VH, offsetting the loss of their reproductive organ. No information was given by women to their loved ones and family members before surgery, reflecting their feeling of embarrassment or shame. The cessation of symptoms was observed in all cases, although in one case (1.25%) a new complication (rectal lesion) was noted. As regards sexual activity, all couples declared their satisfaction after treatment. Women’s dramatic experience of the disease and vaginal hysterectomy improved significantly after surgery.