Comparison of psychological outcome between vaginal and abdominal hysterectomy

Background: Hysterectomy is commonly performed for benign gynecological conditions and may influence psychological wellbeing, body image, self-esteem, and quality of life. Objective: To compare psychological outcomes between women undergoing vaginal hysterectomy and abdominal hysterectomy. Methods: This comparative cross-sectional study was conducted at Mardan medical complex Mardan from February 2025 to February 2026 and included 185 women who underwent hysterectomy for benign gynecological conditions. Patients were divided into vaginal hysterectomy (n=88) and abdominal hysterectomy (n=97) groups. Results: The mean age was 47.8 ± 7.6 years. Vaginal hysterectomy was performed in 88 (47.6%) women and abdominal hysterectomy in 97 (52.4%). Anxiety and depression scores were significantly lower in the vaginal group compared with the abdominal group (6.9 ± 3.2 vs. 9.1 ± 4.1 and 5.8 ± 2.9 vs. 8.0 ± 3.8, respectively; p<0.001). Self-esteem, body image satisfaction, and quality of life scores were significantly higher after vaginal hysterectomy. Adverse psychological outcomes were more common among women undergoing abdominal hysterectomy (73.0%; p<0.001). Conclusion: Vaginal hysterectomy was associated with better psychological outcomes, lower anxiety and depression, improved body image, and better quality of life compared with abdominal hysterectomy

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