Available online 2 November 2022

To determine predictors for placing high value on the uterus in patients who no longer desire fertility. The secondary objective was to identify reasons for placing high value on the uterus.

Cross-sectional survey study.

Three hospitals within a large healthcare system in the United States.

New patients ≥ 45 years old seeking care for benign gynecologic conditions, including abnormal uterine bleeding, uterine fibroids, pelvic organ prolapse, endometriosis or pelvic pain.

The primary outcome was the summative score of the validated Value of Uterus (VALUS) instrument for measuring value placed on the uterus, as well as the validated visual analogue scale (VAS) with the question “how important is it to you to keep your uterus when you have a gynecologic condition?”

163 surveys were returned for analysis (79.2%). Using the VALUS cut-off, 64 patients (45.7%) were considered to have low-value for their uterus (VALUS score < 14), while 76 patients (54.3%) were considered to have high-value for their uterus (VALUS score ≥ 14). The adjusted odds of placing high-value for the uterus was 5.06 times higher among those who wanted to be sexually active in the future compared to those who do not desire to be sexually active (CI 1.55-16.52, p=0.01). Patients who are sexually active have 3.94 higher adjusted odds of placing high value on the uterus compared to those who are not sexually active and do not desire to be (CI 1.36-11.43, p=0.01). Race, religion and personal history of cancer were not statistically significant.

Patients who highly value the uterus were highly motivated by the desire to be sexually active. Non-white race, religion and personal history of cancer were not predictors for placing high value on uterine preservation.

uterine-preservation

uterine-sparing

hysterectomy

racial disparities

gynecology

© 2022 Published by Elsevier Inc. on behalf of AAGL.