Psychiatric Status After Hysterectomy

To the Editor.— In the recent article by Martin et al, the authors noted that the symptoms observed in their patients a year later were already present before surgery. However, in the Results section, one notes the appearance of three new cases of psychiatric treatment, three new cases of psychiatric diagnosis, and the worsening of symptoms in a few. Obviously, these new cases do not add statistical significance. Psychological sequelae of gynecologic surgery are not usually seen until at least two years after the operation. The initial concern is survival. Other considerations, such as the desire for more children, sexuality, and self-esteem may be deferred, but they later reappear. Menstruation has a self-reassuring effect on some women and, when it is missing, may alter self-image. Furthermore, some persons have unrealistic expectations about procedures or treatments; they assign them magic qualities. 1 Luckily, more women are participating in the decision-making process