Endoscopic surgery plus psychological intervention improving symptoms, anxiety, and depression in patients undergoing panhysterectomy for benign gynecological diseases

BACKGROUND Single-port transvaginal natural orifice transluminal endoscopic surgery (vNOTES) has limited effect on psychological stress in patients undergoing total hysterectomy for benign gynecological diseases, and optimization of relevant clinical practice is therefore warranted.AIM To evaluate the effects of vNOTES combined with psychological intervention on pelvic floor symptom distress, anxiety, and depression in patients undergoing total hysterectomy for benign gynecological diseases.METHODS This single-center, retrospective, nonrandomized controlled cohort study included 196 patients who underwent total hysterectomy for benign gynecological diseases at Hunan Provincial People's Hospital (The First Affiliated Hospital of Hunan Normal University) between January 2020 and June 2025.Patients were grouped according to the intervention received: The control group (n = 96) received vNOTES alone, whereas the research group (n = 100) received vNOTES plus psychological intervention.Pelvic floor symptom distress (pelvic floor distress inventory-short form 20), psychological stress (self-rating anxiety scale; self-rating depression scale), oxidative stress (superoxide dismutase, glutathione peroxidase, and malondialdehyde), quality of life (short form health survey questionnaire), and adverse reactions (lower abdominal distension, nausea and vomiting, pollakiuria and micturition urgency, shoulder and back soreness, and pelvic infection) were assessed and compared between the two groups. RESULTSCompared with the control group, the research group had significantly lower pelvic 3 / 30 floor distress inventory-short form 20, self-rating anxiety scale, and self-rating depression scale scores and malondialdehyde levels and significantly higher superoxide dismutase and glutathione peroxidase levels and short form health survey questionnaire scores (P < 0.05).No significant between-group difference was observed in the incidence of total adverse reactions (P > 0.05). CONCLUSIONThe vNOTES combined with psychological intervention was significantly associated with improved pelvic floor symptom distress and reduced psychological stress in patients undergoing total hysterectomy for benign gynecological diseases, with clinical safety comparable to that of vNOTES alone.However, residual confounding factors limit the generalizability of these findings.