Understanding the Value of the Uterus: A Nationwide Cross-sectional Survey on Women's Preferences With Benign Gynecological Conditions

IF 2.9 2区医学 Q1 OBSTETRICS & GYNECOLOGY

Journal of minimally invasive gynecology Pub Date : 2026-09-01 Epub Date: 2026-03-12 DOI:10.1016/j.jmig.2026.03.009

Ashley Huynh BS, Whitney Horner MD, Danielle Antosh MD, Isuzu Meyer MD, William D. Winkelman MD, Gabriela E. Halder MD, Jessica Ton MD, Kate V. Meriwether MD, Patricia L. Hudson MD, Nancy Ringel MD, Emily R.W. Davidson MD, Olivia H. Chang MD, MPH

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Chang MD, MPH","doi":"10.1016/j.jmig.2026.03.009","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To identify clinical and demographic predictors associated with placing high value on the uterus among women with gynecological conditions in the United States.</div></div><div>To identify clinical and demographic predictors associated with placing high value on the uterus among women with gynecological conditions in the United States.</div><div><h3>Design</h3><div>Multicenter cross-sectional survey study utilizing the validated Value of the Uterus (VALUS) instrument and visual analog scale (VAS) to assess uterine value perceptions.</div></div><div>Multicenter cross-sectional survey study utilizing the validated Value of the Uterus (VALUS) instrument and visual analog scale (VAS) to assess uterine value perceptions.</div><div><h3>Setting</h3><div>Eleven medical centers across four U.S. regions (South, Southwest, West, and Northeast) from December 2023 to June 2024.</div></div><div>Eleven medical centers across four U.S. regions (South, Southwest, West, and Northeast) from December 2023 to June 2024.</div><div><h3>Patients</h3><div>Participants included adult patients with a uterus, assigned female sex at birth, and not considering future pregnancies. Of 906 surveys distributed, 714 completed surveys (79% response rate) were analyzed. Most participants identified as White (74.9%), were 45 to 60 years old (36%), and postmenopausal (55.3%). Regional distribution included South (35.6%), West (34.7%), Northeast (22%), and Southwest (4.3%).</div></div><div>Participants included adult patients with a uterus, assigned female sex at birth, and not considering future pregnancies. Of 906 surveys distributed, 714 completed surveys (79% response rate) were analyzed. Most participants identified as White (74.9%), were 45 to 60 years old (36%), and postmenopausal (55.3%). Regional distribution included South (35.6%), West (34.7%), Northeast (22%), and Southwest (4.3%).</div><div><h3>Interventions</h3><div>Participants completed surveys assessing demographics, clinical history, the VALUS instrument (range 6–30), and a VAS question rating importance of uterine preservation (0–100 scale). Participants were stratified using median VALUS score of 16 as the cut-off: 336 (47%) had low uterine value (VALUS <16) and 378 (53%) had high uterine value (VALUS ≥16).</div></div><div>Participants completed surveys assessing demographics, clinical history, the VALUS instrument (range 6–30), and a VAS question rating importance of uterine preservation (0–100 scale). Participants were stratified using median VALUS score of 16 as the cut-off: 336 (47%) had low uterine value (VALUS <16) and 378 (53%) had high uterine value (VALUS ≥16).</div><div><h3>Measurements and Main Results</h3><div>The mean VAS score was 40.8 (SD: 32.4). Multivariable logistic regression, controlling for income, age, and urinary incontinence (UI), revealed significant predictors of high uterine value. Asian American/Pacific Islander (AAPI) individuals had higher odds compared to White individuals (adjusted OR = 2.34; 95% CI, 1.24–4.60; p = .01). Annual income of $20 000 to $49 000 was associated with higher odds vs the highest income bracket (adjusted OR = 2.53; 95% CI, 1.49–4.36; p <.01). Self-reported UI was associated with lower odds of high uterine value (adjusted OR = 0.71; 95% CI, 0.51–0.97; p = .03).</div></div><div>The mean VAS score was 40.8 (SD: 32.4). Multivariable logistic regression, controlling for income, age, and urinary incontinence (UI), revealed significant predictors of high uterine value. Asian American/Pacific Islander (AAPI) individuals had higher odds compared to White individuals (adjusted OR = 2.34; 95% CI, 1.24–4.60; p = .01). Annual income of $20 000 to $49 000 was associated with higher odds vs the highest income bracket (adjusted OR = 2.53; 95% CI, 1.49–4.36; p <.01). Self-reported UI was associated with lower odds of high uterine value (adjusted OR = 0.71; 95% CI, 0.51–0.97; p = .03).</div><div><h3>Conclusion</h3><div>AAPI racial identity, lower income, and absence of UI predict placing high value on the uterus. Clinicians should incorporate these factors into shared decision-making when counseling patients regarding hysterectomy vs uterine-preserving procedures.</div></div><div>AAPI racial identity, lower income, and absence of UI predict placing high value on the uterus. 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引用次数: 0

Abstract

Objective

To identify clinical and demographic predictors associated with placing high value on the uterus among women with gynecological conditions in the United States.

Design

Multicenter cross-sectional survey study utilizing the validated Value of the Uterus (VALUS) instrument and visual analog scale (VAS) to assess uterine value perceptions.

Setting

Eleven medical centers across four U.S. regions (South, Southwest, West, and Northeast) from December 2023 to June 2024.

Patients

Participants included adult patients with a uterus, assigned female sex at birth, and not considering future pregnancies. Of 906 surveys distributed, 714 completed surveys (79% response rate) were analyzed. Most participants identified as White (74.9%), were 45 to 60 years old (36%), and postmenopausal (55.3%). Regional distribution included South (35.6%), West (34.7%), Northeast (22%), and Southwest (4.3%).

Interventions

Participants completed surveys assessing demographics, clinical history, the VALUS instrument (range 6–30), and a VAS question rating importance of uterine preservation (0–100 scale). Participants were stratified using median VALUS score of 16 as the cut-off: 336 (47%) had low uterine value (VALUS <16) and 378 (53%) had high uterine value (VALUS ≥16).

Measurements and Main Results

The mean VAS score was 40.8 (SD: 32.4). Multivariable logistic regression, controlling for income, age, and urinary incontinence (UI), revealed significant predictors of high uterine value. Asian American/Pacific Islander (AAPI) individuals had higher odds compared to White individuals (adjusted OR = 2.34; 95% CI, 1.24–4.60; p = .01). Annual income of $20 000 to $49 000 was associated with higher odds vs the highest income bracket (adjusted OR = 2.53; 95% CI, 1.49–4.36; p <.01). Self-reported UI was associated with lower odds of high uterine value (adjusted OR = 0.71; 95% CI, 0.51–0.97; p = .03).

Conclusion

AAPI racial identity, lower income, and absence of UI predict placing high value on the uterus. Clinicians should incorporate these factors into shared decision-making when counseling patients regarding hysterectomy vs uterine-preserving procedures.

查看原文本刊更多论文

了解子宫的价值：一项关于女性对良性妇科疾病偏好的全国性横断面调查。

目的：确定临床和人口统计学的预测因素与高度重视子宫在美国的妇女妇科疾病。设计：多中心横断面调查研究，利用经验证的子宫价值（VALUS）仪器和视觉模拟量表（VAS）评估子宫价值感知。设置：从2023年12月到2024年6月，在美国四个地区（南部，西南，西部和东北部）的11个医疗中心。参与者：参与者包括有子宫的成年患者，出生时被指定为女性，没有考虑将来怀孕。在分发的906份调查中，分析了714份完成的调查（79%的回复率）。大多数参与者被确定为白人（74.9%），45-60岁（36%）和绝经后（55.3%）。区域分布为南方（35.6%）、西部（34.7%）、东北（22%）和西南（4.3%）。干预措施：参与者完成调查，评估人口统计学，临床病史，VALUS仪器（范围6-30）和VAS问题评估子宫保存的重要性（0-100分）。参与者分层使用中位VALUS评分16作为截止点：336（47%）有低子宫价值(VALUS结果：平均VAS评分为40.8 （SD: 32.4）。多变量logistic回归，控制收入，年龄，尿失禁（UI），显示显著预测高子宫价值。亚裔美国人/太平洋岛民（AAPI）的患病几率高于白人（调整后OR=2.34; 95% CI 1.24-4.60; p=0.01）。与最高收入阶层相比，年收入在20,000- 49,000美元之间的女性患子宫的几率更高（调整后OR=2.53; 95% CI 1.49-4.36）。结论：亚太裔的种族认同、较低的收入和无子宫内膜不清预示着对子宫的高度重视。临床医生应将这些因素纳入共同决策时，咨询患者关于子宫切除术和子宫保留程序。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of minimally invasive gynecology 医学-妇产科学

CiteScore

5.00

自引率

7.30%

发文量

272

审稿时长

37 days

期刊介绍： The Journal of Minimally Invasive Gynecology, formerly titled The Journal of the American Association of Gynecologic Laparoscopists, is an international clinical forum for the exchange and dissemination of ideas, findings and techniques relevant to gynecologic endoscopy and other minimally invasive procedures. The Journal, which presents research, clinical opinions and case reports from the brightest minds in gynecologic surgery, is an authoritative source informing practicing physicians of the latest, cutting-edge developments occurring in this emerging field.