Quality of life before and after sympathectomy in primary hyperhidrosis: a recall-based paired analysis of 94 patients
Year: 2026
Type: article
Abstract: Objectives Primary hyperhidrosis substantially impairs quality of life. Sympathectomy is an established treatment for severe focal hyperhidrosis; however, patient-reported outcomes in Arab populations remain limited. This study evaluated recalled preoperative and current postoperative quality of life after sympathectomy using validated Arabic instruments. Methods We conducted a secondary, recall-based paired analysis of a cross-sectional survey of 94 participants with primary hyperhidrosis who reported having undergone bilateral sympathectomy. Participants completed an Arabic electronic survey between May 2024 and April 2025. Current postoperative quality-of-life scores were compared with retrospectively recalled preoperative scores using the Arabic Hyperhidrosis Quality of Life Index (HidroQoL©); severity was assessed using the Arabic Hyperhidrosis Disease Severity Scale. Wilcoxon signed-rank tests were primary; paired t tests were sensitivity analyses. Results The mean participant age was 30.7 ± 8.9 years, and 63.8% were men. At the recalled preoperative assessment, 55 participants (58.5%) reported Grade 4 disease severity. All 94 participants provided complete paired data. The mean daily-life score decreased from 8.5 ± 2.8 to 4.9 ± 4.5 [mean paired change −3.6; 95% confidence interval (CI) −4.5 to −2.8; d z = −0.88]. The mean psychosocial score decreased from 16.9 ± 5.5 to 8.8 ± 8.7 (−8.1; 95% CI −9.7 to −6.4; d z = −0.97). The total score decreased from 25.4 ± 7.5 to 13.7 ± 12.8 (−11.7; 95% CI −14.1 to −9.3; d z = −0.98); all p < 0.001. Thirteen participants (13.8%) reported a higher total score after surgery. Conclusions Participants reported substantially lower hyperhidrosis-related daily-life and psychosocial impairment after sympathectomy. Recall bias may affect the magnitude and direction of these differences, which do not establish causal treatment effects. Prospective studies incorporating true preoperative baseline assessment, operative details, compensatory sweating, and longer follow-up are needed to confirm the magnitude and durability of these improvements.
Source: Frontiers in Surgery
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7222198008