Sexual function after total laparoscopic hysterectomy or transabdominal hysterectomy for benign uterine disorders: a retrospective cohort

Abstract

The objective of this study was to evaluate changes in sexual function after total laparoscopic hysterectomy (TLH) or transabdominal hysterectomy (TAH). This retrospective cohort study included patients with benign uterine tumors that were divided into TLH group and TAH group based on the hysterectomy technique used. Baseline, intraoperative, and postoperative characteristics were compared between groups. Postoperative sexual function was assessed using the Brief Index of Sexual Functioning for Women. The TLH and TAH groups contained 119 patients (age, 51.5±6.1 years) and 126 patients (age, 50.0 ± 4.7 years), respectively. Baseline characteristics were comparable between groups, although uterine size was larger in the TAH group (Po0.001). Compared with the TAH group, the TLH group had a longer operative time (130.0 ± 36.2 vs 107.3 ± 28.5 min, Po0.001), lower pain index at 24 h (2.0 ± 1.6 vs 4.0 ± 2.6, Po0.001), and shorter hospitalization time (5.7 ± 1.1 vs 8.1 ± 1.2 days, Po0.001). Many patients in the TLH and TAH groups reported decreased satisfaction with their sexual life (67.5 and 56.0%, respectively), reduced frequency of sexual activity (70.1 and 56.0%, respectively), decreased libido (67.5 and 56.0%, respectively), orgasm dysfunction (42.9 and 42.9%, respectively), and increased dyspareunia (77.9 and 85.7%, respectively). However, there was no significant difference between groups in any of the indexes of postoperative sexual function (P40.05). Both TLH and TAH had comparable negative effects on sexual function in women treated for benign uterine tumors in China, with a decreased frequency of sexual activity, reduced libido, orgasm dysfunction, and increased dyspareunia.

Effect of Hysterectomy due to Benign Diseases on Female Sexual Function: A Systematic Review and Meta-analysis

“…Wang concluded that total hysterectomy has a negative effect on women's sexual function by reducing the frequency of sexual activity, decreased libido, orgasmic dysfunction, and increased dyspareunia (8). In contrast, other reports suggest that hysterectomy can improve female sexual function because it reduces symptoms associated with benign conditions such as bleeding problems, dyspareunia, prolapse-related reluctance, fear of pregnancy.…”

The Influence of Laparoscopic Benign Hysterectomy in Sexual Function

“…By contrast Wang et al [41] analyzed a retrospective chinese study between abdominal and laparoscopic hysterectomy using the Brief Index of Sexual Functioning for Women (BISF-W) [36]. The authors found lower sexual satisfaction after surgery in both groups with no significant difference between them in any of the indexes of postoperative sexual function.…”

“…Small number of studies have reported than postoperative sexual function is comparable between open or laparoscopic approach with similar negative effects in patients undergoing hysterectomy for benign conditions [41][42][43][44][45][46], A chinese retrospective study for benign tumors found no significant differences between open or laparoscopic hysterectomy, reporting for both groups decreased satisfaction with sexual life, reduced frequency of sexual activity, decreased libido, orgasm dysfunction and increased dyspareunia after hysterectomy [41]. Prospective studies in turkish population [43][44][45] also revealed a detrimental effect using validated pre and postoperative questionnaires, without differences for the two different hysterectomy techniques.…”

Prophylaxis Effect of Metronidazole Vaginal Gel in Decreasing the Risk of Surgical Site Infections after Elective Hysterectomy

“…Women often see the uterus as a sexual organ that controls and regulates important physiological functions in the body and a source of youth, energy, activity, and a symbol of fertility. [ 10 ]…”