Sexual functioning before and after vaginal hysterectomy to treat pelvic organ prolapse and the effects of vaginal cuff closure techniques: a prospective randomised study

Uçar, Mustafa Gazi; İlhan, Tolgay Tuyan; Şanlıkan, Fatih; Çelık, Çetin

doi:10.1016/j.ejogrb.2016.08.041

Cited by 22 publications

(14 citation statements)

References 22 publications

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“…However, it was observed that VH might have negative impact on sexual function if new-onset or worsening dyspareunia or incontinence develops postoperatively. 15 We had thirty-one patients who underwent concomitant surgery for POP and SUI and showed improvement in FSFI scores postoperatively. Similar results were observed in a prospective study of 159 women, where the use of transobturator tape (TOT) was associated with decrease in coital incontinence and significant improvement in FSFI desire and total scores with no significant difference in patients undergoing TOT and concomitant surgery group except for the worsening of lubrication.…”

Section: Discussionmentioning

confidence: 99%

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Surgery for pelvic organ prolapse and stress urinary incontinence and female sexual functions: A quasi-experimental study

2021

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Objectives: To assess the effect of pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI) on various domains of female sexual functions in patients before and after reconstructive surgery for these pelvic floor disorders. Methods: We conducted a quasi-experimental study of 126 women aged 25-65 years, presenting with POP / SUI, from January 1st 2019 to December 31st 2019 at Aga Khan University Hospital. POP surgery was performed only in patients with symptomatic POP ≥ stage 2 according to POP-Q (quantification). Sexual functions were assessed using Female Sexual Function Index (FSFI) questionnaire, among sexually active women at baseline and 18 months after surgery. Results: Mean age of the participants was 51.6, with a mean parity of four. Out of 126 patients, 31 patients underwent vaginal hysterectomy, pelvic floor repair and mid-urethral sling (MUS), 55 had vaginal hysterectomy with pelvic floor repair, 12 women had only pelvic floor repair and 10 patients had uterine suspension surgery for prolapse, while 18 patients underwent MUS operation alone for SUI. There was a statistically significant difference in female sexual functions after surgery for POP and/or SUI (p<0.01). This improvement was observed in both total and individual scores of each domain of FSFI with an overall improvement in sexual function from a mean of 18.5 pre-surgery to 20.8 post-surgery. Conclusions: This study reveals that women sexual functions are affected by POP and SUI and improve remarkably after reconstructive surgeries for these pelvic floor disorders. doi: https://doi.org/10.12669/pjms.37.4.3892 How to cite this:Abrar S, Mohsin R, Saleem H. Surgery for pelvic organ prolapse and stress urinary incontinence and female sexual functions: A quasi-experimental study. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.3892 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Section: Discussionmentioning

confidence: 99%

“…However, it was observed that VH might have negative impact on sexual function if new-onset or worsening dyspareunia or incontinence develops postoperatively. 15 …”

Section: Discussionmentioning

confidence: 99%

Surgery for pelvic organ prolapse and stress urinary incontinence and female sexual functions: A quasi-experimental study

2021

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“…Hysterectomy alters the anatomic relationships, innervation, and blood supply of the pelvic floor, which could theoretically alter sexual function (29). Although several previous studies have suggested that sexual function is often improved after hysterectomy for benign uterine disease due to alleviation of symptoms (10-16), a large minority of patients with benign disorders of the uterus exhibit a worsening of sexual function after hysterectomy (17)(18)(19). Indeed, Goktas et al observed that total hysterectomy and bilateral salpingo-oophorectomy in women with benign disease led to a deterioration in sexual function, which was assessed using the Female Sexual Function Index (20).…”

Section: Discussionmentioning

confidence: 99%

“…Most studies have reported that hysterectomy for benign diseases results in an overall improvement in sexual function (10)(11)(12)(13)(14)(15), likely because of the alleviation of symptoms such as abnormal uterine bleeding and pelvic pain (16). However, around 20-40% of patients with benign disease experience a worsening of sexual function after hysterectomy (17)(18)(19), and one study even showed an overall worsening of sexual function (20). Furthermore, clinical studies of women with malignant disease have consistently reported a worsening of sexual function after hysterectomy (21)(22)(23)(24)(25)(26), and hysterectomy was found to be a factor associated with poorer sexual function in middle-aged women (27).…”

Section: Introductionmentioning

confidence: 99%

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

Wang

Xiao

2020

Braz J Med Biol Res

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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.

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“…There is only a few data about this issue. In a study searching the effect of horizontal and vertical vaginal cuff closure following vaginal hysterectomy for pelvic organ prolapsus it was demonstrated that there was no difference in female sexuality between two closure techniques [6]. On the other hand, another study investigating the effect of vaginal cuff closure technique after laparoscopic hysterectomy showed improvement in female sexuality through laparoscopic approach [7].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic versus vaginal cuff closure in laparoscopic hysterectomy: does it affect female sexuality?

et al. 2019

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Objectives:To investigate the effect of vaginal cuff closure technique in laparoscopic hysterectomy on vaginal length and female sexual functions. Material and methods:This study was conducted at a tertiary research hospital. Women who underwent laparoscopic hysterectomy were included and classified according to vaginal cuff closure technique as laparoscopic (n = 75) and vaginal route (n = 25). Vaginal lengths were measured preoperatively and at 6th month postoperatively. Golombok-Rust Inventory of Sexual Satisfaction (GRISS) was used to evaluate female sexual functions. SPSS was used for statistical analysis and the level of significance was p = 0.05. Results:Preoperative GRISS scores and vaginal lengths were similar in two groups. The shortening of vaginal length and the worsening of GRISS scores were more prominent in vaginal cuff closure group (p = 0.002, p < 0.001). The alteration in vaginal length was positively correlated with the alteration in GRISS score in vaginal and laparoscopic route groups (r = 0.800, p < 0.001; r = 0.680, p < 0.001). The risk of female sexual dysfunction increases 69.88 fold for each 1 cm shortening of vaginal length (p = 0.039). Discriminative value of postoperative vaginal length for female sexual dysfunction in patients who underwent laparoscopic hysterectomy was investigated and a cut-off value of 7.4 cm (p < 0.001) was found. Conclusions:Laparoscopic route instead of vaginal route in laparoscopic hysterectomy is preferable to preserve a better vaginal length, which may be an important factor for female sexual functions.

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Sexual functioning before and after vaginal hysterectomy to treat pelvic organ prolapse and the effects of vaginal cuff closure techniques: a prospective randomised study

Cited by 22 publications

References 22 publications

Surgery for pelvic organ prolapse and stress urinary incontinence and female sexual functions: A quasi-experimental study

Surgery for pelvic organ prolapse and stress urinary incontinence and female sexual functions: A quasi-experimental study

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

Laparoscopic versus vaginal cuff closure in laparoscopic hysterectomy: does it affect female sexuality?

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