Supra Vaginal Uterine Amputation VS. Hysterectomy

Abstract

Postoperative symptoms of hysterectomy have received relatively little attention. In the present study, the first author has personally interviewed and examined 105 abdominal hysterectomy patients and 107 patients with supravaginal uterine amputation preoperatively and 6 weeks, 6 months and 12 months postoperatively. Participation in the follow-up study was 99.5% (211/212) at one year. This paper deals with the effects of the two operations on libido and the frequency of orgasms. In the statistical analysis, McNemar's test of symmetry and the Fisher exact test were used. Weak or absent libido was reported preoperatively by 28.0% of hysterectomy patients and by 26.4% of amputation patients. One year postoperatively the corresponding figures were 35.4% and 31.4%. No statistical changes were observed between the two groups or within either group. In the frequency of orgasms a highly significant (p less than 0.001) reduction from the situation before operation to one year postoperatively was detected after hysterectomy. In the supravaginal amputation group no statistically significant decrease was detected. Preoperatively the two groups were alike; one year postoperatively the difference was almost significant (p less than 0.05). The reductions in orgasms after hysterectomy as compared with supravaginal amputation appears to result from the greater radicality of the former; at hysterectomy, the autonomous innervation of the proximal vagina and cervix is damaged more than in supravaginal amputation, the anatomy of the vagina is altered and scar tissue forms in the vagina. It is probable that these changes and subconscious psychological reactions due to total removal of the uterus explain why supravaginal uterine amputation gives better results than hysterectomy.

Pelvic organ prolapse after subtotal and total hysterectomy: a long‐term follow‐up of an open randomised controlled multicentre study

“…This procedure has gained popularity among women and doctors because of reports indicating potential advantages. [2][3][4][5] It also seems to be a mode of hysterectomy that is preferred and recommended by gynaecologists to women with certain gynaecological disorders. [6][7][8] Relatively few randomised trials have compared subtotal abdominal hysterectomy (SH) and total abdominal hysterectomy (TH).…”

Función Sexual Tras 9 Meses De Una Histerectomía : Comparación De Los Resultados Del Cuestionario De Salud Sexual Fsm® Versus Percepción Subjetiva De La Mujer

“…Kilkku dice que tras la histerectomía la libido no cambia pero la capacidad para alcanzar el orgasmo disminuye 58 , algo que tampoco es acorde con nuestros hallazgos según el test FSM ® , pero sí hemos visto que parte de las mujeres que consideran que su vida sexual empeora lo relacionan con menos orgasmos y menos intensidad en los mismos.…”

“…Puede ocurrir deterioro en la función sexual tras la cirugía. Las razones que pueden afectar a la sexualidad tras la histerectomía son: las consideraciones anatómicas como la cicatriz que queda en la vagina o la disrupción de nervios, la posible disminución en la sensibilidad de la vagina, el hecho de quitar el cérvix, el empeoramiento del orgasmo en aquellas mujeres con contracciones uterinas durante el mismo, las preocupaciones porque el útero pueda contribuir a aportar una sensación de bienestar y feminidad, etc 3,4,18,19,58 .…”

Subtotal Versus Total Abdominal Hysterectomy for Benign Gynecological Conditions

“…With regard to sexual outcome including coital frequency, desire, orgasm frequency, dyspareunia and overall sexual outcome, a systematic review of effect on sexual function following subtotal abdominal hysterectomy versus total abdominal hysterectomy identified four non-randomized studies, one of which showed that total abdominal hysterectomy had advantages over subtotal abdominal hysterectomy (20), two of which showed that subtotal abdominal hysterectomy had advantages over total abdominal hysterectomy with respect to sexual function (36,37). The remaining one, in addition to five randomized controlled trials showed no difference (20,(38)(39)(40)(41)(42).…”