Sexuality after total vs. subtotal hysterectomy

Vibeke Zobbe*, Helga Gimbel, Birthe Margrethe Andersen, Thomas Filtenborg, Kristian Jakobsen, Helle Christina Sørensen, Kim Toftager-Larsen, Katrine Sidenius, Nini Møller, Ellen Merete Madsen, Mogens Vejtorp, Helle Clausen, Annie Rosgaard, Christian Gluud, Bent S. Ottesen, Ann Tabor

*Corresponding author af dette arbejde

    Publikation: Bidrag til tidsskriftArtikelForskningpeer review


    Background. The effect of hysterectomy on sexuality is not fully elucidated and until recently total and subtotal hysterectomies have only been compared in observational studies. Aims. To compare total abdominal hysterectomy (TAH) to subtotal abdominal hysterectomy (SAH) regarding effects on sexuality. Methods. In a Danish multicenter trial 319 women were randomized to TAH (n = 158) or SAH (n = 161); 185 women had self-selected TAH (n = 80) or SAH (n = 105) in a simultaneously conducted observational study. Women were followed for 1 year by strict data collection procedures, including postal questionnaires. Results were analyzed by intention to treat (ITT) analyses. Results. No significant differences were observed between TAH and SAH at 1-year follow-up in both the randomized trial and the observational study regarding women's desire for sex, frequency of intercourse, frequency of orgasm, quality of orgasm, localization of orgasm, satisfaction with sexual life, and dyspareunia. None of these sexual variables changed significantly from entry to the 1-year follow-up, apart from dyspareunia, which was significantly (p = 0.009) reduced in both intervention groups. Significant (p < 0.05) predictors for satisfaction with sexual life after hysterectomy were the preoperative satisfaction with sexual life [odds ratio (OR) 32, 95% confidence interval (CI) 10-125], good relationship with partner (OR 50, 95% CI 9-354), physical well-being (OR 0.30, 95% CI 0.09-0.88) and hormone replacement therapy (OR 0.23, 95% CI 0.06-0.78). Conclusions. Both TAH and SAH significantly reduce dyspareunia without having a negative effect on sexual function. The shift toward SAH seems unwarranted.

    Sider (fra-til)191-196
    Antal sider6
    TidsskriftActa Obstetricia et Gynecologica Scandinavica
    Udgave nummer2
    StatusUdgivet - 1 feb. 2004


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