Abstract
Objective. To evaluate changes in sexual health and psychological well-being one year after subtotal and total hysterectomies. Design. Prospective randomized controlled trial. Material and methods. One hundred and thirty-two premenopausal patients scheduled for hysterectomy without planned oophorectomy for benign disorders and without a history of cervical dysplasia or symptomatic prolapse were randomized to total (n = 66) or subtotal hysterectomy (n = 66). The McCoy Female Sexuality Questionnaire was used to evaluate changes in sexual health and the Psychological General Well-Being index was used to evaluate changes in psychological well-being. Differences in outcome before and one year after the hysterectomy were calculated for each individual, and changes compared between the groups. Results. Women who had subtotal hysterectomy (SH) reported a significantly greater positive change in frequency of orgasm and sexual pleasure as compared with women who had total hysterectomy (TH) (mean values ± standard deviation (SD), orgasm: SH: 0.4 ± 1.1; TH: -0.2 ± 0.9, p = 0.012, sexual enjoyment: SH 0.3 ± 1.5; TH: -0.3 ± 1.3, p = 0.039). There was a significantly greater general health gain for the women who underwent subtotal hysterectomy as compared with total hysterectomy (mean values ± SD SH: 1.2 ± 2.3; TH: 0.3 ± 1.6, p = 0.03). The total score did not show a difference. Conclusions. Women undergoing subtotal hysterectomy experience a greater positive change in the frequency of orgasm and extent of sexual pleasure after surgery than women undergoing total hysterectomy, but the results must be interpreted with caution.
Acknowledgements
The authors thank Marianne Windh and Katarina Storek for helping with the recruitment of patients. Anders Möller assisted with designing the study and Anders Oden provided statistical guidance. The study was supported by grants from the Swedish Medical Research Council (B95-17X-11237-01A) and the Göteborg Medical Society Fund.
Disclosure of interest: None of the authors has any financial or other conflict of interest to disclose.