Sexual function after hysterectomy according to surgical indication: a prospective cohort study
Sara R. Till
A C * , Andrew Schrepf B C , Jennifer Pierce B , Stephanie Moser B , Ellen Kolarik B , Chad Brummett B C and Sawsan As-Sanie A C
+ Author Affiliations
- Author Affiliations
A Department of Obstetrics and Gynecology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
B Department of Anesthesiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
C Chronic Pain and Fatigue Research Center, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48105, USA.
Sexual Health 19(1) 46-54 https://doi.org/10.1071/SH21153
Submitted: 17 August 2021 Accepted: 19 January 2022 Published: 1 March 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing
Abstract
Background: Our aims were to describe characteristics of sexual function prior to and 6 months following benign hysterectomy in patients with three common surgical indications, and to identify preoperative factors that influence the magnitude and direction of change in sexual function after the procedure.
Methods: This prospective observational cohort study enrolled women (n = 80) undergoing hysterectomy for benign indications. Patients were categorised into three groups according to surgical indication: (1) pelvic pain (PP), (2) abnormal uterine bleeding (AUB), and (3) pelvic organ prolapse (POP). Primary outcome was Female Sexual Function Index (FSFI), which patients completed preoperatively and 6 months postoperatively.
Results: The study included 80 patients, of whom 25.0% (n = 20) had surgical indication of PP, 46.3% (n = 37) of AUB, and 28.7% (n = 23) of POP. PP patients experienced a significant improvement in overall sexual function, as well as orgasm and pain domains following hysterectomy. Significant improvements were not found in AUB and POP patients. In multivariate analysis, lower baseline sexual function (P < 0.001), younger age (P = 0.013), and pelvic pain <6 months (P = 0.020) were each independently associated with improvement in sexual function, but surgical indication was not significant.
Conclusion: Individual patient factors including younger age, lower baseline sexual function, and short duration of pelvic pain are associated with a higher likelihood of improvement in sexual function after hysterectomy. Surgical indication does not appear to be predictive of postoperative sexual function once accounting for other factors.
Keywords: dyspareunia, evidence-based medicine, hysterectomy, pelvic pain, sexual dysfunction, sexual experience, women’s issues.
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