Sexuality After Total Vs. Subtotal Hysterectomy

Objective: Hysterectomy is the most common major gynecologic operation,it include total abdominal hysterectomy and subtotal abdominal hysterectomy. Now almost every gynecologist can finish the operation very well, but it is uncertain whether subtotal abdominal hysterectomy results in better sexual function than total abdominal hysterectomy,so further studies are required. The aim of this study was to investigate the impact of sub-total and total hysterectomy on women's satisfaction, evaluated with questionnaire assessment of sexual activity, sexual intercourse, dyspareunia and orgasm.Methods: A prospective, randomized, nonblind study was conducted on 133 patients with hysterectomy which admitted between February 1st 2009 until August 31st to The department of gynecology of The First Affiliated Hospital of Chongqing Medical University. In the study period of 6 months, 133 women were enrolled and completed the questionnaires, including 84 total abdominal hysterectomy patients and 49 sub total abdominal hysterectomy patients. The data was analyzed according to age, gestation, educational background, occupation, mental growth of sexuality, the relationship between couple, sexual function and so on. It was then compared for any significant differences. And then the data was analyzed about the change of sexual function after the operation between total abdominal hysterectomy and subtotal abdominal hysterectomy.Results: There was no significant difference among total abdominal hysterectomy and subtotal abdominal hysterectomy in age, gestation, educational background, occupation, mental growth of sexuality, the relationship between couple. Three months after the operation, both total and sub-total hysterectomy resulted with retrogressions in the women's sexual satisfaction (6 months after surgery) about orgasm , sexual activity and algopareunia, but no statistically significant differences in dyspareunia were reached. A highly significant differences in the orgasm and sexual activity between total and sub-total hysterectomy was underlined. And 4.1% patients had sex life in total hysterectomy group, but patients in sub-total hysterectomy group who had sex life reached 75.6%. Six months later, there was also a significant differences in the orgasm about total hysterectomy patients than preoperative. There was on significant difference in any aspect. The orgasm resulted significant better in the"sub-total hysterectomy"group six months after surgery (P < 0.020).Conclusion: We concluded that the effect of total and sub-total hysterectomy were mainly on sexual desire and sexual intercourse, and dyspareunia in the postoperative period did not make any difference between the two groups. But the orgasm was degraded in the two groups, and the orgasm resulted significant better in the"sub-total hysterectomy"group.