Meta-analysis Of Sexuality After Total And Subtotal Hysterectomy

Background: Hysterectomy is a common gynecologic surgery. It includestotal hysterectomy, subtotal hysterectomy and expand hysterectomy. If theexpectant management or the drug therapy can’t solve the problems, andhysteromyoma is unfit for the patients, we should choose hysterectomy. Theuterus is characteristic of the female, which is one of the most important femalegenital organs. Because of the special social and psychological status of theuterus. After hysterectomy, we should pay attention to releasing of the pain, aswell as the change of patients’ psychological status, the spirit and the sexuallife. And it becomes a focus on gynecological both at home and abroad. But atpresent, There are few studies of this kind in our country. We want to know theinfluence of total hysterectomy and subtotal hysterectomy on the patients byanalysis the sexual life after both the surgeries. Then it will help the clinicaldoctors explain and suggest how to improve their quality of life preoperativeand postoperative exactly.Objective: To investigate the effect on patients’ sex life, the totalhysterectomy vs. subtotal hysterectomy.Materials and Methods:1.Search strategy: We searched eleetronic databases Pubmed、Medline、Elsevier、Springlink、China National Knowledge infrastructure、CBMdise andreference lists of artieles and Wanfang data base and targeted reports publishedbetween1979and2011.2. Selection criteria:Inclusion criteria:(l)Studies published of case-contorl trials with full text.(2)The articles had provided the original data.(3)The ease group was the sexual life of the women who had underwent the total hysterectomy for benign disease.(4)The control group was the sexual life of the women who had underwentthe subtotal hysterectomy for benign disease.Exclusion criteria:(1)Studies without a randomized controlled group.(2)Studies including different treatment methods,such as theoophorectomy, or the outcomes for each method were not reported separately.(3)The studies included the patients who had other diseases, affecting theirsexual life.(4)Reviews or repeated literature.3.Measures:The sexual frequency,libido,orgasm,dyspareunia,vaginallubrication, arousal, the satisfaction of sex, and so on.4. Data collection and analysis: Data screening and quality assessment wasperformed independently by the author. We analysed data by using the softwareRevman5.0, provided by Coehrane Collaboration.We caleulated the studies’heterogeneity after we got the risk ratio also by using the sofeware,and we alsocompared the95%CI. Then we did the X2test.Main Results:1.Seven ease-control trials were included in our study.2.The characteristies of the inclusive studies: there were622totalhysterectomied patients and500subtotal hysterectomied patients,and they werefollowed up at least6months after their sexual life.Conclusion: It showed in our study that neither the total hysterectomy norsubtotal hysterectomy affected the sexual life of the patients. There were nosignificant differences on the sex frequency,libido, dyspareunia,orgasm,vaginal lubrication(et al),between the both kinds of surgeries.But referring tothe satisfaction， the total hysterectomy is1.35times of the subtotalhysterectomy. According to the other factors, psychological factor played an important role. After the hysterectomy, patients has certain psychologicaltrauma more or less. Husband and wife considered the sexincomplete,reducing the their satisfaction. What’s more,the sex life should beavoided for a long time after the surgery, which also reduced the satisfaction.So the sexual life will be as good as before,if the patients know the status ofthe uterus,releasing their nervous mood,and with the understanding oftheir husbands.