Hysterectomy and sexual wellbeing: prospective observational study of vaginal hysterectomy, subtotal abdominal hysterectomy, and total abdominal hysterectomy

doi:10.1136/bmj.327.7418.774

BMJ 2003;327:774-778 (4 October), doi:10.1136/bmj.327.7418.774

Paper

Hysterectomy and sexual wellbeing: prospective observational study of vaginal hysterectomy, subtotal abdominal hysterectomy, and total abdominal hysterectomy

Jan-Paul W R Roovers, registrar¹, Johanna G van der Bom, assistant professor of epidemiology², C Huub van der Vaart, consultant¹, A Peter M Heintz, professor of gynaecology¹

¹ Department of Obstetrics and Gynaecology, University Medical Center Utrecht, 3584 CX Utrecht, Netherlands, ² Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Netherlands

Correspondence to: J-P Roovers j_proovers{at}hotmail.com

Objectives To compare the effects of vaginal hysterectomy, subtotalabdominal hysterectomy, and total abdominal hysterectomy onsexual wellbeing.

Design Prospective observational study over six months.

Setting 13 teaching and non-teaching hospitals in the Netherlands.

Participants 413 women who underwent hysterectomy for benigndisease other than symptomatic prolapse of the uterus and endometriosis.

Main outcome measures Reported sexual pleasure, sexual activity,and bothersome sexual problems.

Results Sexual pleasure significantly improved in all patients,independent of the type of hysterectomy. The prevalence of oneor more bothersome sexual problems six months after vaginalhysterectomy, subtotal abdominal hysterectomy, and total abdominalhysterectomy was 43% (38/89), 41% (31/76), and 39% (57/145),respectively ( ${chi}$ ² test, P = 0.88).

Conclusion Sexual pleasure improves after vaginal hysterectomy,subtotal abdominal hysterectomy, and total abdominal hysterectomy.The persistence and development of bothersome problems duringsexual activity were similar for all three techniques.

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