Journal of Women’s Medicine Vol. 1 No. 1 June 2008
Original Articles
Laparoscopic total hysterectomy versus laparoscopic supracervical hysterectomy: The effect on female sexuality Anna Nam, MD1, SiHyun Cho, MD1, Seok Kyo Seo, MD1, Young Eun Jeon, MD1, Hye Yoen Kim, MD2, Young Sik Choi, MD2, Byung Seok Lee, MD1 1
Department of Obstetrics and Gynecology, Yongdong Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea 2 Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea Objective: This study was designed to compare the effects of laparoscopic total hysterectomy and laparoscopic supracervical hysterectomy on female sexual quality. Methods: A Prospective observational study over 6 months was performed. Ninety four patients who had laparoscopic hysterectomy for benign disease excluding uterine prolapse and endometriosis were recruited to the study. All patients completed a questionnaires for self report of changes in sexual quality before laparoscopic total or supracervical hysterectomy and six months after surgery. Results: Compared to the laparoscopic total hysterectomy group, those who had laparoscopic supracervical hysterectomy had a shorter time to the first intercourse after surgery (5.78 weeks vs. 4.92 weeks, p=0.001). The overall sexual quality after surgery remained unchanged; it was 90.2% for the total group and 87.2% for the supracervical laparoscopic hysterectomy cases. Conclusions: The quality of sexual life did not show significant change in most cases after either laparoscopic total hysterectomy or laparoscopic supracervical hysterectomy. Key words: Laparoscopic total hysterectomy; Laparoscopic supracervical hysterectomy; Female sexuality
INTRODUCTION Hysterectomy is the most common surgical procedure in gynecology practice in Korea. Hysterectomies are performed by different approaches depending on the case. There are abdominal, vaginal, supracervical, and laparoscopic hysterectomies. The abdominal hysterectomy is the classical type of hysterectomy and it continues to be performed frequently worldwide. However, laparoscopic surgery is being used in almost every Corresponding author: Byung Seok Lee, M.D. Department of Obstetrics and Gynecology Yongdong Severance Hospital, Yonsei University College of Medicine Eunjuro 162, Dogok-dong, Kangnam-gu, Seoul 135-720, Korea Tel: 82-2-2019-3430 Fax: 82-2-3462-8209 E-mail:
[email protected]
field of surgery. The number of laparoscopic hysterectomies performed is increasing. As the laparoscopic hysterectomy has become an important technique in gynecology, various methods of laparoscopic hysterectomy have been developed. The advantages of laparoscopic hysterectomy compared to the abdominal and vaginal hysterectomies include that it is a minimally invasive surgery and adnexal surgery can be performed at the same time. The laparoscopic supracervical hysterectomy is relatively new and its use debated. Irrespective of the type of surgery, the hysterectomy has some postoperative complications. One of the complications is sexual dysfunction. While sexual quality has been a subject of interest, the effect of different types of hysterectomies, on sexual function, has been studied extensively. We compared the effects of the laparoscopic total hysterectomy and laparoscopic supracervical hyste-
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rectomy on female sexual activity after surgery.
MATERIALS AND METHODS From June 2005 through January 2007, 95 women had laparoscopic hysterectomies at the department of obstetrics and gynecology, Yongdong Severance Hospital, Yonsei University, Seoul, Korea. Four women were excluded from the study (two widows without sex partners, one divorced without sex partners, one woman who never married and not sexually active). Ninety one women participated in the study; they all had laparoscopic hysterectomies for benign gynecologic conditions. A laparoscopic supracervical hysterectomy was offered to patients with normal cervical cytology. A questionnaire concerning sexual activity was administered during the hospital stay with an interview by a research assistant. Approximately 6 months after the operation, the patients were asked again about their sexual activity over the phone. The questionnaires asked about the frequency of coitus per week, time taken until the first intercourse after the operation, dyspareunia, sexual satisfaction (scale: 1=not satisfied, 2=somewhat, 3=satisfied), and overall subjective sexual quality. The statistical analysis was performed with SPSS (version 13.0; SPSS for Windows) and an unpaired Student’t test was used for the analysis. Statistical significance was considered at a p
