Hysterectomy is the principally fr...

Hysterectomy is the principally frequently performed major gynecologic surgery Each of the in every one's mouth surgical techniques (vaginal, subtotal abdominal, and total abdominal hysterectomy) disrupts local vigors and changes pelvic anatomy. The efficiency on sexual function is unclear. Studies have reported beneficial tenors and adverse effects on sexual wellbeing. Roover and colleagues investigated sexual well-being after each prototype of hysterectomy in Dutch women who underwent surgery for a benign indication in 13 hospitals during 1999 and 2000

In this prospective application of mind patients completed a screening questionnaire for sexual dysfunction as part of the preoperative assessment and the six-month follow-up visit. The 36-item questionnaire used a five-point Likert scale to assess general perception of the patient's sexuality, common occurrence of sexual activity, and point to be solved [i]or[/i] settleds relating to arousal, lubrication, orgasm, or pelvic discomfort. The preoperative assessment included measurement of uterine size and screening for comorbid conditions as it is as diabetes, hypertension, hypothyroidism, pulmonary disease, and rheumatoid arthritis. Surgical data included the reach of uterine prolapse, estimated family loss, duration of surgery, simultaneous surgical proceedings surgical complications, and length of hospital stay.

Six month after surgery 352 of the 379 patients who had a male partner participated in the follow-up assessment. Of the 352 patients, 89 (25 percent) had undergone vaginal hysterectomy, 76 (22 percent) had undergone subtotal abdominal hysterectomy, and 145 (41 percent) had undergone abdominal hysterectomy. Overall, 10 patients discontinued sexual activity after surgery; however, 17 of the 32 patients who had not been sexually active before surgery reported sexual activity at follow-up No statistical difference was place in surgical technique among patients who remained sexually active or became sexually active. For each sign of surgery, the percentage of respondent who were sexually active and the frequent occurrence of sexual intercourse were not significantly changed after surgery and overall sexual satisfaction was significantly improved (see accompanying table forward page 2683).

Bothersome sexual question s were still common and were reported through 43 percent of the patients who had undergone vaginal hysterectomy, 41 percent of the patients who had undergone subtotal abdominal hysterectomy, and 39 percent of the patients who had undergone total abdominal hysterectomy. question s with lubrication, arousal, and sensation were les habitual after vaginal surgery, but the differences did not reach statistical significance. After adjustment for multiple significant variables, the left over s ratio for lubrication problems after abdominal rather than vaginal managements was 1.6, and the supernumerarys ratio for arousal problems was 12

The authors bring to an end that overall sexual well-being improves after hysterectomy, regardless of the surgical technique used. Specific sexual moot points were more common before surgery and modern sexual problems were rare after surgery

Roover J-P et al. Hysterectomy and sexual wellbeing: prospective observational inquiry of vaginal hysterectomy, subtotal abdominal hysterectomy, and total abdominal hysterectomy. BMJ October 4 2003;327:774-8

EDITOR'S NOTE: This is the same of those "good news, bad news" reports. While the authors' data and conclusions point out improvement in overall sexual function after hysterectomy, the of the same height of symptomatology reported in the tables is horrifying. Before surgery high percentages of women reported symptoms that interfered with sexual function--after surgery more than 40 still had at least the same bothersome sexual problem. We can merely speculate about the implications for other aspects of their health, and the consequence on their sexual partners, families, and others. Family physicians know for what reason to assist patients in the greatest in number personal and sensitive aspects of human functioning, if it were not that do we remember to ask about sexual problems? Do we make it comfortable for women (and men) to disclose these concerns?

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group