{"paper_id":"3113ca5d-f6bb-4c6f-992f-b661b79687b2","body_text":"Abstract\nAim\nTo evaluate postoperative sexual functioning and the influence of patients’ expectations on the change in sexuality following laparoscopic total (TLH) versus subtotal hysterectomy (LASH).\nMethods\nA total of 120 women undergoing laparoscopic hysterectomy were preoperatively enrolled in this bicentric prospective study. Sexual functioning (SF) was evaluated using the female sexual function index (FSFI). Additionally, participants filled in a standardised questionnaire concerning expected changes in SF after surgery. At 3, 6 and 12 months following surgery, women were asked again to assess their level of SF (FSFI). Data of women who participated in at least one FSFI follow-up assessment were analysed (n = 92). We compared the change in SF after surgery between patients with TLH (n = 46) and LASH (n = 46). Additionally, we calculated regression analyses with the patients’ expectations as a predictor for change in FSFI scores.\nResults\nComparing the change of FSFI scores after surgery in both collectives revealed differences only 3 months after surgery, as improvement was stronger for the LASH collective compared to the THL group (p = 0.006). There were no changes comparing collectives after 6 (p = 0.663) and 12 (p = 0.326) months. Concerning patientsʼ expectations, for the LASH group baseline SF (p < 0.001), but not expectations (p = 0.567) predicted the strength of change at each of the follow ups: a lower level of baseline SF was linked to a stronger improvement after surgery. For the THL collective, both baseline SF (p < 0.001) as well as patients’ expectations (3 months: p = 0.077, 6 months: p = 0.37, 12 months: p = 0.024) predicted the strength of change: both, a lower level of baseline SF and higher expectations towards an improvement predicted a stronger improvement.\nConclusion\nThe preservation of the cervix does not show an advantage in improving SF after surgery. Both methods induce a comparable improvement in long-time SF, especially in patients with an impaired sexuality pre-surgery. Furthermore, patients’ expectations concerning this matter seem to have an impact on the postoperative outcome; therefore, this circumstance should be considered in future projects.\nSimilar content being viewed by others\nReferences\nStang A, Merrill RM, Kuss O (2011) Hysterectomy in Germany: a DRG-based nationwide analysis, 2005-2006. 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Arch Gen Psychiatry 61(4):412–420. https://doi.org/10.1001/archpsyc.61.4.412\nFunding\nThere was no funding for this study.\nAuthor information\nAuthors and Affiliations\nContributions\nSB project development, manuscript writing, BT data collection, manuscript editing, AW data collection, SJ data collection, OB data collection, ATK data collection, MS manuscript editing, SL data analysis, AH data collection, manuscript editing, project development.\nCorresponding author\nEthics declarations\nConflict of interest\nAll authors declare to have no conflict of interest.\nEthical approval\nAll procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.\nInformed consent\nInformed consent was obtained from all individual participants included in the study.\nRights and permissions\nAbout this article\nCite this article\nBerlit, S., Tuschy, B., Wuhrer, A. et al. Sexual functioning after total versus subtotal laparoscopic hysterectomy. Arch Gynecol Obstet 298, 337–344 (2018). https://doi.org/10.1007/s00404-018-4812-7\nReceived:\nAccepted:\nPublished:\nVersion of record:\nIssue date:\nDOI: https://doi.org/10.1007/s00404-018-4812-7","source_license":"CC0","license_restricted":false}