A randomized trial comparing changes in sexual health and psychological well‐being after subtotal and total hysterectomies

Marie Anne Engh, KARIN JERHAMRE, KARIN JUNSKOG
In: Acta Obstetricia et Gynecologica Scandinavica · 2009 · vol. 89(1) , pp. 65–70 · doi:10.3109/00016340903353276 · PMID:19900131 · W2055104681
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Subtotal hysterectomy patients reported significantly greater positive changes in orgasm frequency and sexual pleasure compared to total hysterectomy patients one year post-surgery.

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Abstract

OBJECTIVE: To evaluate changes in sexual health and psychological well-being one year after subtotal and total hysterectomies. DESIGN: Prospective randomized controlled trial. MATERIAL AND METHODS: One hundred and thirty-two premenopausal patients scheduled for hysterectomy without planned oophorectomy for benign disorders and without a history of cervical dysplasia or symptomatic prolapse were randomized to total (n = 66) or subtotal hysterectomy (n = 66). The McCoy Female Sexuality Questionnaire was used to evaluate changes in sexual health and the Psychological General Well-Being index was used to evaluate changes in psychological well-being. Differences in outcome before and one year after the hysterectomy were calculated for each individual, and changes compared between the groups. RESULTS: Women who had subtotal hysterectomy (SH) reported a significantly greater positive change in frequency of orgasm and sexual pleasure as compared with women who had total hysterectomy (TH) (mean values +/- standard deviation (SD), orgasm: SH: 0.4 +/- 1.1; TH: -0.2 +/- 0.9, p = 0.012, sexual enjoyment: SH 0.3 +/- 1.5; TH: -0.3 +/- 1.3, p = 0.039). There was a significantly greater general health gain for the women who underwent subtotal hysterectomy as compared with total hysterectomy (mean values +/- SD SH: 1.2 +/- 2.3; TH: 0.3 +/- 1.6, p = 0.03). The total score did not show a difference. CONCLUSIONS: Women undergoing subtotal hysterectomy experience a greater positive change in the frequency of orgasm and extent of sexual pleasure after surgery than women undergoing total hysterectomy, but the results must be interpreted with caution.

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