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Xu J, Qian Q, Ren M, Shen Y. Variations in sexual function after laparoendoscopic single-site hysterectomy in women with benign gynecologic diseases. Open Med (Wars) 2023; 18:20230761. [PMID: 37554149 PMCID: PMC10404898 DOI: 10.1515/med-2023-0761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 04/28/2023] [Accepted: 06/30/2023] [Indexed: 08/10/2023] Open
Abstract
Laparoendoscopic single-site surgery (LESS) has become a novel minimally invasive approach applied as an option to perform hysterectomy. The aim of the study was to evaluate the influence of LESS hysterectomy on the sexual function in women with benign gynecologic indications. From October 2016 to May 2021, a total of 486 premenopausal, sexually active women were eligible. Female sexual function index (FSFI) was used to assess sexual function preoperatively and 6, 12 months postoperatively. Total FSFI score ≤26.55 indicated female sexual dysfunction (FSD). Compared with pre-operation, each subdomain and total FSFI scores increased at 6 (all p < 0.05) and 12 months (all p < 0.001). Prevalence of FSD decreased at 6 (30 vs 39.9%, p = 0.002) and 12 months (27 vs 39.9%, p < 0.001). In patients with preoperative FSD, each subdomain and total FSFI scores improved at 6 and 12 months (all p < 0.001), while decreased at 6 months (p < 0.001) and had no significant difference at 12 months (p = 0.54) in patients without preoperative FSD. These results suggest that LESS hysterectomy has a significant positive effect on the sexual function in women with benign gynecologic diseases, especially those with preoperative FSD.
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Affiliation(s)
- Jingyun Xu
- Department of Obstetrics and Gynecology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing210009, Jiangsu, China
| | - Qiuping Qian
- Department of Gynecology and Obstetrics, Wuxi Hospital of Maternal and Child Health Care, Wuxi214000, Jiangsu, China
| | - Mulan Ren
- Department of Obstetrics and Gynecology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing210009, Jiangsu, China
| | - Yang Shen
- Department of Obstetrics and Gynecology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing210009, Jiangsu, China
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Alkatout I, Mazidimoradi A, Günther V, Salehiniya H, Allahqoli L. Total or Subtotal Hysterectomy for the Treatment of Endometriosis: A Review. J Clin Med 2023; 12:jcm12113697. [PMID: 37297893 DOI: 10.3390/jcm12113697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/07/2023] [Accepted: 05/22/2023] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVE The purpose of the review was to evaluate and compare outcomes after total or subtotal hysterectomy in women with endometriosis or adenomyosis. METHODS We searched four electronic databases: Medline (PubMed), Scopus, Embase, and Web of Science (WoS). The first aim of the study was to compare outcomes after total and subtotal hysterectomy in women with endometriosis, and the second aim was to compare the two procedures in women with adenomyosis. Publications that reported short- and long-term outcomes after total and subtotal hysterectomy were included in the review. The search was not subject to any limitation in terms of time or method. RESULTS After screening 4948 records, we included 35 studies published from 1988 to 2021; the studies were based on various methodologies. With regard to the first aim of the review, we found 32 eligible studies and divided these into the following four categories: postoperative short- and long-term outcomes, recurrence of endometriosis, quality of life and sexual function, and patient satisfaction after total or subtotal hysterectomy in women with endometriosis. Five investigations were deemed eligible for the second aim of the review. No differences were seen in terms of postoperative short- and long-term outcomes after subtotal or total hysterectomy in women with endometriosis or adenomyosis. CONCLUSIONS Preservation or removal of the cervix in women with endometriosis or adenomyosis appears to have no effect on short- or long-term outcomes, recurrence of endometriosis, quality of life and sexual function, or patient satisfaction. Nevertheless, we lack randomized blinded controlled trials on these aspects. Such trials will be needed to enhance our comprehension of both surgical approaches.
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Affiliation(s)
- Ibrahim Alkatout
- Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 24, 24105 Kiel, Germany
| | - Afrooz Mazidimoradi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran
| | - Veronika Günther
- Kiel School of Gynaecological Endoscopy, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, Haus 24, 24105 Kiel, Germany
| | - Hamid Salehiniya
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand 9717853577, Iran
| | - Leila Allahqoli
- Midwifery Department, Ministry of Health and Medical Education, Tehran 1467664961, Iran
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Kazemi F, Alimoradi Z, Tavakolian S. Effect of hysterectomy due to benign diseases on female sexual function: A systematic review and meta-analysis. J Minim Invasive Gynecol 2021; 29:476-488. [PMID: 34732379 DOI: 10.1016/j.jmig.2021.10.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Determination of the effect of hysterectomy due to benign diseases on female sexual function DATA SOURCES: A search was performed on Scopus, PubMed, Science Direct, ProQuest, ISI Web of Knowledge and Embase databases. The keywords included Hysterectomy (as exposure) and Female sexual function (as outcome). Original English observational studies, including cohort, case-control, and cross-sectional studies published as of February 2021, which reported an association between any type of hysterectomy due to benign female disease and sexual function as an outcome, were included in the study. Studies in participants who received HRT and had sex other than heterosexuals were not included. There was no limit to the initial search period, and articles published by February 2021 were searched. METHODS OF STUDY SELECTION The search process resulted in the retrieval of 5,587 potentially related articles. After removing duplicated studies, the title and abstract were reviewed and 77 articles remained with the removal of unrelated items. The full text of 14 articles was published in non-English languages, and 52 articles were removed because they did not meet the inclusion criteria, and finally 11 articles were included in the final analysis. TABULATION, INTEGRATION, AND RESULTS The Newcastle-Ottawa Scale was used to assess the methodological quality of included studies. The evidence was synthesized using meta-analysis via random effect model with the Der Simonian and Laird weighted method. Publication bias was assessed using the funnel plot and Begg's and Egger's tests. The pooled standardized mean difference for sexual function in hysterectomy versus non-hysterectomy group was .08 (CI95%: -.38 to .55; I2 = 96.8%; χ2 = 307.94, p-value <.001; τ2 = .59). Publication bias and small study effects were not detected. The results of the subgroup analysis showed that the possible sources of heterogeneity are the World Bank countries' classification and type of hysterectomy (in some studies the type of hysterectomy was not specified separately for the study groups, because of this, comparisons were made between Total and supracervical/total). Pooled SMD was affected by type of sexual function scale, World Bank countries' classification, type of hysterectomy, ovary status, and reproductive status. The results of meta-regression analysis also showed that for each month of distance from hysterectomy, women's sexual function score increases by .18. CONCLUSION The results of the present study showed that hysterectomy due to benign disease does not change the sexual function significantly. REGISTRATION OF SYSTEMATIC REVIEWS The study protocol was registered in PROSPERO system with the code CRD42021228314.
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Affiliation(s)
- Farideh Kazemi
- Instructor, PhD in Reproductive Health, Mother and Child Care Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
| | - Zainab Alimoradi
- Assistant Professor, PhD in Reproductive Health, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
| | - Samira Tavakolian
- MSC in Midwifery, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran.
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Impact of Hysterectomy on Quality of Life, Urinary Incontinence, Sexual Functions and Urethral Length. J Clin Med 2021; 10:jcm10163608. [PMID: 34441904 PMCID: PMC8396917 DOI: 10.3390/jcm10163608] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 01/01/2023] Open
Abstract
The aim of the study was to evaluate the influence of different types of hysterectomy on UI symptoms, quality of life and sexual functions using dedicated questionnaires. We investigated a correlation between the urethral length (UL), UI symptoms and the length of the cervix (left after LSH and SH) with sexual functions. The study enrolled 500 consecutive women referred for hysterectomy: 121 underwent VH, 171 underwent LSH, 96 underwent SH, 68 underwent TAH, and 44 underwent TLH. The patients filled in the UI-specific questionnaires and FSFI before and 12 months after hysterectomy. The UL was measured by introital ultrasound before and 12 months after hysterectomy. Before surgery, 137 out of 399 (34.3%) patients had UI symptoms; afterwards, 139 (34.8%) indicated the same (p > 0.05). There was no statistically significant difference in the UL in the patients before and after the procedure, and the cervix length did not differ between patients after LSH and SH. When the entire investigated population was analyzed, a significant improvement of the QoL was found on the IIQ-7. Hysterectomy performed due to benign diseases has effects on UI regardless of the surgical technique used. The UI symptoms improved only in the patients after LSH. The UL measured 12 months after hysterectomy did not change.
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Hsieh CH, Lu YY, Liang SY. The health concerns related to hysterectomy among Taiwanese women with uterine fibroids- a mixed-methods study. Women Health 2021; 61:581-590. [PMID: 34187330 DOI: 10.1080/03630242.2021.1938791] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study aimed to assess health concerns after hysterectomy from different perspectives among Taiwanese women with uterine fibroids. A mixed-methods was used in this study. In a cross-sectional study, 95 patients completed a structured questionnaire (Health Concern Questionnaire-HCQ). Face-to-face interviews with 5 patients were implemented for the qualitative component from OBS-GYN outpatient departments at two hospitals in Northern Taiwan. Participants who met the following criteria, 20 years of age or older, conscious alert without mental disturbances were recruited to this study. Descriptive statistics were calculated for social demographic variables and HCQ. A content analysis was used to analyze the qualitative data. The mean age was 46.28 of 95 patients. Findings of the present study showed that the most health concerns among patients with UFs after hysterectomy are hysterectomy-related complications, follow by impacts on daily life, body image and female identity, and intimacy and sexual relations. The findings of qualitative interviews supported the above findings. In addition, the information needs of post-operative self-care were identify in this qualitative interviews. The results of this research study could help healthcare professionals to address women's health concerns and provide adequate care for Taiwanese women with uterine fibroids after hysterectomy.
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Affiliation(s)
- Chun-Hsin Hsieh
- Nurse Practitioner, MSN, Department of Nursing, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Yu-Ying Lu
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Shu-Yuan Liang
- Department of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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Sukgen G, Türkay Ü. Effects of Total Abdominal Hysterectomy and Total Laparoscopic Hysterectomy on Urinary Tract Dysfunction. Gynecol Minim Invasive Ther 2020; 9:113-117. [PMID: 33101910 PMCID: PMC7545048 DOI: 10.4103/gmit.gmit_43_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 12/05/2019] [Accepted: 02/19/2020] [Indexed: 11/21/2022] Open
Abstract
Objectives: The aim of this study is to compare the urinary tract dysfunction rates of total abdominal hysterectomy (TAH) and total laparoscopic hysterectomy. Materials and Methods: Turkish patients who underwent TAH and laparoscopic hysterectomy were invited to participate in this study. In this study, 140 patients were examined who underwent hysterectomy in gynecology clinic between 2013 and 2018. The post residual urine volumes of patients were measured in the preoperative period and 8th week of the postoperative period as urodynamic evaluation (with office cystometry and Q tip test). Statistical analysis was performed using Kruskal–Wallis Mann–Whitney U test by using SPSS 22.0 statistical program. Results: No statistical significance (P > 0.05) was found between age, parity, menopause, and obesity in our patients who underwent TAH and laparoscopic hysterectomy with high postvoid residual values in the postoperative period. Conclusion: In this study, no statistical significance was found between the hysterectomy techniques on urinary tract dysfunction. It can be said that laparoscopy should be more preferable in correctly selected patients for minimal dysfunctional complications.
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Affiliation(s)
- Gökmen Sukgen
- Private Practice Clinics, Sukgen Gynecology and Obstetrics Clinic, Adana, Turkey
| | - Ünal Türkay
- Department of Gynecology and Obstetrics, Derince Training and Research Hospital, University of Health Sciences, Derince, Kocaeli, Turkey
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Emergency peripartum hysterectomy at Jordan University hospital - a teaching hospital experience. MENOPAUSE REVIEW 2020; 19:66-71. [PMID: 32802016 PMCID: PMC7422286 DOI: 10.5114/pm.2020.97840] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/21/2020] [Indexed: 11/28/2022]
Abstract
Introduction Emergency peripartum hysterectomy (EPH) is a foremost operation and is perpetually implemented in the presence of life intimidating hemorrhage during or immediately after abdominal or vaginal deliveries. The aim of this study was to review cases managed at the Department of Gynecology and Obstetrics at Jordan University Hospital (JUH). Material and methods All women who underwent EPH due to any cause in the period from January 2010, to December 2017 were included in the study. Data were collected retrospectively using the patients’ files namelessly. Main measures: age, gravidity, parity, number of previous cesarean sections, previous uterine surgeries, indication for hysterectomy, complications, antepartum bleeding and the need for blood transfusion. Results In total, 74 cases of EPH were managed during the study period. The incidence of EPH ranged from 0.24 to 8.7 per 1000 deliveries. EPH was found to be more common following cesarean sections than vaginal deliveries. The prime indication was abnormal placentation, uterine atony, and uterine rupture. The risk factors included previous cesarean sections, scarred uteruses, multiparity, older age group. Maternal morbidity ranged from 26.5 to 31.5% and mortality from 0 to 12.5% with a mean of 4.8%. Conclusions EPH is the most demanding obstetric surgery performed in very tiresome circumstances of life threatening hemorrhage. The indication for EPH in recent years has changed from outdated uterine atony to abnormal placentation. Antenatal eagerness of the risk factors, engrossment of proficient obstetricians at an early stage of management and a prompt hysterectomy after adequate resuscitation would go a long way in tumbling morbidity and mortality.
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8
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Alshawish E, Qadous MS, Yamani MA. Experience of Palestinian Women After Hysterectomy Using a Descriptive Phenomenological Study. Open Nurs J 2020. [DOI: 10.2174/1874434602014010074] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Universally, hysterectomy is considered as the second most frequent surgery after cesarean section performed on women in the reproductive age. After a hysterectomy, women no longer have menstrual periods, so they cannot become pregnant. Like most other countries, hysterectomy is the most common major gynecological operation in Palestine. However, the psychological, physical, and sexual consequences of hysterectomy are conflicting, and the findings are mixed. While some studies report that patients experience more significant improvement in their mental health, sexual desire, and overall satisfaction, other studies show that patients report various adverse outcomes, with detrimental effects on sexual functioning being the main concern.
Objective:
This study aimed to describe women's experiences of hysterectomy and identify their fears, concerns, and what coping mechanisms do they adopt to enhance the quality of their lives.
Methodology:
Qualitative descriptive phenomenological research design was used in this study. The study aims to gain insight into the experiences of fifteen patients after hysterectomy using semi-structured in-depth interviews. The interview was conducted in both private and governmental hospitals using purposeful sampling.
Results:
Giorgi's phenomenological analysis process was used as a tool for analyzing data. Analysis of the interview transcripts led to five themes, including a total of eighteen subthemes. The first theme is physical change that has pain, insomnia, eating habits, and immobility as subthemes. The second theme is psychological changes with depression, de-socialization, anxiety, and aggressiveness as its subthemes. The third theme is defense mechanisms with praying, listening to music, reciting the Holy Quran, walking, and sports as subthemes. The fourth theme is self-esteem and body image with confidence, appearance, and concerns as subthemes. Lastly, the fifth them is sexuality with excitement and sexual pattern as subthemes.
Conclusion:
The results of this study demonstrated that hysterectomy had significant adverse effects on patients' body image, and self-esteem. Moreover, the study identified common meanings and themes associated with hysterectomy stressors. These are difficulties or limitations in physical and psychological aspects perceived by patients after hysterectomy. The health care provider must be aware of these potentially problematic issues to provide competent health care.
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¿Cambia la función sexual tras la histerectomía? CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2020. [DOI: 10.1016/j.gine.2020.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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10
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Iglesias Fernández L, Soto González M. Vida sexual tras histerectomía por motivos benignos. Una revisión sistemática. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2020. [DOI: 10.1016/j.gine.2019.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Schmidt A, Sehnem GD, Cardoso LS, Quadros JSD, Ribeiro AC, Neves ET. Sexuality experiences of hysterectomized women. ESCOLA ANNA NERY 2019. [DOI: 10.1590/2177-9465-ean-2019-0065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Objective: To know the sexuality experiences of hysterectomized women. Method: Qualitative study carried out in Family Health Strategies with 19 hysterectomized women. A semi-structured interview was conducted, combined with the Creativity and Sensitivity Technique called Speaker Map, after approval by the Ethics Committee from January to February 2018. Data were analyzed according to analysis of the thematic content. Results: The participants had different sexuality experiences after the hysterectomy. The procedure was associated with restoration of health, resuming sexual activity, and changes in relationships. It was also related to the onset of dyspareunia and decrease in libido. Conclusion and implications for practice: The changes experienced after surgery led women to build new meanings for sexuality and their relationships. The surgery shows concrete results, such as decreased or increased pain in sexual practice, and subjective results, such as the feeling of freedom and the impact on female identity. These results may contribute to direct educational strategies to approach sexuality with each woman who undergoes hysterectomy.
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Sukgen G, Ellibeş Kaya A. Laparoskopik histerektominin cinsel işlevler ve yaşam kalitesi üzerine etkisi: 12 aylık izlem sonuçları. CUKUROVA MEDICAL JOURNAL 2018. [DOI: 10.17826/cumj.442973] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Danesh M, Hamzehgardeshi Z, Moosazadeh M, Shabani-Asrami F. The Effect of Hysterectomy on Women's Sexual Function: a Narrative Review. Med Arch 2018; 69:387-92. [PMID: 26843731 PMCID: PMC4720466 DOI: 10.5455/medarh.2015.69.387-392] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Regarding the contradictions about positive and negative effects of hysterectomy on women's sexual functioning, this study was conducted to review the studies on the effect of hysterectomy on postoperative women's sexual function. METHOD This study was a narrative review and performed in 5 steps: a) Determining the research questions, b) Search methods for identification of relevant studies, c) Choosing the studies, d) Classifying, sorting out, and summarizing the data, and e) reporting the results. FINDINGS The review of the studies yielded 5 main categories of results as follows: The effect of hysterectomy on Sexual desire, the effect of hysterectomy on sexual arousal, the effect of hysterectomy on orgasm, the effect of hysterectomy on dyspareunia, and the effect of hysterectomy on sexual satisfaction. CONCLUSION According to the studies reviewed in this study, most of the sexual disorders improve after hysterectomy for uterine benign diseases, and most of the patients who were sexually active before the surgery experienced the same or better sexual functioning after the surgery. An important solution for making these women ready to face with postoperative sexual complications is to train them on the basis of needs assessment in order that the patients undergoing hysterectomy be ready and capable of coping with the complications, and their sexual functioning improves after the surgery.
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Affiliation(s)
- Mahmonier Danesh
- Nasibeh Nursing and Midwifery Faculty, MazandaranUniversity of Medical Sciences, Sari, Iran
| | - Zeinab Hamzehgardeshi
- Department of Reproductive Health and Midwifery, Nasibeh Nursing and Midwifery Faculty, Mazandaran University of Medical Sciences, Sari, Iran; Traditional and Complementary Medicine Research Centre, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran
| | - Fereshteh Shabani-Asrami
- Department of Reproductive Health and Midwifery, Nasibeh Nursing and Midwifery Faculty, Mazandaran University of Medical Sciences, Sari, Iran; Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
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Kayataş S, Özkaya E, Api M, Çıkman S, Gürbüz A, Eser A. Comparison of libido, Female Sexual Function Index, and Arizona scores in women who underwent laparoscopic or conventional abdominal hysterectomy. Turk J Obstet Gynecol 2017; 14:128-132. [PMID: 28913149 PMCID: PMC5558413 DOI: 10.4274/tjod.78803] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 04/10/2017] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The aim of the present study was to compare female sexual function between women who underwent conventional abdominal or laparoscopic hysterectomy. MATERIALS AND METHODS Seventy-seven women who were scheduled to undergo hysterectomy without oophorectomy for benign gynecologic conditions were included in the study. The women were assigned to laparoscopic or open abdominal hysterectomy according to the surgeons preference. Women with endometriosis and symptomatic prolapsus were excluded. Female sexual function scores were obtained before and six months after the operation from each participant by using validated questionnaires. RESULTS Pre- and postoperative scores of three different quationnaires were found as comparable in the group that underwent laparoscopic hysterectomy (p>0.05). Scores were also found as comparable in the group that underwent laparotomic hysterectomy (p>0.05). Pre- and postoperative values were compared between the two groups and revealed similar results with regard to all three scores (p>0.05). CONCLUSION Our data showed comparable pre- and the postoperative scores for the two different hysterectomy techniques. The two groups were also found to have similar pre- and postoperative score values.
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Affiliation(s)
- Semra Kayataş
- Zeynep Kamil Women and Children's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Enis Özkaya
- Zeynep Kamil Women and Children's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Murat Api
- Zeynep Kamil Women and Children's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Seyhan Çıkman
- Zeynep Kamil Women and Children's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Ayşen Gürbüz
- Zeynep Kamil Women and Children's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
| | - Ahmet Eser
- Zeynep Kamil Women and Children's Health Training and Research Hospital, Clinic of Obstetrics and Gynecology, İstanbul, Turkey
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He H, Yang Z, Zeng D, Fan J, Hu X, Ye Y, Bai H, Jiang Y, Lin Z, Lei Z, Li X, Li L, Gan J, Lan Y, Tang X, Wang D, Jiang J, Wu X, Li M, Ren X, Yang X, Liu M, Wang Q, Jiang F, Li L. Comparison of the short-term and long-term outcomes of laparoscopic hysterectomies and of abdominal hysterectomies: a case study of 4,895 patients in the Guangxi Zhuang Autonomous Region, China. Chin J Cancer Res 2016; 28:187-96. [PMID: 27199516 PMCID: PMC4865611 DOI: 10.21147/j.issn.1000-9604.2016.02.06] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To evaluate the short-term and long-term outcomes after laparoscopic hysterectomy (LH) compared with abdominal hysterectomy (AH) in case of benign gynecological disease. METHODS A multi-center cohort retrospective comparative study of population among 4,895 hysterectomies (3,539 LH vs.1,356 AH) between 2007 and 2013 was involved. Operative time (OT), estimated blood loss (EBL), intra-operative and post-operative complications, passing flatus; days with indwelling catheter, questionnaires covering pelvic floor functions and sexual functions were assessed. RESULTS The EBL (174.1±157.4 vs. 263.1±183.2 cc, LH and AH groups, respectively), passing flatus (38.7±14.1 vs. 48.1±13.2 hours), days with indwelling catheter (1.5±0.6 vs. 2.2±0.8 days), use of analgesics (6.5% vs. 73.1%), intra-operative complication rate (2.4% vs. 4.1%), post-operative complication rate (2.3% vs. 5.7%), post-operative constipation (12.1% vs. 24.6%), mild and serious stress urinary incontinence (SUI) post-operative (P<0.001; P=0.014), and proportion of Female Sexual Functioning Index (FSFI) total score <26.55 post-operative (P<0.001) of the LH group were significantly less than those of AH group. There were no significant differences in OT (106.5±34.5 vs. 106.2±40.3 min) between the two groups. CONCLUSIONS LH is a safe and efficient operation for improving patients?long-term quality of life (QoL), and LH is a cost-effectiveness procedure for treating benign gynecological disease. LH is superior to AH due to reduced EBL, reduced post-operative pain and earlier passing flatus.
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Affiliation(s)
- Hongying He
- Department of Gynecological Oncology, Cancer Institute and Hospital of Guangxi Medical University, Nanning 530021, China
| | - Zhijun Yang
- Department of Gynecological Oncology, Cancer Institute and Hospital of Guangxi Medical University, Nanning 530021, China
| | - Dingyuan Zeng
- Department of Gynecological Oncology, The Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou 545005, China
| | - Jiangtao Fan
- Department of Gynecological and Obstetrics, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
| | - Xiaoxia Hu
- Department of Gynecological and Obstetrics, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning 530022, China
| | - Yuan Ye
- Department of Gynecological and Obstetrics, The Affiliated Hospital of Guilin Medical University, Guilin 541004, China
| | - Hua Bai
- Department of Gynecological and Obstetrics, The Maternal & Child Health Hospital, Nanning 530003, China
| | - Yanming Jiang
- Department of Gynecological and Obstetrics, The People's Hospital of Liuzhou, Liuzhou 545006, China
| | - Zhong Lin
- Department of Gynecological and Obstetrics, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning 530011, China
| | - Zhiying Lei
- Department of Gynecological and Obstetrics, Affiliated Hospital of Youjiang Medical University for Nationalities, Baise 533000, China
| | - Xinlin Li
- Department of Gynecological and Obstetrics, Liuzhou Maternal & Child Health Hospital, Liuzhou 545000, China
| | - Lian Li
- Department of Gynecological and Obstetrics, The First People's Hospital of Nanning, Nanning 530000, China
| | - Jinghua Gan
- Department of Gynecological and Obstetrics, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001, China
| | - Ying Lan
- Department of Gynecological and Obstetrics, The First Affiliated Hospital of Guangxi Technology University, Liuzhou 545000, China
| | - Xiongzhi Tang
- Department of Gynecological and Obstetrics, The People's Hospital of Guilin, Guilin 541002, China
| | - Danxia Wang
- Department of Gynecological and Obstetrics, The People's Hospital of Beihai, Beihai 536100, China
| | - Junsong Jiang
- Department of Gynecological and Obstetrics, The People's Hospital of Hechi, Hechi 546300, China
| | - Xiaoyan Wu
- Department of Gynecological and Obstetrics, The People's Hospital of Baise, Baise 533000, China
| | - Meiying Li
- Department of Gynecological and Obstetrics, The First People's Hospital of Yulin, Yulin 537000, China
| | - Xiaoqing Ren
- Department of Gynecological and Obstetrics, Wuzhou Worker's Hospital, Wuzhou 543001, China
| | - Xiaomin Yang
- Department of Gynecological and Obstetrics, The People's Hospital of Guigang, Guigang 537100, China
| | - Mei Liu
- Department of Gynecological and Obstetrics, The First People's Hospital of Qinzhou, Qinzhou 535001, China
| | - Qinmei Wang
- Department of Gynecological and Obstetrics, The Third People's Hospital of Liuzhou, Liuzhou 545007, China
| | - Fuyan Jiang
- Department of Gynecological and Obstetrics, Liuzhou Tumor Hospital, Liuzhou 545000, China
| | - Li Li
- Department of Gynecological Oncology, Cancer Institute and Hospital of Guangxi Medical University, Nanning 530021, China
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Yaman Ş, Ayaz S. The effect of education given before surgery on self-esteem and body image in women undergoing hysterectomy. Turk J Obstet Gynecol 2015; 12:211-214. [PMID: 28913071 PMCID: PMC5588473 DOI: 10.4274/tjod.95770] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 11/22/2015] [Indexed: 12/01/2022] Open
Abstract
Objective: To evaluate the effect of information provided before surgery on the self-esteem and body image of women undergoing hysterectomy. Materials and Methods: The study had a semi-experimental design with pre-post tests. A total of 60 women were included in the study and divided into two groups, the intervention group (n=30) and control group (n=30). A questionnaire, the Rosenberg self-esteem scale, and the body image scale were used to collect data. Results: The pre- and post-test body image scores were similar in the intervention group patients, but the post-test scores were significantly higher in the control group (p<0.05). The pre- and post-test self-esteem scores were again similar in the intervention group, but the post-test scores were significantly lower in the control group (p<0.05). Conclusion: This study revealed that health education given to patients prior to hysterectomy protects body image and consequently self-esteem.
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Affiliation(s)
- Şengül Yaman
- Gazi University Faculty of Health Sciences, Department of Nursing, Ankara, Turkey
| | - Sultan Ayaz
- Gazi University Faculty of Health Sciences, Department of Nursing, Ankara, Turkey
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Polat M, Kahramanoglu I, Senol T, Senturk B, Ozkaya E, Karateke A. Comparison of the Effect of Laparoscopic and Abdominal Hysterectomy on Lower Urinary Tract Function, Vaginal Length, and Dyspareunia: A Randomized Clinical Trial. J Laparoendosc Adv Surg Tech A 2015; 26:116-21. [PMID: 26671303 DOI: 10.1089/lap.2015.0437] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The effect of hysterectomy on vesicourethral and sexual functions remains controversial. The primary objective of this study was to compare the effects of a laparoscopic hysterectomy and a total abdominal hysterectomy on lower urinary tract function. The secondary aims were to compare the two surgeries in terms of postoperative vaginal length and dyspareunia. MATERIALS AND METHODS This was a prospective randomized clinical study in which 292 women were assigned to either the laparoscopic hysterectomy (n = 146) or total abdominal hysterectomy (n = 146) groups. The vaginal length and urodynamic measurements were taken, and the patients were asked to grade the presence and severity of dyspareunia using a visual analog scale 3 weeks before and 12 weeks after the surgery. The relationship between the postoperative vaginal length and the incidence of dyspareunia was evaluated. The urodynamic procedures used included uroflowmetry and voiding cystometry to record the maximum flow rate (Q-max) and to assess the bladder capacity. RESULTS The preoperative vaginal length was similar between the groups, whereas the postoperative vaginal length was significantly longer in the laparoscopic hysterectomy group. When the 15 patients who developed postoperative dyspareunia were evaluated, no differences in the postoperative vaginal length were seen, but a significant difference in the change in the length of the vagina was found when compared with the other patients. No significant difference was found with regard to pre- and postoperative Q-max, bladder capacity, and change in bladder capacity between the study groups. CONCLUSIONS The change in the length of the vagina was much more remarkable after total abdominal hysterectomy, compared with laparoscopic hysterectomy. It seems that the Q-max and the bladder capacity increase after hysterectomies, regardless of the surgical type. Further prospective randomized comparative studies are warranted to ascertain whether laparoscopic hysterectomies cause less damage to the pelvic floor, compared with abdominal hysterectomies.
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Affiliation(s)
- Mesut Polat
- 1 Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, Zeynep Kamil Women Health Training and Research Hospital , Istanbul, Turkey
| | - Ilker Kahramanoglu
- 2 Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, Istanbul University Cerrahpasa School of Medicine , Istanbul, Turkey
| | - Taylan Senol
- 1 Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, Zeynep Kamil Women Health Training and Research Hospital , Istanbul, Turkey
| | - Baki Senturk
- 1 Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, Zeynep Kamil Women Health Training and Research Hospital , Istanbul, Turkey
| | - Enis Ozkaya
- 1 Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, Zeynep Kamil Women Health Training and Research Hospital , Istanbul, Turkey
| | - Ates Karateke
- 1 Division of Gynaecologic Oncology, Department of Obstetrics and Gynaecology, Zeynep Kamil Women Health Training and Research Hospital , Istanbul, Turkey
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18
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Kokcu A, Kurtoglu E, Bildircin D, Celik H, Kaya A, Alper T. Does surgical menopause affect sexual performance differently from natural menopause? J Sex Med 2015; 12:1407-14. [PMID: 25923516 DOI: 10.1111/jsm.12891] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Hysterectomy is the most common major gynecologic operation, together with bilateral salpingo-oophorectomy in the majority of women over the age of 45. AIM To investigate whether surgical menopause affects female sexual performance differently from natural menopause. METHODS The study included 121 women who had undergone surgical menopause and 122 women who had undergone natural menopause. All the women had similar economic, sociocultural, and personal demographic profiles, had been postmenopausal for at least 1 year, and were between the ages of 45 and 65. The women were asked to complete a six-question survey of sexual performance parameters (sexual desire, coital frequency, arousal, orgasm frequency, dyspareunia, and vaginal lubrication). These sexual performance parameters were compared between the surgical and natural menopause groups. RESULTS With the exception of vaginal lubrication, sexual performance parameters were not statistically different between the two groups (P > 0.05). Vaginal lubrication in the surgically menopausal group was lower than in the naturally menopausal group (P < 0.05). Serum dehydroepiandrosterone sulphate, prolactin, and thyrotropin levels were not statistically different between the groups (P > 0.05), whereas serum estradiol and total testosterone levels in the surgically menopausal group were lower than those of the naturally menopausal group (P < 0.05). CONCLUSION The results of this study showed that surgical menopause did not affect female sexual performance differently from natural menopause, with the exception of vaginal lubrication.
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Affiliation(s)
- Arif Kokcu
- Department of Obstetrics and Gynecology, School of Medicine, University of Ondokuz Mayis, Samsun, Turkey
| | - Emel Kurtoglu
- Department of Obstetrics and Gynecology, School of Medicine, University of Ondokuz Mayis, Samsun, Turkey
| | - Devran Bildircin
- Department of Obstetrics and Gynecology, School of Medicine, University of Ondokuz Mayis, Samsun, Turkey
| | - Handan Celik
- Department of Obstetrics and Gynecology, School of Medicine, University of Ondokuz Mayis, Samsun, Turkey
| | - Aysegul Kaya
- Department of Obstetrics and Gynecology, School of Medicine, University of Ondokuz Mayis, Samsun, Turkey
| | - Tayfun Alper
- Department of Obstetrics and Gynecology, School of Medicine, University of Ondokuz Mayis, Samsun, Turkey
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Goktas SB, Gun I, Yildiz T, Sakar MN, Caglayan S. The effect of total hysterectomy on sexual function and depression. Pak J Med Sci 2015; 31:700-5. [PMID: 26150871 PMCID: PMC4485298 DOI: 10.12669/pjms.313.7368] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Revised: 01/26/2015] [Accepted: 04/08/2015] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND & OBJECTIVES To investigate whether the operations of Type 1 hysterectomy and bilateral salpingo-oophorectomy performed for benign reasons have any effect on sexual life and levels of depression. METHOD This is a multi-center, comparative, prospective study. Healthy, sexual active patients aged between 40 and 60 were included into the study. Data was collected with the technique of face-to-face meeting held three months before and after the operation by using the demographic data form developed by the researchers i.e. the Female Sexual Function Index (FSFI) and the Beck Depression Scale (BDS). RESULTS In the post-operative third month, there was an improvement in dysuria in terms of symptomatology (34% and 17%, P<0.001), while in FSFI (41.47±25.46 to 34.20±26.67, P<0.001) and BDS (12.87±11.19 to 14.27±10.95, P=0.015) there was a deterioration. For FSFI, 50-60 age range, extended family structure; and for BDS, educational status, not working and extended family structure were statistically important confounding factors for increased risk in the post-operative period. CONCLUSION While hysterectomy and bilateral salpingo-oophorectomy performed for benign reasons brought about short-term improvement in urinary problems after the operation for sexually active and healthy women, they resulted in sexual dysfunction and increase in depression. The age, educational status, working condition and family structure is also important.
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Affiliation(s)
- Sonay Baltaci Goktas
- Sonay Baltaci Goktas, Maltepe University, School of Nursing, Surgical Nursing, Istanbul, Turkey
| | - Ismet Gun
- Ismet Gun, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey
| | - Tulin Yildiz
- Tulin Yildiz, Namik Kemal University, School of Health, Surgical Nursing, Tekirdag, Turkey
| | - Mehmet Nafi Sakar
- Mehmet Nafi Sakar, Suleymaniye Training and Research Hospital, Istanbul, Turkey
| | - Sabiha Caglayan
- Sabiha Caglayan, Medipol University Hospital, Istanbul, Turkey
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