Abstract
Objectives: The aim of the current study is to examine changes in sexual function, incontinence and quality of life after hysterectomy, with particular regard to different surgical methods of hysterectomy. Material and methods: A total number of 210 women with hysterectomy were asked to answer the questionnaire between 2011 and 2013; 164 of them accepted to cooperate. Twenty-one women were excluded from the study because of depression, thus the final number of participants was 143. In our retrospective study, patients were randomized by the snowball sampling (or chain referral sampling) method into three groups: having had 1total abdominal hysterectomy; 2. vaginal hysterectomy; or 3. subtotal abdominal hysterectomy (according to Crobach). Three questionnaires were used to collect quality of life data: 1. our own questionnaire on general health status, 2. the Short Form 36 questionnaire, and 3. a combination of shortened versions of the Lemack and Female Sexual Function Index. For the statistical analysis, Student’s t-test and/or the Mann–Whitney U-test were used. The statistical analysis was performed by using SPSS 20.0.5 system. The significance level of p ≤ 0.05 was used. Results: The mean age of the vaginal total hysterectomy group, abdominal subtotal hysterectomy and abdominal total hysterectomy was 50.08±3.1; 45.47±2.5 and 48.27±2.7 years, respectively (p=0.203). Their average BMI was 26.88±3.45 kg/m2. The average length of the postoperative period was 4.05±2.25 years. Participants had a mean number of children 1.74/person; most of the participants were married (59.44%), and had a college or university degree (37.6%). There was no statistically significant difference in quality of life data between the subgroups. In the subgroup of women with vaginal hysterectomy, significantly higher incidence of pelvic pain was felt once in a while during sexual intercourse (p = 0.047), and there was a significantly higher incidence of urinary incontinence (p = 0.023) as well. Conclusion: Types of hysterectomy did not significantly affect long term quality of life in general, but vaginal hysterectomy was more likely to affect sexual function and to increase the risk of incontinence when compared with abdominal hysterectomy.
Highlights
Hysterectomy is one the most frequent types of gynaecological surgical interventions in both the European Union (EU) and the United States of America (USA). [1] In the United States, more than 600.000 and in Germany around 140.000 hysterectomies are performed each year
American Journal of Health Research 2015; 3(6): 393-398 following either total or subtotal hysterectomy. This may be explained by the fact that most of the significant autonomic innervations are located in the middle and the lateral thirds of the sacral and cardinal ligaments that are mostly preserved during hysterectomies
When findings related to life quality in general were taken into consideration, the lowest scores of pain could be found in the vaginal total hysterectomy group
Summary
Hysterectomy is one the most frequent types of gynaecological surgical interventions in both the European Union (EU) and the United States of America (USA). [1] In the United States, more than 600.000 and in Germany around 140.000 hysterectomies are performed each year. American Journal of Health Research 2015; 3(6): 393-398 following either total or subtotal hysterectomy. This may be explained by the fact that most of the significant autonomic innervations are located in the middle and the lateral thirds of the sacral and cardinal ligaments that are mostly preserved during hysterectomies. [2] The short-term effects of hysterectomy are satisfactory on quality of life according to most studies. No other previous research has found significant difference either in the quality of life, or in sexual functions when different modes of hysterectomy (vaginal or abdominal) were compared. [3, 4] the effects of the various hysterectomy techniques concerning sexual functions and quality of life still need to be clarified No other previous research has found significant difference either in the quality of life, or in sexual functions when different modes of hysterectomy (vaginal or abdominal) were compared. [3, 4] the effects of the various hysterectomy techniques concerning sexual functions and quality of life still need to be clarified
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