The effect of vaginal hysterectomy with and without sacrospinous ligament fixation on the female sexual function

Abstract

Objective The aim of the current study was to compare the effect of vaginal hysterectomy (VH) with and without sacrospinous ligament fixation (SSF) on the patients’ sexual function. Study design The current retrospective case–control study was conducted at Ain-Shams University Maternity Hospital, and it included patients, who were sexually active, who underwent VH with and without SSF for uterovaginal prolapsed in the past 3 years (2010–2012). The included women were divided into two groups: group I (study group) that included women who underwent VH plus SSF, and group II (control group) that included women who underwent VH without SSF. A questionnaire (female sexual function index scoring appendix) on sexual function was answered by the patient that was presented to her by a female doctor. The questioner investigates sexual activity with six domains investigating sexual function in relation to desire, arousal, lubrication, orgasm, satisfaction, and pain after at least 6 months after operation. Results A total of 72 women who underwent VH with or without SSF were included in the current study. The included women were divided into two groups: group I (study group) that included 30 women who underwent VH plus SSF, and group II (control group) that included 42 women who underwent VH without SSF. No significant difference was found between patients who underwent VH with or without SSF in terms of age, parity, BMI, and time passed since operation. Desire, arousal, lubrication, orgasm, satisfaction, pain, and total scores were significantly higher in patients without SSF than in patients with SSF. Conclusion VH with SSF was considered as an option in an elderly patient who was not sexually active, as it lowers the rate of vault prolapse. However, in younger patients, VH alone has a better effect as it does not interfere with the normal vaginal axis.