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A randomized trial comparing changes in sexual health and psychological well-being after subtotal and total
Marie A Ellström Engh1, Karin Jerhamre, Karin Junskog
1Department of Obstetrics and Gynecology, Akershus University Hospital, Lørenskog, Norway. m.e.engh@medisin.uio.no
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.