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Updated: Feb 8, 2026

Laparoscopic Extracorporeal Knot-Tying for Uterine Vessel Occlusion during Hysterectomy with Cervical Cerclage in Large Uteri
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Sexual functioning after total versus subtotal laparoscopic hysterectomy.

Sebastian Berlit1, Benjamin Tuschy1, Anne Wuhrer1

  • 1Department of Obstetrics and Gynaecology, University Medical Centre Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.

Archives of Gynecology and Obstetrics
|June 28, 2018
PubMed
Summary

Laparoscopic subtotal hysterectomy (LASH) showed a stronger initial improvement in sexual functioning compared to total hysterectomy (TLH) three months post-surgery. Patient expectations and baseline sexual health influenced outcomes, particularly in the TLH group.

Keywords:
CervixLaparoscopic hysterectomyPatient expectationsSexualitySupracervical hysterectomy

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Area of Science:

  • Gynecology
  • Surgical Outcomes
  • Sexual Health

Background:

  • Hysterectomy is a common gynecological procedure.
  • Sexual functioning can be affected by hysterectomy.
  • Different surgical approaches may yield varied outcomes.

Purpose of the Study:

  • To compare postoperative sexual functioning after laparoscopic total hysterectomy (TLH) and subtotal hysterectomy (LASH).
  • To investigate the influence of patient expectations on sexual function changes following hysterectomy.

Main Methods:

  • A prospective study of 120 women undergoing laparoscopic hysterectomy.
  • Sexual functioning assessed using the Female Sexual Function Index (FSFI) at 3, 6, and 12 months.
  • Regression analyses explored the impact of pre-operative expectations and baseline sexual function.

Main Results:

  • LASH demonstrated a significantly greater improvement in sexual functioning at 3 months compared to TLH (p=0.006).
  • No significant differences in sexual functioning were observed between LASH and TLH at 6 or 12 months.
  • For TLH, both lower baseline sexual function and higher expectations predicted greater improvement; for LASH, only lower baseline function was a predictor.

Conclusions:

  • Cervix preservation in LASH does not offer a distinct advantage for long-term sexual function improvement.
  • Both TLH and LASH lead to comparable long-term sexual function improvements, especially in patients with pre-existing sexual dysfunction.
  • Patient expectations should be considered as a factor influencing postoperative sexual outcomes.