Hysterectomy and sexual function: a systematic review and meta-analysis

Area of Science:

• Gynecology
• Sexual Health
• Surgical Outcomes

Background:

• Sexual function changes after hysterectomy are a significant patient concern, yet research findings remain inconclusive.
• This meta-analysis investigates the impact of hysterectomy on sexual function and explores variations based on surgical techniques.

Approach:

• A comprehensive meta-analysis was conducted on 32 studies (4054 patients) published in peer-reviewed journals, examining sexual function pre- and post-hysterectomy for benign conditions.
• Data were analyzed using random effects multilevel models to assess changes in overall sexual function, dyspareunia, desire, arousal, lubrication, and orgasm.

Key Points:

• Hysterectomy, regardless of surgical route or cervix removal, was not associated with significant changes in overall sexual function.
• Patients undergoing hysterectomy may experience persistent sexual dysfunction.
• Hysterectomy without bilateral salpingo-oophorectomy (BSO) showed improved lubrication and orgasm compared to hysterectomy with BSO, though these findings require cautious interpretation due to study limitations.

Conclusions:

• Clinicians should proactively address persistent sexual dysfunction following hysterectomy.
• Bilateral salpingo-oophorectomy (BSO) should be avoided unless medically indicated to potentially preserve sexual function.