Changes in Sexual Function After Minimally Invasive Hysterectomy in Reproductive-Aged Women: A Systematic Review and...

Area of Science:

• Gynecology
• Minimally Invasive Surgery
• Sexual Health

Background:

• Postsurgical sexual function is a key concern for patients undergoing minimally invasive hysterectomy (MIH).
• Existing evidence is conflicting due to variations in sexual function measures, menopausal status, and inclusion of laparotomy data.
• This study focuses on premenopausal women to clarify the impact of MIH on sexual function.

Purpose of the Study:

• To systematically review and meta-analyze the effects of minimally invasive hysterectomy (MIH) on sexual function in premenopausal women.
• To account for confounders such as surgical approach and measurement tools.
• To provide a clearer understanding of sexual function outcomes after MIH in this specific population.

Main Methods:

• A comprehensive literature search was conducted across multiple databases (PubMed, Scopus, etc.) up to December 2024.
• Eight studies met eligibility criteria, focusing on premenopausal women undergoing MIH for benign conditions and using the Female Sexual Function Index (FSFI).
• Meta-analysis of pre- and postsurgery FSFI scores was performed to assess changes in overall sexual function and specific domains.

Main Results:

• A small, statistically significant improvement in overall sexual function (total FSFI score) was observed post-MIH.
• Significant improvements were noted in the FSFI domains of desire, arousal, orgasm, and satisfaction.
• No significant changes were found in the lubrication or pain domains; evidence level is low with moderate heterogeneity.

Conclusions:

• Premenopausal women undergoing hysterectomy with ovarian preservation report a small, statistically significant improvement in overall sexual function.
• These improvements, while statistically significant, are unlikely to be clinically significant.
• Further research with consistent methodologies is needed to confirm these findings.