[Sexual function and sexual disorders after hysterectomy]

Hysterectomy leads to a temporary impairment of sexual behaviour. Discussions during pre-operative consultancy and at the time of discharge and follow-up examinations dealing with the sexual function, can in general avoid lasting or chronic sexual disturbances. The incidence of psychosomatic disturbances, which also influence sexual behaviour, is found to be under 10% and are projected onto the operation, have therefore intra-psychic or psycho-social roots, which are independent of it. As a rule, the ability to experience orgasm is retained and, in many cases, improved; although there are exceptions to the rule. A certain method of hysterectomy cannot have any decisive significance with regard to the capacity to experience sexual pleasure. This is indicated by our knowledge of the physiology of the sexual response and by the follow-up investigations concerning the sexual function after a hysterectomy conducted to date. An all-too-local/genital approach deflects us from our understanding of the orgasm, as the latter is a central experience in which extra-genital and, above all, psychological factors also play an important part.