Impact on sexual functioning: total versus subtotal hysterectomy

Objective To evaluate and compare postoperative sexual functioning following total (TH) versus subtotal hysterectomy (STH). Design A longitudinal, prospective and comparative study in women undergoing hysterectomy for benign diseases in Ibn El Jazzar Hospital, Kairouan in Tunisia. Sample Sixty women undergoing hysterectomy for benign disease. Main outcome measures Sexual functioning evaluation using the Arizona Sexual Experiences Scale (ASEX) and Female Sexual Function Index (FSFI) before the operation and after 6 months. Results Following surgery, significant improvement in sexual functioning according to both scales. In fact, the mean total score of the ASEX scale went from 25.14 to 21.15 and from 11,99 to 19,31 for the FSFI. The average time to resume sexuality postoperatively was 50 days. No significant difference was found in these results between total and subtotal hysterectomy. Conclusion Hysterectomy, whether total or subtotal, has a positive impact on the overall sexual satisfaction of the patients especially in those with an impaired sexuality before surgery. There were no statistically significant differences in sexual function between the two groups TH versus STH. Therefore, cervix preservation for the purpose of improving overall sexual satisfaction cannot be recommended. Keywords Hysterectomy . Sexual dysfunction . Supracervical hysterectomy . Cervix