title: Sexuality after total vs. subtotal hysterectomy.
abstract: BACKGROUND
  The effect of hysterectomy on sexuality is not fully elucidated and until recently total and subtotal hysterectomies have only been compared in observational studies.
  
  
  OBJECTIVE
  To compare total abdominal hysterectomy (TAH) to subtotal abdominal hysterectomy (SAH) regarding effects on sexuality.
  
  
  METHODS
  In a Danish multicenter trial 319 women were randomized to TAH (n = 158) or SAH (n = 161); 185 women had self-selected TAH (n = 80) or SAH (n = 105) in a simultaneously conducted observational study. Women were followed for 1 year by strict data collection procedures, including postal questionnaires. Results were analyzed by intention to treat (ITT) analyses.
  
  
  RESULTS
  No significant differences were observed between TAH and SAH at 1-year follow-up in both the randomized trial and the observational study regarding women's desire for sex, frequency of intercourse, frequency of orgasm, quality of orgasm, localization of orgasm, satisfaction with sexual life, and dyspareunia. None of these sexual variables changed significantly from entry to the 1-year follow-up, apart from dyspareunia, which was significantly (p = 0.009) reduced in both intervention groups. Significant (p < 0.05) predictors for satisfaction with sexual life after hysterectomy were the preoperative satisfaction with sexual life [odds ratio (OR) 32, 95% confidence interval (CI) 10-125], good relationship with partner (OR 50, 95% CI 9-354), physical well-being (OR 0.30, 95% CI 0.09-0.88) and hormone replacement therapy (OR 0.23, 95% CI 0.06-0.78).
  
  
  CONCLUSIONS
  Both TAH and SAH significantly reduce dyspareunia without having a negative effect on sexual function. The shift toward SAH seems unwarranted.
authors.affiliation: Department of Gynecology and Obstetrics, Roskilde County Hospital, Denmark. vibeke@zobbe.dk
authors.forename: Vibeke
authors.initials: V
authors.lastname: Zobbe
authors.forename: Helga
authors.initials: H
authors.lastname: Gimbel
authors.forename: Birthe Margrethe
authors.initials: BM
authors.lastname: Andersen
authors.forename: Thomas
authors.initials: T
authors.lastname: Filtenborg
authors.forename: Kristian
authors.initials: K
authors.lastname: Jakobsen
authors.forename: Helle Christina
authors.initials: HC
authors.lastname: Sørensen
authors.forename: Kim
authors.initials: K
authors.lastname: Toftager-Larsen
authors.forename: Katrine
authors.initials: K
authors.lastname: Sidenius
authors.forename: Nini
authors.initials: N
authors.lastname: Møller
authors.forename: Ellen Merete
authors.initials: EM
authors.lastname: Madsen
authors.forename: Mogens
authors.initials: M
authors.lastname: Vejtorp
authors.forename: Helle
authors.initials: H
authors.lastname: Clausen
authors.forename: Annie
authors.initials: A
authors.lastname: Rosgaard
authors.forename: Christian
authors.initials: C
authors.lastname: Gluud
authors.forename: Bent S
authors.initials: BS
authors.lastname: Ottesen
authors.forename: Ann
authors.initials: A
authors.lastname: Tabor
mesh_terms: D002584:Cervix Uteri / Q000502:physiology; D004414:Dyspareunia / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000379:methods; D019529:Sexuality; D011795:Surveys and Questionnaires; D013997:Time Factors