Sexual functioning after total compared with supracervical hysterectomy: a randomized trial.
OBJECTIVE
To compare sexual functioning and health-related quality-of-life outcomes of total abdominal hysterectomy (TAH) and supracervical hysterectomy (SCH) among women with symptomatic uterine leiomyomata or abnormal uterine bleeding refractory to hormonal management.


METHODS
We randomly assigned 135 women scheduled to undergo abdominal hysterectomy in 4 U.S. clinical centers to either a total or supracervical procedure. The primary outcome was sexual functioning at 2 years, as assessed by the Medical Outcomes Study Sexual Problems Scale. Secondary outcomes included specific aspects of sexual functioning and health-related quality-of-life at 6 months and 2 years.


RESULTS
Sexual problems improved dramatically in both randomized groups during the first 6 months and plateaued by 1 year. Health-related quality-of-life scores also improved in both groups. At 2 years, both groups reported few problems with sexual functioning (mean score on the Sexual Problems Scale for SCH group 82, TAH group 80, on a 0-to-100 scale with 100 indicating an absence of problems; difference = +2.95% confidence interval -8 to +11), and there were no significant differences between groups.


CONCLUSIONS
Supracervical and total abdominal hysterectomy result in similar sexual functioning and health-related quality of life during 2 years of follow-up. This information can help guide physicians as they discuss surgical options with their patients.
Kuppermann
Miriam
M
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California 94143, USA. kuppermannm@obgyn.ucsf.edu
Summitt
Robert L
RL
Varner
R Edward
RE
McNeeley
S Gene
SG
Goodman-Gruen
Deborah
D
Learman
Lee A
LA
Ireland
Christine C
CC
Vittinghoff
Eric
E
Lin
Feng
F
Richter
Holly E
HE
Showstack
Jonathan
J
Hulley
Stephen B
SB
Washington
A Eugene
AE
D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007889:Leiomyoma / Q000601:surgery; D011788:Quality of Life; D012725:Sexual Behavior / Q000502:physiology*; D014592:Uterine Hemorrhage / Q000601:surgery; D014594:Uterine Neoplasms / Q000601:surgery