title: Sexual functioning after total compared with supracervical hysterectomy: a randomized trial.
abstract: 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.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California 94143, USA. kuppermannm@obgyn.ucsf.edu
authors.forename: Miriam
authors.initials: M
authors.lastname: Kuppermann
authors.forename: Robert L
authors.initials: RL
authors.lastname: Summitt
authors.forename: R Edward
authors.initials: RE
authors.lastname: Varner
authors.forename: S Gene
authors.initials: SG
authors.lastname: McNeeley
authors.forename: Deborah
authors.initials: D
authors.lastname: Goodman-Gruen
authors.forename: Lee A
authors.initials: LA
authors.lastname: Learman
authors.forename: Christine C
authors.initials: CC
authors.lastname: Ireland
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: Feng
authors.initials: F
authors.lastname: Lin
authors.forename: Holly E
authors.initials: HE
authors.lastname: Richter
authors.forename: Jonathan
authors.initials: J
authors.lastname: Showstack
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Hulley
authors.forename: A Eugene
authors.initials: AE
authors.lastname: Washington
mesh_terms: 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