title: [Dyspareunia after total abdominal hysterectomy. Anatomical relation].
abstract: BACKGROUND
  We undertook this study to determine whether anatomic changes after total abdominal hysterectomy are a cause of dyspareunia in premenopausal women.
  
  
  METHODS
  This is a comparative, prospective and longitudinal study in 50 premenopausal women with benign uterine disease without dyspareunia treated with total abdominal hysterectomy. Primary variable was presence of postsurgical dyspareunia. Secondary variables are presurgical and assessment 3 months after surgery of left, right, anterior and posterior vaginal longitude (VLL, VRL, VAL and VPL, respectively) expressed in centimeters, as well as of the vaginal volume (VV). Statistical analysis for mean, central tendency and t-test. Group 1 (G1) is comprised of patients with postsurgical dyspareunia and Group 2 (G2) is comprised of patients without dyspareunia.
  
  
  RESULTS
  In G1, three patients (mean age: 42 years) had dyspareunia, pre- and postsurgical mean values were VV 146.6 and 100, VLL 8 and 7.3, VPL 9.16 and 7.3, VLL 8 and 7.3, VRL 8 and 7.3. In G2, 47 patients (mean age: 40.36 years) were without dyspareunia, pre- and postsurgical values were VV 150.6 and 121.57, VLL 8.81 and 8.12, VPL 9.7 and 8.69, VLL 9.24 and 8.3, VRL 9.28 and 8.33. We did not find significant differences between the groups. Two of the three patients with dyspareunia had a vaginal granuloma, but the third case did not show an anatomical cause.
  
  
  CONCLUSIONS
  There is no relationship between total abdominal hysterectomy in premenopausal women and anatomical vaginal changes after surgery as assessed by vaginal volume and longitude. Presence of vaginal granuloma was responsible for dyspareunia in 4% of cases. Dyspareunia was found in 2% of premenopausal women without posthysterectomy anatomical cause.
authors.affiliation: Servicio De Ginecología y Obstetricia, Hospital General de México, Hospital Angeles de Las Lomas, consultorio 585, Vialidad de la Barranca s/n, Col. Valle de Las Palmas, 52763 Huixquilucan, Estado de México, México. estelamonroy@terra.com.mx
authors.forename: Blanca Estela
authors.initials: BE
authors.lastname: Monroy-Lozano
authors.forename: Eduardo
authors.initials: E
authors.lastname: Motta-Martínez
authors.forename: Rafael
authors.initials: R
authors.lastname: Huitrón-García
authors.forename: Felipe Rafael
authors.initials: FR
authors.lastname: Zaldívar-Ramírez
authors.forename: Luis Mauricio
authors.initials: LM
authors.lastname: Hurtado-López
mesh_terms: D000328:Adult; D004414:Dyspareunia / Q000209:etiology*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000379:methods; D008875:Middle Aged; D011446:Prospective Studies; D014621:Vagina / Q000033:anatomy & histology