title: Influences of different hysterectomy techniques on patients' postoperative sexual function and quality of life.
abstract: BACKGROUND
  Hysterectomy ranks among the most frequently performed gynecological surgical procedures. At the time of operation, the majority of patients are premenopausal and sexually active. Hence, detailed counseling about the effects of hysterectomy on postoperative sexuality and quality of life can be regarded as an integral part of preoperative counseling. However, available data on these subjects are limited and contradictory.
  
  
  OBJECTIVE
  The aim of this study was to assess quality of life and sexuality following three common hysterectomy procedures-total laparoscopic hysterectomy (TLH), supracervical laparoscopic hysterectomy (SLH), and vaginal hysterectomy (VH)-in premenopausal patients using the European Quality of Life Five-Dimension Scale (EQ-5D) and Female Sexual Function Index (FSFI).
  
  
  METHODS
  Preoperative and postoperative EQ-5D and FSFI scores were compared using the Wilcoxon signed-rank test. Kruskal-Wallis analysis and Mann-Whitney U-test with post hoc Bonferroni correction were used to assess differences among the three subgroups.
  
  
  METHODS
  All premenopausal patients who underwent TLH, SLH, or VH without adnexectomy due to benign uterine disorders between April 2011 and June 2013 at the Department of Gynaecology and Obstetrics of Saarland University Hospital were enrolled in this observational cohort study. Sexuality and quality of life status were assessed preoperatively and 6 months postoperatively using two standardized validated questionnaires: the FSFI, a multidimensional, self-reported instrument for the assessment of female sexual function, and the EQ-5D, a standardized, validated instrument to measure an individual's health status.
  
  
  RESULTS
  Of 402 eligible patients, 237 completed the study. Patient characteristics and preoperative FSFI and EQ-5D scores did not differ among the three hysterectomy subgroups. Postoperative FSFI and EQ-5D scores were significantly higher (P ≤ 0.01) than preoperative scores for all procedures but did not differ among the groups.
  
  
  CONCLUSIONS
  In this cohort of premenopausal women, hysterectomy without adnexectomy performed due to benign uterine pathologies had significant positive effects on postoperative sexual function and quality of life, regardless of the surgical technique used.
authors.affiliation: Department of Gynaecology & Obstetrics, Saarland University Hospital, Homburg, Germany.
authors.forename: Julia C
authors.initials: JC
authors.lastname: Radosa
authors.forename: Gabriele
authors.initials: G
authors.lastname: Meyberg-Solomayer
authors.forename: Christina
authors.initials: C
authors.lastname: Kastl
authors.forename: Christoph G
authors.initials: CG
authors.lastname: Radosa
authors.forename: Russalina
authors.initials: R
authors.lastname: Mavrova
authors.forename: Stefan
authors.initials: S
authors.lastname: Gräber
authors.forename: Sascha
authors.initials: S
authors.lastname: Baum
authors.forename: Marc P
authors.initials: MP
authors.lastname: Radosa
mesh_terms: D000328:Adult; D005260:Female; D005858:Germany; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D008875:Middle Aged; D011788:Quality of Life; D019529:Sexuality
keywords: Gynaecology; Hysterectomy; Laparoscopy; Quality of Life; Sexual Function; Sexuality