Abdominal Hysterectomy - Vaginal Hysterectomy - Laparoscopically Assisted Vaginal Hysterectomy

Obstet Gynecol. 2005 Jun;105(6):1309-18.

Sexual functioning after total compared with supracervical hysterectomy: a randomized trial.

Kuppermann M,Summitt RL Jr,Varner RE,McNeeley SG,Goodman-Gruen D,Learman LA,Ireland CC,Vittinghoff E,Lin F,Richter HE,Showstack J,Hulley SB,Washington AE;

Total or Supracervical Hysterectomy Research Group.

Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California 94143, USA. kuppermannm@obgyn.ucsf.edu

Objectives:

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 group2, TAH group0, 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.

Conclusion:

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.

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