Our Summary

This research paper is about the effects of a hysterectomy, a surgery to remove a woman’s uterus, on vaginal length and sexual function. The study involved 136 sexually active women under 60 years old who had undergone a hysterectomy. They were divided into three groups based on the type of hysterectomy they had: total abdominal hysterectomy (TAH), vaginal hysterectomy (VH), or total laparoscopic hysterectomy (TLH).

The researchers found that after surgery, vaginal length was longest in women who had a TLH and shortest in women who had a VH. They also calculated something called the vaginal shortening rate (VSR), which showed how much the vagina had shortened after the operation. The VSR was highest in the TAH group, followed by the VH group, and lowest in the TLH group.

The women also completed a survey about their sexual function after the surgery. The results showed that women who had a TLH had the highest scores, indicating better sexual function compared to the other two groups.

The researchers concluded that calculating the VSR after a hysterectomy could be a more accurate way of predicting sexual function after the surgery. Furthermore, they found that TLH might be the best hysterectomy method in terms of preserving sexual function because it leads to less loss of vaginal tissue.

FAQs

  1. Does the type of hysterectomy affect vaginal length and sexual function after the surgery?
  2. What is the vaginal shortening rate (VSR) and how is it related to sexual function after a hysterectomy?
  3. Which hysterectomy method, among total abdominal hysterectomy (TAH), vaginal hysterectomy (VH), and total laparoscopic hysterectomy (TLH), is found to be the best in terms of preserving sexual function?

Doctor’s Tip

One helpful tip a doctor might tell a patient about hysterectomy is to discuss the different types of hysterectomy procedures available and their potential impact on sexual function. This research suggests that total laparoscopic hysterectomy (TLH) may be associated with better sexual function outcomes compared to total abdominal hysterectomy (TAH) or vaginal hysterectomy (VH). Patients should consider discussing with their doctor the potential benefits and risks of each procedure in relation to their sexual health.

Suitable For

Patients who may be recommended for a hysterectomy include those with:

  1. Severe and persistent pelvic pain: Conditions such as endometriosis, fibroids, or adenomyosis can cause severe pelvic pain that does not respond to other treatments.

  2. Heavy menstrual bleeding: Women with conditions such as fibroids or abnormal uterine bleeding may benefit from a hysterectomy to alleviate their symptoms.

  3. Uterine prolapse: When the uterus descends into the vaginal canal, causing discomfort or difficulty with bowel or bladder function, a hysterectomy may be recommended.

  4. Cancer: Women with gynecological cancers such as cervical, uterine, or ovarian cancer may require a hysterectomy as part of their treatment plan.

  5. Chronic pelvic inflammatory disease: In cases where medical treatment has not been successful in managing chronic pelvic inflammatory disease, a hysterectomy may be considered.

  6. Endometrial hyperplasia: Women with abnormal thickening of the uterine lining may be recommended for a hysterectomy to prevent the development of endometrial cancer.

  7. Adenomyosis: A condition where the lining of the uterus grows into the muscle wall, causing heavy bleeding and pain, may be treated with a hysterectomy.

It is important for patients to discuss their options with their healthcare provider to determine if a hysterectomy is the best course of action for their individual situation.

Timeline

Before the hysterectomy:

  • The patient may have been experiencing symptoms such as heavy menstrual bleeding, pelvic pain, or fibroids that have not responded to other treatments.
  • The patient would have consultations with their gynecologist to discuss the reasons for the surgery, the risks and benefits, and the different types of hysterectomy available.
  • Pre-operative tests and evaluations would be conducted to ensure the patient is a suitable candidate for surgery.

After the hysterectomy:

  • The patient will undergo the surgery, which can be performed through different methods such as abdominal, vaginal, or laparoscopic.
  • After the surgery, the patient will stay in the hospital for a few days to recover and monitor for any complications.
  • The patient will experience post-operative symptoms such as pain, bleeding, and fatigue, which can last for a few weeks.
  • The patient will have follow-up appointments with their gynecologist to monitor their recovery and address any concerns or complications.
  • Over time, the patient may experience changes in vaginal length and sexual function, which can vary depending on the type of hysterectomy performed.

What to Ask Your Doctor

  1. What are the different types of hysterectomy and which one is recommended for me?
  2. How will a hysterectomy affect my vaginal length and sexual function?
  3. What is the likelihood of experiencing vaginal shortening after a hysterectomy?
  4. Will I need any additional procedures or treatments to address changes in vaginal length or sexual function after the surgery?
  5. Are there any potential complications or risks associated with a hysterectomy that could impact my sexual health?
  6. How soon after the surgery can I expect to resume sexual activity?
  7. Are there any lifestyle changes or precautions I should take to support my sexual health post-hysterectomy?
  8. Will I need any follow-up appointments or evaluations to monitor my sexual function after the surgery?
  9. Are there any resources or support groups available for women who have undergone a hysterectomy and are experiencing changes in sexual function?
  10. How can I best communicate any concerns or questions about my sexual health with my healthcare provider before and after the surgery?

Reference

Authors: Kiremitli S, Kiremitli T, Ulug P, Yilmaz N, Yilmaz B, Kulhan M, Kulhan NG, Dinc K, Kirkinci A, Kurnuc FZ. Journal: Taiwan J Obstet Gynecol. 2022 May;61(3):427-432. doi: 10.1016/j.tjog.2022.02.042. PMID: 35595433