SEXUALITY AFTER TOTAL ABDOMINAL HYSTERECTOMY FOR BENIGN GYNECOLOGICAL CONDITIONS

Objectives Since antiquity, the uterus has been associated with femininity and sexuality in addition to its reproductive function. This work proposes to evaluate the medium-term impact of hysterectomy for a benign pathology on the sexual function of patients. Methods This is a descriptive cross-sectional study that included initially non-menopausal women with hysterectomy without abdominal adnexectomy for a benign pathology at our Department, between January 2017 and December 2019. Patients reporting sexual complaints prior to surgery were excluded. A self-administered questionnaire was distributed during the first follow-up visit to confirm the benign nature of the pathology after the anatomopathological examination of the surgical specimens. The female sexual function was evaluated by the questionnaire translated into Arabic and validated that is the Female Sexual Function Index (Ar FSFI). Results The study thus recruited 88 patients whose mean age was 48.9 years (from 40 to 55 years). Preoperatively, 50% of the participants had contraception, 60% of which was hormonal. Preoperatively, 40% reported regular sexual activity. Hysterectomies were indicated for myomatous and/or adenomyotic uterus in 88% of cases and for premenopausal metrorrhagia resistant to medical treatment in the other cases. Per and postoperative hemorrhagic complications were reported in 7.84% of cases. Postoperatively, low sexual desire was found in 50%, subjective arousal disorder in 44% of cases, lubrication disorder in 18%, and orgasm disorder in 26%. The overall satisfaction rate was 84%. Dyspareunia was reported in 18% during intercourse versus 12% after intercourse. Conclusions Total abdominal hysterectomy without adnexectomy for benign pathology in previously non-menopausal women alters sexual function with essentially a decrease in desire and subjective arousal. Conflicts of Interest Nothing to declare.