Sexual functioning after total versus subtotal laparoscopic hysterectomy—long term follow up results after 7 years

The aim of this study was to evaluate sexual function in the long term after total laparoscopic hysterectomy (TLH) versus laparoscopic supracervical hysterectomy (LASH) in patients with benign indications.

As part of a longitudinal follow-up, 74 patients who had originally participated in a prospective study on sexual function after TLH or LASH were surveyed again (TLH: n = 45; LASH: n = 29). The median follow-up period was 92 months (TLH) and 98 months (LASH). Sexual function was assessed using the validated Female Sexual Function Index (FSFI). Statistical analyses were performed using a 2 sample t test, Chi² test and Fisher’s exact test.

Over the long term, there was no significant difference in the FSFI total score between TLH and LASH (22.51 vs. 22.25, p-value: 0.261). Within the TLH group, sexual function remained stable compared to baseline data (p = 0.20). In contrast, the LASH group showed a significant deterioration in the total score (p = 0.028), particularly in the lubrication (p = 0.007) over time.

Both surgical methods ensure comparable sexual function. While TLH shows stable results over the years, LASH shows a significant decrease in some areas of sexual function, particularly with regard to lubrication. However, these differences do not result in a significantly worse overall outcome compared to TLH.