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

Arch Gynecol Obstet. 2026 Jun 7;313(1):200. doi: 10.1007/s00404-026-08479-z.

ABSTRACT

PURPOSE: 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.

METHODS: 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.

RESULTS: 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.

CONCLUSION: 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.

PMID:42251612 | DOI:10.1007/s00404-026-08479-z

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