Lonnée-Hoffmann Risa, Pinas Ingrid
Institute of Public Health, St. Olav's Hospital, Norwegian University of Science and Technology, Trondheim, Norway.
ZBC FeM-poli, Zwolle, The Netherlands ; Faculty of Applied Psychology, University of Applied Sciences, Leiden, The Netherlands.
Curr Sex Health Rep. 2014;6(4):244-251. doi: 10.1007/s11930-014-0029-3.
Hysterectomy remains the most common major gynecological surgery. Postoperative sexual function is a concern for many women and their partners. In this respect, a beneficial effect of hysterectomy for benign disease independent of surgical techniques or removal of the cervix has been demonstrated in the past decade by the majority of studies. For about 20 % of women, deteriorated sexual function has been reported and current research is attempting to identify mechanisms and predictive factors explaining these postoperative changes. Alternative treatments of benign uterine disorders or uterus preserving surgery for genital prolapse appeared to have similar outcomes in terms of sexual function. Concomitant oophorectomy had negative effects on sexual function and long-term health, particularly in premenopausal women. This may not be reversed by estrogen replacement. Hysterectomy performed for malignancy had a detrimental effect on sexual function. Individualized risk assessment and information should be aimed at during preoperative decision making.
子宫切除术仍然是最常见的大型妇科手术。术后性功能是许多女性及其伴侣关注的问题。在这方面，过去十年中的大多数研究表明，子宫切除术对良性疾病具有有益效果，且与手术技术或宫颈切除无关。据报道，约20%的女性性功能会恶化，目前的研究正试图确定解释这些术后变化的机制和预测因素。良性子宫疾病的替代治疗或生殖器脱垂的子宫保留手术在性功能方面似乎有相似的结果。同时进行卵巢切除术对性功能和长期健康有负面影响，尤其是对绝经前女性。雌激素替代可能无法逆转这种情况。因恶性肿瘤进行的子宫切除术对性功能有不利影响。术前决策应旨在进行个体化风险评估并提供相关信息。
