Jiangsu Zhenjiang Maternal and Child Health Hospital, Zhenjiang, China.
Second Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Braz J Med Biol Res. 2020 Feb 14;53(3):e9058. doi: 10.1590/1414-431X20199058. eCollection 2020.
The objective of this study was to evaluate changes in sexual function after total laparoscopic hysterectomy (TLH) or transabdominal hysterectomy (TAH). This retrospective cohort study included patients with benign uterine tumors that were divided into TLH group and TAH group based on the hysterectomy technique used. Baseline, intraoperative, and postoperative characteristics were compared between groups. Postoperative sexual function was assessed using the Brief Index of Sexual Functioning for Women. The TLH and TAH groups contained 119 patients (age, 51.5±6.1 years) and 126 patients (age, 50.0±4.7 years), respectively. Baseline characteristics were comparable between groups, although uterine size was larger in the TAH group (P<0.001). Compared with the TAH group, the TLH group had a longer operative time (130.0±36.2 vs 107.3±28.5 min, P<0.001), lower pain index at 24 h (2.0±1.6 vs 4.0±2.6, P<0.001), and shorter hospitalization time (5.7±1.1 vs 8.1±1.2 days, P<0.001). Many patients in the TLH and TAH groups reported decreased satisfaction with their sexual life (67.5 and 56.0%, respectively), reduced frequency of sexual activity (70.1 and 56.0%, respectively), decreased libido (67.5 and 56.0%, respectively), orgasm dysfunction (42.9 and 42.9%, respectively), and increased dyspareunia (77.9 and 85.7%, respectively). However, there was no significant difference between groups in any of the indexes of postoperative sexual function (P>0.05). Both TLH and TAH had comparable negative effects on sexual function in women treated for benign uterine tumors in China, with a decreased frequency of sexual activity, reduced libido, orgasm dysfunction, and increased dyspareunia.
本研究旨在评估经腹腔镜子宫切除术（TLH）或经腹子宫切除术（TAH）后性功能的变化。这项回顾性队列研究纳入了良性子宫肿瘤患者，根据所采用的子宫切除术技术将患者分为 TLH 组和 TAH 组。比较两组患者的基线、术中及术后特征。采用女性性功能简化量表评估术后性功能。TLH 组和 TAH 组分别纳入 119 例（年龄 51.5±6.1 岁）和 126 例（年龄 50.0±4.7 岁）患者。两组患者的基线特征相似，但 TAH 组子宫较大（P<0.001）。与 TAH 组相比，TLH 组手术时间更长（130.0±36.2 分钟比 107.3±28.5 分钟，P<0.001），术后 24 小时疼痛指数更低（2.0±1.6 分比 4.0±2.6 分，P<0.001），住院时间更短（5.7±1.1 天比 8.1±1.2 天，P<0.001）。TLH 组和 TAH 组均有较多患者报告性生活满意度降低（分别为 67.5%和 56.0%）、性生活频率降低（分别为 70.1%和 56.0%）、性欲降低（分别为 67.5%和 56.0%）、性高潮功能障碍（分别为 42.9%和 42.9%）和性交困难增加（分别为 77.9%和 85.7%）。但两组患者术后性功能的各项指标差异均无统计学意义（P>0.05）。在中国，TLH 和 TAH 治疗良性子宫肿瘤对女性的性功能均有类似的负面影响，导致性生活频率降低、性欲降低、性高潮功能障碍和性交困难增加。
