Reproductive Health, Mother and Child Care Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Hamadan University of Medical Sciences, Hamadan, Iran (Dr. Kazemi).
Reproductive Health, Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran (Dr. Alimoradi).
J Minim Invasive Gynecol. 2022 Apr;29(4):476-488. doi: 10.1016/j.jmig.2021.10.012. Epub 2021 Oct 31.
Determination of the effect of hysterectomy caused by benign diseases on female sexual function.
A search was performed on Scopus, PubMed, Science Direct, ProQuest, ISI Web of Knowledge, and Embase databases. The keywords included hysterectomy (as exposure) and female sexual function (as outcome). Original English observational studies, including cohort, case-control, and cross-sectional studies published as of February 2021, which reported an association between any type of hysterectomy caused by benign female disease and sexual function as an outcome, were included in the study. Studies in participants who received hormone replacement therapy and had sex other than heterosexuals were not included. There was no limit to the initial search period, and articles published by February 2021 were searched.
The search process resulted in the retrieval of 5587 potentially related articles. After removing duplicated studies, the title and abstract were reviewed and 77 articles remained with the removal of unrelated items. The full text of 14 articles was published in non-English languages, and 52 articles were removed because they did not meet the inclusion criteria, and finally, 11 articles were included in the final analysis.
TABULATION, INTEGRATION, AND RESULTS: The Newcastle-Ottawa scale was used to assess the methodological quality of included studies. The evidence was synthesized using meta-analysis via random-effect model with the Der Simonian and Laird weighted method. Publication bias was assessed using the funnel plot and Begg's and Egger's tests. The pooled standardized mean difference for sexual function in hysterectomy vs nonhysterectomy group was 0.08 (95% confidence interval, -0.38 to 0.55; I = 96.8%; χ = 307.94; p <.001; τ = 0.59). Publication bias and small study effects were not detected. The results of the subgroup analysis showed that the possible sources of heterogeneity are the World Bank countries classification and type of hysterectomy (in some studies, the type of hysterectomy was not specified separately for the study groups; because of this, comparisons were made between Total and supracervical/total). Pooled standardized mean difference was affected by the type of sexual function scale, World Bank countries classification, type of hysterectomy, ovary status, and reproductive status. The results of meta-regression analysis also showed that for each month of distance from hysterectomy, women's sexual function score increases by 0.18.
The results of this study showed that hysterectomy caused by benign diseases does not change the sexual function significantly.
确定良性疾病所致子宫切除术对女性性功能的影响。
在 Scopus、PubMed、Science Direct、ProQuest、ISI Web of Knowledge 和 Embase 数据库中进行了检索。关键词包括子宫切除术（作为暴露因素）和女性性功能（作为结局）。本研究纳入了截至 2021 年 2 月发表的报告任何类型良性女性疾病所致子宫切除术与性功能结局之间关联的观察性原始英语研究，包括队列研究、病例对照研究和横断面研究。不包括接受激素替代疗法和非异性恋性行为的参与者的研究。初始搜索期没有限制，并搜索了截至 2021 年 2 月发表的文章。
搜索过程共检索到 5587 篇潜在相关文章。在去除重复的研究后，对标题和摘要进行了审查，去除了不相关的内容，保留了 77 篇文章。由于非英语语言出版了 14 篇文章的全文，以及由于不符合纳入标准而去除了 52 篇文章，最终有 11 篇文章纳入最终分析。
列表、综合和结果：使用纽卡斯尔-渥太华量表评估纳入研究的方法学质量。使用随机效应模型通过 Der Simonian 和 Laird 加权法进行荟萃分析综合证据。使用漏斗图和 Begg 和 Egger 检验评估发表偏倚。子宫切除术与非子宫切除术组性功能的标准化均数差合并值为 0.08（95%置信区间，-0.38 至 0.55；I=96.8%；χ=307.94；p<.001；τ=0.59）。未检测到发表偏倚和小样本效应。亚组分析的结果表明，异质性的可能来源是世界银行国家分类和子宫切除术类型（在一些研究中，未分别为研究组指定子宫切除术类型；因此，在 Total 和 supracervical/total 之间进行了比较）。标准化均数差受性功能量表类型、世界银行国家分类、子宫切除术类型、卵巢状态和生殖状态的影响。元回归分析的结果还表明，距子宫切除术每增加一个月，女性性功能评分增加 0.18。
本研究结果表明，良性疾病所致子宫切除术对女性性功能无显著影响。
