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Impact on Sexual Life in Women Treated with LASH versus LAVH

Sexual life after hysterectomy remains a great concern for patients and their partners. The aim of the present study was to compare the sexual function of 102 patients who received a subtotal hysterectomy (laparoscopic assisted supracervical hysterectomy, LASH) with 49 who underwent Laparoscopic Assisted Total Vaginal Hysterectomy (LAVH). Six weeks postoperatively, libido (p = 0.001), coital frequency (p = 0.001) and masturbation frequency (p = 0.003) were significantly better in the LASH group. Painful intercourse was higher in the LAVH group (p = 0.007). At six months, masturbation frequency (p = 0.013) and overall quality of life (p = 0.031) were better in the LASH group. No differences between groups were found at 12 months, with the exception of painful intercourse, which had higher rates (p = 0.018) in the LAVH group. Despite the improved short-term postoperative sexual outcomes with LASH as compared to LAVH, twelve months after surgery, these differences had almost vanished, with the exception of painful intercourse which persisted one year after total uterus and cervix excision. Further evaluation of cervix preservation on the quality of patient’s sexual life should also consider the role of other psycho-social factors.