Comparison of postoperative vaginal length and sexual function after abdominal, vaginal, and laparoscopic hysterectomy

Objective: To compare vaginal length and sexual function after total laparoscopic hysterectomy (TLH), total abdominal hysterectomy (TAH), and vaginal hysterectomy (VH). Methods: The present cross-sectional study at a single center in Turkey compared vaginal length and sexual function among women who received TLH, TAH, VH, or no surgery (groups 1, 2, 3, and 0, respectively) between January 2011 and April 2014. All women underwent hysterectomy for benign reasons at least 3 months before the study and were sexually active. Vaginal length was measured between the hymenal ring and vaginal apex. Sexual function was assessed via the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire, short form (PISQ-12). Results: Vaginal length in groups 0, 1, 2, and 3 was 10.9 +/- 1.5, 8.9 +/- 1.4, 8.5 +/- 1.2, and 8.1 +/- 0.7 cm, respectively; it was significantly longer in the control group (P < 0.001), and significantly shorter in group 3 than in group 1 (P = 0.03). The mean PISQ-12 score in groups 0, 1, 2, and 3 was 18.6 +/- 52, 12.9 +/- 3.0, 13.8 +/- 4.4, and 11.5 +/- 4.4, respectively, and was significantly higher in group 0 (P < 0.001). Conclusion: Total hysterectomy shortened vaginal length and compromised sexual function regardless of the technique used. (C) 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.