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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (5): 693-700    DOI: 10.31083/j.ceog.2020.05.5389
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Evaluation of sexual functions and quality of life in female patients after hysterectomy for benign symptomatic diseases
Ö. Koşar Can1, *(), Ö.T. Güler1, Ü. Çabuş1, D. Kılıç1, C. Kabukçu1
1Department of Obstetrics and Gynecology, Pamukkale University, Faculty of Medicine, Kınıklı, 20070, Denizli, Turkey
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Abstract  

Objective: To evaluate selected quality of life parameters among sexually active patients who underwent a total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO) for benign symptomatic disease. Materials and Methods: Fifty-six TAH-BSO patients (20 menopausal + 36 premenopausalhysterectomized women) were evaluated between September 2017 and May 2018 using the FSFI, ASEX and SF-36 scores with individual interviews before and six months after TAH + BSO surgery. Results: The preoperative and postoperative period scores from three different validated questionnaires were found to be significantly different for all patients. Scores in the postoperative periods were better in all patients. Also, scores in the preoperative and postoperative periods were higher among premenopausal patients than menopausal patients. Conclusion: Our results showed that sexual function and quality of life improved in all patients who underwent TAH-BSO for benign symptomatic disease. Also, menopausal status is very important.

Key words:  Female sexual function      Quality of life      Hysterectomy      FSFI      ASEX      SF-36     
Submitted:  07 October 2019      Accepted:  27 March 2020      Published:  15 October 2020     
*Corresponding Author(s):  Ö. KOŞAR CAN     E-mail:  ozlemcan@pau.edu.tr

Cite this article: 

Ö. Koşar Can, Ö.T. Güler, Ü. Çabuş, D. Kılıç, C. Kabukçu. Evaluation of sexual functions and quality of life in female patients after hysterectomy for benign symptomatic diseases. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(5): 693-700.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.05.5389     OR     https://ceog.imrpress.com/EN/Y2020/V47/I5/693

Table 1a  — Demographic characteristics of the female patients.
All Patients (n = 56) Menopausal women (n = 20) Pre-menopausal women (n = 36) Between Groups p
Mean ± SD Med (min - max) Mean ± SD Med (min - max) Mean ± SD Med (min - max)
Age 49.32 ± 9 47 (30 - 78) 58.05 ± 8.79 54.5 (47 - 78) 44.47 ± 4.21 45 (30 - 51) 0.0001* (z = -5.675)
Gravida 3.14 ± 1.52 3 (1 - 9) 3.9 ± 1.92 3 (2 - 9) 2.72 ± 1.06 3 (1 - 6) 0.01* (z = -2.563)
Parity 2.48 ± 1.21 2 (1 - 9) 2.9 ± 1.65 2 (2 - 9) 2.25 ± 0.81 2 (1 - 5) 0.117 (z = -1.569)
Children number 2.41 ± 1.16 2 (1 - 9) 2.8 ± 1.64 2 (1 - 9) 2.19 ± 0.71 2 (1 - 4) 0.134 (z = -1.5)
Table 1b  — Demographic characteristics of the female patients.
Number (n) Percentage (%)
Employment status Not working 39 69.6
Working 17 30.4
Education Primary school 40 71.4
Midde school 5 8.9
High school 6 10.7
Undergraduate 5 8.9
Sports No 38 67.9
Yes 18 32.1
Alcohol consumption No 54 96.4
Yes 2 3.6
Total 56 100
Table 2  — The FSFI scores of the patients in the preoperative and postoperative periods.
All patients (n = 56) Menopausal group (n = 20) Pre-menopausal group (n = 36) Between Groups p
Mean ± SD Med (min - max) Mean ± SD Med (min - max) Mean ± SD Med (min - max)
FSFI Total Score(Pre) 15.78 ± 9.56 16.7 (1.8 - 33.5) 12.18 ± 8.29 7.2 (3.8 - 28.4) 17.78 ± 9.74 21.45 (1.8 - 33.5) 0.049* (z = -1.967)
FSFI Total Score(Post) 20.51 ± 8.77 22.7 (1.2 - 33.8) 14.07 ± 9.88 15.7 (1.2 - 29.6) 24.1 ± 5.54 24.45 (9.7 - 33.8) 0.0001* (z = -3.566)
Within Groups p 0.0001* (z = -4.949) 0.239 (z = -1.179) 0.0001* (z = -4.939)
Desire(Pre) 2.52 ± 1.17 2.4 (1.2 - 4.8) 1.98 ± 1.03 1.2 (1.2 - 4.2) 2.82 ± 1.15 3 (1.2 - 4.8) 0.011* (z = -2.528)
Desire(Post) 2.82 ± 1.12 3 (1.2 - 4.8) 2.25 ± 1.01 2.4 (1.2 - 4.2) 3.13 ± 1.06 3.6 (1.2 - 4.8) 0.005* (z = -2.796)
Within Groups p 0.006* (z = -2.747) 0.131 (z = -1.51) 0.02* (z = -2.33)
Arousal(Pre) 2.28 ± 1.76 2.25 (0 - 5.7) 1.71 ± 1.6 1.2 (0 - 4.8) 2.59 ± 1.79 2.85 (0 - 5.7) 0.092 (z = -1.686)
Arousal(Post) 3.08 ± 1.44 3.45 (0 - 6) 2.15 ± 1.63 2.4 (0 - 4.8) 3.59 ± 1.01 3.6 (1.2 - 6) 0.001* (t = -3.599)
Within Groups p 0.0001* (z = -4.579) 0.032* (z = -2.149) 0.0001* (z = -4.07)
Lubrication(Pre) 2.63 ± 2.15 3.15 (0 - 6) 1.95 ± 2.21 0.45 (0 - 6) 3.01 ± 2.05 3.9 (0 - 6) 0.074 (z = -1.786)
Lubrication(Post) 3.77 ± 1.76 4.2 (0 - 6) 2.43 ± 2.12 2.7 (0 - 6) 4.52 ± 0.92 4.5 (2.1 - 6) 0.0001* (z = -3.795)
Within Groups p 0.0001* (z = -4.763) 0.059 (z = -1.886) 0.0001* (z = -4.221)
Orgasm(Pre) 2.98 ± 1.49 2.4 (0 - 5.6) 2.48 ± 0.74 2.2 (1.6 - 4.4) 3.26 ± 1.72 3.4 (0 - 5.6) 0.077 (z = -1.768)
Orgasm(Post) 3.46 ± 1.87 4 (0 - 6) 2.1 ± 1.87 2.6 (0 - 5.6) 4.22 ± 1.39 4.4 (1.2 - 6) 0.0001* (z = -4.027)
Within Groups p 0.004* (z = -2.886) 0.273 (z = -1.095) 0.0001* (z = -4.687)
Satisfaction(Pre) 3.04 ± 2.07 3 (0 - 6) 2.08 ± 1.77 2 (0 - 5.2) 3.58 ± 2.05 4.4 (0 - 6) 0.009* (z = -2.607)
Satisfaction(Post) 3.64 ± 1.81 4.4 (0 - 6) 2.38 ± 1.87 2.4 (0 - 6) 4.33 ± 1.35 4.8 (1.2 - 6) 0.0001* (z = -3.557)
Within Groups p 0.0001* (z = -3.774) 0.033* (z = -2.132) 0.002* (z = -3.157)
Pain(Pre) 2.34 ± 2.23 2 (0 - 6) 1.98 ± 2.22 1 (0 - 6) 2.53 ± 2.24 2 (0 - 6) 0.324 (z = -0.985)
Pain(Post) 3.75 ± 1.77 4 (0 - 6) 2.76 ± 2.29 3.6 (0 - 6) 4.3 ± 1.1 4.4 (2 - 6) 0.02* (z = -2.335)
Within Group p 0.0001* (z = -4.829) 0.027* (z = -2.207) 0.0001* (z = -4.338)
Table 3  — The total ASEX scores of the patients in the preoperative and postoperative periods.
All patients (n = 56) Menopausal group (n = 20) Pre-menopausal group (n = 36) Between Groups p
Mean ± SD Med (min - max) Mean ± SD Med (min - max) Mean ± SD Med (min - max)
ASEX Total score (Pre) 18.46 ± 5.56 18 (7 - 30) 20.95 ± 5.65 19.5 (9 - 30) 17.08 ± 5.07 16.5 (7 - 30) 0.011* (t = 2.626)
ASEX Total score (Post) 17.66 ± 5.72 16.5 (6 - 30) 20.35 ± 5.69 19 (9 - 30) 16.17 ± 5.23 15.5 (6 - 30) 0.007* (t = 2.779)
Within Group p 0.0001* (z = -3.585) 0.2 (z = -1.282) 0.0001* (z = -3.903)
Table 4  — Comparison of the SF-36 scores in the patients in the preoperative and postoperative periods.
All patients (n = 56) Menopausal group (n = 20) Pre-menopausal group (n = 36) Between Groups p
Mean ± SD Med (min - max) Mean ± SD Med (min - max) Mean ± SD Med (min - max)
Physical functioning(Pre) 59.68 ± 29.01 60 (0 - 100) 58.25 ± 29.17 62.5 (0 - 100) 60.47 ± 29.31 57.5 (0 - 100) 0.786 (t = -0.272)
Physical functioning(Post) 68.04 ± 23.41 72.5 (0 - 100) 60.5 ± 26 67.5 (0 - 100) 72.22 ± 21.06 77.5 (10 - 100) 0.068 (z = -1.828)
Within Groups p 0.001* (z = -3.226) 0.498 (z = -0.677) 0.001* (z = -3.277)
Role-physical(Pre) 41.96 ± 43.72 25 (0 - 100) 36.25 ± 45.51 0 (0 - 100) 45.14 ± 43.02 37.5 (0 - 100) 0.445 (z = -0.763)
Role-physical(Post) 59.82 ± 41.47 75 (0 - 100) 55 ± 44.87 62.5 (0 - 100) 62.5 ± 39.87 75 (0 - 100) 0.54 (z = -0.613)
Within Groups p 0.004* (z = -2.868) 0.058 (z = -1.897) 0.023* (z = -2.278)
Vitality(Pre) 45.89 ± 22.65 45 (10 - 90) 44 ± 21.13 40 (10 - 85) 46.94 ± 23.67 47.5 (10 - 90) 0.645 (t = -0.463)
Vitality(Post) 50 ± 21.7 50 (15 - 90) 48 ± 20.42 47.5 (15 - 85) 51.11 ± 22.59 52.5 (15 - 90) 0.612 (t = -0.511)
Within Groups p 0.003* (z = -2.955) 0.122 (z = -1.548) 0.01* (z = -2.58)
Role-emotional(Pre) 36.3 ± 43.24 0 (0 - 100) 28.33 ± 40.86 0 (0 - 100) 40.73 ± 44.44 33.3 (0 - 100) 0.309 (z = -1.017)
Role-emotional(Post) 60.71 ± 45.44 100 (0 - 100) 58.33 ± 45.73 83.3 (0 - 100) 62.03 ± 45.88 100 (0 - 100) 0.784 (z = -0.274)
Within Groups p 0.0001* (z = -3.505) 0.021* (z = -2.315) 0.008* (z = -2.659)
Bodily pain(Pre) 51.25 ± 26.82 42 (0 - 100) 47.7 ± 25.6 41.5 (0 - 100) 53.22 ± 27.64 51 (10 - 100) 0.508 (z = -0.662)
Bodily pain(Post) 59.63 ± 17.74 62 (21 - 100) 55.35 ± 14.25 58 (21 - 84) 62 ± 19.19 62 (41 - 100) 0.443 (z = -0.768)
Within Groups p 0.001* (z = -3.21) 0.088 (z = -1.706) 0.005* (z = -2.788)
General health(Pre) 52.59 ± 21.45 51 (15 - 97) 46.15 ± 17.48 43.5 (20 - 77) 56.17 ± 22.81 55 (15 - 97) 0.094 (t = -1.703)
General health(Post) 55.2 ± 21.81 56 (15 - 95) 47.5 ± 21.5 43.5 (15 - 92) 59.47 ± 21.07 62 (22 - 95) 0.048* (t = -2.023)
Within Groups p 0.01* (z = -2.578) 0.156 (z = -1.418) 0.027* (z = -2.218)
Social functioning(Pre) 55.8 ± 22.48 50 (12.5 - 100) 56.88 ± 19.65 50 (25 - 100) 55.21 ± 24.16 50 (12.5 - 100) 0.793 (t = 0.264)
Social functioning(Post) 66.96 ± 18.98 62.5 (25 - 100) 62.5 ± 22.58 62.5 (25 - 100) 69.44 ± 16.49 62.5 (50 - 100) 0.355 (z = -0.926)
Within Groups p 0.0001* (z = -4.12) 0.13 (z = -1.513) 0.0001* (z = -3.83)
Mental health(Pre) 56.43 ± 19.68 56 (8 - 100) 54 ± 19.36 54 (20 - 100) 57.78 ± 20 56 (8 - 100) 0.496 (t = -0.685)
Mental health(Post) 59.79 ± 19.3 60 (20 - 100) 59 ± 18.16 60 (20 - 100) 60.22 ± 20.15 60 (24 - 100) 0.823 (t = -0.225)
Within Groups p 0.001* (z = -3.188) 0.01* (z = -2.585) 0.025* (z = -2.246)
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