Sexual function after hysterectomy and myomectomy. 2014

Luiz Gustavo Oliveira Brito, and Nieck Sebastiaan Alexander Pouwels, and Jon Ivar Einarsson
Department of Obstetrics and Gynecology Minimally Invasive Gynecological Surgery Division Brigham and Women's Hospital Harvard Medical School Boston, MA.

Sexual function after hysterectomy and myomectomy is a controversial topic and influenced by several factors. With regard to hysterectomy, there is not a consensus whether the removal of the cervix will modify sexual function after surgery, and patients who choose to preserve their cervix should be counseled about the possibility of continued vaginal bleeding and the need for continued pap smear surveillance after surgery. In most studies, hysterectomy has been found to improve sexual function because usually patients have symptoms that indicated the surgery, such as abnormal uterine bleeding and pelvic pain, and as these symptoms cease, they report an improvement in their sexual life. In regards to myomectomy, literature is scarce, however few studies have shown an improvement in sexual function due to the same reasons as hysterectomy. For purposes of research, it is important to standardize sexual questionnaires when performing studies about this outcome. It is also important to emphasize that during discussion of your patient, sexual outcomes should be addressed and that the surgeon should consider all patients' personal, religious, and cultural background during the decision-making process because it will minimize patient's disappointment if she develops a negative response after surgery.

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