RANCHO MIRAGE, CALIF. — Supracervical hysterectomy did not leave women with better sexual function or quality of life, compared with total abdominal hysterectomy in the first randomized study to evaluate these outcomes in women who have had an abdominal hysterectomy.
Renewed interest in supracervical hysterectomies in recent decades grew out of speculation that women undergoing hysterectomies might enjoy better postoperative sexual function if the cervix were left intact.
The study's findings confirm previous nonrandomized results from British, Danish, and Finnish studies that found no difference in function or quality of life with supracervical rather than total abdominal hysterectomy.
“I hope we can separate myth from reality in counseling patients” who are considering hysterectomy, Lee Learman, M.D., said at the annual meeting of the Society of Gynecologic Surgeons.
The study included 135 women scheduled for hysterectomies at four U.S. clinical centers to treat symptomatic uterine fibroids and/or abnormal uterine bleeding refractory to hormonal management.
At randomization, women in the supracervical hysterectomy group had higher scores on the 100-point Medical Outcomes Study sexual problems scale, with 100 representing no problems. The mean score of 69 suggested better baseline sexual function, compared with the abdominal hysterectomy group (mean score of 55).
Phone interviews 4 weeks after surgery and then every 3 months for 2 years found significant improvements in sexual problems scores in both groups within 6 months. Scores plateaued by 1 year. At 2 years, scores were similar between groups—82 in the supracervical hysterectomy group, and 80 in the abdominal hysterectomy group, said Dr. Learman of San Francisco General Hospital, and his associates.
The principal investigator for the study was Miriam Kupperman, Ph.D., also of the hospital.
The supracervical hysterectomy group reported higher orgasm frequency and quality scores at 6 months, but no differences between groups were seen at 2 years.
Both groups reported psychological benefits even before they had physically recovered from the surgery, quality of life assessments found. Health-related quality of life after hysterectomy was similar between groups.