Sexual Experience of Partners After Hysterectomy, Comparing Subtotal With Total Abdominal Hysterectomy

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Numerous studies have shown that hysterectomy for benign disorders improves the quality of life in general and sexual function in particular no matter what surgical technique is employed. Preoperative satisfaction with one’s sex life and a good relationship with one’s partner both predict a satisfactory postoperative sexual outcome. Because little is known of the partner’s experience of sexuality following hysterectomy, the investigators assessed the experience of sexual intercourse (SI) in the partners of 25 Norwegian women having total abdominal hysterectomy (TAH) and 26 others undergoing subtotal abdominal hysterectomy (SAH). In addition to being asked a number of questions relating to sexuality by postal questionnaire, partners graded their satisfaction with SI before and after surgery on a 0-to-10 visual analog scale. All women in the study had been operated on for benign indications during a 2-year period in 2001–2003.

In both groups, the partners were very satisfied with their erections before and during intercourse. Few partners noticed that that the uterus had been removed. More than half of respondents in both the TAH and SAH groups believed that their partners felt less SI-related pain after surgery. Only in the TAH group did a small proportion of respondents (12%) feel that their partners suffered more pain during SI after hysterectomy. A large majority of partners in both groups expressed no preference, in retrospect, for one or the other type of hysterectomy. In both groups, most women and their partners engaged in SI as often as—or more often than—before hysterectomy. Sexual satisfaction scores did not change significantly but tended to be higher after than before hysterectomy, with no difference between the two groups. Poor sexual satisfaction before surgery correlated with lower satisfaction scores afterward, but the difference was of only borderline significance.

These findings indicate that a majority of couples are no less satisfied with SI following abdominal hysterectomy, whether total or subtotal. The only factor predicting a negative sexual experience in this survey was less than optimal experience preoperatively.

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