Do hysterectomy techniques affect sexual functions and lower urinary system complaints?

Yıl 2020, , 1152 - 1156, 01.12.2020

Demet Aydoğan Kırmızı , Emre Başer

https://doi.org/10.28982/josam.823448

Öz

Aim: Hysterectomy is the most common gynecological surgical procedure. Therefore, detailed consultation about the postoperative effects of hysterectomy is an integral part of the operation. However, available data on these issues are limited and conflicting. The aim of this study is to evaluate the effects of hysterectomy types on lower urinary tract symptoms (LUTS), sexual function and quality of life.
Methods: Patients between 38-60 years of age who underwent total laparoscopic hysterectomy (TLH), vaginal hysterectomy (VH), and, in addition to standard total abdominal hysterectomy (TAH), uterosacral ligament-cuff suturing operation between June 2017 and 2019 were included in this cross-sectional study. Urgency, urge incontinence, frequency, abnormal emptying, hesitancy, nocturia, overflow, and interrupted stream are considered LUTS symptoms. Sexual functions were evaluated by Index of Female Sexual Function Index (FSFI) and the quality of life was evaluated by the EQ-5D (European Quality of Life Five- Dimension Scale) during the post-operative period.
Results: There was a significant decrease in urgency, urge incontinence, frequency, abnormal emptying, nocturia and interrupted stream symptoms (P<0.05) in the VH group (n=30), and urge and urge incontinence symptoms in TAH group (n=213) (P<0.05) postoperatively. In terms of the FSFI total score, the highest sexual dysfunction was in the TAH group whereas the lowest was in the TLH (n=60) group.
Conclusions: Hysterectomy does not worsen LUTS. The best post-operative sexual functions were found in the TLH group. The post-operative quality of life was better in patients operated vaginally and laparoscopically.

Anahtar Kelimeler

vaginal hysterectomy, abdominal hysterectomy, laparoscopic hysterectomy, sexual dysfunction, lower urinary tract symptoms, quality of life

Histerektomi tekniklerinin cinsel fonksiyonlara, alt üriner sistem semptomları ve yaşam kalitesi üzerine etkisi var mıdır?

Öz

Amaç: Histerektomi, en yaygın jinekolojik cerrahi prosedürdür. Bu nedenle, histerektominin postoperatif etkileri hakkında ayrıntılı konsültasyon operasyonun ayrılmaz bir parçasıdır. Ancak, bu konularla ilgili mevcut veriler sınırlıdır ve çelişkilidir. Bu çalışmanın amacı, histerektomi tiplerinin alt üriner sistem semptomları (LUTS), cinsel fonksiyon ve yaşam kalitesi üzerine etkilerini değerlendirmektir.
Yöntemler: Haziran 2017-2019 tarihleri arasında benign nedenlerle total laparoskopik (TLH), vajinal (VH) ve standart total abdominal histerektomi (TAH) operasyonuna ek olarak sakrouterin ligamanent-cuff sütürizasyonu yapılmış olan 38-60 yaş arasındaki hastalar bu kesitsel çalışmaya dahil edildi. Urge, urge inkontinansı, frequency, anormal boşalma, zor idrar yapma, noktüri, taşma, kesik kesik idrar yapma AÜSS semptomları olarak değerlendirildi. Sexüel fonksiyon Index of Female Sexual Function Indexi (FSFI) ve yaşam kalitesi European Quality of Life Five-Dimension Scale (EQ-5D) ölçeği ile postoperatif dönemde değerlendirildi.
Bulgular: Preoperatif döneme göre postoperatif dönemde, VH (n=30) grubunda urgency, urge incontinence, frequency, anormal boşalma, noktüri ve kesik kesik idrar yapma semptomlarında (P<0,05), TAH (n=213) hastalarında ise urge ve urge inkontinans semptomlarında anlamlı olarak azalma olduğu saptandı (P<0,05). FSFI total skoruna göre sexual disfonksiyonun en fazla TAH ve en az TLH (n=60) grubunda görüldü. En iyi genel yaşam kalitesi skorunun VH ve ardından TLH grubunda saptandı.
Sonuç: Histerektomi AÜSS’nı kötüleştirmemektedir. Vajinal yaklaşım pelvik taban onarımı imkanıyla en belirgin düzelmeyi sağlamaktadır. Post-operatif en iyi sexual fonksiyonlar TLH grubunda saptanmıştır. Vajinal ve laparoskopik olarak opere edilen hastalarda postoperatif yaşam kalitesinin daha iyi olduğu görülmektedir.

Anahtar Kelimeler

Vajinal histerektomi, Abdominal histerektomi, Laparoskopik histerektomi, Cinsel işlev bozukluğu, Alt üriner sistem semptomları, Yaşam kalitesi

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