Comparison of Sexual Function in Patients Undergoing Hysterectomy through Laparoscopic versus Abdominal Method: A Systematic Review.

Uterus is the symbol of femininity; thus, hysterectomy is an important decision in a woman's life. It can create certain physical, psychological, and sexual impacts in the relationship between the couple. This review has tried to analyze the effect of hysterectomy on postoperative sexual outcomes through a comparison between laparoscopic versus abdominal routes of surgery. An initial systematic search identified 247 studies. After screening the title and abstracts, 243 studies were included, out of which 213 articles were assessed for eligibility. A careful analysis resulted in 15 studies being rendered out for the review. Extracted information included study design, menopausal status, use of hormone replacement therapy, and sexual function outcome parameters following laparoscopic and abdominal hysterectomy. Data were also retrieved at the time of assessment of sexual outcome after surgery, and any significant difference between the two techniques of hysterectomy was analyzed. Different articles evaluated sexual function using different validated scores such as female sexual function satisfaction score, Arizona Sexual Experiences Scale, and Brief Index of Sexual Functioning for Women to include different components of female sexuality. Due to differences in sexual function outcome scales, meta-analysis could not be performed. The majority of the studies indicated a similar impact of hysterectomy on sexuality, irrespective of the route, while a few of them showed improvement with laparoscopic method. Assessment of sexual function is a complex task. Women undergoing hysterectomy need good psychological counseling and assessment before choosing the route and method of hysterectomy. Further multicentric studies are needed to draw a final conclusion.