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Subtotal versus total laparoscopic hysterectomy: could women sexual function recovery overcome the surgical outcomes in pre-operatory decision making?

  • General Gynecology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Hysterectomy is the most common surgical procedure performed in gynecology and, in over 95 % of the cases, does not necessarily require the removal of the uterine cervix to be completed successfully. In clinical practice, however, less than 20 % of gynecologists offer patients the possibility to express a personal preference concerning the choice between total laparoscopic hysterectomy (TLH) and laparoscopic subtotal hysterectomy (LSH). The aim of this study is to compare patients who have undergone TLH versus LSH for benign uterine diseases in terms of intra-operative/peri-operative surgical outcomes and short-term recovery of sexual function.

Methods

We performed an observational, retrospective study on 478 women who underwent hysterectomy for benign uterine disease at Gyn/Ob Clinic, Department of Women’s and Children’s Health of Padua University between January 2003 and December 2012. Surgical data were recorded. We investigated and compared outcomes between the two groups of patients (TLH vs LSH) in terms of the following: surgical complications rate, post-operative therapy, women satisfaction and sexual activity recovery.

Results

We found that operating time and length of hospital stay were significantly lower in patients who underwent LSH. A higher rate of post-operative fever was reported in the TLH treatment group although antibiotic prophylaxis was implemented in a similar fashion for both groups. At 60–70 days following surgery, women of LSH group reported a greater ease in recovery of sexual function as opposed to those who underwent TLH.

Conclusions

The advantages and potential drawbacks of both procedures need to be discussed with women presenting with benign disease. LSH is a reasonable option for women, representing both an excellent minimally invasive approach in a proper clinical setting and an appropriate procedure for those women who prefer conservative surgery.

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Conflict of interest

The authors have no conflict of interest.

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Authors and Affiliations

  1. Department of Women’s and Children’s Health, Obstetrics and Gynecology Clinic, University of Padua, Padua, Italy

    Carlo Saccardi, Salvatore Gizzo, Marco Noventa, Shara Borgato, Lorena Conte & Pietro Litta

  2. Department of Obstetrics and Gynecology, University of Verona, Verona, Italy

    Michela Quaranta

  3. Division of Obstetrics and Gynecology, University of Pisa, Pisa, Italy

    Nicola Pluchino

  4. Dipartimento della Salute della Donna e del Bambino, U.O.C. di Clinica Ginecologica e Ostetrica, Via Giustiniani 3, 35128, Padua, Italy

    Salvatore Gizzo

Authors
  1. Carlo Saccardi
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  2. Salvatore Gizzo
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  3. Marco Noventa
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  4. Michela Quaranta
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  5. Shara Borgato
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  7. Nicola Pluchino
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  8. Pietro Litta
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Correspondence to Salvatore Gizzo.

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Saccardi, C., Gizzo, S., Noventa, M. et al. Subtotal versus total laparoscopic hysterectomy: could women sexual function recovery overcome the surgical outcomes in pre-operatory decision making?. Arch Gynecol Obstet 291, 1321–1326 (2015). https://doi.org/10.1007/s00404-014-3569-x

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  • DOI: https://doi.org/10.1007/s00404-014-3569-x

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