Sexual Dysfunction After Hysterectomy Based on Female Sexual Function

Hysterectomy is the most common major gynecological surgical procedure. There are raised concerns regarding its impact on sexual function. Objective: This study aimed to assess the effects of vaginal, abdominal, and laparoscopic hysterectomy on women’s sexual functioning based on the female sexual function index (FSFI). Methods: This prospective Cohort study was conducted on 48 patients who underwent hysterectomy by different routes at the OB/GYN department at Mansoura University Hospitals, Mansoura, Egypt, aged between 25 and 49 years, from October 2024 to October 2025. The patients’ sociodemographic and clinical data were collected. The patients were asked to fill the FSFI questionnaire as well preoperatively, 3 months, and 6 months postoperatively. Results: 16 included patients underwent abdominal hysterectomy, 17 underwent vaginal and 15 underwent laparoscopic hysterectomy. No significant difference was detected between studied groups regarding age, education, residence and occupation. No significant difference was found between the studied groups regarding the cause of hysterectomy. Regarding the sexual functions, the Mean total score domain was 21.24±7.21, 21.88±6.12, and 23.03±6.23 for abdominal, vaginal, and laparoscopic hysterectomy, respectively. No significant difference was detected between the studied groups as regards to mean scores of desire, arousal, lubrication, orgasm, satisfaction, pain, and total score at baseline, after 3months, and after 6 months. The only significant difference between the studied groups was detected between abdominal versus laparoscopic hysterectomy for the desire domain of FSFI after 3 months. While comparing follow-up data, there is significant improvement for the total score between after 3 versus 6 months from 21.34±6.35 to 22.64±6.71 among the abdominal hysterectomy group. Conclusions: The hysterectomy is not directly related to the female sexual dysfunction (FSD) and will not contribute to resolving the already present sexual dysfunction except in limited conditions. Since the FSFI is a valid and reliable tool, it could be used in large-scale health surveys where assessing FSD is required to be a regular practice, and it could also be used as a routine screening tool for FSD before and after hysterectomy in clinical settings.