Introduction: Hysterectomy is a common gynecological operation in which the uterus is removed. Several types of hysterectomy are known, total, subtotal and radical. The operative approaches can be abdominal, laparoscopic and vaginal. It is important that we know how removal of the uterus affects sexual function. Hysterectomy can affect sexuality physical and psychological. In the literature, the prevailing view is that hysterectomy has a positive effect on quality of life and sexuality, but the impact of uterine removal varies from woman to woman. Purpose: Purpose of this systematic review is to investigate and present how hysterectomy affects sexuality, describe different types and modes of hysterectomy and compare their effects on sexuality, present psychological impact of uterine removal and the effect of a hysterectomy on a partner. Methods: Descriptive method was used. Professional and academic articles which were found in electronic databases CINAHL and MEDLINE were finded. Search databases were: PubMed, DiKul and Google Scholar. With help of various bibliographic-catalogue databases COBISS and DiKUL. Key words and phrases that were used at searching in slovene language were: ginekološka operacija, odstranitev maternice, spolna funkcija, svetovanje which were connected by the word “IN”. Used key words and phrases in English were gynecological operations, hysterectomy, sexual intercourses, advises which were connected together by the word “AND”. Searching for literature wasn’t linguisticly limited. The included criteria for choosing literature were: clear connection of the article and the theme of hysterectomy, with which the article's type of methodology wasn't important, the access to the whole article was complete, the literature was published between 2010 and 2020. Discussion and conclusion: The mode and surgical approach of hysterectomy can affect sexual function. Vaginal hysterectomy should be performed whenever possible, laparoscopic and abdominal hysterectomy have their strenghts and weaknesses that need to be included in the decision making process before surgery. Recent research comparing subtotal and total hysterectomy has not shown major differences in postoperative quality of life and sexual function. While radical hysterectomy causes more negative effects on sexuality and quality of life, due to the removal of larger parts of the pelvic ligaments, the autonomic nerves and the shortening of the upper part of the vagina. A very important factor affecting less sex after hysterectomy are problems in sexual intercourses that were present before surgery. After reviewing the literature, we found that in most cases, hysterectomy has a positive effect on sex and quality of life, as it alleviates pain, reduces bleeding, and removes the unpleasant symptoms that were indications of the operation. Several factors affect sex after hysterectomy, namely, frequency intercourses, desire for relationships, arousal, relationship with sexual partner, and dyspareunia. If the sexual function before the hysterectomy was satisfactory and the relationship between the partners was good, in most of the cases there is no fear that the sexuality will become worse. Studies show that most women can expect unchanged or improved sexual function after the hysterectomy. Feeling the relief of the symptoms may outweigh some of the risk of changes in sexual function after surgery.
|
