Comparison of Female Sexual Function Before and After Total Abdominal Hysterectomy

Background: The uterus has a vital role in females' reproductive and sexual health. Total abdominal hysterectomy (TAH) is a common surgical intervention for benign conditions, but its impact on sexual function remains controversial.Aim: To evaluate alterations in women's sexual function before and after TAH without oophorectomy for benign indications.Patients and Methods: This prospective comparative analytical research has been performed on 34 sexually active women undergoing TAH at Al-Zahraa University Hospital and Beni-Suef Specialized Hospital. Sexual function has been evaluated utilizing the Female Sexual Function Index (FSFI) one week before and three months after surgery. Patients with psychiatric illness, postoperative complications, or partners with severe illness were excluded.Results: Postoperative sexual dysfunction decreased from 61.8% to 55.9%, but this change was statistically insignificant (p=0.851). Insignificant variances were observed in individual FSFI domains—desire, arousal, lubrication, orgasm, satisfaction, and pain—before and after surgery. The total FSFI score showed a slight, non-significant improvement postoperatively (26.32±1.05 vs. 26.06±1.08; p=0.272). Subgroup analysis revealed that patients with severe preoperative menstrual blood loss experienced better postoperative sexual function (p=0.04). Additionally, women undergoing hysterectomy for dysfunctional uterine bleeding had significantly higher postoperative FSFI scores compared to those treated for fibroids (26.45±1.0 vs. 25.33±0.72; p=0.04), indicating a more favorable sexual function outcome in this group.Conclusion: Sexual function after TAH for benign causes showed minimal change overall, though patients with DUB may experience greater postoperative improvement. Further studies with larger samples and longer follow-up are warranted.