Erdal YERMEZ, ESRA BAHAR GÜR, İbrahim SEKÜ, Seçil KURTULMUŞ, HAYAL BOYACIOĞLU

Serviks ve overleri koruyarak yapılan histerektominin seksüel fonksiyonlar üzerindeki etkisi

Amaç: Çalışmamızın amacı, histerektomide serviksin ve överlerin korunmasının, seksüel fonksiyonlara etkisini belirlemektir. Materyal ve Metod: Çalışmamız SSK Ege Doğumevi ve Kadın Hastalıkları Hastanesinde subtotal histerektomi (STH), total abdominal histerektomi (TAH) ve total abdominal histerektomi ve bilateral salpingoooferektomi (TAH+BSO) uygulanıp hormon replasman tedavisi (HRT) alan hastalar üzerinde uygulanmıştır. Adres kayıtlarına ulaşılan ve çalışmaya katılmayı kabul eden hastalara, prepostoperatif seksüel fonksiyonu değerlendirmek amacıyla hazırlanan anket formu uygulandı. Sonuçlar, STH ve TAH ile TAH ve TAH+BSO grupları arasında karşılaştırılma yapılarak değerlendirildi. Sonuçlar: Anket çalışmasına katılan 32'si STH, 34'ü TAH ve 30'u TAH+BSO geçirmiş hasta, verdikleri cevaplarla değerlendirildi. Her üç grup arasında demografik özelliklerde fark yoktu. TAH uygulanan hastalarda, STH olanlara kıyasla, orgazm, çoklu orgazm ve koital sıklık ile tüm seksüel yeterlilik daha kötü idi (p= 0.024, p=0.012, p=0.032 ve p=0.003 sırasıyla). TAH+BSO grubu ile TAH grubu arasında ise, sadece postoperatif libidoda değişim konusunda, TAH grubu lehine anlamlı fark elde edildi (p=0.014). Tartışma: Çalışmamızın sonuçları, serviksin ve överlerin korunmasının seksüel fonksiyonlara olumlu etkileri olduğu yönündedir. Ancak, objektif değerlendirmenin ve sağlıklı analiz yapabilmenin oldukça güç olduğu bu konuda, kesin yargıya varabilmek için daha çok kontrollü çalışmaya ihtiyaç vardır.

Anahtar Kelimeler:

Serviks uteri, Histerektomi, Yumurtalık, Uterus

The effect of cervix and ovary sparing hysterectomy on sexual functions

Aim: The aim of our study was to assess the effect of cervical and ovarian protection during hysterectomy on sexual functions. Material and methods: Study group consisted of patients who had undergone subtotal hysterectomy (STH), total abdominal hysterectomy (TAH) or total abdominal hysterectomy and bilateral salpingooopherectomy (TAH+BSO); and received hormonal replacement therapy (HRT) in our maternity hospital. An inquiry form was prepared to determine pre-and postoperative sexual functions and was applied to patients in whom address informations could be reached and to whom approved join the study. The results were assessed by making comparison between the groups of STH and TAH, TAH and, TAH+BSO There were no demographic differences between the three groups. In the patients who undergone TAH; orgasm, multiple orgasm, coital frequency and whole sexual sufficiency scores were worse than the patients who had undergone STH (p=0.024, p=0.012, p-0.032 and p=0.003; consecutively).The only statistically significant difference between TAH+BSO and TAH groups was in postoperative libido changes and it was better in TAH group(p=0.014). Discussion:Results of our study shows that procting cervix and ovaries during hysterectomy has positive effects on sexual functions.Larger prospective studies are needed on this subject which is hard to make objective assessment to make certain decisions.

Keywords:

Cervix Uteri, Hysterectomy, Ovary, Uterus,

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