Investigating the Impact of Benign Indication Hysterectomy on Pelvic Floor Symptoms and Sexual Function: A Prospective Study Integrating Pelvic Floor Ultrasonography and Surface Electromyography Test

TL;DR

This study examines how single-port laparoscopic hysterectomy for benign conditions affects pelvic floor symptoms and sexual function within six months.

Contribution

The study provides new insights into the short-term effects of single-port laparoscopic hysterectomy on pelvic floor function and sexual health using advanced diagnostic techniques.

Findings

Pelvic floor function significantly improved postoperatively, but sexual function, as measured by FSFI scores, decreased.

Bladder neck descent increased significantly six months after surgery, but other pelvic floor structure indicators remained unchanged.

Some sEMG indicators showed significant changes post-surgery, but most pelvic floor muscle functions were unaffected in the short term.

Abstract

This prospective study aimed to investigate the short-term effects of single-port laparoscopic hysterectomy for benign conditions on postoperative pelvic floor symptoms, pelvic floor structure, and pelvic floor muscle function.

The study was conducted at Zhongda Hospital, Southeast University, from May 2022 to September 2023. Patients who underwent elective single-port laparoscopic hysterectomy for benign conditions were recruited. Paired t-tests and non-parametric rank-sum tests were used to compare changes in pelvic floor function, female sexual function index (FSFI), 4D pelvic floor ultrasonography, and surface electromyography (sEMG) indicators between pre- and postoperative periods.

A total of 71 participants were included, with 69 patients successfully followed up. There was a significant improvement in pelvic floor function postoperatively (p < 0.001). FSFI scores significantly decreased postoperatively. Bladder neck descent increased significantly postoperatively (p = 0.024) in 6 months. However, there were no significant differences in the other ultrasound indicators between preoperative and 6-month postoperative assessments. The time after the peak of the tonic contraction phase significantly decreased postoperatively (p = 0.047), and the average mean of post-baseline value decreased postoperatively with statistical significance (p < 0.001). There were no significant differences in other pelvic floor sEMG indicators between preoperative and postoperative assessments.

Within 6 months post-hysterectomy, Pelvic Floor Disorders Impact Questionnaire-20 (PFDI-20) scores significantly improved, and FSFI scores significantly decreased postoperatively. Single-port laparoscopic hysterectomy did not significantly affect pelvic floor structure or muscle function in the short-term postoperative period. However, overall sexual function decreased within the same timeframe.

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