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Master Thesis

Étude comparative de l’impact de l’hystérectomie totale et subtotale sur la sexualité et l’orgasme féminin

Abstract : Background: Hysterectomy is a routine procedure in gynecological surgery. Currently, there is no argument to favor subtotal hysterectomy over total hysterectomy in the context of benign pathologies, both in terms of surgical complications and overall post-operative sexual satisfaction. However, it seems that some parameters of sexual function are better in the subtotal hysterectomy group, especially with regard to orgasm. Recent studies on pelvic innervation demonstrate that the cervix and vagina have their own innervation, independent of clitoral innervation, and are involved in the sexual response by activating a spinal bypass pathway of vagal origin. Our hypothesis is therefore based on the fact that, during a functionally motivated hysterectomy, cervical amputation can further impair the quality of orgasm. Material and method: The objective of our study is to compare the overall sexual satisfaction and the quality of the orgasm by comparing the scores to the surveys "Female Sexual Function Index" and "Body Sensations of Orgasm", between a group of patients who benefited from total hysterectomy, and a group that underwent subtotal hysterectomy for functional reasons. This is a retrospective study of 37 patients operated on for a hysterectomy between September 1, 2019 and January 31, 2021 at CHU Grenoble Alpes. In total of the respondents, 20 patients underwent total hysterectomy and 17 patients undergoing subtotal hysterectomy. Results: Our study did not find any significant superiority in overall sexual satisfaction in the subtotal hysterectomy group (p = 0.054). There is no significant superiority on the criteria of desire, arousal, relationship, overall satisfaction or pain and discomfort. On the other hand, lubrication would be better in the subtotal group (p = 0.03). Likewise, the sensations experienced during orgasm are significantly more intense in the subtotal group (p = 0.048). Conclusion: These results suggest a lesser impact of subtotal hysterectomy on genital and extra genital reactions experienced during orgasm. These results call for caution in the choice of the type of hysterectomy, especially in patients at risk of neurodegeneration, in order to maximize the innervation pathways involved in the sexual response.
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Master Thesis
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Submitted on : Tuesday, December 14, 2021 - 10:26:19 AM
Last modification on : Thursday, December 16, 2021 - 3:32:27 AM
Long-term archiving on: : Tuesday, March 15, 2022 - 6:32:56 PM


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  • HAL Id : dumas-03478842, version 1
  • PPN : 258714727


Charlotte Bailly. Étude comparative de l’impact de l’hystérectomie totale et subtotale sur la sexualité et l’orgasme féminin. Médecine humaine et pathologie. 2021. ⟨dumas-03478842⟩



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