C. P. Maas was supported by the Dutch Cancer Society.
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Objective assessment of sexual arousal in women with a history of hysterectomy
Article first published online: 16 FEB 2004
DOI: 10.1111/j.1471-0528.2004.00104.x
Issue
BJOG: An International Journal of Obstetrics & Gynaecology
Volume 111, Issue 5, pages 456–462, May 2004
Additional Information
How to Cite
Maas, C.P., ter Kuile, M.M., Laan, E., Tuijnman, C.C., Weijenborg, Ph.Th.M., Trimbos, J.B. and Kenter, G.G. (2004), Objective assessment of sexual arousal in women with a history of hysterectomy. BJOG: An International Journal of Obstetrics & Gynaecology, 111: 456–462. doi: 10.1111/j.1471-0528.2004.00104.x
Publication History
- Issue published online: 19 APR 2004
- Article first published online: 16 FEB 2004
- Abstract
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Objective The potential contribution of psychological and anatomical changes to sexual dysfunction following hysterectomy is not clear. Radical hysterectomy for cervical cancer causes surgical damage to the autonomic nerves which are responsible for the increased vaginal blood flow during sexual arousal. Simple hysterectomy causes more limited nerve disruption. Photoplethysmographic assessment of vaginal pulse amplitude objectively measures vaginal blood flow during sexual arousal. We hypothesised that damage of the autonomic nerves results in a disrupted vaginal blood flow response during sexual stimulation.
Design Between-groups comparison of vaginal pulse amplitude.
Setting University hospital.
Sample Twelve women with a history of radical hysterectomy, 12 women with a history of simple abdomonal hysterectomy and 17 aged-matched controls.
Methods Photoplethysmographic assessment of vaginal pulse amplitude during sexual stimulation by erotic films. Self-reported ratings of subjective sexual arousal were collected after each erotic stimulus condition.
Main outcome measure Maximum vaginal pulse amplitude.
Results Maximum vaginal pulse amplitude differed between the three groups (P= 0.043). Women with a history of radical hysterectomy had a lower response than controls (P= 0.015). Women in the radical hysterectomy group and controls reported an equally strong subjective arousal. Women with a history of simple hysterectomy showed an intermediate maximum vaginal pulse amplitude.
Conclusions Radical hysterectomy seems associated with a disturbed vaginal blood flow response during sexual arousal. This cannot be explained solely by uteric extirpation, since it was not observed to the same extent after simple hysterectomy, but might be related to a denervation of the vagina which increases with increasing radicality of surgery.