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.

Abstract

Objective: 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.

Study design: 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.

Results: 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.

Conclusions: 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.