The Pelvic Floor Function and Sexual Life of the Women After Different Type of Hysterectomy

Study Overview
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Brief Summary
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In this prospective, comparative non-randomized multiple teaching hospitals study, the investigators try to determine the relationship of total hysterectomy and Taiwanese female pelvic floor and sexual function from the view of epidemiology and clinical survey. This is an important issue that related to female autonomy, health care resources and even national health policy. The study results will help to understand whether there is unnecessary part in the current hysterectomy procedures and its potential health hazard.

Detailed Description
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Women with benign gynecology disease and indicated for laparoscopic hysterectomy (laparoscopic subtotal hysterectomy: LSH, laparoscopic cervical ligament sparing hysterectomy: CLSH, laparoscopic assisted vaginal hysterectomy: LAVH) are invited and explained the details of the protocol by the surgeon. The types of hysterectomy are determined by the patient and the surgeon together after discussion. All participant have to sign the informed consent. The participant will be followed up for two years after surgery. Preoperative evaluation on uterine condition, pelvic floor, questionaires were recorded. The perioperative parameters including surgical time, blood loss, and postoperative parameters such as pain score, hospitalization etc were recorded. The postoperative evaluation on pelvic floor condition, questionaires etc were also recorded at different time points.

Official Title
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The Association of Total Hysterectomy and Disorders of Female Pelvic Floor or Sexual Function: a Survey on Pelvic Floor Function and Sexual Life for Women After Different Type of Hysterectomy

Conditions
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Quality of Life, Urinary Incontinence, Pelvic Organ Prolapse

Intervention / Treatment
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* Procedure: LSH
* Procedure: CLSH
* Procedure: LAVH


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patient who is indicated for hysterectomy due to benign gynecology disease. The participant's husband is also welcomed to join the survey of the sexual life questionnaire but this is not a necessary inclusion criteria. Exclusion Criteria: Suspect of or diagnosed as cancer patient Age < 30 or > 50 years old Menopausal woman or woman who is nulliparous Patient with advanced pelvic floor prolapse (stage 2, 3, 4) including uterine prolapse, cystocele, enterocele, rectocele. Patient with prominent urinary incontinence that affect social activity or suggested to have surgery by gynecologist or urologist. Patient with severe medical diseases such as liver cirrhosis, heart failure, poor control diabetes mellitus etc. Patient with severe pelvic inflammatory disease/tubo-ovarian abcess or pelvic endometriosis or history of severe pelvic adhesions. Psychiatric patients Patient with chronic lung disease such as bronchial asthma, bronchiectasis, chronic obstructive pulmonary disease and interstitial lung disease

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Laparoscopic subtotal hysterectomy<br>women with benign gynecology disease and decided to receive laparoscopic subtotal hysterectomy (LSH) after discussion with her surgeon. | Procedure: LSH<br>* laparoscopic subtotal hysterectomy: LSH<br>* Other names: laparoscopic subtotal hysterectomy: LSH;|
| Laparoscopic CLSH<br>women with benign gynecology disease and decided to receive laparoscopic cervical ligament sparing hysterectomy (CLSH) after discussion with her surgeon. | Procedure: CLSH<br>* laparoscopic cervical ligament sparing hysterectomy: CLSH<br>|
| Laparoscopic AVH<br>women with benign gynecology disease and decided to receive laparoscopic assisted vaginal hysterectomy (LAVH) after discussion with her surgeon. | Procedure: LAVH<br>* laparoscopic assisted vaginal hysterectomy: LAVH<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quality of life change | Evaluate the change of quality of life by questionaire --WHOQOL-BREF Taiwan version, at preoperation,1,3,6 and 12 months after hysterectomy. | up to 12 months after hysterectomy | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pelvic organ prolapse change | evaluate by Pelvic Organ Prolapse Quantification System (POP-Q) at preoperation, 6,12 and 24 months after hysterectomy. | up to 24 months after hysterectomy | 
| Urinary disorders change | evaluate by UDI-6 short form at preoperation,3,6 and 12 months after hysterectomy. | preoperation and 3,6 and 12 months after hysterectomy | 
| Sexual life change | short form of PISQ-9 approved by International Urogynecological Association, IUGA, at preoperation,3,6 and 12 months after hysterectomy. | preoperation and 3,6 and 12 months after hysterectomy | 
| Urinary incontinence status change | evaluate by IIQ-7 short form at preoperation,3,6 and 12 months after hysterectomy. | preoperation and 3,6 and 12 months after hysterectomy | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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quality of life, urinary incontinence, POP