Effect of total abdominal hysterectomy on pelvic floor function

Historically, hysterectomy is one of the oldest gynecologic operations, dating back to the 1840s. Currently, it is the most common gynecologic operation performed and is associated with marked improvement in the patients' quality of life. It is widely considered a safe procedure with an extremely low mortality rate (<0.1%). The majority of hysterectomies are done abdominally, with the vast majority being total abdominal hysterectomies. The effect of hysterectomy on pelvic floor function has been a subject of long debate. Various studies have reached different and rather contradictory results. Most of these studies lack stringent methodologic standards, being retrospective, observational, or uncontrolled. A recent excellent study assessed the effect of abdominal hysterectomy on pelvic floor function as I functional unit and concluded that both total and subtotal abdominal hysterectomies have no detrimental effect on the pelvic floor function up to 1 year postoperatively.
Target Audience: Obstetricians & Gynecologists, Family Physicians
Learning objectives: After completion of this article, the reader should be able to outline the potential long-term complications of hysterectomy, to describe the autonomic innervation of the pelvic organs, and to summarize the various studies evaluating long-term complications of hysterectomy.