Pelvic floor symptoms after gynaecological surgery

The first part of this thesis focuses on micturition and defecation symptoms after hysterectomy. We conclude that, when scheduling hysterectomy, one should realize that vaginal hysterectomy does increase the risk of developing micturition symptoms after surgery. As these symptoms are known to negatively affect the quality of life, we recommend that the search for a less traumatic operative technique should continue. We attempt to reduce the risk of developing micturition symptoms by using vessel sealing techniques. We cannot show a decrease in micturition symptoms after using this technique.
The second part of this thesis focuses on the evaluation of vaginal wall sensibility, vaginal vasocongestion and sexual function after hysterectomy and prolapse surgery. With our studies we provide support for the hypothesis that vaginal prolapse surgery and vaginal hysterectomy affect vaginal wall sensibility in the proximal posterior vaginal wall and that vaginal prolapse surgery affects vaginal vasocongestion. As both of these physiological parameters seem relevant for optimal sexual function, one could expect to find a decrease in sexual function after surgery. Future studies should therefore evaluate these findings within the multidimensional framework of female sexual dysfunction. If these studies indeed show that damage to vaginal innervation and vasocongestion are important in the development of female sexual dysfunction, the performed surgical techniques should be adjusted accordingly.