INTRODUCTION: Sexual dysfunction is commonly reported after cancer surgery or pelvic surgery
however, the incidence following major emergency abdominal surgery remains unknown. This study aimed to investigate the incidence and sex differences in sexual dysfunction up to 90 days postoperatively after major emergency abdominal surgery. METHODS: This single-center prospective cohort study included all consecutive patients undergoing major emergency abdominal surgery at Copenhagen University Hospital Herlev from March 2023 to March 2024. Follow-up was conducted at 30 and 90 days postoperatively. Sexual function was assessed using the Brief Sexual Symptom Checklist (BSSC), and patients were asked to report whether they were sexually active before and after surgery. RESULTS: Of the 180 patients who responded at postoperative day (POD) 30, 69 patients (38.3%) reported being sexually active before surgery but only 31 patients (17.2%) remained active after surgery. At POD 90, 71 (48.3%) of 147 patients reported being sexually active before surgery, whereas 48 patients (32.7%) remained active postoperatively. A significant decrease in sexual activity was observed in both men (63.2% at POD 30 and 45.5% at POD 90) and women (45.2% at POD 30 and 21.1% at POD 90) (p <
0.001 for both time points). Out of the patients who completed the BSSC questionnaire, 32 patients (32.6%) reported dissatisfaction with their sexual function at POD 30, which slightly decreased to 22 patients (26.8%) at POD 90. No significant difference in dissatisfaction rates between men and women was found at either time point. CONCLUSION: Sexual dysfunction was common after major emergency abdominal surgery in both men and women, with no significant sex differences observed. These findings highlight the need for proactive discussions, information, and management of sexual health in the perioperative period to improve patient outcomes and quality of life.