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Background:The impact of transvaginal appendectomy on female sexual function is unknown. We therefore performed a prospective cohort study of women undergoing pure transvaginal appendectomies (TVA) versus traditional laparoscopic appendectomies (LA). Using a validated, 19 point, female sexual function index questionnaire (FSFI) assessing 6 domains of sexual function: desire, arousal, lubrication, orgasm, satisfaction and pain with intercourse, pre and post-operative sexual function were compared.Methods:Between August 2008 and August 2010, 42 patients with acute appendicitis were offered a pure TVA. Patients who did not wish to undergo a TVA underwent a LA and served as controls. Both groups were provided a FSFI before surgery and at regular intervals for up to 1 year. Pre and post-operative FSFI results were compared between cohorts using unpaired t-tests, and between individuals within each cohort pre and post operatively using paired t-tests.Results: 18 patients underwent a pure TVA, 22 underwent LA, and 2 refused participation in this study. Pre-operative and >60 day post-operative FSFI data was available for 21 patients (11 TVA, 10 LA). Baseline FSFI scores were not significantly different between groups (TVA: 18.0±1.46, LA: 15.0±2.1, p=0.92). FSFI scores at greater than 60 days post-operatively did not differ significantly from pre-operatively in either group. (TVA: 18.0±1.46 to 16.7±2.4; p=0.49, LA:15.0±2.1 to 16.4±2.1; p=0.49). No FSFI domain in either cohort was significantly changed post-operatively.Conclusions:Neither TVA nor LA affected female sexual function scores. This suggests that TVA does not have negative effects on female sexual function. The results of this study may prove beneficial in consultations with patients concerning the sexual sequelae of transvaginal surgery.