Sexual Functioning and Vaginal Changes after Radical Vaginal Trachelectomy in Early Stage Cervical Cancer Patients: A Longitudinal Study

• DOI: 10.1111/jsm.12399
• Publication Date: 2013-11-29T11:37:03Z
• Authors: Ligita Paskeviciu...; Christian Ottosen; Helle Rung-Hansen; Danny Svane; Berit Jul Mosgaard; Pernille Tine Jensen
• Keywords: Adult; Sexual Dysfunction; Hysterectomy, Vaginal/adverse effects; Libido; Sexual Behavior; Uterine Cervical Neoplasms; Cevical Cancer; Physiological/etiology; Sexual Behavior/physiology; Hysterectomy; Radical Trachelectomy; Young Adult; 03 medical and health sciences; 0302 clinical medicine; 5. Gender equality; Surveys and Questionnaires; Hysterectomy, Vaginal; Humans; Longitudinal Studies; Sexual Dysfunctions, Psychological; Psychological/etiology; Orgasm; Vagina/physiopathology; Uterine Cervical Neoplasms/pathology; Radical Hysterectomy; Sexual Dysfunction, Physiological/etiology; Sexual Dysfunctions, Psychological/etiology; Vaginal/adverse effects; Sexual Dysfunctions; Dyspareunia/etiology; 3. Good health; Sexual Functioning; Sexual Dysfunction, Physiological; Dyspareunia; Vagina; Quality of Life; Female

Abstract

Introduction Radical vaginal trachelectomy (RVT) offers low complication rate, good survival, and possibility for future childbearing for young women with early stage cervical cancer. However, the literature on quality of life (QOL) and sexual functioning in patients undergoing RVT is scarce.

Aim The aims of this study were to prospectively assess sexual function after RVT and to compare scores of sexual function in patients operated by RVT and radical abdominal hysterectomy (RAH) with those of age-matched control women from the general population.

Methods Eighteen patients with early stage cervical cancer operated with RVT were prospectively included and assessed preoperatively, and 3, 6, and 12 months postoperatively using validated questionnaires. RAH patients were included consecutively and assessed once at 12 months postsurgery, while an age-matched control group of 30 healthy women was assessed once.

Main Outcome Measure Sexual dysfunction total score as measured by the Female Sexual Function Index (FSFI) was the main outcome measure.

Results During the 12 months posttreatment, RVT patients tended to have persistent sexual dysfunction as measured by FSFI (mean overall score <26.55 at each assessment) and Female Sexual Distress Scale (mean overall score > 11). Sexual worry (P < 0.001) and lack of sexual desire (P = 0.038) were more frequently reported among patients in both treatment groups compared with control women. Sexual activity increased significantly during the observation time for the RVT group (P = 0.023) and reached that of healthy women. Global Health Status score improved over time for the RVT group but never reached that of healthy control women (P = 0.029).

Conclusions Our data suggest that patients treated with RVT for early stage cervical cancer experience persistent sexual dysfunction up to one year post surgery influencing negatively on their QOL.