Amsterdam Alison, Krychman Michael L
Department of Surgery, Division of Gynecology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Department of Surgery, Division of Gynecology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
J Sex Med. 2006 Jul;3(4):646-649. doi: 10.1111/j.1743-6109.2006.00204.x. Epub 2006 Jun 15.
Little is known regarding the impact of a sexual health program on the sexual functioning of patients with a history of a gynecologic malignancy.
To evaluate as a pilot study the prevalence of common sexual health symptoms and evaluate the effects and compliance with clinical recommendations in gynecologic oncology patients.
A retrospective cohort study of 259 female cancer patients who attended a survivorship program at an academic medical center from March 1, 2003 through December 31, 2004. Patients received symptomatic treatment recommendations including hormone therapy alternatives, psychosexual counseling, minimally absorbed vaginal estrogen suppositories, and vaginal dilators.
Patient self-report of the severity of sexual symptomology at follow-up visit.
Ninety-six patients (37%) had gynecologic neoplasms and the most common gynecologic malignancy seen was ovarian (27%). Median age at initial visit was 51 years (range 25-76) and 88 patients (92%) were postmenopausal. The most frequent presenting complaint encountered was dyspareunia (72%), atrophic vaginitis (65%), hypoactive desire (43%), and orgasmic dysfunction (17%). At a median of 6 months (range 0-20), 60 patients (63%) received follow-up, and of them 42 (70%) self-reported improvement in their symptoms.
The establishment of a well-structured sexual health program in a cancer setting can result in a 63% compliance rate with a 70% subjective improvement in sexual health complaints. Further research with objective measures of sexual dysfunction is needed to better evaluate patients' progress in this setting.
关于性健康计划对有妇科恶性肿瘤病史患者性功能的影响,目前所知甚少。
作为一项试点研究,评估妇科肿瘤患者常见性健康症状的患病率,并评估临床建议的效果及患者的依从性。
对259名女性癌症患者进行回顾性队列研究,这些患者于2003年3月1日至2004年12月31日在一家学术医疗中心参加了生存计划。患者接受了对症治疗建议,包括激素替代疗法、性心理咨询、低吸收性阴道雌激素栓剂和阴道扩张器。
随访时患者对性症状严重程度的自我报告。
96名患者(37%)患有妇科肿瘤,最常见的妇科恶性肿瘤是卵巢癌(27%)。初次就诊时的中位年龄为51岁(范围25 - 76岁),88名患者(92%)已绝经。最常见的主诉是性交困难(72%)、萎缩性阴道炎(65%)、性欲减退(43%)和性高潮功能障碍(17%)。中位随访时间为6个月(范围0 - 20个月),60名患者(63%)接受了随访,其中42名(70%)自我报告症状有所改善。
在癌症环境中建立结构完善的性健康计划可使依从率达到63%,性健康主诉的主观改善率达到70%。需要进一步采用性功能障碍的客观测量方法进行研究,以更好地评估患者在这种情况下的进展。