Pieterse Q D, Maas C P, ter Kuile M M, Lowik M, van Eijkeren M A, Trimbos J B M Z, Kenter G G
Department of Gynaecology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands.
Int J Gynecol Cancer. 2006 May-Jun;16(3):1119-29. doi: 10.1111/j.1525-1438.2006.00461.x.
The objective of this study was to evaluate the problems with miction, defecation, and sexuality after a radical hysterectomy with or without adjuvant radiotherapy for the treatment of cervical cancer stage I-IIA. This study included an observational longitudinal study of self-reported bladder, defecation, and sexual problems with a baseline score. Ninety-four women were included in the study. An age-matched control group consisted of 224 women. The patients showed significantly more negative effects on sexual function compared with both the controls and their situation before the treatment throughout 24 months of follow-up. The problems included less lubrication, a narrow and short vagina, senseless areas around the labia, dyspareunia, and sexual dissatisfaction. Up to 12 months after the treatment, the patients complained significantly more of little or no urge to urinate and diarrhea as compared with the controls. Adjuvant radiotherapy did not increase the risk of bladder dysfunction, colorectal motility disorders, and sexual functions. We conclude that a radical hysterectomy for the treatment of early-stage cervical carcinoma is associated with adverse effects mainly on sexual functioning.
本研究的目的是评估在治疗I-IIA期宫颈癌时，行或不行辅助放疗的根治性子宫切除术后的排尿、排便及性功能问题。本研究包括一项对自我报告的膀胱、排便及性问题进行的观察性纵向研究，并设有基线评分。94名女性纳入本研究。一个年龄匹配的对照组由224名女性组成。在整个24个月的随访期间，与对照组及治疗前自身情况相比，患者的性功能受到的负面影响显著更多。这些问题包括润滑减少、阴道狭窄短小、阴唇周围感觉缺失、性交困难及性不满。与对照组相比，治疗后长达12个月时，患者更多地抱怨排尿冲动很少或没有以及腹泻。辅助放疗并未增加膀胱功能障碍、结肠动力障碍及性功能方面的风险。我们得出结论，根治性子宫切除术治疗早期宫颈癌主要与性功能方面的不良反应有关。
