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早期宫颈癌根治性子宫切除术后的性功能

Sexual function after radical hysterectomy for early-stage cervical cancer.

作者信息

Jongpipan Juntana, Charoenkwan Kittipat

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

出版信息

J Sex Med. 2007 Nov;4(6):1659-65. doi: 10.1111/j.1743-6109.2007.00454.x. Epub 2007 Apr 13.

Abstract

INTRODUCTION

For early-stage cervical cancer, treatment with radical surgery appears effective with excellent survival. However, the treatment is associated with significant morbidities. Sexual dysfunction is the leading cause of symptom-induced distress after the treatments for early-stage cervical cancer. There has been no study that evaluates the effect of surgical treatments for cervical cancer on sexual function in the Eastern/Asian patients.

AIM

To examine the effect of radical hysterectomy on postoperative sexual function in women with early-stage cervical cancer. MAIN OUTCOME MEASURES. The visual analog score on seven aspects of sexual function: overall satisfaction with sexual intercourse, sexual desire, vaginal lubrication, vaginal elasticity, orgasmic satisfaction, patient-perceived partner satisfaction, and associated anxiety.

METHODS

Thirty patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB cervical cancer undergoing radical hysterectomy and pelvic lymphadenectomy at the Chiang Mai University Hospital were recruited. All of the patients were interviewed by questionnaire on sexual function at preoperative hospital admission and then at 3 and 6 months after surgery. Relevant clinical and pathologic data were also prospectively collected.

RESULTS

The mean age of the patients was 45.3 +/- 6 years (range 28-59). Seven (23%) of the patients were postmenopausal. Almost all (97%) had FIGO stage IB1 disease. Fourteen (46.7%) patients had bilateral salpingo-oophorectomy, and one (3.3%) patient had unilateral salpingo-oophorectomy. Squamous-cell carcinoma and adenocarcinoma were diagnosed in 83% and 17%, respectively. At 3 and 6 months after operation, 63% and 93% of the patients had sexual intercourse, respectively. Considering the overall sexual satisfaction, the patient-rated visual analog score appeared comparable at preoperative and 6-month postoperative assessment (4.2 +/- 2.5 vs. 3.6 +/- 2.2, P > 0.05).

CONCLUSION

Radical hysterectomy using the current technique has a minimal short-term impact on sexual function. A comparative study with long-term follow-up would provide clearer information on permanent effect of radical hysterectomy on sexual function.

摘要

引言

对于早期宫颈癌,根治性手术治疗似乎疗效显著,患者生存率高。然而,该治疗会引发严重的并发症。性功能障碍是早期宫颈癌治疗后症状性困扰的主要原因。尚无研究评估宫颈癌手术治疗对东亚患者性功能的影响。

目的

探讨根治性子宫切除术对早期宫颈癌患者术后性功能的影响。主要观察指标:性功能七个方面的视觉模拟评分:对性交的总体满意度、性欲、阴道润滑、阴道弹性、性高潮满意度、患者感知的伴侣满意度以及相关焦虑。

方法

招募了30例在清迈大学医院接受根治性子宫切除术和盆腔淋巴结清扫术的国际妇产科联盟(FIGO)IB期宫颈癌患者。所有患者在术前入院时以及术后3个月和6个月接受性功能问卷调查。还前瞻性收集了相关的临床和病理数据。

结果

患者的平均年龄为45.3±6岁(范围28 - 59岁)。7例(23%)患者为绝经后。几乎所有患者(97%)患有FIGO IB1期疾病。14例(46.7%)患者进行了双侧输卵管卵巢切除术,1例(3.3%)患者进行了单侧输卵管卵巢切除术。鳞状细胞癌和腺癌的诊断率分别为83%和17%。术后3个月和6个月,分别有63%和93%的患者进行了性交。考虑总体性满意度,患者自评的视觉模拟评分在术前和术后6个月评估时相当(4.2±2.5对3.6±2.2,P>0.05)。

结论

采用当前技术的根治性子宫切除术对性功能的短期影响极小。一项长期随访的对比研究将为根治性子宫切除术对性功能的长期影响提供更清晰的信息。

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