Sexual function after modified radical hysterectomy (Piver II/Type B) vs. classic radical hysterectomy (Piver III/Type C2) for early stage cervical cancer. A prospective study.

INTRODUCTION

When cervical cancer is detected at an early stage (International Federation of Gynecology and Obstetrics [FIGO] IA2-IB1), it can be successfully treated by radical surgery alone. Considering that most patients are young and sexually active at the moment of diagnosis and the long life expectancy of survivors after the treatment, quality of life (QoL) and sexual function are important issues for cancer survivors and caregivers. However, only a few studies have examined the QoL and sexual function in disease-free cervical cancer survivors, and there are no studies in the literature comparing prospectively sexual function after different types of radical hysterectomy.

AIM

To compare sexual function in two groups of early stage cervical cancer survivors treated by radical surgery alone, undergoing two different types of radical hysterectomy.

METHODS

Patients treated by radical hysterectomy with systematic lymphadenectomy for early stage cervical cancer (FIGO IA2-IB1) have been enrolled and divided in two groups with regard to type of radical hysterectomy performed; S1: modified radical hysterectomy (Piver II/Type B), S2: classic radical hysterectomy (Piver III/ Type C2).

MAIN OUTCOME MEASURE

Twenty-four months after surgery we assessed the sexual function using the European Organization for Research and Treatment of Cancer Cervix Cancer Module Questionnaire, which is a validated system for the assessment of disease- and treatment-specific issues that affect the QoL and sexual functioning of women who are treated for cervical cancer.

RESULTS

Of the 31 patients enrolled in the S1 group and 46 in the S2 group, 23 and 33 patients have been included, respectively. We observed significant differences between the two groups in terms of symptom experience, sexual/vaginal functioning, sexual activity, and sexual enjoyment. There was not any significant difference regarding lymphedema, peripheral neuropathy, and sexual worry.

CONCLUSION

Survivors of early stage cervical cancer treated by modified radical hysterectomy (Piver II/ Type B) have a better sexual function than those operated by classic radical hysterectomy (Piver III/ Type C2).