Ye Shuang, Yang Jiaxin, Cao Dongyan, Zhu Lan, Lang Jinghe, Chuang Linus T, Shen Keng
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Science, Peking Union Medical College, Beijing, China.
J Sex Med. 2014 May;11(5):1334-42. doi: 10.1111/jsm.12498. Epub 2014 Mar 14.
Radical hysterectomy (RH) has negative consequences on sexual function due to a shortened vagina, vaginal dryness, and dyspareunia. Peritoneovaginoplasty aims to extend vagina by vesical peritoneum and anterior rectal wall to improve postoperative sexual function.
The aim of this study was to investigate whether vaginal extension can improve sexual function and quality of life and the problem of sexual dysfunction in early-stage cervical cancer survivors (CCSs) in China.
Case-control and questionnaire-based methods were employed. Thirty-one patients who had undergone vaginal extension following RH and 28 patients with matching factors after RH alone were enrolled in the study.
Both groups were assessed retrospectively by questionnaires at least 6 months after treatment. The European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire cervical cancer module and the Sexual Function Vaginal Changes Questionnaire are validated measurements for disease- and treatment-specific issues.
Vaginal length was 10.03 ± 1.26 cm and 5.92 ± 1.05 cm in study and control group, respectively (P < 0.05). In the study group, 67.7% patients and 64.3% of control group resumed sexual activity at the time of interview, averaging 6 months between treatment and sexual activity. While difficulty emptying bladder, incomplete emptying, and constipation were the most commonly reported symptoms, no significant difference was observed regarding pelvic floor symptoms. Reduced vagina size and shortened vagina was significantly more prominent in the control group, whereas both group presented with hypoactive sexual desire (88.1%), orgasm dysfunction (71.8%), and low enjoyment or relaxation after sex (51.3%).
Shortened vagina was significantly less reported in study group, while no difference was observed in other sex-related dimensions. Vaginal extension does not worsen pelvic floor symptoms. Sexual rehabilitation interventions are of significance and should be paid more attention to the CCSs in China.
根治性子宫切除术（RH）会因阴道缩短、阴道干燥和性交困难而对性功能产生负面影响。腹膜阴道成形术旨在通过膀胱腹膜和直肠前壁延长阴道，以改善术后性功能。
本研究旨在调查在中国早期宫颈癌幸存者（CCSs）中，阴道延长是否能改善性功能和生活质量以及性功能障碍问题。
采用病例对照和问卷调查法。本研究纳入了31例行RH术后阴道延长术的患者和28例仅行RH术且具有匹配因素的患者。
两组患者在治疗后至少6个月通过问卷调查进行回顾性评估。欧洲癌症研究与治疗组织生活质量问卷宫颈癌模块和性功能阴道变化问卷是针对疾病和治疗特定问题的有效测量工具。
研究组和对照组的阴道长度分别为10.03±1.26 cm和5.92±1.05 cm（P<0.05）。在研究组中，67.7%的患者和对照组64.3%的患者在访谈时恢复了性活动，治疗与性活动之间的平均间隔为6个月。虽然膀胱排空困难、排空不完全和便秘是最常报告的症状，但在盆底症状方面未观察到显著差异。对照组阴道尺寸减小和阴道缩短更为明显，而两组均表现为性欲减退（88.1%）、性高潮功能障碍（71.8%）和性交后愉悦或放松感低（51.3%）。
研究组报告的阴道缩短明显较少，而在其他与性相关维度上未观察到差异。阴道延长不会加重盆底症状。性康复干预具有重要意义，在中国应对CCSs给予更多关注。
