Department of Obstetrics and Gynecology, IRCCS San Matteo Hospital, Pavia, Italy.
Department of Pathology, IRCCS San Matteo Hospital, Pavia, Italy.
Bone Marrow Transplant. 2018 Sep;53(9):1157-1164. doi: 10.1038/s41409-018-0149-x. Epub 2018 Mar 15.
To study vaginal development and sexual functioning in young women after childhood hemopoietic stem cell transplantation (HSCT) and radio/chemotherapy. Observational case-control study on 30 young sexually active women survived after HSCT and/or radio/chemotherapy for childhood malignancies or hematologic diseases and 48 controls matched for age. Female Sexual Function Index was lower (median 24.05, IQR = 17.30-28.30 vs. 29.00, IQR = 25.30-31.40, p = 0.001), Female Sexual Distress Scale higher (median 16.00, IQR = 8.00-23.00 vs. 2.00, IQR = 0.00-4.00, p < 0.001), vaginal length shorter (mean difference = 21.1 mm; 95% CI = 19.3-23, p < .001) and vaginal maturation index worst in cases than in controls. Subjects treated by irradiation before HSCT had lower FSFI (median 21.85, IQR = 9.60-31.10 vs. 24.90, IQR = 17.30-28.30) and shorter vaginal length (median 45.55, IQR = 42.60-45.80 vs. 50.10, IQR = 45.30-52.90) compared to those who had not received conditioning treatment (p-values = 0.004 and p = 0.05, respectively). Compared to untreated subjects, women receiving hormonal replacement therapy had higher overall FSFI (p = 0.02), lower FSDS (0.04), and better VMI. Gonadotoxic therapies have adverse effects on vaginal development, sexual functioning, and distress in young females. Hormonal replacement therapy should be shortly considered after main gonodatoxic treatments to improve vaginal and sex health.
研究儿童造血干细胞移植（HSCT）和放化疗后年轻女性的阴道发育和性功能。对 30 名接受过 HSCT 和/或放化疗的年轻、有性生活的女性进行观察性病例对照研究，这些女性均因儿童恶性肿瘤或血液疾病而存活，对照组为 48 名年龄匹配的女性。女性性功能指数较低（中位数 24.05，IQR=17.30-28.30 与 29.00，IQR=25.30-31.40，p=0.001），女性性困扰量表评分较高（中位数 16.00，IQR=8.00-23.00 与 2.00，IQR=0.00-4.00，p<0.001），阴道长度较短（平均差异 21.1mm；95%CI=19.3-23，p<0.001），且阴道成熟指数比对照组差。在 HSCT 前接受过放疗的患者的 FSFI 较低（中位数 21.85，IQR=9.60-31.10 与 24.90，IQR=17.30-28.30），阴道长度较短（中位数 45.55，IQR=42.60-45.80 与 50.10，IQR=45.30-52.90），与未接受预处理的患者相比（p 值分别为 0.004 和 0.05）。与未接受治疗的患者相比，接受激素替代治疗的患者总体 FSFI 较高（p=0.02），FSDS 较低（p=0.04），VMI 较好。性腺毒性治疗对年轻女性的阴道发育、性功能和性困扰有不良影响。激素替代治疗应在主要性腺毒性治疗后尽快考虑，以改善阴道和性健康。
