Heinzler Judith, Brucker Janina, Bruckner Thomas, Dinkic Christine, Hoffmann Janine, Dornhöfer Nadja, Seitz Stephan, Sohn Christof, Rom Joachim, Schott Timm C, Schott Sarah
Department of Obstetrics and Gynecology, University Hospital Heidelberg, Im Neuenheimer Feld 440, Heidelberg, Germany.
Institut für Medizinische Biometrie Und Informatik, Universitätsklinik Heidelberg, Heidelberg, Germany.
Arch Gynecol Obstet. 2018 Oct;298(4):737-745. doi: 10.1007/s00404-018-4853-y. Epub 2018 Aug 3.
In this case-control study, the impact on quality of life and sexual function in women with cervical dysplasia and conization will be evaluated, in order to address coping with such a premalignant lesion and to improve strategies for salutogenesis.
This multicenter case-control study evaluates women at special dysplasia outpatient clinic (T1) as well as 3 (T2) and 6 (T3) months after the diagnosis of a dysplasia. The women were subgrouped upon dysplasia only (S2) or dysplasia with conization (S1). Sexual function as well as cervix-related and general quality of life was assessed using validated instruments (FSFI-d, EORTC-QLQ-CX24, SF-36).
Women with dysplasia had a lower sexual functioning than controls (FSFI: S1: 23.8 ± 9.7 (p < 0.003); S2: 25.3 ± 7.5 (p < 0.03); K: 29.1 ± 4.5) as well as a lower physical component score (SF-36: S1: 51.3 ± 8.6 (p < 0.02); S2: 51.7 ± 7.8 (p < 0.05); K: 54.2 ± 6.6) and had a significantly reduced body image (EORTC-QLQ-CX24: S1: 75.7 (p < 0.001); S2: 76.5 (p < 0.001), K:89.2). Sexual functioning was not affected by conization in the observational period over 6 months; however, sexual worry was impacted. Over temporal progression women who underwent conization worried more. Regression analysis revealed a cervical dysplasia to impact sexual function.
Data suggest that women with the diagnosis of a cervical dysplasia are impaired in their sexual function as well as general and cervix-related quality of life, mostly independent of conization or further observation. To improve salutogenesis in the long run, the communication on dysplasia and its treatment strategy at the beginning, as well as part of aftercare, or psychosomatic intervention, might be treatment options for women at risk.
在这项病例对照研究中，将评估宫颈发育异常及锥切术对女性生活质量和性功能的影响，以应对这种癌前病变并改进健康促进策略。
这项多中心病例对照研究对在特殊发育异常门诊就诊的女性（T1）以及发育异常诊断后3个月（T2）和6个月（T3）的女性进行评估。这些女性根据仅发育异常（S2）或发育异常伴锥切术（S1）进行分组。使用经过验证的工具（FSFI-d、EORTC-QLQ-CX24、SF-36）评估性功能以及与宫颈相关的和总体生活质量。
发育异常女性的性功能低于对照组（FSFI：S1：23.8±9.7（p<0.003）；S2：25.3±7.5（p<0.03）；K：29.1±4.5），身体成分得分也较低（SF-36：S1：51.3±8.6（p<0.02）；S2：51.7±7.8（p<0.05）；K：54.2±6.6），身体形象显著降低（EORTC-QLQ-CX24：S1：75.7（p<0.001）；S2：76.5（p<0.001），K：89.2）。在6个月的观察期内，性功能不受锥切术影响；然而，性担忧受到影响。随着时间推移，接受锥切术的女性担忧更多。回归分析显示宫颈发育异常会影响性功能。
数据表明，被诊断为宫颈发育异常的女性性功能以及总体和与宫颈相关的生活质量受损，大多与锥切术或进一步观察无关。从长远来看，为改善健康促进，在开始时就发育异常及其治疗策略进行沟通，以及部分后续护理或身心干预，可能是有风险女性的治疗选择。
