Zhang Yunqiang, Sun Shugen, Ding Jingxin, Hua Keqin
Department of Gynecology, The Obstetrics and Gynecology Hospital, Shanghai, P.R. China; Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, The Obstetrics and Gynecology Hospital, Fudan University, Shanghai, P.R. China.
Department of Gynecology, The Obstetrics and Gynecology Hospital, Shanghai, P.R. China; Shanghai Key Laboratory of Female Reproductive Endocrine-Related Diseases, The Obstetrics and Gynecology Hospital, Fudan University, Shanghai, P.R. China.
Sex Med. 2020 Jun;8(2):307-314. doi: 10.1016/j.esxm.2020.02.001. Epub 2020 Mar 20.
Sexual activity is important for marital quality, especially in cervical cancer survivors. Vagina extension following laparoscopic radical hysterectomy with bilateral ovarian preservation (VEOP), vagina extension following laparoscopic radical hysterectomy with bilateral oophorectomy (VEBO), radical hysterectomy with bilateral ovarian preservation (RHOP), and radical hysterectomy with bilateral oophorectomy (RHBO) are the common surgeries for young cervical cancer patients.
To investigate the effect of the 4 surgical methods on female/male sexual activity and marital quality in early-stage cervical cancer survivors.
Multiple linear regression analysis was conducted in 205 patients with stage Ia1-IIa2 cervical cancer to evaluate the factors that affected male/female sexual function and marital quality.
Female Sexual Function Index (FSFI), modified Kupperman Index (KI), modified Sexual Life Quality Questionnaire (mSLQQ-QoL), and ENRICH marital inventory were used to reflect changes in female/male sexual function and marital quality in the 4 groups.
Female/male sexual function and marital quality were both highest in the VEOP group and lowest in the RHBO group. The regression results showed that ovarian preservation and vaginal extension were associated with female/male sexual function and marital quality. Furthermore, when vaginal extension and ovarian preservation were replaced by vaginal length, sexual psychological change, and hormone level index (KI), respectively; male sexual function was associated with vaginal length and sexual psychological change, whereas female sexual function and marital quality were only associated with hormone level and sexual psychological change. Clinical statistics found that four-fifths of the recurrent patients had vaginal extension (P = .042), and 3-quarters of these patients had large tumors.
Ovarian preservation and vaginal extension are both important for male/female sexual activity and marital quality. Vaginal extension may play a positive role in female sexual life via psychology and in male sexual life via vaginal length. Vaginal extension may not be suitable for patients with large masses. Zhang Y, Sun S, Ding J, et al. The Effect of Different Surgical Methods on Female and Male Sexual Activity and Marital Quality in Patients With Early-Stage Cervical Cancer. Sex Med 2020;8:307-314.
性活动对婚姻质量很重要，尤其是对于宫颈癌幸存者而言。保留双侧卵巢的腹腔镜根治性子宫切除术（VEOP）后的阴道延长、双侧卵巢切除术的腹腔镜根治性子宫切除术（VEBO）后的阴道延长、保留双侧卵巢的根治性子宫切除术（RHOP）以及双侧卵巢切除术的根治性子宫切除术（RHBO）是年轻宫颈癌患者的常见手术方式。
探讨这4种手术方法对早期宫颈癌幸存者的男女性活动及婚姻质量的影响。
对205例Ia1-IIa2期宫颈癌患者进行多元线性回归分析，以评估影响男女性功能及婚姻质量的因素。
采用女性性功能指数（FSFI）、改良库珀曼指数（KI）、改良性生活质量问卷（mSLQQ-QoL）和ENRICH婚姻量表来反映4组患者的男女性功能及婚姻质量变化。
VEOP组的男女性功能及婚姻质量均最高，RHBO组最低。回归结果显示，保留卵巢和阴道延长与男女性功能及婚姻质量相关。此外，当分别用阴道长度、性心理变化和激素水平指数（KI）替代阴道延长和保留卵巢时；男性性功能与阴道长度和性心理变化相关，而女性性功能及婚姻质量仅与激素水平和性心理变化相关。临床统计发现，五分之四的复发患者有阴道延长（P = 0.042），其中四分之三的患者肿瘤较大。
保留卵巢和阴道延长对男女性活动及婚姻质量均很重要。阴道延长可能通过心理因素对女性性生活起积极作用，通过阴道长度对男性性生活起积极作用。阴道延长可能不适用于肿瘤较大的患者。张Y、孙S、丁J等。不同手术方法对早期宫颈癌患者男女性活动及婚姻质量的影响。性医学2020；8：307-314。
