Department of Obstetrics and Gynecology, Peking University People's Hospital, Beijing, China.
Beijing Key Laboratory of Female Pelvic Floor Disorders, Beijing, China.
Arch Gynecol Obstet. 2021 Oct;304(4):999-1006. doi: 10.1007/s00404-021-06005-x. Epub 2021 Feb 22.
The purpose of this study was to explore the factors influencing the sexual quality of life of patients with cervical cancer who underwent radical hysterectomy.
This multicenter retrospective cohort study was conducted from June 2013 to June 2018 at nine hospitals in China. In total, 204 women diagnosed with stage IA to stage IIB cervical cancer who underwent radical hysterectomy completed the questionnaire. Sexual function was measured with the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ). All analyses were performed with R version 3.4.3 statistical software packages. A two-sided significance level of 0.05 was used to evaluate the statistical significance.
The mean sexual quality of life score was 37.21 ± 17.28, where a higher PISQ score indicates a better sexual quality of life, and we identified the factors associated with sexual dysfunction. The average follow-up time was 29.0 ± 16.0 months. In addition to radical hysterectomy, 182 (89.2%) patients underwent ovarian suspension, 93 (45.6%) underwent chemotherapy, and 74 (36.3%) underwent concurrent radiotherapy. The univariate analysis confirmed that age represents a protective factor for sexual function (odds ratio (OR) 6.0, 95% confidence interval (CI) 1.1-10.8, p = 0.017). The patients who underwent ovarian suspension were more likely to experience a good sexual quality of life (OR - 7.2, 95% CI [- 14.8, - 0.4], p = 0.035) compared to those who did not undergo ovarian suspension. A significant negative association was observed between radiotherapy and the behavioral-emotive, physical and partner-related domains of the PISQ (behavioral-emotive, OR - 1.5, 95% CI [- 2.6, - 0.4], p = 0.011; physical, OR - 0.9, 95% CI [- 1.5, - 0.3], p = 0.006; partner-related, OR - 0.7, 95% CI [- 1.3, 0.0], p = 0.043). Chemotherapy and radiotherapy were common risk factors for sexual dysfunction, and radiotherapy exerted a stronger effect than chemotherapy.
This study shows that the sexual function of cervical cancer patients tends to be related to age, radiotherapy, and chemotherapy. However, across these factors, patients with preserved ovaries tend to return to a satisfactory sexual quality of life after recovering from surgery.
本研究旨在探讨接受根治性子宫切除术的宫颈癌患者性生活质量的影响因素。
这是一项多中心回顾性队列研究，于 2013 年 6 月至 2018 年 6 月在中国的 9 家医院进行。共 204 名诊断为 IA 期至 IIB 期宫颈癌且接受根治性子宫切除术的女性完成了问卷调查。采用盆腔器官脱垂/尿失禁性功能问卷（PISQ）评估性功能。所有分析均使用 R 版本 3.4.3 统计软件包进行。双侧显著性水平为 0.05 用于评估统计显著性。
平均性生活质量评分 37.21±17.28，PISQ 评分越高表示性生活质量越好，我们确定了与性功能障碍相关的因素。平均随访时间为 29.0±16.0 个月。除根治性子宫切除术外，182 例（89.2%）患者行卵巢悬吊带术，93 例（45.6%）行化疗，74 例（36.3%）行同期放化疗。单因素分析证实年龄是性功能的保护因素（比值比（OR）6.0，95%置信区间（CI）1.1-10.8，p=0.017）。与未行卵巢悬吊带术的患者相比，行卵巢悬吊带术的患者更有可能获得良好的性生活质量（OR-7.2，95%CI[-14.8，-0.4]，p=0.035）。放疗与 PISQ 的行为-情感、身体和伴侣相关领域呈显著负相关（行为-情感，OR-1.5，95%CI[-2.6，-0.4]，p=0.011；身体，OR-0.9，95%CI[-1.5，-0.3]，p=0.006；伴侣相关，OR-0.7，95%CI[-1.3，0.0]，p=0.043）。化疗和放疗是性功能障碍的常见危险因素，且放疗的作用强于化疗。
本研究表明，宫颈癌患者的性功能往往与年龄、放疗和化疗有关。然而，在这些因素中，保留卵巢的患者在手术后恢复时往往能恢复到满意的性生活质量。
