Department of Obstetrics and Gynaecology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.
Department of Obstetrics and Gynaecology, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic.
Taiwan J Obstet Gynecol. 2022 Jul;61(4):641-645. doi: 10.1016/j.tjog.2021.10.006.
Nerve-sparing radical hysterectomy (NSRH) decreases the negative postoperative consequences of radical surgery for cervical cancer, such as bladder evacuation disorders, colorectal motility disorders, and sexual dysfunction. The aim of this study was to prospectively assess the sexuality and quality of life in a group of women who underwent NSRH with lymphadenectomy for cervical cancer.
A total of 65 patients with early-stage cervical cancer underwent NSRH between 2014 and 2016. Patient examinations and questionnaire surveys (Female Sexual Function Index questionnaire and European Organization for Research and Treatment of Cancer questionnaires QLQ-C30 and QLQ-CX24) were conducted, before and one year after the surgery.
After the exclusion of 19 sexually inactive women and 10 women who received adjuvant anticancer treatment, 36 sexually active patients treated solely with nerve-sparing surgery were eligible for evaluation. The mean age was 47 years. The average preoperative vaginal length was 9.4 cm, whereas the postoperative length was shortened to 7.1 cm. This study showed no negative impact of NSRH on sexual desire, arousal, satisfaction, orgasm, pain, sexual activity, sexual enjoyment, and sexual worry. The worsening of sexual functioning was recorded during the one-year follow-up. The QLQ-C30 questionnaire confirmed postoperative improvement in global health status and role, emotional, and social functioning.
Our study showed using standardized questionnaires that NSRH has no negative impact on sexual desire, arousal, satisfaction, orgasm, pain, sexual activity, frequency of sexual intercourse, sexual enjoyment, and sexual worry, while only the worsening of sexual functioning was recorded. Moreover, NSRH did not cause postoperative deterioration in the quality of life parameters.
保留神经的根治性子宫切除术（NSRH）可降低宫颈癌根治性手术的术后负面后果，如膀胱排空障碍、结直肠蠕动障碍和性功能障碍。本研究旨在前瞻性评估一组接受 NSRH 加淋巴结清扫术治疗宫颈癌的女性的性生活和生活质量。
2014 年至 2016 年期间，共有 65 例早期宫颈癌患者接受 NSRH。在手术前和手术后一年，对患者进行检查和问卷调查（女性性功能指数问卷和欧洲癌症研究与治疗组织问卷 QLQ-C30 和 QLQ-CX24）。
排除 19 例无性生活的女性和 10 例接受辅助抗癌治疗的女性后，36 例仅接受保留神经手术的有性生活的活跃患者有资格进行评估。平均年龄为 47 岁。术前阴道平均长度为 9.4cm，术后缩短至 7.1cm。本研究表明 NSRH 对性欲、唤起、满意度、高潮、疼痛、性活动、性享受和性担忧没有负面影响。在一年的随访中记录到性功能恶化。QLQ-C30 问卷证实术后整体健康状况和角色、情绪和社会功能得到改善。
我们的研究使用标准化问卷表明，NSRH 对性欲、唤起、满意度、高潮、疼痛、性活动、性交频率、性享受和性担忧没有负面影响，仅记录到性功能恶化。此外，NSRH 并未导致术后生活质量参数恶化。
