Department of Obstetrics and Gynecology, Peking University First Hospital, Beijing, China.
Department of Obstetrics and Gynecology, The Affiliated Hospital of Chengde Medical College, Chengde, China.
J Obstet Gynaecol Res. 2022 Nov;48(11):2888-2895. doi: 10.1111/jog.15406. Epub 2022 Sep 2.
This study aimed to investigate the long-term sexual function of patients with cervical cancer who underwent treatment and to explore influential factors.
This retrospective cross-sectional study was conducted at Peking University First Hospital in (Beijing, China). A total of 207 patients, who were diagnosed with Stage IA-IIA cervical cancer and had undergone surgical treatment (some patients had also been treated with adjuvant radiotherapy and chemotherapy) between January 2010 and August 2020, completed questionnaires via telephone. The median time since diagnosis was 54 (range, 13-138) months. Sexual function was assessed using the validated short form of Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). The multivariate logistic regression analysis was performed to determine factors influencing sexual function after treatment.
The mean preoperative PISQ-12 score was 39.42 ± 3.922, and the mean postoperative PISQ-12 score was 32.60 ± 6.592, indicating a significant decrease in postoperative PISQ-12 score compared with preoperation (p < 0.001). In total, 49.8% of the patients had sexual dysfunction after treatment. According to the results of the multivariate logistic regression analysis, longer follow-up (months), ovariectomy, lack of hormone replacement therapy after ovariectomy and adjuvant radiotherapy were significantly associated with sexual dysfunction after treatment (p < 0.05). There was no significant correlation among surgical method, tumor stage, adjuvant chemotherapy, and sexual dysfunction after treatment.
The sexual function of cervical cancer survivors significantly decreased after treatment, which was related to the length of follow-up, ovariectomy, and adjuvant radiotherapy. Hormone replacement therapy after ovariectomy can help patients to improve their sexual function.
本研究旨在探讨接受治疗的宫颈癌患者的长期性功能，并探讨其影响因素。
这是一项在北京北京大学第一医院进行的回顾性横断面研究。共纳入 207 例诊断为 IA-IIA 期宫颈癌并接受手术治疗（部分患者还接受了辅助放疗和化疗）的患者，他们于 2010 年 1 月至 2020 年 8 月间通过电话完成了问卷。中位诊断后时间为 54（范围，13-138）个月。采用已验证的盆腔器官脱垂/尿失禁性功能问卷（PISQ-12）短表评估性功能。采用多变量逻辑回归分析确定治疗后影响性功能的因素。
术前 PISQ-12 评分的平均值为 39.42±3.922，术后 PISQ-12 评分的平均值为 32.60±6.592，表明术后 PISQ-12 评分显著下降（p<0.001）。治疗后共有 49.8%的患者存在性功能障碍。多变量逻辑回归分析结果显示，随访时间较长（月）、卵巢切除、卵巢切除后缺乏激素替代治疗以及辅助放疗与治疗后性功能障碍显著相关（p<0.05）。手术方法、肿瘤分期、辅助化疗与治疗后性功能障碍之间无显著相关性。
宫颈癌幸存者治疗后性功能显著下降，与随访时间、卵巢切除及辅助放疗有关。卵巢切除后激素替代治疗有助于改善患者的性功能。
