Bartnik Paweł, Kacperczyk-Bartnik Joanna, Różańska-Walędziak Anna, Wróbel Andrzej, Kobierzycki Christopher, Czajkowski Krzysztof, Romejko-Wolniewicz Ewa
II Department of Obstetrics and Gynaecology, Medical University of Warsaw, 02-091 Warsaw, Poland.
Department of Human Physiology and Patophysiology, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warsaw, Poland.
Cancers (Basel). 2025 Mar 20;17(6):1033. doi: 10.3390/cancers17061033.
: The aim of the study was to analyze and compare the possible effect of cervical conization and the loop electrosurgical excision procedure (LEEP) on female sexual function up to one year after intervention, as existing studies provide incoherent results. : This prospective cohort study enrolled patients who underwent either LEEP (n = 35) or surgical conization of the cervix (n = 44). Patients completed the questionnaire before the intervention and at three, six, and twelve months after the end of the postoperative period. The questionnaire included the Polish version of the Female Sexual Function Index (FSFI) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire of Cancer Patients with the module Cervix-24. : In the LEEP group, significant deterioration was observed in the FSFI orgasm subscale after three and six months in comparison to the baseline (3.98 ± 2.08 vs. 3.19 ± 2.29 vs. 3.09 ± 2.24; < 0.02). The difference in the orgasm subscale compared to the baseline score was not reported after twelve months of follow-up. In the surgical conization group, significant deterioration was observed in the general FSFI score between the baseline and three months after (22.37 ± 12.38 vs. 20.82 ± 12.02; < 0.003) and in the arousal subscale between the baseline and three months after (3.69 ± 2.14 vs. 3.01 ± 2.02; < 0.001). In the orgasm subscale, there was a significant improvement between three and twelve months of observation (3.05 ± 2.22 vs. 3.63 ± 2.29; < 0.003). A significant deterioration was observed in the sexual activity subscale of the EORTC QLQ-C30 + CX24 between baseline and after three months (49.42 ± 36.12 vs. 39.09 ± 36.81; < 0.03). All reported deteriorations had a tendency to resolve within twelve months of observation. : Both LEEP and surgical conization of the cervix seem to have a mild, transient negative impact on female sexual function, which normalizes one year after the procedure. Long-term consequences of both procedures are similar. Further research with larger sample sizes is necessary to confirm these findings.
本研究的目的是分析和比较宫颈锥切术和环形电切术（LEEP）对干预后长达一年的女性性功能的可能影响，因为现有研究结果不一致。
这项前瞻性队列研究纳入了接受LEEP（n = 35）或宫颈手术锥切术（n = 44）的患者。患者在干预前以及术后三个月、六个月和十二个月完成问卷。问卷包括波兰语版的女性性功能指数（FSFI）和欧洲癌症研究与治疗组织癌症患者生活质量问卷的宫颈模块-24。
在LEEP组中，与基线相比，术后三个月和六个月时FSFI性高潮子量表出现显著恶化（3.98±2.08 vs. 3.19±2.29 vs. 3.09±2.24；P<0.02）。随访十二个月后，未报告性高潮子量表与基线评分的差异。在手术锥切术组中，基线与术后三个月之间FSFI总分出现显著恶化（22.37±12.38 vs. 20.82±12.02；P<0.003），基线与术后三个月之间性唤起子量表也出现显著恶化（3.69±2.14 vs. 3.01±2.02；P<0.001）。在性高潮子量表中，观察的三个月至十二个月之间有显著改善（3.05±2.22 vs. 3.63±2.29；P<0.003）。欧洲癌症研究与治疗组织QLQ-C30 + CX24的性活动子量表在基线与术后三个月之间出现显著恶化（49.42±36.12 vs. 39.09±36.81；P<0.03）。所有报告的恶化在观察的十二个月内都有恢复的趋势。
宫颈LEEP和手术锥切术似乎对女性性功能都有轻微、短暂的负面影响，术后一年性功能恢复正常。两种手术的长期后果相似。需要进行更大样本量的进一步研究来证实这些发现。
