Early-stage cervical carcinoma, radical hysterectomy, and sexual function. A longitudinal study.
BACKGROUND
Limited knowledge exists concerning the impact of radical hysterectomy (RH) alone on the sexual function of patients with early-stage cervical carcinoma. The authors investigated the longitudinal course of self-reported sexual function after RH.


METHODS
The current study was comprised of 173 patients with lymph node-negative, early-stage cervical carcinoma who had undergone RH and pelvic lymphadenectomy. They were assessed prospectively using a validated self-assessment questionnaire 5 weeks and 3 months, 6 months, 12 months, 18 months, and 24 months after RH. Results were compared with an age-matched control group from the general population.


RESULTS
Compared with control women, patients experienced severe orgasmic problems and uncomfortable sexual intercourse due to a reduced vaginal size during the first 6 months after RH, severe dyspareunia during the first 3 months, and sexual dissatisfaction during the 5 weeks after RH. A persistent lack of sexual interest and lubrication were reported throughout the first 2 years after RH. Long-term lack of sexual interest and insufficient vaginal lubrication were confirmed by the patient's self-reported changes 12 months after RH compared with before the cancer diagnosis and by a pre-post comparison within patients. However, most of the patients who were sexually active before their cancer diagnosis were sexually active again 12 months after surgery (91%), although with a decrease in sexual frequency reported.


CONCLUSIONS
RH had a persistent and negative impact on patients' sexual interest and vaginal lubrication whereas the majority of other sexual and vaginal problems disappeared over time. Sexual and vaginal problems in the short-term and long-term after RH should be discussed with the patient before and after surgery.
Jensen
Pernille T
PT
Department of Gynecology and Obstetrics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. pernille_jensen@dadlnet.dk
Groenvold
Mogens
M
Klee
Marianne C
MC
Thranov
Ingrid
I
Petersen
Morten Aa
MA
Machin
David
D
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D008137:Longitudinal Studies; D008197:Lymph Node Excision; D008875:Middle Aged; D009367:Neoplasm Staging; D017060:Patient Satisfaction; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery*; D014621:Vagina / Q000502:physiology / Q000601:surgery