title: The effect of colorectal surgery in female sexual function, body image, self-esteem and general health: a prospective study.
abstract: OBJECTIVE
  To evaluate women's sexual function, self-esteem, body image, and health-related quality of life after colorectal surgery.
  
  
  BACKGROUND
  Current literature lacks prospective studies that evaluate female sexuality/quality of life after colorectal surgery using validated instruments.
  
  
  METHODS
  Sexual function, self-esteem, body image, and general health of female patients undergoing colorectal surgery were evaluated preoperatively, at 6 and 12 months after surgery, using the Female Sexual Function Index, Rosenberg Self-Esteem scale, Body Image scale and SF-36, respectively.
  
  
  RESULTS
  Ninety-three women with a mean age of 43.0 +/- 11.6 years old were enrolled in the study. Fifty-seven (61.3%) patients underwent pelvic and 36 (38.7%) underwent abdominal procedures. There was a significant deterioration in overall sexual function at 6 months after surgery, with a partial recovery at 12 months (P = 0.02). Self-esteem did not change significantly after surgery. Body image improved, with slight changes at 6 months and significant improvement at 12 months, compared with baseline (P = 0.05). Similarly, mental status improved over time with significant improvement at 12 months, with values superior than baseline (P = 0.007). Physical recovery was significantly better than baseline in the first 6 months after surgery with no significant further improvement between 6 and 12 months. Overall, there were no differences between patients who had abdominal procedures and those who underwent pelvic dissection, except that patients from the former group had faster physical recovery than patients in the latter (P = 0.031). When asked about the importance of discussing sexual issues, 81.4% of the woman stated it to be extremely or somewhat important.
  
  
  CONCLUSIONS
  Surgical treatment of colorectal diseases leads to improvement in global quality of life. There is, however, a significant decline in sexual function postoperatively. Preoperative counseling is desired by most of the patients.
authors.affiliation: Department of Colorectal Surgery, Cleveland Clinic Florida, Weston, Florida 33331, USA.
authors.forename: Giovanna M
authors.initials: GM
authors.lastname: da Silva
authors.forename: Tracy
authors.initials: T
authors.lastname: Hull
authors.forename: Patricia L
authors.initials: PL
authors.lastname: Roberts
authors.forename: Dan E
authors.initials: DE
authors.lastname: Ruiz
authors.forename: Steven D
authors.initials: SD
authors.lastname: Wexner
authors.forename: Eric G
authors.initials: EG
authors.lastname: Weiss
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Nogueras
authors.forename: Norma
authors.initials: N
authors.lastname: Daniel
authors.forename: Jane
authors.initials: J
authors.lastname: Bast
authors.forename: Jeff
authors.initials: J
authors.lastname: Hammel
authors.forename: Dana
authors.initials: D
authors.lastname: Sands
mesh_terms: D000222:Adaptation, Physiological; D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D001828:Body Image; D003107:Colorectal Surgery / Q000009:adverse effects* / Q000379:methods / Q000523:psychology; D005260:Female; D006801:Humans; D008603:Mental Health; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000453:epidemiology / Q000523:psychology; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D012649:Self Concept; D012725:Sexual Behavior; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires