title: Transvaginal cholecystectomy: effect on quality of life and female sexual function.
abstract: OBJECTIVE
  Transvaginal cholecystectomy (TVC) is the leading natural orifice transluminal endoscopic surgery to date and has the potential to offer improved cosmesis, less pain, and shorter recovery times for female patients.
  
  
  OBJECTIVE
  To investigate quality of life and female sexual function in our patients undergoing TVC.
  
  
  METHODS
  A prospective cohort study from August 14, 2009, to June 12, 2012, of TVCs performed at our institution to date.
  
  
  METHODS
  Tertiary academic referral center.
  
  
  METHODS
  The first 47 consecutive female patients (aged 18-65 years) who received a TVC by a single surgeon.
  
  
  METHODS
  A hybrid TVC was performed by a 5-mm umbilical trocar and a 12-mm transvaginal trocar with standard laparoscopic instruments.
  
  
  METHODS
  Quality-of-life index (36-Item Short Form Health Survey) and female sexual function (Female Sexual Function Index) scores.
  
  
  RESULTS
  A total of 47 TVCs were performed, with a mean age of 39 years, mean body mass index (calculated as weight in kilograms divided by height in meters squared) of 31, and mean operative time of 65 minutes. No difference was noted in overall female sexual function from preoperatively to 1 and 3 months postoperatively. When comparing quality of life preoperatively vs 1 and 3 months postoperatively, there were significant improvements in physical function (P = .02), energy and fatigue (P = .001), emotional well-being (P = .01), pain (P < .001), and general health (P = .03). No significant changes were noted in physical limitations (P = .18), emotional problems (P = .72), and social function (P = .12).
  
  
  CONCLUSIONS
  In our experience to date, female sexual function is unchanged and quality of life either is unchanged or improves at 1 and 3 months following TVC. Undergoing TVC does not appear to negatively affect female sexual function or quality of life in the short term.
authors.affiliation: Department of Surgery, Yale School of Medicine, 40 Temple St, Ste 7B, New Haven, CT 06510, USA.
authors.forename: Stephanie G
authors.initials: SG
authors.lastname: Wood
authors.forename: Daniel
authors.initials: D
authors.lastname: Solomon
authors.forename: Lucian
authors.initials: L
authors.lastname: Panait
authors.forename: Robert L
authors.initials: RL
authors.lastname: Bell
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Duffy
authors.forename: Kurt E
authors.initials: KE
authors.lastname: Roberts
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002763:Cholecystectomy; D015331:Cohort Studies; D005260:Female; D005705:Gallbladder Diseases / Q000150:complications / Q000523:psychology / Q000601:surgery*; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery; D011788:Quality of Life; D012725:Sexual Behavior; D016896:Treatment Outcome; D014621:Vagina / Q000601:surgery*; D055815:Young Adult