title: Quality of life and sexual function of patients following radical hysterectomy and vaginal extension.
abstract: BACKGROUND
  Radical hysterectomy (RH) has negative consequences on sexual function due to a shortened vagina, vaginal dryness, and dyspareunia. Peritoneovaginoplasty aims to extend vagina by vesical peritoneum and anterior rectal wall to improve postoperative sexual function.
  
  
  OBJECTIVE
  The aim of this study was to investigate whether vaginal extension can improve sexual function and quality of life and the problem of sexual dysfunction in early-stage cervical cancer survivors (CCSs) in China.
  
  
  METHODS
  Case-control and questionnaire-based methods were employed. Thirty-one patients who had undergone vaginal extension following RH and 28 patients with matching factors after RH alone were enrolled in the study.
  
  
  METHODS
  Both groups were assessed retrospectively by questionnaires at least 6 months after treatment. The European Organization for Research and Treatment of Cancer Quality-of-Life questionnaire cervical cancer module and the Sexual Function Vaginal Changes Questionnaire are validated measurements for disease- and treatment-specific issues.
  
  
  RESULTS
  Vaginal length was 10.03 ± 1.26 cm and 5.92 ± 1.05 cm in study and control group, respectively (P < 0.05). In the study group, 67.7% patients and 64.3% of control group resumed sexual activity at the time of interview, averaging 6 months between treatment and sexual activity. While difficulty emptying bladder, incomplete emptying, and constipation were the most commonly reported symptoms, no significant difference was observed regarding pelvic floor symptoms. Reduced vagina size and shortened vagina was significantly more prominent in the control group, whereas both group presented with hypoactive sexual desire (88.1%), orgasm dysfunction (71.8%), and low enjoyment or relaxation after sex (51.3%).
  
  
  CONCLUSIONS
  Shortened vagina was significantly less reported in study group, while no difference was observed in other sex-related dimensions. Vaginal extension does not worsen pelvic floor symptoms. Sexual rehabilitation interventions are of significance and should be paid more attention to the CCSs in China.
authors.affiliation: Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Science, Peking Union Medical College, Beijing, China.
authors.forename: Shuang
authors.initials: S
authors.lastname: Ye
authors.forename: Jiaxin
authors.initials: J
authors.lastname: Yang
authors.forename: Dongyan
authors.initials: D
authors.lastname: Cao
authors.forename: Lan
authors.initials: L
authors.lastname: Zhu
authors.forename: Jinghe
authors.initials: J
authors.lastname: Lang
authors.forename: Linus T
authors.initials: LT
authors.lastname: Chuang
authors.forename: Keng
authors.initials: K
authors.lastname: Shen
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002681:China; D004414:Dyspareunia / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects* / Q000523:psychology; D007989:Libido; D008875:Middle Aged; D059952:Pelvic Floor Disorders / Q000209:etiology; D011788:Quality of Life; D012725:Sexual Behavior; D020018:Sexual Dysfunctions, Psychological / Q000601:surgery*; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000601:surgery*; D014621:Vagina / Q000601:surgery*
keywords: Early-Stage Cervical Cancer; Quality of Life; Questionnaire; Radical Hysterectomy; Sexual Function; Vaginal Extension