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Cianci S, Tarascio M, Arcieri M, La Verde M, Martinelli C, Capozzi VA, Palmara V, Gulino F, Gueli Alletti S, Caruso G, Restaino S, Vizzielli G, Conte C, Palumbo M, Ercoli A. Post Treatment Sexual Function and Quality of Life of Patients Affected by Cervical Cancer: A Systematic Review. Medicina (B Aires) 2023; 59:medicina59040704. [PMID: 37109662 PMCID: PMC10144819 DOI: 10.3390/medicina59040704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/28/2023] [Accepted: 03/29/2023] [Indexed: 04/07/2023] Open
Abstract
Introduction: The aim of this study is to analyze the available scientific evidence regarding the quality of life (QoL) and sexual function (SF) in patients affected by cervical cancer (CC) after surgical and adjuvant treatments. Materials and Methods: Preliminary research was conducted via electronic database (MEDLINE, PubMed and Cochrane Library) with the use of a combination of the following keywords: SF, QoL, and CC. The principal findings considered in the present review were the study design, the number of patients included in each study, the information about the malignancy (histology and stage of disease), the questionnaires administered, and the principal findings concerning SF and QoL. Results: All studies were published between 2003–2022. The studies selected consisted of one randomized control study, seven observational studies (three prospective series), and nine case control studies. The scores used were focused on SF, QOL, fatigue, and psychological aspects. All studies reported a decreased SF and QOL. The most developed questionnaires were the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Female Sexual Function Index (FSFI), the Hospital Anxiety and Depression scale (HADS), and the Female Sexual Distress Scale (FSDS). Discussion: All studies reported a decreased SF and QOL. In addition to the perception of body image, several factors coexist in influencing the outcomes such as the physical, hormonal, psychological. Conclusions: Sexual dysfunction after CC treatment has a multifactorial aetiology which negatively affects the quality of life. For these reasons, it is important to follow and support patients with a multidisciplinary team (doctors, nurses, psychologists, dieticians) before and after therapy. This type of tailored therapeutic approach should become a standard. Women should be informed about possible vaginal changes and menopausal symptoms after surgery and on the positive effects of psychological therapy.
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Affiliation(s)
- Stefano Cianci
- Obstetrics and Gynecology Unit, Department of Human Pathology of Adult and Childhood “G. Barresi”, University of Messina, 98124 Messina, Italy
| | - Mattia Tarascio
- Obstetrics and Gynecology Unit, Department of Woman and Child, Azienda Sanitaria Provinciale di Catania, 95124 Catania, Italy
| | - Martina Arcieri
- Department of Biomedical, Dental, Morphological and Functional Imaging Science, University of Messina, 98122 Messina, Italy
- Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
| | - Marco La Verde
- Obstetrics and Gynecology Unit, Department of Woman, Child and General and Specialized Surgery, University of Campania Luigi Vanvitelli, 80138 Napoli, Italy
| | - Canio Martinelli
- Obstetrics and Gynecology Unit, Department of Human Pathology of Adult and Childhood “G. Barresi”, University of Messina, 98124 Messina, Italy
| | - Vito Andrea Capozzi
- Department of Medicine and Surgery, University Hospital of Parma, 43125 Parma, Italy
| | - Vittorio Palmara
- Obstetrics and Gynecology Unit, Department of Human Pathology of Adult and Childhood “G. Barresi”, University of Messina, 98124 Messina, Italy
| | - Ferdinando Gulino
- Department of Obstetrics and Gynaecology, Azienda di Rilievo Nazionale e di Alta Specializzazione (ARNAS) Garibaldi Nesima, 95124 Catania, Italy
| | - Salvatore Gueli Alletti
- Obstetrics and Gynecology Unit, Department of Woman and Child, Ospedale Buccheri La Ferla Fatebenefratelli, 90123 Palermo, Italy
| | - Giuseppe Caruso
- Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy
| | - Stefano Restaino
- Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
| | - Giuseppe Vizzielli
- Department of Medical Area (DAME), Clinic of Obstretics and Gynecology “Santa Maria della Misericordia”, University Hospital Azienda Sanitaria Universitaria Friuli Centrale, University of Udine, 33100 Udine, Italy
| | - Carmine Conte
- Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy
| | - Marco Palumbo
- Department of General Surgery and Medical Surgical Specialties, Gynecological Clinic, University of Catania, 95123 Catania, Italy
| | - Alfredo Ercoli
- Obstetrics and Gynecology Unit, Department of Human Pathology of Adult and Childhood “G. Barresi”, University of Messina, 98124 Messina, Italy
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Rasekh Jahromi A, Ranjbar A, Naseripour P, Rahmanian V, Jamali S. Body image and sexual function in women with breast cancer. SEXUAL AND RELATIONSHIP THERAPY 2022. [DOI: 10.1080/14681994.2022.2097212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Athar Rasekh Jahromi
- Department Obstetrics and Gynecology, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Afsaneh Ranjbar
- Department of Physiology, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Vahid Rahmanian
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Safieh Jamali
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
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Palaia I, Santangelo G, Caruso G, Perniola G, Tibaldi V, Muzii L, Benedetti Panici P, Di Donato V. Long-term Quality of Life and Sexual Function After Neoadjuvant Chemotherapy and Radical Surgery for Locally Advanced Cervical Cancer. J Sex Med 2022; 19:613-619. [PMID: 35227622 DOI: 10.1016/j.jsxm.2022.01.519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 01/13/2022] [Accepted: 01/30/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Cervical cancer survivors report the worst quality of life (QoL) among all cancer survivors and this is mainly due to their younger age and the long-term treatment sequelae. AIM The purpose of this study is to assess the long-term QoL and sexual function of locally advanced cervical cancer (LACC) patients treated with neoadjuvant chemotherapy (NACT) and radical hysterectomy (RH) instead of the standard chemoradiotherapy. METHODS This is a retrospective case-control study including LACC patients (FIGO stage IIB-IVA) treated with the NACT-RH strategy and a control group of healthy women undergoing hysterectomy for uterine fibromatosis in the same period. OUTCOMES Main outcome measures were the EORTC QLQ-C30 and EORTC QLQ-CX24 for quality of life and Female Sexual Function Index (FSFI) for sexual function. RESULTS Overall, 96 patients were included: 48 LACC and 48 controls. The mean age at diagnosis was 45.5 ± 9.0 and 47.0 ± 7.8, respectively (P = .38). Compared to controls, LACC patients reported lower mean scores for the global health status (69.4 ± 22.6 vs 81.2 ± 24.3; Mean Difference (MD): -11.80 [95% CI: -21.19, -2.41]; P = .016), QLQ-C30 functional scale (80.1 ± 22.6 vs 92.4 ± 14.9; MD: -12.30 [95% CI: -19.96, -4.64]; P = .002), QLQ-Cx24 functional scale (55.5 ± 25.0 vs 80.4 ± 22.4; MD: -24.00 [95% CI: -34.40, -15.40]; P < .001), and the total FSFI (19.3 ± 9.6 vs 26.2 ± 9.9; MD: -6.90 [95% CI: -10.80, -3.00]; P < .001). On the other hand, LACC patients reported higher mean scores on the QLQ-C30 (16.9 ± 22.1 vs 8.4 ± 16.6; MD: 8.50 [95% CI: 0.68, 16.32]; P = .03) and QLQ-CX24 (26.0 ± 28.8 vs 15.0 ± 11.7; MD: 11.00 [95% CI: -2.21, 19.79]; P = .01) symptoms scales. CLINICAL IMPLICATIONS The confirmed poor quality of life even in surgically treated LACC survivors underlines the importance of tailoring parametrectomy based on lymph node status and developing personalized strategies. STRENGTHS AND LIMITATIONS The study assessed the long-term QoL and sexual function in the specific subpopulation of LACC patients treated with NACT-RH. Main limitations include the small sample size and the retrospective design. CONCLUSION LACC long-term survivors treated with NACT-RH experience poor QoL and sexual dysfunction. Palaia I, Santangelo G, Caruso G, et al. Long-term Quality of Life and Sexual Function After Neoadjuvant Chemotherapy and Radical Surgery for Locally Advanced Cervical Cancer. J Sex Med 2022;19:613-619.
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Affiliation(s)
- Innocenza Palaia
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Giusi Santangelo
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Giuseppe Caruso
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.
| | - Giorgia Perniola
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Valentina Tibaldi
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Ludovico Muzii
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Pierluigi Benedetti Panici
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - Violante Di Donato
- Department of Maternal and Child Health and Urological Sciences, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
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Stanca M, Căpîlna DM, Trâmbițaș C, Căpîlna ME. The Overall Quality of Life and Oncological Outcomes Following Radical Hysterectomy in Cervical Cancer Survivors Results from a Large Long-Term Single-Institution Study. Cancers (Basel) 2022; 14:cancers14020317. [PMID: 35053481 PMCID: PMC8773665 DOI: 10.3390/cancers14020317] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 12/31/2021] [Accepted: 01/07/2022] [Indexed: 12/19/2022] Open
Abstract
Simple Summary Romania maintains its regrettably leading position in terms of mortality caused by cervical cancer in Europe, with any available studies evaluating the oncological outcomes and quality of life of these patients. Our study could provide a historical comparison for future randomized controlled trials in Eastern Europe needed to confirm these results. Abstract (1) Background: Cervical cancer patients have been found to have worse quality of life (QoL) scores due to cancer treatment, not only when compared to the general population, but also when compared to other gynecological cancer survivors. In Eastern European developing countries, the health care system often cannot afford the uppermost standardized treatment for these patients. In the absence of a comparable study in our country, the authors’ aim for this retrospective cross-sectional observational study was to evaluate the overall survival (OS) and the QoL o cervical cancer survivors; (2) Methods: 430 patients were analyzed. The first objective is to evaluate the OS rates of patients with cervical cancer stages IA2 to IIB undergoing radical hysterectomy (RH) +/− neoadjuvant or adjuvant radiotherapy +/− chemoradiotherapy treatment combinations. The second objective is to assess their QoL, using two standardized questionnaires issued by the European Organisation for Research and Treatment of Cancer (EORTC), namely QLQ-C30 and QLQ-CX24. (3) Results: The mean age of the participants was 51 years (22–76) and the average follow-up time was 65 months (2–128). At the time of the analysis, 308 out of 430 patients were alive, with a mean five-year OS of 72.4%. The multivariate Cox regression analysis identified stage IIB, parametrial invasion, and the lymph node metastases as independent prognostic risk factors negatively impacting the OS. Of the 308 patients still alive at the time of the analysis, 208 (68%) answered the QoL questionnaires. The QLQ-C30 shows a good long-term Global QoL of 64.6 (median), good functioning scores, and a decent symptom scale value. However, the EORTC QLQ-CX24 showed high values of cervical cancer-specific symptoms, namely: lymphedema, peripheral neuropathy, severe menopausal symptoms, and distorted body-image perception. The results also indicate a significant decline in the quality of sexual life with a low sexual enjoyment and decreased level of sexual activities. (4) Conclusion: Despite a good OS, in this setting of patients, cervical cancer survivors have a modest QoL and sexual function. Our study may provide a comparison for future randomized, controlled trials in Eastern European countries needing to confirm these results.
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Affiliation(s)
- Mihai Stanca
- First Obstetrics and Gynecology Clinic, University of Medicine, Pharmacy, Science and Technology “G.E. Palade” of Târgu Mureș, Gheorghe Marinescu Street, Number 38, 540142 Targu Mures, Romania; (D.M.C.); (M.E.C.)
- Correspondence: ; Tel.: +40-074-2537323
| | - Dan Mihai Căpîlna
- First Obstetrics and Gynecology Clinic, University of Medicine, Pharmacy, Science and Technology “G.E. Palade” of Târgu Mureș, Gheorghe Marinescu Street, Number 38, 540142 Targu Mures, Romania; (D.M.C.); (M.E.C.)
| | - Cristian Trâmbițaș
- Anatomy and Embryology Department, University of Medicine, Pharmacy, Science and Technology “G.E. Palade” of Târgu Mureș, Gheorghe Marinescu Street, Number 38, 540142 Targu Mures, Romania;
| | - Mihai Emil Căpîlna
- First Obstetrics and Gynecology Clinic, University of Medicine, Pharmacy, Science and Technology “G.E. Palade” of Târgu Mureș, Gheorghe Marinescu Street, Number 38, 540142 Targu Mures, Romania; (D.M.C.); (M.E.C.)
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Plotti F, Ficarola F, Messina G, Terranova C, Montera R, Guzzo F, DE Cicco Nardone C, Rossini G, Schirò T, Gatti A, Luvero D, Feole L, Angioli R. Tailoring parametrectomy for early cervical cancer (Stage IA-IIA FIGO): a review on surgical, oncologic outcome and sexual function. Minerva Obstet Gynecol 2020; 73:149-159. [PMID: 33249819 DOI: 10.23736/s2724-606x.20.04683-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Cervical cancer is currently one of the most common cancers afflicting the female population worldwide and in industrialized countries the presence of screening and a specific diagnostic and therapeutic process has favored early diagnosis of cervical cancer. In literature have found that reducing the radicality on the parametria in early cervical cancer (ECC), reduces complications without impacting oncological outcomes, but the data in the literature are not yet clear. EVIDENCE ACQUISITION Searching on PubMed, we included 1473 articles from January 1974 to 2020. We identified all the studies that compared different type of radical hysterectomy in the primary surgical treatment of ECC. 16 articles were elected for the review. EVIDENCE SYNTHESIS Modified radical hysterectomy (Piver II/Querleu-Morrow Type B) in ECC, if compared to CRH (Piver III/Querleu-Morrow Type C2), is not associated with worse cancer outcome and patient survival, but it is associated with a minor operating time, lower blood loss and minor bladder dysfunction. Nerve sparing radical hysterectomy approach (NSRH/Querleu-Morrow Type C1) compared to CRH (Piver III/Type C2) in the ECC, with our data we can confirm a non-inferiority regarding the oncological outcome. CONCLUSIONS Reduced radicality on the parametrium offers positive effects on the quality of life (sexual life and bladder function) of patients without impacting on survival, oncological outcome.
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Affiliation(s)
- Francesco Plotti
- Unit of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy
| | - Fernando Ficarola
- Unit of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy -
| | - Giuseppe Messina
- Unit of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy
| | - Corrado Terranova
- Unit of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy
| | - Roberto Montera
- Unit of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy
| | - Federica Guzzo
- Unit of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy
| | | | - Gianmarco Rossini
- Unit of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy
| | - Teresa Schirò
- Unit of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy
| | - Alessandra Gatti
- Unit of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy
| | - Daniela Luvero
- Unit of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy
| | - Laura Feole
- Unit of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy
| | - Roberto Angioli
- Unit of Obstetrics and Gynecology, Campus Bio-Medico University, Rome, Italy
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Body Image, Sexuality, and Sexual Functioning in Women With Gynecologic Cancer: An Integrative Review of the Literature and Implications for Research. Cancer Nurs 2020; 44:E252-E286. [PMID: 32332264 DOI: 10.1097/ncc.0000000000000818] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cervical and uterine cancers are common in women. Diagnosis and treatment of these cancers can lead to significant issues with body image, sexuality, and sexual functioning. A comprehensive review can improve understanding of these 3 concepts, in turn enhancing identification and management. OBJECTIVES To (1) present the qualitative, descriptive, and correlational research literature surrounding body image, sexuality, and sexual functioning in women with uterine and cervical cancer; (2) identify gaps in the literature; and (3) explore the implications of the findings for future research. METHODS A comprehensive search of the literature was undertaken by searching PubMed, CINAHL, and PsycINFO using predetermined subject headings, keywords, and exploded topics. After a comprehensive evaluation using specific criteria, 121 articles were reviewed. RESULTS Qualitative studies provided information about women's issues with body image, sexuality, and sexual functioning, whereas quantitative studies focused primarily on sexual functioning. The literature lacks correlational studies examining body image and sexuality. Significant issues regarding communication and quality of life were noted, and few studies were based on clear conceptual models. CONCLUSION The state of the science gleaned from this review reveals that while much is known about sexual functioning, little is known about body image and sexuality. IMPLICATIONS FOR PRACTICE Further work is warranted to develop conceptual models and research on body image, sexuality, and sexual functioning as a foundation for interventions to improve quality of life.
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Assessment of Quality of Life and Urinary and Sexual Function After Radical Hysterectomy in Long-Term Cervical Cancer Survivors. Int J Gynecol Cancer 2019. [PMID: 29538249 DOI: 10.1097/igc.0000000000001239] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
AIMS The aim of this study was to evaluate long-term quality of life and urinary and sexual function in long-term cervical cancer survivors previously treated with radical hysterectomy (RH) type C2/type III. METHODS All patients who presented at Campus Bio-Medico of Rome for RH type C2/type III for cervical cancer were considered eligible for this retrospective study protocol. We included exclusively patients with complete response to primary treatment with at least 36 months of follow up. Included subjects were interviewed with the European Organization for Research and Treatment of Cancer QLQ-CX24 Questionnaire, European Organization for Research and Treatment of Cancer QLQ-C30, and an Incontinence Impact Questionnaire 7. RESULTS From January 2004 to June 2014, 251 patients affected by locally advanced cervical cancer were treated at Campus Bio-Medico of Rome treated with type C2/type III RH. At time point of March 2017, 90 patients were included with a mean age of 55.6 ± 8.5 years. The questionnaires were administered after a median follow-up of 49 months after the end of therapy. The symptoms of fatigue, nausea and vomiting, appetite loss, pain, insomnia, and dyspnea, as well as a negative financial impact, were reported as not frequent and rarely disabling. On the contrary, patients frequently reported gastrointestinal complaints. Diarrhea was present in 6% of patients and was referred as mild; constipation was present in 75% of women and was reported as mild in 30% of cases, moderate in 30%, and severe in 15%. Concerning sexual activity, data indicated a good level of sexual enjoyment with a slight worsening of sexual activity. Incontinence was reported in 28% of cases and appeared to be mild and rarely disabling (all mean values <2). CONCLUSIONS Waiting for ongoing randomized controlled trials, this study confirmed that RH may be considered as a useful treatment plan, according to its negligible long-term impact on quality of life, urinary dysfunction, and sexual function.
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Sun H, Cao D, Shen K, Yang J, Xiang Y, Feng F, Wu L, Zhang Z, Ling B, Song L. Piver Type II vs. Type III Hysterectomy in the Treatment of Early-Stage Cervical Cancer: Midterm Follow-up Results of a Randomized Controlled Trial. Front Oncol 2018; 8:568. [PMID: 30555800 PMCID: PMC6280766 DOI: 10.3389/fonc.2018.00568] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 11/13/2018] [Indexed: 11/13/2022] Open
Abstract
Introduction: With the expansion of value-based medicine, we explore whether using type III hysterectomy to treat low-risk, early-stage cervical cancer constitutes overtreatment. In present study, we evaluate the midterm safety and postoperative quality of life of patients who underwent type II hysterectomy vs. type III hysterectomy with systematic lymphadenectomy for low-risk early-stage cervical cancer (International Federation of Gynecology and Obstetrics (FIGO) IA2-IB1; maximum tumor diameter < 2 cm). Patients and methods: The main study was a multicenter, phase III, randomized controlled trial (NCT02368574, https://www.clinicaltrials.gov/ct2/show/NCT02368574). Patients meeting the criteria were randomly divided into type II and type III hysterectomy groups between 2015 and 2018. Midterm outcomes were analyzed at 36 months after the first eligible patient was enrolled. The primary end point was disease-free survival, and the secondary end point was postoperative quality of life. Results: A total of 97 patients were preliminarily enrolled, 93 of whom were included in the final analysis. The general information of the two groups did not differ. The 2-year DFS rate in the type II group was 100% compared with 97.9% in the type III group (P > 0.05). Compared to the type III group, the patients who underwent type II hysterectomy showed a shorter surgical time (163 ± 18.8 min vs. 226 ± 16.4 min, P = 0.014), less intraoperative blood loss (174 ± 27.7 ml vs. 268 ± 37.4 ml, P = 0.047), less postoperative urinary retention (5/46 vs. 11/47 cases, P = 0.109), and milder bladder injuries. The postoperative symptom experience scores of the type II group were significantly lower than those of the type III group. Moreover, the postoperative sexual/vaginal functioning and lubrication scores of the type II group were significantly lower than those of the type III group in subgroup analyses of patients who did not undergo postoperative chemoradiotherapy. Sexual apprehension scores were increased postoperatively in both groups. Conclusion: Based on the midterm analysis, the two groups show considerable security within 2 years after surgery, but long-term security requires further analysis. Type II hysterectomy can effectively reduce the surgical time and intraoperative blood loss, decrease postoperative complications, and improve the quality of life of early-stage cervical cancer patients.
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Affiliation(s)
- Hengzi Sun
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dongyan Cao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Keng Shen
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jiaxin Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yang Xiang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Fengzhi Feng
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lingying Wu
- Department of Gynecological Oncology, Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - Zhenyu Zhang
- Department of Obstetrics and Gynecology, Beijing Chao-Yang Hospital, Beijing, China
| | - Bin Ling
- Department of Obstetrics and Gynecology, China-Japan Friendship Hospital, Beijing, China
| | - Lei Song
- Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, China
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Soleimani MA, Bahrami N, Yaghoobzadeh A, Parker A, Chan YH. Sexual distress and sexual function in a sample of Iranian women with gynecologic cancers. Eur J Oncol Nurs 2018; 35:47-53. [DOI: 10.1016/j.ejon.2018.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 04/06/2018] [Accepted: 05/14/2018] [Indexed: 02/07/2023]
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Wang X, Chen C, Liu P, Li W, Wang L, Liu Y. The morbidity of sexual dysfunction of 125 Chinese women following different types of radical hysterectomy for gynaecological malignancies. Arch Gynecol Obstet 2017; 297:459-466. [PMID: 29282516 DOI: 10.1007/s00404-017-4625-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Accepted: 12/11/2017] [Indexed: 01/23/2023]
Abstract
PURPOSE Due to early detection and effective treatment, quality of sexual life of patients with gynaecological malignancies has become an important issue. However, the morbidity of sexual dysfunction and the proportion of different kinds of sexual dysfunction after radical hysterectomy are unclear. The aim of the current study was to assess the morbidity of sexual dysfunction and to conduct multivariate logistic regression analysis of patients' sexual dysfunction. METHODS Between July 2007 and December 2012, 125 women underwent radical hysterectomy, modified radical hysterectomy, and nerve-sparing radical hysterectomy were administered a self-reported sexual function questionnaire. RESULTS The preoperative, and 1- and 2-year postoperative sexual dysfunction rates were 50.5% (50/99), 86.9% (93/107), and 92.3% (72/78), respectively. The incidence rates of sexual desire disorders before operation, at postoperative year 1, and at postoperative year 2 were 14.7% (14/95), 42.1% (45/107), and 51.9% (40/77), respectively. The preoperative incidence rates of sexual arousal disorders, orgasmic disorders, and sexual pain disorders were 18.4% (18/98), 51.1% (48/94), and 10.9% (11/101), respectively. At postoperative years 1 and 2, these were 38.8% (31/80), 81.0% (64/79), and 24.4% (20/82), and 49.1% (26/53), 84.6% (44/52), and 30.2% (16/53), respectively. Multivariable regression analysis revealed that age, preserved ovary, preserved posterior vaginal wall length, preoperative stage, radiotherapy, and education background were risk factors associated with sexual dysfunction. CONCLUSION The patients following radical hysterectomy had a high incidence of sexual dysfunction, which plateaued in postoperative years 1 and 2.
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Affiliation(s)
- Xueqin Wang
- Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, No. 1838, Guangzhou Avenue, Guangzhou, 510515, People's Republic of China
- Department of Obstetrics and Gynecology, The Fifth Affiliated Hospital of Southern Medical University, No. 566, CongCheng Road, Conghua District, Guangzhou, 510900, People's Republic of China
| | - Chunlin Chen
- Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, No. 1838, Guangzhou Avenue, Guangzhou, 510515, People's Republic of China.
| | - Ping Liu
- Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, No. 1838, Guangzhou Avenue, Guangzhou, 510515, People's Republic of China
| | - Weili Li
- Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, No. 1838, Guangzhou Avenue, Guangzhou, 510515, People's Republic of China
| | - Liling Wang
- Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, No. 1838, Guangzhou Avenue, Guangzhou, 510515, People's Republic of China
| | - Yunlu Liu
- Department of Obstetrics and Gynecology, Nanfang Hospital of Southern Medical University, No. 1838, Guangzhou Avenue, Guangzhou, 510515, People's Republic of China
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11
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Shayan A, Jamshidi F, Tahmasebiboldaji V, Khani S, Babaei M, Havasian MR, Masoumi SZ. Impact of a Stress Management Intervention Program on Sexual Functioning and Stress Reduction in Women with Breast Cancer. Asian Pac J Cancer Prev 2017; 18:2787-2793. [PMID: 29072415 PMCID: PMC5747405 DOI: 10.22034/apjcp.2017.18.10.2787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Breast cancer as the most common cancer among women endangers various aspects of their sexual lives and is a major culprit regarding health impairment and low life quality. The aim of this study was to examine the effect of a stress management intervention program on sexual functioning and stress reduction in women with breast cancer. This study employed a quasi-experimental pre-test, post-test design which included follow-up checks and a control group. To this end, 104 women with breast cancer referring to Hamadan’s Mahdiyeh MRI Center at the time of data collection were conventionally selected in 2015. Using permuted blocks, they were randomly divided into experimental and control groups (n= 52), only the former receiving stress management counseling for 18 hours. Data were collected through a demographic questionnaire, the Female Sexual Function Index (FSFI) questionnaire, and Harry’s stress questionnaire, filled out by patients before and after the intervention. To analyze the data, descriptive statistics and two-way ANOVA were used. The results showed that cognitive - behavioral stress management group therapy improved total sexual functioning and its subscales. After the treatment, there was a significant difference in mean scores between the groups (p=0.01). Moreover, significant differences were observed in the mean scores for stress with improvement in the experimental group in post-test results. Cognitive - behavioral group therapy for stress management was thuis found to improve total sexual functioning and its subscales and reduce the level of stress in the experimental group after the intervention and follow-up period with an interval of two weeks. Therefore, this method can be used as a complementary therapy along with medical treatment in oncology centers.
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Affiliation(s)
- Arezoo Shayan
- Instructor of Midwifery, Mother and child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.
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12
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Panici PB, Di Donato V, Palaia I, Visentin VS, Marchetti C, Perniola G, Musella A, Gasparri ML, Lecce F, Sabatucci I, Monti M, Muzii L. Type B versus Type C Radical Hysterectomy After Neoadjuvant Chemotherapy in Locally Advanced Cervical Carcinoma: A Propensity-Matched Analysis. Ann Surg Oncol 2016; 23:2176-2182. [DOI: 10.1245/s10434-015-4996-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
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13
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Fahami F, Savabi M, Mohamadirizi S. Relationship of sexual dysfunction and its associated factors in women with genital and breast cancers. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2015; 20:516-20. [PMID: 26257810 PMCID: PMC4525353 DOI: 10.4103/1735-9066.161008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 11/05/2014] [Indexed: 11/17/2022]
Abstract
Background: Sexuality is a basic and important factor in human experiences, which varies among different types of cancers. This study was carried out with the aim of defining the relationship between sexual dysfunction and related factors in genital and breast cancers. Materials and Methods: This cross-sectional study was conducted on 150 women with genital and breast cancers admitted to two specialized hospitals in Isfahan and by using a two-stage sampling method. Participants completed demographic/disease questionnaire and sexual function questionnaire. Collected data were analyzed by using SPSS software version 14 and statistical tests of correlation coefficient, Student's t-test and one-way analysis of variance (ANOVA). Results: The obtained results showed that 47% of women had sexual dysfunction with the mean (SD) age of 47 (7.7) years (with the range of 25–65 years). There was a significant correlation between sexual functioning and age, occupation, educational level, and treatment duration (P < 0.05). There was also a significant correlation between the stage of disease, primary disorder (0.003), and recent disorder (0.028). Meanwhile, Chi-square test showed no significant relationship between cancer type and primary disorder (0.403) and recent disorder (0.416). Conclusions: Breast and genital cancers may result in significant difficulties with sexual functioning and sexual life. Addressing these problems is essential to improve the quality of life in women with cancer and further investigations should be conducted for prevention and treatment of disorders by the health authorities.
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Affiliation(s)
- Fariba Fahami
- Department of Midwifery, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mitra Savabi
- Department of Midwifery, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Soheila Mohamadirizi
- Department of Midwifery, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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14
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Lamblin G, Rouffiac M, Mathevet P, Martin E, Peignaux-Casasnovas K, Chabert P, Lebail-Carval K, Chene G. [Surgery alone or in association with preoperative uterovaginal brachytherapy for stage IB1 cervical cancer: Toxicities profiles]. ACTA ACUST UNITED AC 2015; 43:485-90. [PMID: 25986397 DOI: 10.1016/j.gyobfe.2015.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 04/03/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To assess toxicity profile in two stage-IB1 cervical cancer treatment strategies: surgery with and without preoperative uterovaginal pulsed dose-rate brachytherapy. METHODS A retrospective study included 45 patients presenting stage-IB1 cervical cancer without pelvic lymph-node invasion, between 2009 and 2011: 25 treated by colpohysterectomy alone (group A) and 20 with preoperative uterovaginal pulsed dose-rate brachytherapy (group B). The median follow-up was 45 and 39 months (group A and B). RESULTS Groups were comparable for age (median, 46.9 vs 47.6 years), histologic type (52% vs 65% squamous cell carcinoma) and tumor size (68% vs 60%, <2cm). In postoperative year 1, rates of urinary, digestive and gynaecological disorder were 39.1%, 8.7% and 15% respectively in group A versus 36.8%, 5.3% and 31.6% in group B and in year 2, 5.9%, 8.4% and 15% versus 5.6%, 5.1% and 27.8%. DISCUSSION AND CONCLUSION The present study comparing two stage-IB1 cervical cancer treatment strategies found no significant difference in early or late complications. In 2 months, there was greater grade-3 urinary toxicity (21.1%) and sexual disorder (15.8%) with preoperative brachytherapy but no significant difference. Exclusive surgery is probably preferable for the patient's quality of life.
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Affiliation(s)
- G Lamblin
- Service de chirurgie gynécologique, hôpital Femme-Mère-Enfant, université Claude-Bernard-Lyon 1, 59, boulevard Pinel, 69677 Lyon-Bron, France.
| | - M Rouffiac
- Département de radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France
| | - P Mathevet
- Service de chirurgie gynécologique, hôpital Femme-Mère-Enfant, université Claude-Bernard-Lyon 1, 59, boulevard Pinel, 69677 Lyon-Bron, France
| | - E Martin
- Département de radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France
| | - K Peignaux-Casasnovas
- Département de radiothérapie, centre Georges-François-Leclerc, 1, rue du Professeur-Marion, 21000 Dijon, France
| | - P Chabert
- Service de chirurgie gynécologique, hôpital Femme-Mère-Enfant, université Claude-Bernard-Lyon 1, 59, boulevard Pinel, 69677 Lyon-Bron, France
| | - K Lebail-Carval
- Service de chirurgie gynécologique, hôpital Femme-Mère-Enfant, université Claude-Bernard-Lyon 1, 59, boulevard Pinel, 69677 Lyon-Bron, France
| | - G Chene
- Service de chirurgie gynécologique, hôpital Femme-Mère-Enfant, université Claude-Bernard-Lyon 1, 59, boulevard Pinel, 69677 Lyon-Bron, France
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15
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Pfaendler KS, Wenzel L, Mechanic MB, Penner KR. Cervical cancer survivorship: long-term quality of life and social support. Clin Ther 2015; 37:39-48. [PMID: 25592090 PMCID: PMC4404405 DOI: 10.1016/j.clinthera.2014.11.013] [Citation(s) in RCA: 97] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 11/25/2014] [Accepted: 11/25/2014] [Indexed: 11/12/2022]
Abstract
PURPOSE Surgery, radiotherapy, and chemotherapy are the mainstays of cervical cancer treatment. Many patients receive multiple treatment modalities, each with its own long-term effects. Given the high 5-year survival rate for cervical cancer patients, evaluation and improvement of long-term quality of life are essential. METHODS Pertinent articles were identified through searches of PubMed for literature published from 1993 to 2014. We summarize quality of life data from long-term follow-up studies of cervical cancer patients. We additionally summarize small group interviews of Hispanic and non-Hispanic cervical cancer survivors regarding social support and coping. FINDINGS Data are varied in terms of the long-term impact of treatment on quality of life, but consistent in suggesting that patients who receive radiotherapy as part of their treatment have the highest risk of increased long-term dysfunction of bladder and bowel, as well as sexual dysfunction and psychosocial consequences. Rigorous investigations regarding long-term consequences of treatment modalities are lacking. IMPLICATIONS Continued work to improve treatment outcomes and survival should also include a focus on reducing adverse long-term side effects. Providing supportive care during treatment and evaluating the effects of supportive care can reduce the prevalence and magnitude of long-term sequelae of cervical cancer, which will in turn improve quality of life and quality of care.
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Affiliation(s)
- Krista S Pfaendler
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California at Irvine Medical Center, Orange, California
| | - Lari Wenzel
- Program in Public Health, University of California, Irvine, Irvine, California; Department of Medicine and Program in Public Health, Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, California
| | - Mindy B Mechanic
- Department of Psychology, California State University, Fullerton, Fullerton, California
| | - Kristine R Penner
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of California at Irvine Medical Center, Orange, California.
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Podnar S, Vodušek DB. Sexual dysfunction in patients with peripheral nervous system lesions. HANDBOOK OF CLINICAL NEUROLOGY 2015; 130:179-202. [PMID: 26003245 DOI: 10.1016/b978-0-444-63247-0.00011-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Peripheral nervous system (PNS) disorders may cause sexual dysfunction (SD) in patients of both genders. These disorders include mainly polyneuropathies (particularly those affecting the autonomic nervous system (ANS)) and localized lesions affecting the innervation of genital organs. Impaired neural control may produce a malfunction of the genital response consisting of loss of genital sensitivity, erectile dysfunction, loss of vaginal lubrication, ejaculation disorder, and orgasmic disorder. In addition, there is often a loss of desire which actually has a complex pathogenesis, which goes beyond the mere loss of relevant nerve function. In patients who have no manifest health problems - particularly men with erectile dysfunction - one should always consider the possibility of an underlying polyneuropathy; in patients with SD after suspected denervation lesions of the innervation of genital organs within the lumbosacral spinal canal and in the pelvis, clinical neurophysiologic testing may clarify the PNS involvement. SD can alter self-esteem and lower patients' quality of life; opening up a discussion on sexual issues should be a part of the management of patients with PNS disorders. They may greatly benefit from counseling, education on coping strategies, and specific treatments.
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Affiliation(s)
- Simon Podnar
- Institute of Clinical Neurophysiology, Division of Neurology, University Medical Center Ljubljana, Ljubljana, Slovenia.
| | - David B Vodušek
- Division of Neurology, University Medical Center Ljubljana, and Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
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Bogani G, Serati M, Nappi R, Cromi A, di Naro E, Ghezzi F. Nerve‐Sparing Approach Reduces Sexual Dysfunction in Patients Undergoing Laparoscopic Radical Hysterectomy. J Sex Med 2014; 11:3012-20. [PMID: 25244064 DOI: 10.1111/jsm.12702] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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18
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Radosa JC, Meyberg‐Solomayer G, Kastl C, Radosa CG, Mavrova R, Gräber S, Baum S, Radosa MP. Influences of Different Hysterectomy Techniques on Patients' Postoperative Sexual Function and Quality of Life. J Sex Med 2014; 11:2342-50. [DOI: 10.1111/jsm.12623] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Ye S, Yang J, Cao D, Zhu L, Lang J, Chuang LT, Shen K. Quality of life and sexual function of patients following radical hysterectomy and vaginal extension. J Sex Med 2014; 11:1334-42. [PMID: 24628816 DOI: 10.1111/jsm.12498] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION 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. AIM 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. MAIN OUTCOME MEASURES 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%). CONCLUSION 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.
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Affiliation(s)
- Shuang Ye
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Science, Peking Union Medical College, Beijing, China
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Chen C, Huang L, Liu P, Su G, Li W, Lu L, Wang L, Li X, Duan H, Zou C, Hatch K. Neurovascular quantitative study of the uterosacral ligament related to nerve-sparing radical hysterectomy. Eur J Obstet Gynecol Reprod Biol 2014; 172:74-9. [DOI: 10.1016/j.ejogrb.2013.09.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 08/06/2013] [Accepted: 09/30/2013] [Indexed: 10/26/2022]
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White AJ, Reeve BB, Chen RC, Stover AM, Irwin DE. Urinary incontinence and health-related quality of life among older Americans with and without cancer: a cross-sectional study. BMC Cancer 2013; 13:377. [PMID: 23924272 PMCID: PMC3750543 DOI: 10.1186/1471-2407-13-377] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 07/31/2013] [Indexed: 01/22/2023] Open
Abstract
Background Few studies have investigated the impact of urinary incontinence (UI) on health-related quality of life (HRQOL) among cancer survivors. UI is prevalent in the general population and can be both an indicator of cancer and a side effect of cancer treatment. UI and cancer diagnoses have been associated with decreases in HRQOL. This study evaluates the prevalence of UI and the impact on HRQOL among older cancer survivors. Methods The prevalence of UI among cancer survivors (breast, prostate, bladder, colorectal, lung, and endometrial/uterine cancers) and those without cancer was estimated using the SEER-MHOS database. Factors associated with UI were investigated using logistic regression and the impact of UI on SF-36 scores was determined using linear regression. Results Over 36% of SEER-MHOS beneficiaries without cancer reported UI and higher prevalence was noted among cancer survivors (37%-54% depending on cancer type). History of bladder, breast, endometrial/uterine, or prostate cancer was associated with higher prevalence of UI. UI was independently associated with both lower physical component scores (PCS) (−1.27; 95%CI:-1.34,-1.20) and mental component scores (MCS) (−1.75; 95%CI −1.83, -1.68). A suggested decreasing trend in the prevalence of UI was associated with a longer time since cancer diagnosis. Conclusions UI was highly prevalent, especially in bladder, endometrial/uterine, and prostate cancer survivors. Improved recognition of UI risk among cancer survivors will help clinicians better anticipate and mediate the effect of UI on individuals’ HRQOL.
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Affiliation(s)
- Alexandra J White
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA.
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