Early-stage cervical carcinoma, radical hysterectomy, and sexual function - A longitudinal study
Early-stage cervical carcinoma, radical hysterectomy, and sexual function - A longitudinal study
复制标题
DOI：
10.1002/cncr.11877
复制
发表时间：
2004-01-01
期刊：
影响因子：
6.2
通讯作者：
Machin, D
中科院分区：
文献类型：
--
作者：
Jensen, PT;Groenvold, M;Machin, D
背景。关于单纯根治性子宫切除术（RH）对早期宫颈癌患者性功能的影响，目前所知有限。作者调查了rh术后自我报告性功能的纵向过程。目前的研究包括173例淋巴结阴性的早期宫颈癌患者，他们接受了RH和盆腔淋巴结切除术。在RH后5周、3个月、6个月、12个月、18个月和24个月，采用有效的自我评估问卷对患者进行前瞻性评估。结果与来自一般人群的年龄匹配的对照组进行比较。与对照组女性相比，患者在RH后的前6个月由于阴道缩小而出现严重的性高潮问题和性交不舒服，在前3个月出现严重的性交困难，RH后5周出现性不满意。在RH后的头2年，持续缺乏性兴趣和润滑。患者在RH后12个月的自我报告变化与癌症诊断前和患者内部的前后比较证实了长期缺乏性兴趣和阴道润滑不足。然而，大多数在癌症诊断前性活跃的患者在手术后12个月再次性活跃（91%），尽管报告的性频率有所下降。RH对患者的性兴趣和阴道润滑有持续的负面影响，而大多数其他性和阴道问题随着时间的推移而消失。RH术后短期和长期的性和阴道问题应在术前和术后与患者讨论。(C) 2003年美国癌症协会。
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 nodenegative, 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. (C) 2003 American Cancer Society.