Female Sexual Function and Activity Following Cystectomy and Continent Urinary Tract Diversion for Benign Indications: A Clinical Pilot Study and Review of Literature

Abstract

Introduction There are limited data on female sexual function after cystectomy for benign indications. Aims To evaluate postoperative sexual items following cystectomy and continent urinary diversion for benign indications (e.g., severe incontinence, interstitial cystitis) in female patients. Furthermore, to review the studies investigating changes in women’s sexual function after cystectomy. Methods In a retrospective study, 21 out of 23 patients (91%) who underwent a cystectomy for a benign indication completed a questionnaire. These women had a median age at the date of operation of 47.3 years (range 25–66 years) and a mean follow-up of 11.9 years. Questions on preoperative and postoperative sexuality, postoperative sexual activity, sexual appreciation, and the Female Sexual Function Index (FSFI) in patients at present were evaluated. Electronic databases were searched for the published studies investigating female sexual function after cystectomy. Main Outcome Measures Female sexual function was evaluated by the FSFI domain scores and postoperative sexual appreciation questions. Results Sexual complaints before operation were present in 48% of the patients. The most common complaints reported were incontinence during intercourse, pain, and loss of libido. Seventeen out of 21 patients (81%) were sexually active preoperatively, 14 were still active postoperatively, and two preoperative inactive patients became active. Sexual inactivity postoperatively is mainly due to patient-related or combination of patient- and partner-related issues (70%), such as with pain during intercourse, loss of libido, and impaired body image. In the sexually active group, the majority (62.5%) showed improved or unchanged intercourse postoperatively. In the FSFI in 11 sexually active patients (52%) at present, domains of desire, arousal, lubrication, orgasm, and pain scored above average. The domain of satisfaction scored below average. Conclusion Despite extensive surgery, female sexuality may remain unchanged or even improve, following cystectomy and continent diversion for benign indication. Sexual inactivity postoperatively needs more attention in respect to sexual counseling. Overall, the results are reassuring.

Risk Factors for Low Sexual Function Among Urban Chinese Women: A Hospital-Based Investigation

“…We utilized the FSFI, a well‐validated and widely used instrument for evaluation of sexual function in women [5,13,14,19,20]. The Chinese version of the FSFI has also been utilized and validated in previous studies [21,22].…”

“…Our results are worthwhile in comparison with other epidemiological studies, because of the large sample size. We utilized the FSFI, a well-validated and widely used instrument for evaluation of sexual function in women [5,13,14,19,20]. The Chinese version of the FSFI has also been utilized and validated in previous studies [21,22].…”

Sexual Health Issues in Women with Cancer

“…However, the impact was not as pronounced in those women who had undergone orthotopic and nonstomal types of diversions [20]. Comparatively, data from a small retrospective study showed that the majority of women who undergo cystectomy for benign indications tend to have improvement or no change in sexual function postoperatively [21].…”

Female Sexuel Function After Trans Obturator Tape Placement for Stress Urinary Incontinance

“…Female sexual dysfunction as a clinical term includes a variety of sexual problems. Although 30-50% of women suffer from sexual dysfunction, it was only recently that more medical and clinical researches have focused on the problems related to urologic and gynecologic operations (10,11).…”