Postoperative Quality of Life and Sexual Function in Premenopausal Women Undergoing Laparoscopic Myomectomy for Symptomatic Fibroids: A Prospective Observational Cohort Study

Abstract

IntroductionUterine leiomyomas are the most common benign gynecologic tumors. To date laparoscopy myomectomy is the gold standard for treatment of symptomatic fibroids in reproductive-aged women. Detailed counseling about the effects of this procedure on postoperative sexuality and quality of life is important in these patients. However, available data on these subjects are limited and contradictory. The aim of this study was to assess sexual function and quality of life in premenopausal women undergoing laparoscopic myomectomy for symptomatic uterine fibroids.Material and MethodsAll premenopausal women who underwent laparoscopic myomectomy for symptomatic fibroids between April 2012 and August 2014 at a tertiary university center were enrolled in this prospective observational cohort study. Sexual function and quality of life were assessed for the pre- and postoperative (six months post-operatively) state using two validated questionnaires, the Female Sexual Function Index (FSFI) and the European Quality of Life Five-Dimension Scale (EQ-5D).ResultsNinety-five of the 115 (83%) eligible patients completed the study. Overall a significant improvement in quality of life and sexual function was observed in the study cohort: Median FSFI (28 (18.7–35.2)) and EQ-5D scores (1 (0.61–1) after laparoscopic myomectomy were significantly higher than preoperative scores (21.2 (5.2–33.5); 0.9 (0.2–1); p ≤ 0.01). The number, position and localization of the largest fibroids were not correlated with pre- or postoperative sexual function or quality of life.ConclusionLaparoscopic myomectomy might have positive short-term effects on postoperative quality of life and sexual function in premenopausal women suffering from symptomatic fibroids.

Laparoscopic myomectomy in the treatment of large myomas – unnecessary risk or effective method?

“…LM increases life quality and sexual functions when compared to laparotomy due to less trauma and postsurgical pain 23 . It was found that patients can return to work quicker if they undergo laparoscopic or robotic myomectomy, comparing to those who had laparotomy 24 .…”

Symptoms and Health Quality After Laparoscopic and Robotic Myomectomy

“…Fibroids also negatively affect sexual life because they may cause pain during sexual intercourse and decreased libido. 25 , 27 , 28 Previous studies have shown an improvement in the sexual life of patients who underwent myomectomy. 27 , 28 To our knowledge, there is no study evaluating the effect of RM on sexual life.…”

Impact of different intraoperative CO2 pressure levels (8 and 15 mmHg) during laparoscopic hysterectomy performed due to benign uterine pathologies on postoperative pain and arterial pCO2: a prospective randomised controlled clinical trial

“…Surgeons in the LP group were allowed to increase CO 2 pressure to standard pressure intraoperatively when they felt that the surgery could not be performed with 8 mmHg. The laparoscopic techniques applied have been described in detail in previous publications . All patients were treated according to the department's standardised pain protocol.…”

“…The laparoscopic techniques applied have been described in detail in previous publications. 22,23 All patients were treated according to the department's standardised pain protocol. The patients received intravenous metamizole (1 g/2 ml; Ratiopharm, Neu-Ulm, Germany) diluted in 100 ml 0.9% sodium chloride every 6 hours on the day of surgery and within 24 hours postoperatively.…”