Sexual Functioning and Vaginal Changes after Radical Vaginal Trachelectomy in Early Stage Cervical Cancer Patients: A Longitudinal Study

Abstract

Introduction Radical vaginal trachelectomy (RVT) offers low complication rate, good survival, and possibility for future childbearing for young women with early stage cervical cancer. However, the literature on quality of life (QOL) and sexual functioning in patients undergoing RVT is scarce. Aim The aims of this study were to prospectively assess sexual function after RVT and to compare scores of sexual function in patients operated by RVT and radical abdominal hysterectomy (RAH) with those of age-matched control women from the general population. Methods Eighteen patients with early stage cervical cancer operated with RVT were prospectively included and assessed preoperatively, and 3, 6, and 12 months postoperatively using validated questionnaires. RAH patients were included consecutively and assessed once at 12 months postsurgery, while an age-matched control group of 30 healthy women was assessed once. Main Outcome Measure Sexual dysfunction total score as measured by the Female Sexual Function Index (FSFI) was the main outcome measure. Results During the 12 months posttreatment, RVT patients tended to have persistent sexual dysfunction as measured by FSFI (mean overall score <26.55 at each assessment) and Female Sexual Distress Scale (mean overall score > 11). Sexual worry (P < 0.001) and lack of sexual desire (P = 0.038) were more frequently reported among patients in both treatment groups compared with control women. Sexual activity increased significantly during the observation time for the RVT group (P = 0.023) and reached that of healthy women. Global Health Status score improved over time for the RVT group but never reached that of healthy control women (P = 0.029). Conclusions Our data suggest that patients treated with RVT for early stage cervical cancer experience persistent sexual dysfunction up to one year post surgery influencing negatively on their QOL.

Sexual satisfaction and quality of life in survivors of localized cervical and ovarian cancers following fertility-sparing surgery

“…It is possible that a smaller difference could still exist. Our data are further supported by an additional longitudinal study of young cervical cancer patients who underwent trachelectomy also showed similar sexual dysfunction as patients who underwent radical hysterectomy 12 months after surgery [14].…”

Quality of Life, Urogynecological Morbidity, and Lymphedema After Radical Vaginal Trachelectomy for Early-Stage Cervical Cancer

“…In agreement with our previous findings, it may be concluded that patients treated with RVT are equally affected both regarding urological dysfunction and lymphedema as patients treated with RAH. 11 Our present and former study highlights the importance of presurgery and postsurgery information and counseling of the patient. 11 The current study demonstrates that radical surgery for early-stage cervical cancer may permanently affect the patient postoperatively.…”

“…11 Our present and former study highlights the importance of presurgery and postsurgery information and counseling of the patient. 11 The current study demonstrates that radical surgery for early-stage cervical cancer may permanently affect the patient postoperatively. Our results highlight the necessity to critically evaluate the available evidence regarding treatment options for early-stage cervical cancer.…”

“…10Y12 We have previously reported our results on sexual functioning and vaginal changes after RVT compared with RAH and QOL impact in early-stage cervical cancer patients. 11 Our study showed significant sexual dysfunction and impaired QOL after RVT throughout the first year compared with healthy women. Furthermore, RVT patients had more vaginal changes than the RAH patients, probably caused by more cervical/ vaginal scarring.…”

Maintaining sexual health throughout gynecologic cancer survivorship: A comprehensive review and clinical guide

“…Radical trachelectomy is a safe fertility-sparing surgical option for some women with early-stage cervical cancer who have not completed childbearing [33-36]. Longitudinal comparisons in patients treated with radical trachelectomy versus radical hysterectomy showed no differences in mood, distress, sexual function, and QoL [9, 37]. Many women in both treatment groups faced depression, distress, and sexual dysfunction, although improvement over time was noted in these domains.…”