Women who undergo laparoscopic radical hysterectomy (LRH) for cervical cancer generally have sexual problems afterward, but those who have nerve-sparing surgery tend to fare better than those who have conventional procedures, Italian researchers say.
Worldwide, cervical cancer is the fourth most common cancer in women with approximately 528,000 cases diagnosed in 2012, according to the World Health Organization’s International Agency for Research on Cancer.
Surgery is a common treatment and may even cure the cancer if it is caught early enough. However, surgery can complications that interfere with a patient’s quality of life. Nerve-sparing approaches may minimize these complications, but data on sexual outcomes after nerve-sparing LRH are limited.
To learn more, the researchers recruited 40 women between the ages of 24 and 68 who were surgically treated for cervical cancer between 2004 and 2013. Twenty of the women had nerve-sparing LRH and twenty had conventional LRH.
Before surgery, each woman completed the Female Sexual Function Index (FSFI), a standard tool used to assess the domains of desire, arousal, lubrication, orgasm, satisfaction, and pain. The women again completed the FSFI six to fourteen months after surgery. Higher scores on the FSFI indicate better sexual function.
The women’s preoperative FSFI scores were similar. After surgery, however, their overall scores reflected poorer sexual function regardless of whether they had nerve-sparing or conventional LRH.
Still, the women in the nerve-sparing group had better overall FSFI scores than the women who had had conventional surgery. The scores for the desire, arousal, orgasm, and pain domains were comparable. But the women who had had nerve-sparing LRH had higher scores for the lubrication and satisfaction domains.
The authors pointed out that higher satisfaction scores in the nerve-sparing group might have come from an “expectation effect.” In pre-treatment counseling, the women in this group were told that the nerve-sparing technique was designed to preserve nerves associated with sexual function.
They also noted that all surgeries in this study were performed by the same surgical team. Therefore, their results could not be applied in cases involving less-experienced surgeons.
Because of the small sample size and the fact that all surgeries took place at one center, the authors emphasized that their findings were preliminary.
The study was first published online in September in The Journal of Sexual Medicine.
Resources
The Journal of Sexual Medicine
Bogani, Giorgio, MD, et al.
“Nerve-Sparing Approach Reduces Sexual Dysfunction in Patients Undergoing Laparoscopic Radical Hysterectomy”
(Full-text. First published online: September 21, 2014)
http://onlinelibrary.wiley.com/doi/10.1111/jsm.12702/full
World Health Organization / International Agency for Research on Cancer
“Cervical Cancer – Estimated Incidence, Mortality and Prevalence Worldwide in 2012”
(Data from GLOBOCAN 2012)
http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx