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Evaluation of the sexual quality of life and sexual function of cervical cancer survivors after cancer treatment: a retrospective trial

Abstract

Objective

The purpose of this study was to explore the factors influencing the sexual quality of life of patients with cervical cancer who underwent radical hysterectomy.

Methods

This multicenter retrospective cohort study was conducted from June 2013 to June 2018 at nine hospitals in China. In total, 204 women diagnosed with stage IA to stage IIB cervical cancer who underwent radical hysterectomy completed the questionnaire. Sexual function was measured with the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ). All analyses were performed with R version 3.4.3 statistical software packages. A two-sided significance level of 0.05 was used to evaluate the statistical significance.

Results

The mean sexual quality of life score was 37.21 ± 17.28, where a higher PISQ score indicates a better sexual quality of life, and we identified the factors associated with sexual dysfunction. The average follow-up time was 29.0 ± 16.0 months. In addition to radical hysterectomy, 182 (89.2%) patients underwent ovarian suspension, 93 (45.6%) underwent chemotherapy, and 74 (36.3%) underwent concurrent radiotherapy. The univariate analysis confirmed that age represents a protective factor for sexual function (odds ratio (OR) 6.0, 95% confidence interval (CI) 1.1–10.8, p = 0.017). The patients who underwent ovarian suspension were more likely to experience a good sexual quality of life (OR − 7.2, 95% CI [− 14.8, − 0.4], p = 0.035) compared to those who did not undergo ovarian suspension. A significant negative association was observed between radiotherapy and the behavioral-emotive, physical and partner-related domains of the PISQ (behavioral-emotive, OR − 1.5, 95% CI [− 2.6, − 0.4], p = 0.011; physical, OR − 0.9, 95% CI [− 1.5, − 0.3], p = 0.006; partner-related, OR − 0.7, 95% CI [− 1.3, 0.0], p = 0.043). Chemotherapy and radiotherapy were common risk factors for sexual dysfunction, and radiotherapy exerted a stronger effect than chemotherapy.

Conclusions

This study shows that the sexual function of cervical cancer patients tends to be related to age, radiotherapy, and chemotherapy. However, across these factors, patients with preserved ovaries tend to return to a satisfactory sexual quality of life after recovering from surgery.

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Funding

This study was partially supported by an award from the Beijing Municipal Science & Technology Commission (Grant no. D151100001915003), National key technology R&D program of China (2018YFC2002204, 2019YFC1005200,2019YFC1005201),the Natural Science Foundation of China (81901468).

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Authors

Contributions

JW, XS and XW designed the study and wrote the paper, JH, YW, TC, YG and QL performed the fieldwork. HW, and YL conducted the analyses, SW, SW, HL and NY made the questionnaire and for data work. ZW performed all table data and contributed to writing the paper. All authors approved the final version of the manuscript.

Corresponding authors

Correspondence to Xiuli Sun or Jianliu Wang.

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Conflict of interest

The authors declared that they have no conflicts of interest to this work. We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Wu, X., Wu, L., Han, J. et al. Evaluation of the sexual quality of life and sexual function of cervical cancer survivors after cancer treatment: a retrospective trial. Arch Gynecol Obstet 304, 999–1006 (2021). https://doi.org/10.1007/s00404-021-06005-x

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Keywords

  • Cervical cancer
  • Female sexual function
  • Radical hysterectomy
  • PISQ
  • Questionnaire