Long-Term Sexual Functioning in Women After Surgical Treatment of Cervical Cancer Stages IA to IB: A Prospective Controlled Study

Abstract

ObjectiveWomen with cervical cancer (CC) may be faced with changes in sexual functioning resulting from the cancer itself and/or its surgical treatment. The aims of this study were to prospectively investigate sexual adjustment of CC patients during a follow-up period of 2 years after radical hysterectomy without adjuvant treatment and to compare the results with women who underwent a hysterectomy for a benign gynecological condition and with healthy control women.MethodsIn this prospective controlled study, participants completed the Short Sexual Functioning Scale, Specific Sexual Problems Questionnaire, Beck Depression Inventory Scale, World Health Organization-5 Well-Being Scale, and Dyadic Adjustment Scale to assess various aspects of sexual and psychosocial functioning at certain time intervals, namely, before surgery and 6 months, 1 year, and 2 years after surgical treatment.ResultsThirty-one women with CC, 93 women with a benign gynecological condition, and 93 healthy controls completed the survey. In CC survivors, no differences were found in sexual functioning during prospective analyses and in comparison with women with a benign gynecological condition. However, compared with healthy women, preoperatively and postoperatively, significantly more CC patients reported sexual dysfunctions, including sexual arousal dysfunction, entry dyspareunia, deep dyspareunia, abdominal pain during intercourse, and reduced intensity of the orgasm. Furthermore, compared with healthy controls, CC patients reported worse psychological functioning before surgery and at 6 months after surgery. Finally, before surgery, quality of partner relationship was rated significantly better by CC patients compared with healthy controls; however, quality of the partner relationship declined during the first year of follow-up compared with the situation before surgery.ConclusionsIn CC patients, no differences were found in sexual functioning when prospectively comparing the situation before and after surgery. However, when compared with healthy controls, CC patients are at high risk for sexual dysfunctions, both before and after surgical treatment.