| Cervical cancer is the second largest women's common malignant tumor.Due to the development of screening system of the cervical cancer,and the younger trcend of cervical cancer patients,the patient's quality of life and sexual life status has become the important elements of cervical cancer treatment.Currently,clinical common operation modality includes classic radical hysterectomy(RH),modified radical hysterectomy(mRH)and systematic nerve sparing radical hysterectomy(SNSRH).The sexual dysfunction caused by radical hysterectomy includes sexual desire disorders,sexual arousal disorders,orgasmic disorders and sexual pain disorders.In this study,we adopted questionnaire,and investigated the changes of sexual quality of patients after radical hysterectomy and the change of the quality of sexual life after sexual psychological intervention in patients following radical hysterectomy.[objective]1.Investigate the morbidity of sexual dysfunction in women following different types of radical hysterectomy.2.The comparison of sexual life quality in patients underwent three types of surgical modality of radical hysterectomy,modified radical hysterectomy and systematic nerve sparing radical hysterectomy.3.Multivariate regression analysis of sexual dysfunction after radical hysterectomy.4.The influence of sexual psychological intervention on the quality of sexual life in patients following radical hysterectomy.[method]1.A total of 125 patients underwent radical hysterectomy from July 2007 to December 2012 in Nanfang Hospital meet the inclusion criteria.All patients underwent regular follow-up after surgery.The questionnaire used was Sexual Function Assessment Questionnaire and European tumors Research and Treatment Center for Cervical Cancer Patients Quality of Life Questionnaire(EORTC QLQ-(CX24).2.69 patients were selected from July 2007 to March 2015 in Nanfang Hospital,including 23 cases of RH,23 cases of SNSRH,and 23 cases of mRH.All patients underwent regular follow-ups.The scales used were the Sexual Function Assessment Questionnaire and the European Cancer Research and Treatment Center Cervical Cancer Patients Quality of Life Questionnaire(EORTC QLQ-CX24).3.Select 125 patients of Nanfang Hospital of Southern Medical University underwent radical hysterectomy from July 2007 to December 2012 who met the inclusion criteria.Chose various types of sexual dysfunction as the dependent variable,using multiple logistic regression analysis for the reasons of different sexual dysfunctions.The EORTC QLQ-C30 was used to evaluate the emotional function of patients.Two-year non-sexual adults need to further explored the causes.4.From January 2015 to September 2015,54 patients underwent radical hysterectomy were enrolled in this study,including 25 cases of RH,2 cases of SNSRH and 27 cases of mRH.After 1 year of follow-up,27 cases were analyzed in the study,and 27 cases were matched with the intervention group according to the operation type,age,ovarian conservation and chemoradiotherapy factors.The scale used was Sexual Function Assessment Questionnaire,the European Cancer Research and Treatment Center for cervical cancer quality of life core questionnaire(EORTC QLQ-C30)and quality of life questionnaire(EORTC QLQ-CX24).[results]1.The preoperative sexual dysfunction rate was 50.5%(50/99)of 125 cases of patients,and the rate in postoperative year 1 was 86.9%(93/107).verse 92.3%(72/78)in postoperative year 2.The incidence of sexual dysfunction in postoperative year 1 year and year 2 was significantly higher than preoperative rate(P<0.001).There was no statistically significant difference between the rate of postoperative year 1 and postoperative year 1(P = 0.24)2.The comparison of sexual life quality in radical hysterectomy group,modified radical hysterectomy and systematic nerve sparing radical hysterectomy group in postoperative year 1 assed by EORTC QLQ-CX24 showed there was no statistically significant difference n sexual/vaginal functioning module,sexual worry module,sexual activity module,aind sexual enjoyment module in three groups(P = 0.494)3.Multivariate logistic regression analysis showed age and preserving oavary were significantly associated with sexual desire disorders.Preserving oavary and preserved posterior vaginal wall length were significantly associated with sexual arousal disorders;age and preoperative stage were significantly associated with orgasmic disorders.Radiation therapy and education background were significantly associated with sexual pain disorders.Psychological disorders are closely related to sexual desire disorders and sexual pain disorders4.The standardized scores of the sexual function module in the sexual psychological intervention group were significantly lower than those in the control group,and the sexual enjoyment module score was higher than that in the control group,suggesting that the control group had severe symptoms of vaginal dryness,shortness,tightness and less sexual intercourse discomfort compared with the intervention group[conclusion]Patients after radical hysterectomy had high incidence of sexual dysfunction.There was no statistical difference of the sexual life quality in radical hysterectomy group,modified radical hysterectomy group and systematic nerve sparing radical hysterectomy group.The psychological intervention had significantly improved the quality of postoperative sexual life. |
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