Iranian Society of Gynecology Oncology

Document Type : Original Research Article

Authors

1 Department of Traumatology and Orthopedics, Medical Institute of RUDN, Moscow, Russia

2 Department of Medical Laboratory Techniques, College of Medical Technology, Al-Farahidi University, Baghdad, Iraq

3 Department of Medical Laboratory Technics, Al-Nisour University College/Baghdad, Baghdad, Iraq

4 College of Media, Department of Journalism, The Islamic University in Najaf, Najaf, Iraq

5 Mazaya University College, Nasiriyah, Iraq

6 National University of Science and Technology, Dhi Qar, Iraq

7 Department of Prosthetic Dental Technology, Hilla University College, Babylon, Iraq

8 Department of Medical Laboratory Technics, AlNoor University College, Nineveh, Iraq

Abstract

Background & Objective: Today, the prevalence of cervical cancer in developing societies and its impacts on various body functions, mainly sexual performance, is of particular significance. In order to examine the relationship between sexual function and its domains with different stages of cervical cancer, the present study was conducted.
Materials & Methods: Examined in the current study were 284 cervical cancer patients with a history of trachelectomy surgery, referred to the Baghdad Women's Hospitals in 2020 and 2021 and selected randomly. The personal profile form and the female sexual function index (FSFI) were among the research instruments. The data were investigated by statistical software SPSS.23 and the Spearman correlation coefficient test. A P-value of less than 0.05 was deemed statistically significant.
Results: The results revealed that 26.8% of women complained of low sexual desire, 43.0% did not receive adequate sexual arousal, and 39.1% experienced deficient vaginal lubrication. Additionally, 46.8% of women did not experience a proper orgasm, 27.8% were dissatisfied with their sexual satisfaction, and 37.0% reported experiencing pain during intercourse. In addition, there was an inverse correlation between the stages of cervical cancer and sexual performance (r= -0.25, P= 0.002), as well as its domains, including sexual desire (r= -0.18, P= 0.02), sexual arousal (r= -0.23, P= 0.004), vaginal lubrication (r= -0.23, P= 0.003), orgasm (r= -0.20, P= 0.009), sexual satisfaction (r= -0.21, P= 0.005), and pain during intercourse (r= -0.26, P= 0.001).
Conclusion: The sexual performance of cervical cancer patients is impaired, and the more advanced stages of the disease weaken sexual performance and its domains.

Highlights

✅ The sexual performance of cervical cancer patients is impaired, and the more advanced stages of the disease weaken sexual performance and its domains.
 

Keywords

Main Subjects

1. Araya LT, Fenta TG, Sander B, Gebremariam GT, Gebretekle GB. Health-related quality of life and associated factors among cervical cancer patients at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. Health Qual Life Outcomes. 2020;18(1):1-9. [DOI:10.1186/s12955-020-01319-x] [PMID] [PMCID]
2. Mitra A, Biegert GWG, Delgado AY, Karpinets TV, Solley TN, Mezzari MP, et al. Microbial diversity and composition is associated with patient-reported toxicity during chemoradiation therapy for cervical cancer. Int J Radiat Oncol Biol Phys. 2020;107(1):163-71. [DOI:10.1016/j.ijrobp.2019.12.040] [PMID] [PMCID]
3. Pasek M, Suchocka L, Osuch-Pęcak G, Muzykiewicz K, Iwańska E, Kaducakowa H, et al. Longitudinal Health-Related Quality of Life Study among Cervical Cancer Patients Treated with Radiotherapy. J Clin Med. 2021;10(2):226. [DOI:10.3390/jcm10020226] [PMID] [PMCID]
4. Canfell K, Kim JJ, Kulasingam S, Berkhof J, Barnabas R, Bogaards JA, et al. HPV-FRAME: A consensus statement and quality framework for modelled evaluations of HPV-related cancer control. Papillomavirus Res. 2019;8:100184. [DOI:10.1016/j.pvr.2019.100184] [PMID] [PMCID]
5. Cea Garcia J, Marquez Maraver F, Rodriguez Jimenez I, Ríos-Pena L, Rubio Rodríguez MdC. Treatment and impact of cervical-cancer-related lymphatic disorders on quality of life and sexuality compared with controls. Lymphat Res Biol. 2021;19(3):274-85. [DOI:10.1089/lrb.2020.0078] [PMID]
6. Kamal Masaud H, Ali Mohammed R, Abd El Salam Ramadan S, Elzeblawy Hassan H. Impact of Protocol of Nursing Intervention on Sexual Dysfunction among Women with Cervical Cancer. J nurs sci Benha Univ. 2021;2(2):203-24. [DOI:10.21608/jnsbu.2021.186455]
7. Araya LT, Gebretekle GB, Gebremariam GT, Fenta TG. Reliability and validity of the Amharic version of European Organization for Research and Treatment of cervical Cancer module for the assessment of health related quality of life in women with cervical cancer in Addis Ababa, Ethiopia. Health Qual Life Outcomes. 2019;17(1):1-7. [DOI:10.1186/s12955-019-1089-x] [PMID] [PMCID]
8. Ghanbari Z, Hajibabaei M, Miri Ashtiani E, Ghanbarpour A, Montazeri A. The Impact of Radiofrequency on Pelvic Floor Distress, Restoration, and Sexual Function Among Women Suffering from Pelvic Floor Disorders. J Obstet Gynecol Cancer Res. 2022;7(2):114-20. [DOI:10.30699/jogcr.7.2.114]
9. Wiltink LM, King M, Müller F, Sousa M, Tang M, Pendlebury A, et al. A systematic review of the impact of contemporary treatment modalities for cervical cancer on women's self-reported health-related quality of life. Support Care Cancer. 2020;28(10):4627-44. [DOI:10.1007/s00520-020-05554-2] [PMID]
10. Eftekhar T, Hajibabaei M, Pourali L, Vizheh M, Montazeri A. The Impact of Higgs Radiofrequency on Pelvic Organ Prolapse and Sexual Function Among Women Suffering from Vaginal Laxity. J Obstet Gynecol Cancer Res. 2021;6(3):128-33. [DOI:10.30699/jogcr.6.3.128]
11. O'Donovan B, Mooney T, Rimmer B, Fitzpatrick P, Flannelly G, Doherty L, et al. Advancing understanding of influences on cervical screening (non)‐participation among younger and older women: A qualitative study using the theoretical domains framework and the COM‐B model. Health Expect. 2021;24(6):2023-35. [DOI:10.1111/hex.13346] [PMID] [PMCID]
12. Conway JL, Gerber R, Han K, Jiang H, Xie J, Beiki-Ardakani A, et al. Patient-reported sexual adjustment after definitive chemoradiation and MR-guided brachytherapy for cervical cancer. Brachytherapy. 2019;18(2):133-40. [DOI:10.1016/j.brachy.2018.09.005] [PMID]
13. Atallah S, Barbera L, Folwell M, Howell D, Liu Z, Croke J. Feasibility of implementing a cervix cancer-specific patient-reported outcome measure in routine ambulatory clinics. Support Care Cancer. 2021;29(1):499-507. [DOI:10.1007/s00520-020-05500-2] [PMID]
14. Shi Y, Cai J, Wu Z, Jiang L, Xiong G, Gan X, et al. Effects of a nurse-led positive psychology intervention on sexual function, depression and subjective well-being in postoperative patients with early-stage cervical cancer: A randomized controlled trial. Int J Nurs Stud. 2020;111:103768. [DOI:10.1016/j.ijnurstu.2020.103768] [PMID]
15. Braun LA, Kostas-Polston EA, Miedema J, Hoffecker L, Wilson C. A scoping review of cervical cancer risk factors, prevention, diagnosis, and treatment in US Active Duty Military Women. Women's Health Issues. 2021;31:S53-S65. [DOI:10.1016/j.whi.2021.04.003] [PMID]
16. Lorente RR, Durán DH, Viamontes JG, Anta JL, Reyes RO, Navares ES. Efficacy of Oncoxin-viusid on the reduction of adverse reactions to chemotherapy and radiotherapy in patients diagnosed with cervical cancer and endometrial adenocarcinoma. J Cancer Ther. 2020;11(5):276-95. [DOI:10.4236/jct.2020.115023]
17. McBride E, Tatar O, Rosberger Z, Rockliffe L, Marlow LA, Moss-Morris R, et al. Emotional response to testing positive for human papillomavirus at cervical cancer screening: a mixed method systematic review with meta-analysis. Health Psychol Rev. 2021;15(3):395-429. [DOI:10.1080/17437199.2020.1762106] [PMID]
18. Modares Gilani M, Mousavi AS, Akhavan S, Sheikhhasani S. Investigating the Quality of Life of Patients with Cervical Cancer in Iran. J Obstet Gynecol Cancer Res. 2022;7(6):530-5. [DOI:10.30699/jogcr.7.6.530]
19. Sun Z, Huang B, Liu C, Yang Y, Rao Y, Du Y, et al. Comparison of neoadjuvant treatments followed by radical surgery or chemoradiation on quality of life in patients with stage IB2-IIA cervical cancer. Gynecol Oncol. 2020;157(2):536-41. [DOI:10.1016/j.ygyno.2020.01.039] [PMID]
20. Kirchheiner K, Smet S, Jürgenliemk-Schulz IM, Haie-Meder C, Chargari C, Lindegaard JC, et al. Impact of vaginal symptoms and hormonal replacement therapy on sexual outcomes after definitive chemoradiotherapy in patients with locally advanced cervical cancer: Results from the EMBRACE-I study. Int J Radiat Oncol Biol Phys. 2022;112(2):400-13. [DOI:10.1016/j.ijrobp.2021.08.036] [PMID]
21. Rosen CB, J. Heiman, S. Leiblum, C. Meston, R. Shabsigh, D. Ferguson, R. D'Agostino, R. The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther. 2000;26(2):191-208. [DOI:10.1080/009262300278597] [PMID]
22. Zhang Y, Sun S, Ding J, Hua K. The Effect of Different Surgical Methods on Female and Male Sexual Activity and Marital Quality in Patients With Early-Stage Cervical Cancer. J Sex Med. 2020;8(2):307-14. [DOI:10.1016/j.esxm.2020.02.001] [PMID] [PMCID]
23. Tramacere F, Lancellotta V, Casà C, Fionda B, Cornacchione P, Mazzarella C, et al. Assessment of Sexual Dysfunction in Cervical Cancer Patients after Different Treatment Modality: A Systematic Review. Medicina. 2022;58(9):1223. [DOI:10.3390/medicina58091223] [PMID] [PMCID]
24. Wu X, Wu L, Han J, Wu Y, Cao T, Gao Y, 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. 2021;304(4):999-1006. [DOI:10.1007/s00404-021-06005-x] [PMID]
25. Baessler K, Windemut S, Chiantera V, Köhler C, Sehouli J. Sexual, bladder and bowel function following different minimally invasive techniques of radical hysterectomy in patients with early-stage cervical cancer. Clin Transl Oncol. 2021;23(11):2335-43. [DOI:10.1007/s12094-021-02632-7] [PMID] [PMCID]
26. Sponholtz SE, Ezendam NP, de Rooij BH, Parner E, Mogensen O, Hildebrandt MG, et al. SENTIREC-The sentinel node mapping in women with cervical cancer study-Patient-reported early lymphedema and its impact on quality of life. Gynecol Oncol. 2022;164(3):463-72. [DOI:10.1016/j.ygyno.2021.12.024] [PMID]
27. Peerawong T, Suphasynth Y, Kongkamol C, Rordlamool P, Bridhikitti J, Sangtawan D, et al. Validation of the Functional Assessment of cancer therapy with cervical cancer subscale (fact-cx) for quality of life in thai patients prior to chemoradiotherapy. Asian Pac J Cancer Prev. 2020;21(7):1891. [DOI:10.31557/APJCP.2020.21.7.1891] [PMID] [PMCID]
28. Schroder M, Mell LK, Hurteau JA, Collins YC, Rotmensch J, Waggoner SE, et al. Clitoral therapy device for treatment of sexual dysfunction in irradiated cervical cancer patients. Int J Radiat Oncol Biol Phys. 2005;61(4):1078-86. [DOI:10.1016/j.ijrobp.2004.07.728] [PMID]
29. Serati M, Salvatore S, Uccella S, Laterza RM, Cromi A, Ghezzi F, et al. Sexual function after radical hysterectomy for early-stage cervical cancer: is there a difference between laparoscopy and laparotomy? J Sex Med. 2009;6(9):2516-22. [DOI:10.1111/j.1743-6109.2009.01363.x] [PMID]
30. Grion RC, Baccaro LF, Vaz AF, Costa-Paiva L, Conde DM, Pinto-Neto AM. Sexual function and quality of life in women with cervical cancer before radiotherapy: a pilot study. Arch Gynecol Obstet. 2016;293(4):879-86. [DOI:10.1007/s00404-015-3874-z] [PMID]
31. Khalil J, Bellefqih S, Sahli N, Afif M, Elkacemi H, Elmajjaoui S, et al. Impact of cervical cancer on quality of life: beyond the short term (results from a single institution). Gynecol Oncol Res Pract. 2015;2(1):1-6. [DOI:10.1186/s40661-015-0011-4] [PMID] [PMCID]
32. Liu H, Yu J, Chen Y, He P, Zhou L, Tang X, et al. Sexual function in cervical cancer patients: Psychometric properties and performance of a Chinese version of the Female Sexual Function Index. Eur J Oncol Nurs. 2016;20:24-30. [DOI:10.1016/j.ejon.2015.06.007] [PMID]
33. Xiao M, Gao H, Bai H, Zhang Z. Quality of life and sexuality in disease-free survivors of cervical cancer after radical hysterectomy alone: a comparison between total laparoscopy and laparotomy. Medicine. 2016;95(36). [DOI:10.1097/MD.0000000000004787] [PMID] [PMCID]