An examination of the sexual functions of patients who underwent a gynecologic cancer operation and received brachytherapy

The impact of gynecologic cancer on female sexuality in Europe and MENA (Middle East and North Africa): a literature review

INTRODUCTION

Gynecologic cancer has a negative impact on the sexuality of women who are or have been affected by this disease. In fact, gynecologic cancers cause negative changes in female sexuality, affecting body image and psychophysical well-being, with serious consequences for women's sex lives.

OBJECTIVES

The aim of this study is to analyze the differences in sexuality among women who have or have had gynecologic cancer in Europe and in the Middle East and North Africa (MENA). We also explored possible factors that may influence women's sexuality in the 2 populations compared.

METHODS

The literature search was carried out using PubMed and Google Scholar, considering the 10-year period of 2013 to 2023. Studies were initially selected according to the criterion that the title and abstract were in English. We then reviewed all the articles selected in the first phase and analyzed the following information: author, year of publication, type of gynecologic cancer, country in which the study was conducted, design, and materials used. Finally, we defined the inclusion criteria for the present paper: women 18 years of age or older, diagnosed with gynecologic cancer, and who had undergone treatment (surgery, chemotherapy, radiotherapy). The studies reviewed were conducted between 2013 and 2023 in Europe and MENA, and all analyzed sexual function after the disease, understood as a general dimension that includes physiological and psychological aspects.

RESULTS

The results of this research show that patients in both geographical areas (Europe and MENA) report changes in sexuality as a result of the cancer. Studies show that cancer reduces, interrupts, and impairs women's sexual activity, resulting in experiences of discomfort, anxiety, guilt, inadequacy, pain, and poorer quality of life.

CONCLUSIONS

The data analyzed in this review show that cancer causes changes and deterioration in sexuality in both populations studied. No cultural or social factors were found to cause differences between the variables studied in the 2 populations. In the future, it may be interesting to carry out further studies to improve the treatment of women with gynecologic cancer, as sexuality is a very important part of a person's life.

Assessment of long-term sexual function of cervical cancer survivors after treatment: A cross-sectional study

OBJECTIVES

This study aimed to investigate the long-term sexual function of patients with cervical cancer who underwent treatment and to explore influential factors.

METHODS

This retrospective cross-sectional study was conducted at Peking University First Hospital in (Beijing, China). A total of 207 patients, who were diagnosed with Stage IA-IIA cervical cancer and had undergone surgical treatment (some patients had also been treated with adjuvant radiotherapy and chemotherapy) between January 2010 and August 2020, completed questionnaires via telephone. The median time since diagnosis was 54 (range, 13-138) months. Sexual function was assessed using the validated short form of Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12). The multivariate logistic regression analysis was performed to determine factors influencing sexual function after treatment.

RESULTS

The mean preoperative PISQ-12 score was 39.42 ± 3.922, and the mean postoperative PISQ-12 score was 32.60 ± 6.592, indicating a significant decrease in postoperative PISQ-12 score compared with preoperation (p < 0.001). In total, 49.8% of the patients had sexual dysfunction after treatment. According to the results of the multivariate logistic regression analysis, longer follow-up (months), ovariectomy, lack of hormone replacement therapy after ovariectomy and adjuvant radiotherapy were significantly associated with sexual dysfunction after treatment (p < 0.05). There was no significant correlation among surgical method, tumor stage, adjuvant chemotherapy, and sexual dysfunction after treatment.

CONCLUSIONS

The sexual function of cervical cancer survivors significantly decreased after treatment, which was related to the length of follow-up, ovariectomy, and adjuvant radiotherapy. Hormone replacement therapy after ovariectomy can help patients to improve their sexual function.

Ethiopian women's sexual experiences and coping strategies for sexual problems after gynaecological cancer treatment: a qualitative study

OBJECTIVE

This study explored women's sexual experiences and coping strategies for sexual problems after gynaecological treatment.

SETTING

The research was carried out at Tikur Anbessa Specialized Hospital, one of the two cancer centre hospitals in the country.

STUDY DESIGN

A phenomenological qualitative study design was employed in this study.

STUDY PARTICIPANTS

Participants were recruited using purposeful sampling. Thirteen eligible study participants were interviewed face to face. Data were collected from 2 February to 15 March 2019 and analysed at the same time. For data analysis, thematic analysis was used, which comprises three stages: data reduction, data display and data conclusion.

RESULTS

Four themes resulted from the analysis of individual interview data, including treatment side effects, sexual issues following radiation therapy, lack of awareness regarding cancer treatment and sexual dysfunction, and coping strategies for sexual dysfunction following gynaecological cancer treatment. Three subthemes emerged as coping mechanisms for managing sexual issues and dysfunction among Ethiopian women with gynaecological cancer: avoiding sexual intercourse, praying for healing and seeking professional help. These themes were identified as the rich and detailed account of the experiences of sexually active women who have received treatment for their cervical cancer.

CONCLUSION

This study has broadened the perspectives on sexuality in the setting of gynaecological cancer and challenged certain commonly held beliefs about sexuality after treatment. Researchers should look into how inclusive sexuality education and training may be better integrated into the training programmes of healthcare workers. More research is needed to learn how partners of women with gynaecological cancer cope with sexual changes after treatment, how the couple as a partnership negotiates changes after treatment, and the facilitators and barriers that healthcare providers face when discussing sexuality issues with patients.

Disfunção sexual em mulheres com câncer do colo do útero submetidas à radioterapia: análise de conceito

Resumo Objetivo analisar o conceito de disfunção sexual em mulheres com câncer do colo do útero submetidas a tratamento radioterápico. Método estudo de análise de conceito fundamentado no referencial metodológico proposto por Walker e Avant, o qual é composto por oito etapas: seleção do conceito; determinação dos objetivos da análise conceitual; identificação dos possíveis usos do conceito; determinação dos atributos críticos ou essenciais; construção de um caso modelo; construção de casos adicionais; identificação dos antecedentes e consequentes do conceito; e definição das referências empíricas. Resultados a amostra final resultou em 11 artigos, que identificaram 4 atributos críticos, 18 antecedentes e 07 consequentes do conceito, os quais permitiram a construção de uma definição conceitual e elaboração de um caso-modelo, com a finalidade de exemplificar o contexto social no qual o conceito encontra-se inserido. Conclusão e implicações para prática alterações na estrutura corporal, déficit de conhecimento, diminuição da frequência das relações sexuais, dispareunia e indiferença do parceiro são alguns dos principais antecedentes e consequentes da disfunção sexual na população estudada. Entretanto, esses fatores ainda são pouco conhecidos, o que limita a realização de ações de promoção, prevenção e reabilitação sexual, sobretudo no campo da enfermagem.

Sexuality post gynaecological cancer treatment: a qualitative study with South African women

OBJECTIVES

This study investigated women's experiences of their sexuality post gynaecological cancer treatment. Using a holistic sexuality framework, the study explored how women felt their sexual functioning, sexual relationships and sexual identity had been affected by treatment.

DESIGN

The study was qualitative in nature and made use of an interpretive descriptive design. Data were analysed using thematic analysis.

SETTING

Data collection took place at a follow-up clinic within the gynaeoncology unit at a public-sector tertiary hospital in Cape Town, South Africa.

PARTICIPANTS

Purposive sampling was used to recruit participants, and the final sample consisted of 34 women aged 29-70 ([Formula: see text]=52). All women had received a gynaecological cancer diagnosis and had been treated with either surgery, chemotherapy, radiation or a combination of these. On average, the participants were between 12 and 30 months post treatment.

RESULTS

Women expressed how their sexual functioning post treatment was both nuanced and complex, how heteronormative gender expectations influenced their intimate relationships, and how they experienced a re-embodiment of their sexual subjectivity post treatment. Participants felt that more sexual functioning information from healthcare providers, as well as peer support groups, would assist them in navigating the sexuality changes they experienced.

CONCLUSIONS

The findings of this study broaden conceptualisations of sexuality post treatment by detailing the ways that it is complex, nuanced, relational and ever shifting. More research is needed about how to incorporate holistic psychosexual support post treatment into the public healthcare system in South Africa.

Fisioterapia na função sexual e muscular do assoalho pélvico pós tratamento do câncer de colo do útero

Objetivo: Verificar a eficácia da fisioterapia na função sexual e muscular do assoalho pélvico após tratamento do câncer de colo do útero. Métodos: Trata-se de uma série de casos de 10 mulheres submetidas a tratamento para câncer do colo de útero e seguimento fisioterapêutico pós-cirúrgico no Hospital Ophir Loyola, Belém, Pará. A função muscular do assoalho pélvico foi avaliada por meio do PERFECT e a função sexual pelo Female Sexual Function index. No protocolo fisioterapêutico foi realizado liberação de pontos gatilhos nos músculos do assoalho pélvico, massagem perineal, e treinamento dos músculos do assoalho pélvico. Os procedimentos foram realizados semanalmente em período de seis semanas. Resultados: A média de idade foi de 39,6 ± 7,6 anos. Todas as participantes foram submetidas a radioterapia. A função dos músculos do assoalho pélvico apresentou melhora ao final do protocolo, bem como a função sexual, porém ambos sem significância estatística. Conclusão: Tratamento fisioterapêutico pode melhorar funções sexual e muscular em mulheres submetidas a tratamento de câncer de colo de útero.