BACKGROUND Limited knowledge exists concerning the impact of radical hysterectomy (RH) alone on the sexual function of patients with early‐stage cervical carcinoma. The authors investigated the longitudinal course of self‐reported sexual function after RH. METHODS The current study was comprised of 173 patients with lymph node‐negative, early‐stage cervical carcinoma who had undergone RH and pelvic lymphadenectomy. They were assessed prospectively using a validated self‐assessment questionnaire 5 weeks and 3 months, 6 months, 12 months, 18 months, and 24 months after RH. Results were compared with an age‐matched control group from the general population. RESULTS Compared with control women, patients experienced severe orgasmic problems and uncomfortable sexual intercourse due to a reduced vaginal size during the first 6 months after RH, severe dyspareunia during the first 3 months, and sexual dissatisfaction during the 5 weeks after RH. A persistent lack of sexual interest and lubrication were reported throughout the first 2 years after RH. Long‐term lack of sexual interest and insufficient vaginal lubrication were confirmed by the patient's self‐reported changes 12 months after RH compared with before the cancer diagnosis and by a pre‐post comparison within patients. However, most of the patients who were sexually active before their cancer diagnosis were sexually active again 12 months after surgery (91%), although with a decrease in sexual frequency reported. CONCLUSIONS RH had a persistent and negative impact on patients' sexual interest and vaginal lubrication whereas the majority of other sexual and vaginal problems disappeared over time. Sexual and vaginal problems in the short‐term and long‐term after RH should be discussed with the patient before and after surgery. Cancer 2004;100:97–106. © 2003 American Cancer Society.

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The Sexual function‐Vaginal changes Questionnaire (SVQ), was developed to investigate sexual and vaginal problems in gynaecological cancer patients. The instrument consists of 20 core items, measuring sexual interest, lubrication, orgasm, dyspareunia, vaginal dimensions, intimacy, sexual problems of partner, sexual activity, sexual satisfaction, and body image. Seven additional items assessing current levels of sexual and vaginal problems compared to pre‐diagnosis are intended to be used only once in longitudinal studies. The SVQ was validated in two ways: first, the comprehensibility of each item was investigated through combined quantitative and qualitative assessment of patient‐observer agreement in 75 gynaecological cancer patients, second, multitrait analyses and principal component analyses were applied to responses from 257 patients with cervical cancer to investigate the scale properties. The level of agreement between the patients' and the observer's ratings was high (median overall agreement 0.84, range 0.46–1.00; median kappa: 0.80, range 0.52–1.00). From the 10 items applicable to all patients, three scales were hypothesized: intimacy, sexual interest and global sexual satisfaction. For sexually active respondents an additional two scales were hypothesized: vaginal changes and sexual functioning. The psychometric analyses confirmed these scales. The internal consistency of the scales ranged 0.76–0.83 (Cronbach's alpha). The study supports the validity and reliability of the SVQ. Copyright © 2003 John Wiley & Sons, Ltd.

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