The aim of this study was to assess the magnitude of the morbidity following radical surgery for early stage cervical cancer. We performed a retrospective survey of all women who had undergone a radical hysterectomy and lymphadenectomy between the months of July 1995 and December 1996 inclusive at either the Royal Marsden or St George's Hospital (n =38), using a detailed questionnaire on bladder, ano-rectal and sexual function, both before and after treatment. Sixteen women (44.4%) received adjuvant radiotherapy. The mean interval between surgery and inquiry was 16.4% months (range 8-25 months). The mean age at the time of surgery was 40.5 years. Thirty-six out of 38 women contacted responded (94.7%). Overall 33 women (91.7%) reported new bladder, ano-rectal or sexual symptoms. Complaints of urinary incontinence, particularly of urge incontinence, and of voiding difficulties increased significantly after surgery (P <0.05). However, only 5.3% of women had sought treatment. Tenesmus increased significantly (P <0.05), while increases in diarrhoea and faecal incontinence were not statistically significant (P =0.051). Although 12.9% of women stated an improvement in their sex lives, 54.8% thought that their sex life was worse after treatment, and 12.9% of women had ceased sexual activity altogether. Of women of childbearing age 53.8% felt adversely affected by their loss of fertility. Bladder, ano-rectal and sexual symptoms are very common following radical hysterectomy for cervical cancer, with adverse effect on quality of life, and persist into the second year after treatment.

1 The effect of a single oral dose of labetalol (100 mg), propranolol (80 mg) and placebo on the pressor response to sexual autostimulation has been studied in six female volunteers. 2 Labetalol but not propranolol significantly reduced the increase in blood pressure that occurred at orgasm. 3 The subjective features of the sexual response were assessed by each subject using visual analogue scales. 4 Subjects reported a significant reduction in vaginal lubrication with labetalol compared to both placebo and propranolol. 5 No other effects were noted.

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3 Exposure to f3-adrenoceptor antagonists did not increase the prevalence of Raynaud's phenomenon in either men or women in the study, but did increase the prevalence of cold extremities in men (P < 0.001). Propranolol, labetalol, oxprenolol and possibly atenolol were likely to produce such side effects. Smoking and the addition of vasodilators did not alter the effect of 1-adrenoceptor blockers on peripheral vascular symptoms. Complaints of cold extremities were not associated with an excess of complaints of other side effects.

1 A method for monitoring the effect of drugs on the genital response to stimulation provided by vibration is described. 2 Using this method, the effect on male sexual response of two oral doses (100 mg and 300 mg) labetalol were studied and compared with placebo in six subjects. 3 Labetalol did not affect the attainment or maintenance of erection. 4 Labetalol delayed ejaculation in a dose-related manner. 5 Labetalol treatment resulted in a significant dose-related delay in detumescence.