Original Research—Surgery: Sexual Function after Loop Electrosurgical Excision Procedure for Cervical Dysplasia

Abstract

Introduction Loop electrosurgical excision procedure (LEEP) is an effective tool for management of cervical dysplasia. However, removal of a part of the cervix might have a negative impact on sexual function. Aim To examine the effect of LEEP on overall sexual satisfaction and other specific aspects of sexual function in women with cervical dysplasia. Methods Eighty-nine premenopausal women with cervical dysplasia who had undergone LEEP at least 3 months previously were interviewed once on post-LEEP follow-up visits with a questionnaire on pre- and post-procedural sexual function. Data on frequency of sexual intercourse, the presence of dysmenorrhea, dyspareunia, and postcoital bleeding were compared using the McNemar test. Data on specific aspects of sexual function rated by the 6-point Likert scale were analyzed using Wilcoxon signed ranks test. Main Outcome Measure The main outcome is the overall sexual intercourse satisfaction. Results The mean age was 41.7 years. The median interval from LEEP to the time of interview was 29.3 weeks. The time of resumption of sexual intercourse after LEEP was 8.1 weeks on the average. The changes in the frequency of sexual intercourse, dysmenorrhea, and dyspareunia after LEEP were not statistically significant. The changes in overall satisfaction, vaginal elasticity, and orgasmic satisfaction appeared statistically significant (P <0.05). Conclusion Having LEEP done along with other “non-surgical” parts of cervical pre-cancer management is associated with small but statistically significant decreases in overall sexual satisfaction, vaginal elasticity, and orgasmic satisfaction when interviewed near to the procedure at 29.3 weeks post-operation. However, the changes on other aspects of sexual function are insignificant. The LEEP procedure itself appears to have a minimal, if any, clinically important adverse effect on sexual function.

A Meta-Analysis Detailing Overall Sexual Function and Orgasmic Function in Women Undergoing Midurethral Sling Surgery for Stress Incontinence

“…Gravina et al 13 found that the urethrovaginal tissue was thinner overall in women who were unable to experience vaginally elicited orgasm. We have complementary analogous data that loop electrosurgical excision procedures of the cervix adversely affect orgasm in 11% of patients 44 . In consequence, any surgical intervention in the female genitalia, especially the vagina, cervix, or anterior vaginal wall, can adversely influence neural input to orgasm.…”

Effect of Loop Electrosurgical Excision Procedure (LEEP) on Sexual Functions of Women in the Reproductive Age Group with Cervical Dysplasia

“…Servikal intraepitelyal neoplazi nedeni ile tedavi edilen hastalarda tedavi sonrasında özellikle cinsel istek ve ilgide, cinsel ilişki sıklığında anlamlı azalmalar bil-dirilmiştir (13,14) . Bunun nedeni olarak da özellikle tanı ve tedavinin neden olduğu anksiyeteye bağlı psikoloijk etkilerin olduğu vurgulanmıştır (24) .…”

“…Cinsel istek bozukluğu, uyarılma ve orgazm bozuklukları, ağrılı cinsel ilişki şeklinde görülebilmektedir (12) . Literatürde LEEP'in kadın cinsel fonksiyonları üzerine etkisini araştıran çalışmalar yapılmıştır (4,13,14) . (15) .…”

Does treatment for cervical and vulvar dysplasia impact women’s sexual health?

“…15,18,20 These studies postulated that the domains significantly affected were psychological in nature, possibly attributed to the anxiety associated with the diagnosis and treatment of CIN. It is not unreasonable to hypothesize that similar psychological components of sexual health are negatively affected in women treated for VIN.…”

“…19 This study found that desire was significantly decreased after treatment, while the other domains were unaffected. Inna et al 20 used a self- designed questionnaire and found that frequency of sexual intercourse, dysmenorrhea, and dyspareunia after LEEP were not significantly different following treatment. However, overall sexual satisfaction, orgasmic satisfaction and vaginal elasticity were significantly decreased up to one year following LEEP.…”