Sexual satisfaction and quality of life in survivors of localized cervical and ovarian cancers following fertility-sparing surgery

Evaluating Sexual Satisfaction and Quality of Life in Patients with Gynecological Cancer

“…The satisfaction with Life scale was used in this study. Sexual dissatisfaction was reported 49% of the patients surveyed in this study (24). In another study, sexual satisfaction was found to be lower (41%) in ovarian cancer patients (25).…”

Fertility preservation in women with cervical, endometrial or ovarian cancers

“…Techniques described for vaginal, abdominal, laparoscopic or robotic trachelectomy Resection of the cervix and surrounding parametria with conservation of the uterus and the ovaries, pelvic lymphadenectomy Spontaneous pregnancy rates in >60 % of patients Preterm deliveries with 28 % of infants born <32 weeks of gestation [ 17 , 132 ] Rates of recurrence and mortality are comparable with those described for similar cases treated with radical hysterectomy; long-term survival 98.4 %. Low relapse rates (4.5 %) [ 16 , 17 ] Lower quality of life than healthy controls but similar to radical hysterectomy No significant impairment in sexual satisfaction Long-term bladder complications (40 %) and lymphedema (10 %) [ 46 – 48 ] FIGO Stage IB1, >2 cm Neoadjuvant chemotherapy followed by radical trachelectomy Three cycles of paclitaxel, cisplatin and ifosfamide followed by radical trachelectomy After neoadjuvant chemotherapy and trachelectomy up to 86 % live-birth rates with 86 % spontaneous conception rate [ 134 ] Reported relapse rate of 7.6 % with 90 % survival [ 23 , 24 ] Lack of data Endometrial Cancer FIGO stage IA Medical conservative treatment with hormone therapy using progestational agents either orally or by IUD for >6 months Myometrial evaluation by MRI should be performed to confirm absence of myometrial infiltration and no extrauterine involvement [ 52 ]. Follow-up by hysteroscopic exams with endometrial biopsies every 3 months Pregnancy rates of >60 % Uneventful pregnancies reported [ 63 , 72 ] Positive response rate to progesterone treatment of 72 %.…”

“…Regarding quality of life, compared with women with radical hysterectomy who had at least one ovary, patients who had undergone trachelectomy had similar sexual satisfaction and quality of life after surgery [ 46 ]. However, another study group reported low sexual satisfaction in the first year after surgery compared with healthy subjects and patients after abdominal hysterectomy.…”

“…Recurrence 0 %–20 % versus 12 %–58 % when only cystectomy was performed [ 6 ] High quality of life and higher sexual satisfaction scores after fertility-sparing surgery [ 103 ] Borderline Ovarian Tumor FIGO Stages Ic–III Unilateral oophorectomy/bilateral cystectomy, peritoneal staging, pelvic & para-aortic lymphadenectomy, omentectomy Removing the affected ovary only, thorough oncological staging Pregnancy rate of 86 %, more than half of the patients required fertility treatment [ 99 ] No difference in recurrence or survival compared with radical surgery removing both ovaries and the uterus [ 6 , 99 ]. Lack of data Ovarian Epithelial Cancer FIGO Stage IA, grade 1 Unilateral oophorectomy, peritoneal staging, pelvic & para-aortic lymphadenectomy and omentectomy Removing the affected ovary only, thorough oncological staging Pregnancy rates of >60 % Pregnancies have been reported with favorable obstetric outcome [ 145 ] 5-year survival 87 %, recurrence 7–12 % [ 6 , 17 ] No difference in quality of life aspects or sexual satisfaction scores compared with radical surgery [ 46 ] Ovarian Epithelial Cancer – FIGO Stage IA, grade 2–3 or Clear Cell Carcinoma Unilateral oophorectomy, peritoneal staging, pelvic & para-aortic lymphadenectomy, omentectomy and adjuvant chemotherapy Removing the affected ovary only, thorough oncological staging Adjuvant platinum-based chemotherapy Pregnancy rate of 80 % with live-birth rate of 65 % in women presenting with cancer grades 1–3. Higher number of women with cancer grades 1–2 attempting pregnancy in comparison with women with grade 3 cancers [ 87 ] No difference in recurrence or survival compared with radical surgery [ 86 ] Lack of data Malignant Germ Cell Cancers grade I Unilateral oophorectomy, peritoneal staging, omentectomy, pelvic & para-aortic lymphadenectomy and adjuvant chemotherapy Removing the affected ovary only, adjuvant BEP chemotherapy has been recommended, or expectant management 76 % pregnancy rate.…”

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“…Satisfying sexual experiences are addressed as an aspect of sexual health and well-being in the health care arena 1 , and being satisfied with fruitful sex is considered an integral part of people's quality of life 2 . Satisfying sex has positive effects on and strengthens couple's relationships and has pleasant effects on many of the aspects of marital life [3][4][5][6] .…”