Female Sexual Function After Radical Cystectomy: A Cross-sectional Study

Background and objective: Radical cystectomy (RC) is the gold-standard treatment for muscle-invasive bladder cancer (MIBC). Approximately 25% of MIBC patients are women. In women, RC includes removal of the ovaries, uterus, and the anterior vaginal wall, during which nerve damage can occur, potentia...

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Main Authors: Rikke Vilsbøll Milling, Anne-Dorte Seyer-Hansen, Charlotte Graugaard-Jensen, Jørgen Bjerggaard Jensen, Pernille Skjold Kingo
Format: Article
Language:English
Published: Elsevier 2024-12-01
Series:European Urology Open Science
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666168324010991
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author Rikke Vilsbøll Milling
Anne-Dorte Seyer-Hansen
Charlotte Graugaard-Jensen
Jørgen Bjerggaard Jensen
Pernille Skjold Kingo
author_facet Rikke Vilsbøll Milling
Anne-Dorte Seyer-Hansen
Charlotte Graugaard-Jensen
Jørgen Bjerggaard Jensen
Pernille Skjold Kingo
author_sort Rikke Vilsbøll Milling
collection DOAJ
description Background and objective: Radical cystectomy (RC) is the gold-standard treatment for muscle-invasive bladder cancer (MIBC). Approximately 25% of MIBC patients are women. In women, RC includes removal of the ovaries, uterus, and the anterior vaginal wall, during which nerve damage can occur, potentially impacting sexual function. Studies on sexual function among females following RC are sparse. Our aim was to investigate the impact of RC on female sexual function. Methods: A cross-sectional registry study and a questionnaire survey were used. The Danish Cancer Registry was used to identify all female patients diagnosed with MIBC between 2015 and 2020 who were treated with RC and an ileal conduit. Comorbidity and complications data were obtained from the Danish National Patient Registry. The survey included European Organization for Research and Treatment of Cancer questionnaires on quality of life (EORTC-QLQ-C30) and sexual health (EORTC-SHQ-C22) and eight questions covering female sexual function. Key findings and limitations: A total of 151 women completed the questionnaires, of whom 30 (21%) reported worries about resuming sexual activity after RC and 51 (34%) about resuming intercourse specifically. An altered perception of vaginal size was reported by 85 (56%) respondents. Prolonged time to experiencing orgasm was reported by 43 (51%) and anorgasmia by 23 (26%) of the sexually active women. Pain during and after penetration in ≥50% of attempts was reported by 29 (54%) and 23 (43%) respondents, respectively. There was moderate correlation between pain and sexual satisfaction (p < 0.001). Conclusions and clinical implications: RC can result in altered perception of vaginal size and pain on intercourse among female patients with bladder cancer, with potential effects on sexual satisfaction. Patient summary: We assessed sexual outcomes for women after removal of the bladder for bladder cancer and carried out a survey among Danish women who underwent this treatment between 2015 and 2020. The majority of the women reported changes in sexual function, including pain during intercourse and altered perception of vaginal size.
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spelling doaj-art-a34b288b4f534f7c8e87e012ec07be372024-12-01T05:08:11ZengElsevierEuropean Urology Open Science2666-16832024-12-0170142147Female Sexual Function After Radical Cystectomy: A Cross-sectional StudyRikke Vilsbøll Milling0Anne-Dorte Seyer-Hansen1Charlotte Graugaard-Jensen2Jørgen Bjerggaard Jensen3Pernille Skjold Kingo4Department of Urology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; Corresponding author. Department of Urology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus, Denmark. Tel. +45 21 219071.Department of Urology, Aarhus University Hospital, Aarhus, DenmarkDepartment of Urology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, DenmarkDepartment of Urology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, DenmarkDepartment of Urology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, DenmarkBackground and objective: Radical cystectomy (RC) is the gold-standard treatment for muscle-invasive bladder cancer (MIBC). Approximately 25% of MIBC patients are women. In women, RC includes removal of the ovaries, uterus, and the anterior vaginal wall, during which nerve damage can occur, potentially impacting sexual function. Studies on sexual function among females following RC are sparse. Our aim was to investigate the impact of RC on female sexual function. Methods: A cross-sectional registry study and a questionnaire survey were used. The Danish Cancer Registry was used to identify all female patients diagnosed with MIBC between 2015 and 2020 who were treated with RC and an ileal conduit. Comorbidity and complications data were obtained from the Danish National Patient Registry. The survey included European Organization for Research and Treatment of Cancer questionnaires on quality of life (EORTC-QLQ-C30) and sexual health (EORTC-SHQ-C22) and eight questions covering female sexual function. Key findings and limitations: A total of 151 women completed the questionnaires, of whom 30 (21%) reported worries about resuming sexual activity after RC and 51 (34%) about resuming intercourse specifically. An altered perception of vaginal size was reported by 85 (56%) respondents. Prolonged time to experiencing orgasm was reported by 43 (51%) and anorgasmia by 23 (26%) of the sexually active women. Pain during and after penetration in ≥50% of attempts was reported by 29 (54%) and 23 (43%) respondents, respectively. There was moderate correlation between pain and sexual satisfaction (p < 0.001). Conclusions and clinical implications: RC can result in altered perception of vaginal size and pain on intercourse among female patients with bladder cancer, with potential effects on sexual satisfaction. Patient summary: We assessed sexual outcomes for women after removal of the bladder for bladder cancer and carried out a survey among Danish women who underwent this treatment between 2015 and 2020. The majority of the women reported changes in sexual function, including pain during intercourse and altered perception of vaginal size.http://www.sciencedirect.com/science/article/pii/S2666168324010991Bladder cancerFemale sexual functionRadical cystectomy
spellingShingle Rikke Vilsbøll Milling
Anne-Dorte Seyer-Hansen
Charlotte Graugaard-Jensen
Jørgen Bjerggaard Jensen
Pernille Skjold Kingo
Female Sexual Function After Radical Cystectomy: A Cross-sectional Study
European Urology Open Science
Bladder cancer
Female sexual function
Radical cystectomy
title Female Sexual Function After Radical Cystectomy: A Cross-sectional Study
title_full Female Sexual Function After Radical Cystectomy: A Cross-sectional Study
title_fullStr Female Sexual Function After Radical Cystectomy: A Cross-sectional Study
title_full_unstemmed Female Sexual Function After Radical Cystectomy: A Cross-sectional Study
title_short Female Sexual Function After Radical Cystectomy: A Cross-sectional Study
title_sort female sexual function after radical cystectomy a cross sectional study
topic Bladder cancer
Female sexual function
Radical cystectomy
url http://www.sciencedirect.com/science/article/pii/S2666168324010991
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AT charlottegraugaardjensen femalesexualfunctionafterradicalcystectomyacrosssectionalstudy
AT jørgenbjerggaardjensen femalesexualfunctionafterradicalcystectomyacrosssectionalstudy
AT pernilleskjoldkingo femalesexualfunctionafterradicalcystectomyacrosssectionalstudy