[Analysis of mailed questionnaire for female sexual dysfunction after intra-pelvic surgery]

Female sexual dysfunction is an unfavorable complication for women after intra-pelvic surgery. However, there has not been enough data obtained to analyze the inconvenience to female patients of intra-pelvic surgery. To clarify the categories of female sexual dysfunction after intra-pelvic surgery, we analyzed mailed questionnaires obtained from female patients who had undergone mono-therapy of intra-pelvic surgery.

A mailed questionnaire regarding female sexual dysfunction was sent to 174 patients, including 118 that had undergone a hysterectomy (Group A) and 56 ostomates (Group B) and the results were analyzed. These patients had received only intra-pelvic surgery, without radiation or chemotherapy. Of the 56 patients in Group B, 50 with rectal cancer had received a colostomy, and 6 with bladder cancer had received ileal conduits. The content of the questionnaire was as follows: age; with or without a male partner; key person for consultation in regard to sexual dysfunction; importance of sex life. Also, a before and after operation comparison was made regarding sexual frequency, sexual desire, genital response, genital transformation, dyspareunia, genital pain and itching, and orgasm.

Seventy-eight of 174 (45%) patients returned the questionnaire. Nineteen patients without a male partner and 18 patients with a male partner had no sexual intercourse, very low sexual desire, and did not consider their sex life of importance. Twenty-five patients with a male partner (18 in Group A and 7 in Group B) had no trouble in their sexual activity after the operations. However, the other 16 patients (5 in Group A and 11 in Group B) had unsatisfactory sexual intercourse after their operations because of a decrease in sexual desire, poor genital response, and/or decrease of orgasms. Furthermore, the patients in Group B suffered significantly from sexual trouble compared with the patients in Group A. Especially, all the patients in Group B complained that their stoma prevented satisfactory sexual intercourse.

Based on this data, we do not need to worry about female sexual dysfunction for patients without a male partner and patients with a partner but who are not sexually active before their operations. More than 60% of patients who had been sexually active before their operations maintained fair sexual activity after intra-pelvic surgery. However, we have to take care of the approximately 40% of patients who suffer from female sexual dysfunction after their operation, especially the ostomate patients.