Evaluation of Clitoral Artery Doppler Parameters After Brachytherapy and Its Effects On Sexual Functions

Assessment of clitoral artery flow parameters (eg, pulsation and resistance indices) is important for individual patient evaluation of sexual function quality. Selected hormonal treatments may also influence these vascular features. The rationale stems from the functional improvements observed after the use of vasodilator agents in systemic diseases affecting vessels and nerves. In this study, we investigated the relationship between Doppler parameters and functional evaluations in patients who underwent brachytherapy.

This study was conducted at the Department of Obstetrics and Gynecology, Faculty of Medicine, University of Selçuk. Patients with endometrial or cervical cancer who underwent surgery between 2010 and 2024 were included. Some patients received brachytherapy, while others were followed with surgery alone. All patients underwent ultrasonographic evaluation and completed the Female Sexual Function Index (FSFI) questionnaire. The resistance index (RI) and pulsatility index (PI) were also evaluated.

A total of 42 patients were included in the study; 21 of them underwent surgery alone, and 21 received postoperative brachytherapy. Significant differences were found in the clitoral artery pulsatility and resistance indices between the hysterectomy-only group (group 1) and the hysterectomy-plus-brachytherapy group (group 2). Lower FSFI scores were associated with decreased PI and increased RI. No significant differences were found in other Doppler parameters. Mean FSFI scores were 17±8.6 in group 1 and 13.2±7.7 in group 2.

Cancer surgery and adjuvant treatment methods can lead to sexual dysfunction through many mechanisms; therefore, the importance of quality of life assessment and examinations is clear.