Impact of a cervical dysplasia and its treatment on quality of life and sexual function.

ABSTRACT

PURPOSE: In this case-control study, the impact on quality of life and sexual function in women with cervical dysplasia and conization will be evaluated, in order to address coping with such a premalignant lesion and to improve strategies for salutogenesis. METHODS: This multicenter case-control study evaluates women at special dysplasia outpatient clinic (T1) as well as 3 (T2) and 6 (T3) months after the diagnosis of a dysplasia. The women were subgrouped upon dysplasia only (S2) or dysplasia with conization (S1). Sexual function as well as cervix-related and general quality of life was assessed using validated instruments (FSFI-d, EORTC-QLQ-CX24, SF-36). RESULTS: Women with dysplasia had a lower sexual functioning than controls (FSFI S1 23.8 ± 9.7 (p < 0.003); S2 25.3 ± 7.5 (p < 0.03); K 29.1 ± 4.5) as well as a lower physical component score (SF-36 S1 51.3 ± 8.6 (p < 0.02); S2 51.7 ± 7.8 (p < 0.05); K 54.2 ± 6.6) and had a significantly reduced body image (EORTC-QLQ-CX24 S1 75.7 (p < 0.001); S2 76.5 (p < 0.001), K89.2). Sexual functioning was not affected by conization in the observational period over 6 months; however, sexual worry was impacted. Over temporal progression women who underwent conization worried more. Regression analysis revealed a cervical dysplasia to impact sexual function. CONCLUSION: Data suggest that women with the diagnosis of a cervical dysplasia are impaired in their sexual function as well as general and cervix-related quality of life, mostly independent of conization or further observation. To improve salutogenesis in the long run, the communication on dysplasia and its treatment strategy at the beginning, as well as part of aftercare, or psychosomatic intervention, might be treatment options for women at risk.