Objectives: The aim of the study was to analyze and compare the possible effect of cervical conization and the loop electrosurgical excision procedure (LEEP) on female sexual function up to one year after intervention, as existing studies provide incoherent results.Methods: This prospective cohort study enrolled patients who underwent either LEEP (n = 35) or surgical conization of the cervix (n = 44). Patients completed the questionnaire before the intervention and at three, six, and twelve months after the end of the postoperative period. The questionnaire included the Polish version of the Female Sexual Function Index (FSFI) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire of Cancer Patients with the module Cervix-24.Results: In the LEEP group, significant deterioration was observed in the FSFI orgasm subscale after three and six months in comparison to the baseline (3.98 ± 2.08 vs. 3.19 ± 2.29 vs. 3.09 ± 2.24;p< 0.02). The difference in the orgasm subscale compared to the baseline score was not reported after twelve months of follow-up. In the surgical conization group, significant deterioration was observed in the general FSFI score between the baseline and three months after (22.37 ± 12.38 vs. 20.82 ± 12.02;p< 0.003) and in the arousal subscale between the baseline and three months after (3.69 ± 2.14 vs. 3.01 ± 2.02;p< 0.001). In the orgasm subscale, there was a significant improvement between three and twelve months of observation (3.05 ± 2.22 vs. 3.63 ± 2.29;p< 0.003). A significant deterioration was observed in the sexual activity subscale of the EORTC QLQ-C30 + CX24 between baseline and after three months (49.42 ± 36.12 vs. 39.09 ± 36.81;p< 0.03). All reported deteriorations had a tendency to resolve within twelve months of observation.Conclusions: Both LEEP and surgical conization of the cervix seem to have a mild, transient negative impact on female sexual function, which normalizes one year after the procedure. Long-term consequences of both procedures are similar. Further research with larger sample sizes is necessary to confirm these findings.
目的：本研究旨在分析和比较宫颈锥切术与环形电切术（LEEP）对女性术后一年内性功能的可能影响，因现有研究结果存在不一致性。 方法：本前瞻性队列研究纳入接受LEEP术（35例）或宫颈锥切术（44例）的患者。患者在术前及术后恢复期结束后3个月、6个月和12个月分别填写问卷。问卷包括波兰版女性性功能指数（FSFI）及欧洲癌症研究与治疗组织生活质量核心问卷配合宫颈癌特异性模块（EORTC QLQ-C30+CX24）。 结果：LEEP组在术后3个月和6个月时，FSFI性高潮维度评分较基线显著下降（3.98±2.08 vs. 3.19±2.29 vs. 3.09±2.24；p<0.02）。随访12个月后，性高潮维度评分与基线的差异消失。宫颈锥切组在术后3个月时，FSFI总分较基线显著下降（22.37±12.38 vs. 20.82±12.02；p<0.003），性唤起维度评分亦显著下降（3.69±2.14 vs. 3.01±2.02；p<0.001）。性高潮维度评分在术后3个月至12个月期间显著改善（3.05±2.22 vs. 3.63±2.29；p<0.003）。EORTC QLQ-C30+CX24的性生活维度评分在术后3个月较基线显著下降（49.42±36.12 vs. 39.09±36.81；p<0.03）。所有观察到的功能下降趋势均在12个月内恢复。 结论：LEEP与宫颈锥切术均可能对女性性功能产生轻度、短暂的负面影响，但在术后一年内可恢复正常。两种术式的长期影响相似。未来需扩大样本量以进一步验证上述结论。
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