文章：

女性直肠与肛门癌幸存者性功能障碍：病理生理学、临床管理及融入生存期照护体系

Sexual Dysfunction in Female Rectal and Anal Cancer Survivors: Pathophysiology, Clinical Management, and Integration into Survivorship Care

原文发布日期：28 September 2025

DOI: 10.3390/cancers17193150

类型: Article

开放获取: 是

英文摘要：

Background: Female Sexual dysfunction (FSD) is a common but under-recognized outcome of rectal and anal cancer treatment. While survival has improved, sexual health remains insufficiently addressed in survivorship care, warranting a multidisciplinary perspective.Methods: A narrative review of studies published between 2000 and 2025 was conducted, including clinical trials, cohort studies, and guideline documents addressing female sexual dysfunction after anorectal cancer treatment. Articles that were not pertinent to the research topic, outdated, or methodologically inadequate were excluded from the analysis.Results: Over 60% of female survivors experience FSD, including decreased libido, vaginal dryness, dyspareunia, and arousal difficulties. Causes include hormonal deficiency, nerve injury, and radiation fibrosis, compounded by psychological distress, altered body image, stoma-related stigma, and communication issues. The FSFI is commonly applied but lacks specificity for this population. Geographic disparities persist, with greater stigma and limited care access in low- and middle-income countries. Emerging therapies, such as immunotherapy, may mitigate FSD risk, though evidence is scarce.Conclusions: FSD after anorectal cancer is highly prevalent and significantly impacts quality of life, yet remains under-assessed in follow-up care. Multidisciplinary, culturally sensitive strategies integrating screening, psychosexual support, and tailored rehabilitation are urgently needed. Future research should address sexual outcomes more systematically, particularly in novel treatment contexts.

摘要翻译： 

背景：女性性功能障碍是直肠癌和肛门癌治疗后常见但未被充分认识的结局。尽管患者生存率有所提高，但在癌症康复护理中，性健康问题仍未得到足够重视，这需要多学科视角的介入。 方法：本研究对2000年至2025年间发表的文献进行了叙述性综述，纳入探讨肛门直肠癌治疗后女性性功能障碍的临床试验、队列研究及指南文件。与研究主题无关、内容过时或方法学质量不足的文献均被排除。 结果：超过60%的女性幸存者存在性功能障碍，具体表现为性欲减退、阴道干涩、性交疼痛及性唤起困难。其成因包括激素缺乏、神经损伤和放射性纤维化，并常因心理困扰、身体意象改变、造口相关污名化及医患沟通障碍而加剧。目前广泛采用的女性性功能指数量表对该人群缺乏特异性。地域差异持续存在，中低收入国家因社会污名更严重且医疗资源有限，患者获得相关照护的机会更少。新兴疗法（如免疫治疗）可能降低性功能障碍风险，但相关证据尚不充分。 结论：肛门直肠癌术后性功能障碍发生率极高，严重影响生活质量，但在随访护理中仍未得到充分评估。亟需建立融合筛查、心理性支持及个体化康复的多学科文化敏感型干预策略。未来研究应更系统性地关注性健康结局，特别是在新型治疗模式下的影响评估。

原文链接：

Sexual Dysfunction in Female Rectal and Anal Cancer Survivors: Pathophysiology, Clinical Management, and Integration into Survivorship Care