# The Impact of Surgical Conization of the Cervix and Loop Electrosurgical Excision Procedure on Female Sexual Function

## TL;DR

This study found that two cervical treatments temporarily affect female sexual function, but improvements return within a year.

## Contribution

The study provides new evidence on the transient sexual function impact of LEEP and surgical conization.

## Key findings

- Both LEEP and surgical conization caused mild, temporary sexual function deterioration.
- Sexual function improvements were observed in both groups within one year.
- Long-term consequences of both procedures appear similar.

## Abstract

This study was proposed to assess the potential association between two different types of treatment for cervical precancer or cancer lesions and female sexual function within one year after intervention. Forty-four women who had surgical conization and thirty-five women who underwent loop electrosurgical excision procedures were enrolled in this prospective cohort study. Patients completed questionnaires to compare their outcomes three, six, and twelve months after the treatment. The results showed that women in both studied groups developed mild, transient deteriorations in sexual function, which resolved spontaneously within one year of observation.

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.