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      Postoperative Quality of Life and Sexual Function in Premenopausal Women Undergoing Laparoscopic Myomectomy for Symptomatic Fibroids: A Prospective Observational Cohort Study

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          Abstract

          Introduction

          Uterine leiomyomas are the most common benign gynecologic tumors. To date laparoscopy myomectomy is the gold standard for treatment of symptomatic fibroids in reproductive-aged women. Detailed counseling about the effects of this procedure on postoperative sexuality and quality of life is important in these patients. However, available data on these subjects are limited and contradictory. The aim of this study was to assess sexual function and quality of life in premenopausal women undergoing laparoscopic myomectomy for symptomatic uterine fibroids.

          Material and Methods

          All premenopausal women who underwent laparoscopic myomectomy for symptomatic fibroids between April 2012 and August 2014 at a tertiary university center were enrolled in this prospective observational cohort study. Sexual function and quality of life were assessed for the pre- and postoperative (six months post-operatively) state using two validated questionnaires, the Female Sexual Function Index (FSFI) and the European Quality of Life Five-Dimension Scale (EQ-5D).

          Results

          Ninety-five of the 115 (83%) eligible patients completed the study. Overall a significant improvement in quality of life and sexual function was observed in the study cohort: Median FSFI (28 (18.7–35.2)) and EQ-5D scores (1 (0.61–1) after laparoscopic myomectomy were significantly higher than preoperative scores (21.2 (5.2–33.5); 0.9 (0.2–1); p ≤ 0.01). The number, position and localization of the largest fibroids were not correlated with pre- or postoperative sexual function or quality of life.

          Conclusion

          Laparoscopic myomectomy might have positive short-term effects on postoperative quality of life and sexual function in premenopausal women suffering from symptomatic fibroids.

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          Most cited references28

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          The frequency of uterine leiomyomas.

          As a leading cause of hysterectomy in premenopausal women. uterine leiomyomas are a major public health problem. However, very little work has been done on their epidemiology. Indeed, their true frequency has never been established using systematic and meticulous methods. In this study, gross serial sectioning at 2-mm intervals was applied as an adjunct to routine pathology processing in 100 consecutive total hysterectomy specimens. This tripled the number of leiomyomas noted in routine pathology reports. There were 649 leiomyomas in 77 of 100 uteri, with multiplicity of leiomyomas in 84%. Although leiomyomas were more numerous and larger in women with a clinical diagnosis of myomatous uterus, the incidence was no higher than in uteri removed for other reasons. The postmenopausal incidence of leiomyomas was no lower than the premenopausal incidence, although postmenopausal leiomyomas were smaller and fewer. These findings suggest that epidemiologic studies of leiomyomas may not be valid if they are based only on clinical diagnoses or routine pathology reports.
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            Clinical practice. Uterine fibroids.

            A 47-year-old black woman has heavy menstrual bleeding and iron-deficiency anemia.She reports nocturia and urinary frequency. A colonoscopy is negative. Ultrasonography shows a modestly enlarged uterus with three uterine fibroids. She is not planning to become pregnant. How should this case be evaluated and managed?
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              Research on the menopause in the 1990s. Report of a WHO Scientific Group.

              (1996)
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                29 November 2016
                2016
                : 11
                : 11
                : e0166659
                Affiliations
                [1 ]Department of Gynecology & Obstetrics, Saarland University Hospital, Homburg/Saar, Germany
                [2 ]Department of Radiology, Dresden University Hospital, Dresden, Germany
                [3 ]Institute of Medical Biometry, Epidemiology & Medical Informatics, Saarland University Hospital, Homburg/Saar, Germany
                [4 ]Department of Gynecology, Charite Berlin, Berlin/Germany
                [5 ]Department of Gynecology and Obstetrics, Jena University Hospital, Jena, Germany
                Duke University, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                • Conceptualization: JCR MPR EFS.

                • Data curation: SW CGR.

                • Formal analysis: SW.

                • Funding acquisition: JCR E-FS.

                • Investigation: CGR RM MK.

                • Methodology: JCR MPR.

                • Project administration: JCR MPR.

                • Resources: E-FS IJ-B SB.

                • Supervision: JCR E-FS.

                • Validation: CGR RJ MK.

                • Visualization: AH.

                • Writing – original draft: JCR MPR.

                • Writing – review & editing: IJ-B SB RJ AH.

                Article
                PONE-D-16-29502
                10.1371/journal.pone.0166659
                5127523
                27898669
                5cd82990-44d4-45f0-8aed-16ca2dfb8ce3
                © 2016 Radosa et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 31 July 2016
                : 1 November 2016
                Page count
                Figures: 1, Tables: 3, Pages: 13
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100001655, Deutscher Akademischer Austauschdienst;
                Award ID: grant number 91533303
                Award Recipient :
                This work was funded by a grant provided to Julia Caroline Radosa by the German academic exchange services (DAAD; grant number 91533303). URL of DAAD website: https://www.daad.de/de/. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. There was no additional external or internal funding received for this study.
                Categories
                Research Article
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Reproductive System Procedures
                Myomectomy
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Surgical Excision
                Myomectomy
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Laparoscopy
                Medicine and Health Sciences
                Health Care
                Quality of Life
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Gynecologic Surgery
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Laparotomy
                Medicine and Health Sciences
                Surgical and Invasive Medical Procedures
                Cardiovascular Procedures
                Vascular Surgery
                Medicine and Health Sciences
                Urology
                Infertility
                Custom metadata
                All relevant data are within the paper and its Supporting Information files.

                Uncategorized
                Uncategorized

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