The Effects of Hysterectomy on Urinary and Sexual Functions of Women with Cervical Cancer: A Systematic Review

Abstract Objective This systematic review aims at describing the prevalence of urinary and sexual symptoms among women who underwent a hysterectomy for cervical cancer. Methods A systematic search in six electronic databases was performed, in September 2019, by two researchers. The text search was limited to the investigation of prevalence or occurrence of lower urinary tract symptoms (LUTS) and sexual dysfunctions in women who underwent a hysterectomy for cervical cancer. For search strategies, specific combinations of terms were used. Results A total of 8 studies, published between 2010 and 2018, were included in the sample. The average age of the participants ranged from 40 to 56 years, and the dysfunctions predominantly investigated in the articles were urinary symptoms (n= 8). The rates of urinary incontinence due to radical abdominal hysterectomy ranged from 7 to 31%. The same dysfunction related to laparoscopic radical hysterectomy varied from 25 to 35% and to laparoscopic nerve sparing radical hysterectomy varied from 25 to 47%. Nocturia ranged from 13%, before treatment, to 30%, after radical hysterectomy. The prevalence rates of dyspareunia related to laparoscopic radical hysterectomy and laparoscopic nerve sparing radical hysterectomy ranged from 5 to 16% and 7 to 19% respectively. The difficulty in having orgasm was related to laparoscopic radical hysterectomy (10 to 14%) and laparoscopic nerve sparing radical hysterectomy (9 to 19%). Conclusion Urinary and sexual dysfunctions after radical hysterectomy to treat cervical cancer are frequent events. The main reported disorders were urinary incontinence and dyspareunia.

摘要 目的
本系统综述旨在描述因宫颈癌接受子宫切除术的女性所出现的泌尿系统与性功能症状的患病率。
方法
2019年9月，由两名研究人员在6个电子数据库中开展系统检索。本次文本检索限定为探究因宫颈癌接受子宫切除术的女性下尿路症状（lower urinary tract symptoms, LUTS）与性功能障碍的患病率或发生情况，检索策略采用特定术语组合方式。
结果
最终纳入2010至2018年间发表的8项研究。受试者平均年龄区间为40~56岁，现有文献主要聚焦的功能障碍为泌尿系统症状（n=8）。因根治性腹部子宫切除术引发的尿失禁发生率为7%~31%；腹腔镜根治性子宫切除术相关的同类功能障碍发生率为25%~35%，腹腔镜保留神经根治性子宫切除术相关的该类障碍发生率则为25%~47%。夜尿症发生率从治疗前的13%升至根治性子宫切除术后的30%。与腹腔镜根治性子宫切除术、腹腔镜保留神经根治性子宫切除术相关的性交痛患病率分别为5%~16%、7%~19%。性高潮困难在腹腔镜根治性子宫切除术受试者中占比为10%~14%，在腹腔镜保留神经根治性子宫切除术受试者中占比为9%~19%。
结论
接受根治性子宫切除术治疗宫颈癌后出现的泌尿系统与性功能障碍较为常见，现有文献报告的主要异常类型为尿失禁与性交痛。