OBJECTIVES: To evaluate our experience in patients undergoing hybrid transvaginal NOTES nephrectomy and evaluate the sexual functions in the post-operative period. METHODS: Prospective data of 71 patients with renal tumors who underwent hybrid NOTES radical nephrectomy in three different centers were collected from March 2010 to October 2015. Patient and surgical characteristics are recorded. Sexual function was evaluated with Female Sexual Function Index (FSFI) questionnaire, the day prior to the operation and three months after. RESULTS: The mean age, tumor size and operation duration were 66.16±11.21, 8.51±3.31 cm and 119.94±21.38 minutes, respectively. Five patients were immediately re-operated due to bleeding from uterine veins. The complication risk increases significantly with increasing tumor size. Among the whole cohort, even the FSFI score differences are small; there is a statistically significant decrease in the postoperative period in all domains except sexual satisfaction. In fact, the patients reported unaltered sexual function after surgery and satisfaction with the result when asked directly. In subgroup analyses, in nulliparous patients (n=60), arousal, sexual desire, orgasm and satisfaction domains have no significant differences in pre- and post-operative periods. CONCLUSIONS: Hybrid NOTES nephrectomy is a feasible, safe operation that can be performed for large renal tumors. Due to incisions in the vaginal wall for specimen retrieval, sexual function can be altered in the post-operative period. So, patient selection, pre-operative evaluation, and close follow-up are mandatory. With this in mind, we strongly support the use of hybrid transvaginal NOTES nephrectomy for large renal tumors especially in nulliparous patients.
Hybrid Transvaginal NOTES Nephrectomy: Postoperative Sexual Outcomes. A Three-center Matched Study
Laganà, As;Pappalardo, R;Magno, C.Ultimo
2017-01-01
Abstract
OBJECTIVES: To evaluate our experience in patients undergoing hybrid transvaginal NOTES nephrectomy and evaluate the sexual functions in the post-operative period. METHODS: Prospective data of 71 patients with renal tumors who underwent hybrid NOTES radical nephrectomy in three different centers were collected from March 2010 to October 2015. Patient and surgical characteristics are recorded. Sexual function was evaluated with Female Sexual Function Index (FSFI) questionnaire, the day prior to the operation and three months after. RESULTS: The mean age, tumor size and operation duration were 66.16±11.21, 8.51±3.31 cm and 119.94±21.38 minutes, respectively. Five patients were immediately re-operated due to bleeding from uterine veins. The complication risk increases significantly with increasing tumor size. Among the whole cohort, even the FSFI score differences are small; there is a statistically significant decrease in the postoperative period in all domains except sexual satisfaction. In fact, the patients reported unaltered sexual function after surgery and satisfaction with the result when asked directly. In subgroup analyses, in nulliparous patients (n=60), arousal, sexual desire, orgasm and satisfaction domains have no significant differences in pre- and post-operative periods. CONCLUSIONS: Hybrid NOTES nephrectomy is a feasible, safe operation that can be performed for large renal tumors. Due to incisions in the vaginal wall for specimen retrieval, sexual function can be altered in the post-operative period. So, patient selection, pre-operative evaluation, and close follow-up are mandatory. With this in mind, we strongly support the use of hybrid transvaginal NOTES nephrectomy for large renal tumors especially in nulliparous patients.File | Dimensione | Formato | |
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