Self-Report Assessment of Sexual Function After LEEP in Women who Report Negative Outcomes
Notice bibliographique
Résumé
ABSTRACT Introduction The Loop Electrosurgical Excision Procedure (LEEP) is a fast and highly effective method of removing cervical dysplasia. Interestingly, it has been reported that a subpopulation of women have negative symptoms post-LEEP, including significant decreases in arousal, lubrication, and orgasm satisfaction. There is discord surrounding the role of the cervix in sexual responses that has likely resulted in a lack of physician-patient communication regarding possible risks of female sexual dysfunction (FSD) after cervical procedures, such as the LEEP. Barriers to discussion may include a lack of standardized sexual health care pre- and post-operatively, lack of FSD resources, and inconsistent practices regarding patient-centered care and open conversations. Our study proposes that the symptom profile of women who have post-LEEP FSD is not only unique, but that it may be revealed by pre-and post-operative assessment using existing validated surveys as well as through open conversations. Objective This study defines a symptom profile of patients who report negative post-LEEP outcomes related to FSD. It also determines whether a combination of validated self-report surveys and open conversations could elucidate FSD concerns pre- and post-operatively. Methods First, a self-report survey was developed by researchers that included questions regarding locations of sexual responses and barriers to sexual health conversations; the full FSFI was included as a discrete component of the survey. Sixty-four participants were recruited from online patient groups, completed the online surveys, and were subsequently interviewed by the research team. The semi-structured interview protocol that was developed aimed to construct a narrative from women who report FSD following LEEP to develop an understanding of the language they use to describe their distress and dysfunction. The responses elucidated from these conversations were transcribed, and qualitative analysis was performed using NVivo12. Results Our study validated the results from previous studies with regards to the existence of a subpopulation of women who report FSD following LEEP using self-report surveys. However, this study is the first to report a unique symptom profile of post-LEEP FSD patients that was not detected using existing validated tools such as the FSFI. Participants consistently described symptoms of altered or loss of cervical sensation during sex (numbness), pain with vaginal penetration, decreased lubrication, depression, loss of interest, arousal, desire, self-confidence, as well as issues with partners. Participants also described inadequate or absent pre-operative care regarding the disclosure of possible risks as well as screening for FSD. Post-operative care was reported to be minimal, with most patients feeling uncomfortable discussing sexual health concerns with their care providers. Patients also described a lack of resources available to them after LEEP, though they wished their physicians had provided them with this information. Conclusions This study identifies a unique symptom profile of women who reported negative post-surgical outcomes which is distinct from symptoms previously reported by validated FSD screeners, an area which has not been researched sufficiently within the focus of LEEP. This study may inform future investigations targeting the development and administration of FSD assessment tools to standardize LEEP counselling and thereby improve patient outcomes. Disclosure No
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».