Sexual functioning after vaginal natural orifice transluminal endoscopic surgery: combined results of two randomized controlled trials

Area of Science:

• Minimally invasive gynecological surgery
• Surgical innovation
• Patient-reported outcomes

Background:

• Vaginal natural orifice transluminal endoscopic surgery (vNOTES) is an emerging minimally invasive technique.
• Laparoscopy is a standard surgical approach for gynecological procedures.
• The impact of vNOTES on sexual health and quality of life requires further investigation.

Purpose of the Study:

• To compare sexual functioning and quality of life in women undergoing hysterectomy or adnexectomy via vNOTES versus laparoscopy.
• To assess the long-term impact of surgical approach on female sexual health.

Main Methods:

• Two parallel group, 1:1 randomized single-blinded trials.
• Inclusion of women aged 18-70 years undergoing hysterectomy or adnexectomy for benign conditions.
• Assessment of sexual functioning and quality of life using questionnaires at baseline, 3, and 6 months post-surgery.

Main Results:

• No significant differences in sexual functioning were observed between vNOTES and laparoscopy groups at 3 and 6 months.
• An increasing negative association between quality of life and sexual functioning was noted at 3 and 6 months post-surgery.
• 68 women were in the vNOTES group and 67 in the laparoscopy group.

Conclusions:

• vNOTES does not offer a differential advantage over laparoscopy regarding sexual functioning after hysterectomy or adnexectomy.
• Sexual function's link to quality of life increases in relevance post-surgery, becoming a negative correlate.