(055) Effect of Loop Electrosurgical Excision Procedure (LEEP) on Female Sexual Function

Abstract

Abstract Introduction Cancer of the uterine cervix is the third most common gynecologic cancer and accounts for approximately 528,000 new cancer cancers globally, on an annual basis. Cervical cancer continues to be the second leading cause of cancer death for women aged 20 to 39. Human papillomavirus (HPV) infection is responsible for the majority of cervical cancer cases. Screening with cervical cell cytology in conjunction with HPV testing is an effective screening technique that enables providers to risk-stratify women with cervical dysplasia for subsequent development of invasive cervical cancer. Colposcopy is a diagnostic technique utilized as a follow-up for abnormal cervical screening test results. Depending on the adequacy of the colposcopy procedure and the patient’s histology, an excisional procedure may be required. Loop electrosurgical excision (LEEP) is one of three common techniques employed to remove the pre- cancerous transformation zone. Theoretically this “minimally invasive” approach reduces thermal injury to surrounding structures, causes less intraoperative bleeding, and creates smaller excised specimens. The aim of this technique is to minimize cervical trauma compared to other excisional techniques. However, to date, there have been no prospective studies to examine the effect of excisional biopsy on patient-centered outcomes, such as sexual satisfaction post-procedure and subsequent development of subsequent sexual dysfunction. A 2015 review article found only 6 studies examining the effect of excisional biopsy on sexual dysfunction. There have only been four published prospective studies examining the effect of LEEP on sexual function, and only two of them utilized validated research questionnaires. Our university-based clinic performs approximately 1000 colposcopies and 100 LEEP procedures annually. The Medical Faculty Associates practice providers care to both a racially and socioeconomically diverse patient population. Objectives We plan to conduct a prospective cohort study in 736 women comparing FSFI and FSDS-R scores, and the prevalence of sexual dysfunction (defined as FSFI < 26 points) among patients who undergo colposcopy versus patients who undergo both colposcopy and LEEP. Methods The FSFI and FSDS-R questionnaires will be completed at their initial encounter after having an abnormal pap smear. This initial questionnaire will serve as our baseline measurement. If the patient did not need any additional procedures, they will complete the FSFI and FSDS-R questionnaires at 6 and 12 weeks after colposcopy. If further excision is required, patients will complete the questionnaires at 6 and at 12 weeks after their LEEP procedure. Results Results are pending completion of study enrollment. Analyses will be controlled for parity, age, menopausal status, psychotropic medication use, anxiety or depression diagnosis. Conclusions We anticipate our study to find no difference in FSFI score or FSDS-R score among women who have undergone colposcopy versus colposcopy versus LEEP. We plan to have interim results to present at the upcoming conference. Disclosure No.