Quality of life, sexuality and reproductive health in women after hybrid transvaginal NOTES

Angel Cuadrado-garcia, MD, PhD, Anna Sanchez Lopez, MD, Jose Francisco Noguera, PhD, MD, Jose Maria Munoz, MD, Rafael Morales Soriano, MD, Santiago Baena Bradaschia, MD, Jose Manuel Olea Martinez, MD, Antonia Crespi Mir, MD

Hospital Son Llatzer, IUNICS (Palma, Spain). Hospital General (Valencia, Spain)

Background:
Hybrid transvaginal approach has been one of the most important efforts to begin and evaluate Natural Orifice Translumenal Endoscopic Surgery (NOTES ) in the last five years. One of the most significant objections to this procedure has been its possible dangers for sexual and reproductive health of the female patients. Quality of Life (QoL) and sexuality questionnaires are the best way to evaluate changes in life of our patients.

Aim: 
Symptomatic cholelithiasis is a relatively common condition in fertile women. Laparoscopic cholecystectomy has been found to be the gold standard of surgical treatment for cholelithiasis. The aim of the present study was to prospectively evaluate the quality of life and sexual function of patients who have undergone hybrid transvaginal NOTES procedures (principally cholecystectomy for symptomatic cholelithiasis) and compare them with those who underwent laparoscopic surgery.

Methods: 
All patients undergoing hybrid transvaginal NOTES surgical procedures in HSLL Surgery Department were prospectively recruited in the study. After ethical committee approval, and with an informed consent, details regarding demography, digestive-related symptoms, procedure and postoperative recovery were collected. From five to one year after the operation patients were phoned and answered a questionnaire asking about digestive-related symptoms, quality of life, reproductive and sexual function. The SF-12 Health Survey and McCoy Female Sexuality Questionnaire were used for this purpose. A randomized group of female cholelap patients between 18 to 65 years old were selected and interviewed as NOTES patients.

Results: 
A total of 60 patients responded to the SF-12 and McCoy questionnaires, 37 in NOTES group and 23 in Cholelap. 6 NOTES patients were lost during follow up. Digestive symptoms decreased significantly after the operation in both groups. The responses showed improvements in the overall score and scores for five different dimensions (usual activities, p=0.03, discomfort and symptoms, p<0.001, distress, p<0.001, vitality, p<0.01, and sexual activity, p<0.01). There were 2 pregnancies in NOTES group , 1 in Cholelap group and no abortions. Sexual, reproductible problems and partner satisfaction scores had not changed significantly. Sexual satisfaction was greater after the operation (p=0.01)

Conclusion: 
Laparoscopic and NOTES cholecystectomies significantly reduce digestive-related symptoms and there weren’t statistically differences between QoL, sexual or reproductive life between both groups.


Session: Poster Presentation

Program Number: P578

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