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Transvaginal Cholecystectomy:  Effect on Quality of Life and Female Sexual Function

Stephanie G. Wood, MD; Daniel Solomon, MD; Lucian Panait, MD; Robert L. Bell, MD; Andrew J. Duffy, MD; Kurt E. Roberts, MD
JAMA Surg. 2013;148(5):435-438. doi:10.1001/jamasurg.2013.108.
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Importance Transvaginal cholecystectomy (TVC) is the leading natural orifice transluminal endoscopic surgery to date and has the potential to offer improved cosmesis, less pain, and shorter recovery times for female patients.

Objective To investigate quality of life and female sexual function in our patients undergoing TVC.

Design A prospective cohort study from August 14, 2009, to June 12, 2012, of TVCs performed at our institution to date.

Setting Tertiary academic referral center.

Participants The first 47 consecutive female patients (aged 18-65 years) who received a TVC by a single surgeon.

Interventions A hybrid TVC was performed by a 5-mm umbilical trocar and a 12-mm transvaginal trocar with standard laparoscopic instruments.

Main Outcomes and Measures Quality-of-life index (36-Item Short Form Health Survey) and female sexual function (Female Sexual Function Index) scores.

Results A total of 47 TVCs were performed, with a mean age of 39 years, mean body mass index (calculated as weight in kilograms divided by height in meters squared) of 31, and mean operative time of 65 minutes. No difference was noted in overall female sexual function from preoperatively to 1 and 3 months postoperatively. When comparing quality of life preoperatively vs 1 and 3 months postoperatively, there were significant improvements in physical function (P = .02), energy and fatigue (P = .001), emotional well-being (P = .01), pain (P < .001), and general health (P = .03). No significant changes were noted in physical limitations (P = .18), emotional problems (P = .72), and social function (P = .12).

Conclusions and Relevance In our experience to date, female sexual function is unchanged and quality of life either is unchanged or improves at 1 and 3 months following TVC. Undergoing TVC does not appear to negatively affect female sexual function or quality of life in the short term.

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Figure. Analysis of female sexual function using Female Sexual Function Index (FSFI) scores of patients undergoing transvaginal cholecystectomy. A, Overall sexual function scores. B, Sexual function domain scores. * P = .02. Error bars indicate standard error of the mean.

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