Abstract
Background
Sexual dysfunction is a medical condition that can lead to relationship issues as well as depression and has a somatoform basis. It is estimated to affect 49 % of Brazilian women. Studies have shown that both cancer diagnosis and its surgical treatment (mastectomy) affect women psychologically and can lead to psychiatric disorders. The aim of this study was to evaluate and compare sexuality in women who underwent mastectomy alone with those who underwent breast reconstruction after mastectomy.
Method
This descriptive transversal study analyzed two groups of patients, one with 17 women after mastectomy alone and another with 19 women who underwent breast reconstruction post mastectomy. The patients ranged in age from 18 to 60 years old. The exclusion criteria were illiteracy; ongoing chemotherapy, radiotherapy, or psychiatric treatment; or if any surgery had been performed the previous year. All patients were from the Gynecology and Plastic Surgery Department of the Federal University of São Paulo. They voluntarily answered the FSFI (Female Sexual Function Index) questionnaire. Statistical analyses were performed using Student’s t test and Pearson’s coefficient, and the significance level used was p < 0.05.
Results
Data showed a lower FSFI score for the mastectomy-alone group compared to the breast reconstruction group (median = 10.15 ± 2.636 and 22.44 ± 3.055, respectively; p = 0.0057). There was no relationship established between the scores and postoperative time (post, p = 0.9382; pre, p = 0.2142) or between scores and remuneration income (post, p = 0.7699; pre, p = 0.5245), stable relationship (post, p = 0.2613; pre, p = 0.5245), and age (post, p = 0.3951; pre, p = 0.8427) for both groups. Mean age has shown no significant difference (p = 0.4740; median post = 47.71 ± 2.012; medina pre = 46.69 ± 1.809).
Conclusion
An improvement in sexual function has been observed in patients who underwent breast reconstruction after mastectomy, probably as a result of better self-esteem as well as body image, both of which are affected by a mastectomy. The aesthetic results were evaluated using a questionnaire, and all the patients answered positively.
Level of Evidence V
This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
References
Hentschel H (2001) Sexualidade humana. In: Freitas FM, Menke CH, Rivoire WA (eds) Rotinas em Ginecologia. Artmed, Porto Alegre
Ganz PA, Greendale GA (2007) Female sexual desire—beyond testosterone. J Natl Cancer Inst 99(9):659–661
Blaicher W, Gruber D, Bieglmayer C, Blaicher AM, Knogler W, Huber JC (1999) The role of oxytocin in relation to female sexual arousal. Gynecol Obstet Invest 47(2):125–126
Salonia A, Nappi RE, Pontillo M, Daerio R, Smerldi A, Briganti A et al (2005) Menstrual cycle-related changes in plasma oxytocin are relevant to normal sexual function in healthy women. Horm Behav 47(2):164–169
Comfort A (1984) O prazer do sexo, 3rd edn. Martin Fontes, São Paulo
Masters WH, Johnson VE (1984) A resposta sexual humana. Roca, São Paulo
Anastasiadis AG, Davis AR, Ghafar MA, Burchardt M, Shabsigh R (2002) The epidemiology and definition of female sexual disorders. World J Urol 20(2):74–78
Basson R (2006) Sexual desire and arousal disorders in women. N Engl J Med 325(14):1497–1506
Kaplan HS, Sadock BJ (1988) Human sexuality. Clinical psychiatry, 5th edn. Williams and Wilkins, Baltimore
Berman J, Bassuk J (2002) Physiology and pathophysiology of female sexual function and dysfunction. World J Urol 20(2):111–118
Salles JM (1984) Tratado de ginecologia: anatomo-fisiologia da resposta sexual humana. Roca, São Paulo
Nicolosi A, Laumann EO, Glasser DB, Moreira ED Jr, Paik A, Gingell C (2004) Sexual behavior and sexual dysfunctions after age 40: the global study of sexual attitudes and behaviors. Urology 64(5):991–997
Alderman AK, Wilkins EG, Lowery JC, Kim M, Davis JA (2000) Determinants of patient satisfaction in postmastectomy breast reconstruction. Plast Reconstr Surg 106:769–776
Veiga DF, Sabino Neto M, Ferreira LM et al (2004) Quality of life outcomes after pedicled TRAM flap delayed breast reconstruction. Br J Plast Surg 57:252–257
Jones LR (2002) The use of validated questionnaires to assess female sexual dysfunction. World J Urol 20(2):89–92
West SL, Vinikoor LC, Zolnoun D (2004) A systematic review of the literature on female sexual dysfunction prevalence and predictors. Annu Rev Sex Res 15:40–172
Conflict of interest
The authors have no conflicts of interest to disclose.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Neto, M.S., de Aguiar Menezes, M.V., Moreira, J.R. et al. Sexuality After Breast Reconstruction Post Mastectomy. Aesth Plast Surg 37, 643–647 (2013). https://doi.org/10.1007/s00266-013-0082-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00266-013-0082-8