Chronic Anal Fissure, Cryptoglandular Anal Fistula, Hemorrhoidal Disease
Conditions
Keywords
Cryptoglandular Anal Fistula, Chronic Anal Fissure, Hemorrhoidal Disease, FSFI, Sexual Functions, Perianal Pain
Brief summary
Benign perianal diseases such as chronic anal fissure, hemorrhoidal disease, and cryptoglandular anal fistula may negatively affect female sexual function through pain, bleeding, discharge, discomfort, and impairment in quality of life. Although improvement in male sexual function after surgery for benign anorectal disorders has been reported, data regarding female sexual function remain limited. This prospective observational cohort study aims to evaluate changes in Female Sexual Function Index (FSFI) scores following surgical treatment of benign perianal diseases. Female patients undergoing surgery for chronic anal fissure, hemorrhoidal disease, or cryptoglandular anal fistula will be assessed preoperatively and at postoperative 3 and 6 months using the FSFI, Cleveland Clinic Incontinence Score (CCIS/Wexner), and Visual Analog Scale (VAS). The primary objective is to determine whether female sexual function improves following surgical treatment. Secondary objectives include evaluating the relationship between symptom improvement, continence status, pain reduction, and changes in female sexual function.
Detailed description
Female sexual function is a multidimensional concept influenced by physical, psychological, and social factors. Benign perianal diseases are common surgical conditions that may adversely affect sexual function through chronic pain, bleeding, discharge, prolapse, discomfort, embarrassment, and reduced quality of life. Previous studies have demonstrated impaired sexual function among patients with anorectal disorders. Furthermore, improvement in male sexual function following surgical treatment of benign anorectal diseases has been reported. However, prospective data regarding female sexual function after surgical treatment of benign perianal diseases remain scarce. This single-center prospective observational cohort study will be conducted at Gazi University Faculty of Medicine. Sexually active women aged 18 to 70 years undergoing surgery for chronic anal fissure, hemorrhoidal disease, or cryptoglandular anal fistula will be enrolled. Participants will complete the Female Sexual Function Index (FSFI), Cleveland Clinic Incontinence Score (CCIS/Wexner), and Visual Analog Scale (VAS) questionnaires before surgery and at postoperative 3 and 6 months. The primary outcome will be the change in total FSFI score from baseline to postoperative 6 months. Secondary outcomes will include changes in FSFI at 3 months, changes in CCIS and VAS scores, and subgroup analyses according to disease type and symptom severity. The investigators hypothesize that successful surgical treatment of benign perianal diseases will result in significant improvement in female sexual function and that this improvement will correlate with reductions in pain and disease-related symptoms.
Interventions
PROCEDURESurgical Treatment for Benign Perianal Diseases
Standard surgical treatment for chronic anal fissure, hemorrhoidal disease, or cryptoglandular anal fistula according to routine clinical indications. No experimental intervention will be administered.
Sponsors
Gazi University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 70 Years
Healthy volunteers
No
Inclusion criteria
* Female patients aged 18-70 years * Sexually active during the previous 4 weeks * Diagnosed with chronic anal fissure, hemorrhoidal disease, or cryptoglandular anal fistula * Scheduled for surgical treatment according to routine clinical indications * Able to understand and complete study questionnaires * Willing to provide written informed consent
Exclusion criteria
* Inflammatory bowel disease (Crohn's disease or ulcerative colitis) * Pregnancy * Postpartum period within the previous 12 months * Pelvic organ prolapse * Previous treatment for female sexual dysfunction * Current antidepressant medication use * Active psychiatric disorder * Gynecological malignancy * Previous pelvic radiotherapy * Inability or unwillingness to complete study questionnaires * Refusal to provide informed consent
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Total Female Sexual Function Index Score From Baseline to 6 Months | Baseline and postoperative 6 months | Change in total Female Sexual Function Index (FSFI) score between the preoperative baseline assessment and postoperative 6-month follow-up. The FSFI total score ranges from 2 to 36, with higher scores indicating better female sexual function. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Total Female Sexual Function Index Score From Baseline to 3 Months | Baseline and postoperative 3 months | Change in total Female Sexual Function Index (FSFI) score between the preoperative baseline assessment and postoperative 3-month follow-up. The FSFI total score ranges from 2 to 36, with higher scores indicating better female sexual function. |
| Change in Cleveland Clinic Incontinence Score From Baseline to 6 Months | Baseline and postoperative 6 months | Change in Cleveland Clinic Incontinence Score/Wexner score between baseline and postoperative 6 months. The score ranges from 0 to 20, with higher scores indicating more severe fecal incontinence. |
| Change in Visual Analog Scale Pain Score From Baseline to 6 Months | Baseline and postoperative 6 months | Change in anal pain assessed using a 0-10 Visual Analog Scale between baseline and postoperative 6 months. Higher scores indicate more severe pain. |
| Disease-specific Change in Total FSFI Score | Baseline, postoperative 3 months, and postoperative 6 months | Comparison of change in total Female Sexual Function Index (FSFI) score among disease subgroups, including chronic anal fissure, hemorrhoidal disease, and cryptoglandular anal fistula. The FSFI total score ranges from 2 to 36, with higher scores indicating better female sexual function. |
Contacts
CONTACTMesut Yavaş, MD, Assistant of Professor
PRINCIPAL_INVESTIGATORMesut Yavaş, MD, Assistant of Professor
Gazi University Faculty of Medicine
Outcome results
None listed