Fertility and Sexual Function after Loop Electrosurgical Excision Procedure in Patients with High-Grade Squamous Intraepithelial Lesion

Objective: Loop electrosurgical excision procedure (LEEP) is the first choice for patients with high-grade squamous intraepithelial lesion (HSIL). This study aimed to investigate postoperative fertility and sexual function in patients with HSIL after LEEP. Methods: This cohort study included patients with HSIL enrolled at 11 obstetrics and gynecology hospitals between January 1, 2013, and December 31,2015. The patients were treated with LEEP only. Ultimately, 760 patients meet our inclusion and exclusion criteria. Our research included two parts: The effect of LEEP on postoperative fertility and the effect of LEEP on postoperative sexual function. In the two different parts of the research, we chose different case series according to their follow up information. Results: In the LEEP group, 125 patients had successful deliveries and 27 were preterm (21.6%). The risk of preterm birth was significantly higher in the case group (relative risk [RR]: 2.634; 95% confidence interval [CI]: 1.689-4.108). As the cone depth and volume increased, the risk of preterm increased. In this study, the raw relative risk of cesarean section (CS) was increased in the LEEP group, however the constituent ratio of the indications in the LEEP group was not significantly different from that of the control group. With increased cone depth and volume, pain during postoperative sexual intercourse gradually increased. Conclusions: LEEP increases the risk of preterm birth. The risk increases as the cone depth and volume increases. LEEP could lead to pain during sexual intercourse.