Women's sexual quality of life after ectopic pregnancy surgery - vNOTES vs conventional laparoscopy - a retrospective cohort study.

Objectives: This study aims to compare the postoperative sexual function and recovery outcomes between women who underwent vNOTES (vaginal natural orifice transluminal endoscopic surgery) and those who underwent conventional laparoscopy (CL) for ectopic pregnancies.

Material and methods: A retrospective cohort study was conducted with data from 98 patients who underwent CL or vNOTES for ectopic pregnancy. Postoperative sexual function and genital self-image were evaluated using the Female Sexual Function Index (FSFI) and Female Genital Self-Image Scale (FGSIS) surveys, respectively. Patients were divided into the vNOTES group (n = 40) and the CL group (n = 58).

Results: The postoperative FSFI total scores did not significantly differ between the vNOTES group and the CL group (p = 0.384). However, the lubrication subgroup score of the FSFI was significantly higher in the CL group compared to the vNOTES group (p = 0.001). The FGSIS total score was significantly higher in the vNOTES group compared to the CL group (p = 0.009).

Conclusions: While vNOTES surgery may offer some postoperative benefits in terms of genital self-image, it is associated with lower lubrication scores compared to conventional laparoscopy. These findings highlight the potential impact of vNOTES on sexual function, emphasizing the need for further research to optimize surgical approaches that balance sexual function and recovery outcomes.