Postoperative Sexual Quality of Life and Associated Factors After Loop Electrosurgical Excision Procedure Versus Cold Knife Conization in 185 Sexually Active Women With Preinvasive Cervical Lesions.

BACKGROUND Excisional treatment is widely used for preinvasive cervical lesions, but its effect on postoperative sexual quality of life remains uncertain. This study aimed to compare postoperative Sexual Quality of Life-Female (SQoL-F) scores and examine associated factors in women treated with cold knife conization or loop electrosurgical excision procedure (LEEP). MATERIAL AND METHODS This study included 185 sexually active women treated with cold knife conization (n=99) or LEEP (n=86) for histologically confirmed preinvasive cervical lesions during 2022-2024 and assessed at least 6 months postoperatively. The primary outcome was the total score on the validated 18-item SQoL-F questionnaire, transformed to a 0-100 scale. Between-group comparisons and multivariable linear regression with heteroskedasticity-consistent type 3 robust standard errors were performed. RESULTS Mean SQoL-F scores were similar after conization and LEEP (48.74±14.76 vs 49.70±12.76; P=0.640; Hedges' g=-0.07). In multivariable analysis, surgical technique was not associated with SQoL-F scores (ß=4.03; 95% confidence interval, -1.13 to 9.20; P=0.125). Age, marital status, weekly sexual frequency, family structure, preoperative sexual life perception, postoperative expectation, and body perception were associated with SQoL-F scores. The model explained 23.7% of the variance (R²=0.237), and internal consistency was high (Cronbach's alpha=0.886). CONCLUSIONS SQoL-F scores did not differ significantly between women who underwent cold knife conization and those who underwent LEEP. Several demographic, psychosocial, and interpersonal factors, rather than surgical technique, were associated with SQoL-F scores, although the cross-sectional design precludes causal inference.