Female Sexual Function After Surgery for Benign Perianal Diseases

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.

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