{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T07:20:45Z","timestamp":1792653645073,"version":"4.5.0"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"\n Objective<\/jats:title>\n To compare postoperative sexual function outcomes following vaginal natural orifice transluminal endoscopic surgery (vNOTES) and laparoscopic tubal sterilization (LTS).<\/jats:p>\n <\/jats:sec>\n \n Material and Methods<\/jats:title>\n \n This retrospective comparative cohort analysis included 64 women with prospectively collected routine clinical data who underwent permanent surgical sterilization using vNOTES (\n n<\/jats:italic>\n = 31) or laparoscopy (\n n<\/jats:italic>\n = 33). Dyspareunia VAS, QSES, and FSFI scores were assessed preoperatively and at 6 months. Six-month outcomes were compared using ANCOVA adjusted for the corresponding baseline scores. Adjusted mean differences, 95% confidence intervals, and partial eta squared (partial \u03b7\n 2<\/jats:sup>\n ) were reported.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n After adjustment for baseline scores, the 6-month dyspareunia VAS score was significantly higher in the vNOTES group than in the LTS group (AMD, 0.44; 95% CI, 0.22 to 0.66; unadjusted\n p<\/jats:italic>\n &lt; 0.001; Holm-adjusted\n p<\/jats:italic>\n &lt; 0.002; partial \u03b7\n 2<\/jats:sup>\n = 0.210). No significant differences were observed in the primary outcome, total FSFI (AMD, -1.00; 95% CI, -2.70 to 0.70;\n p<\/jats:italic>\n = 0.240), or in QSES (AMD, -0.40; 95% CI, -2.10 to 1.30; Holm-adjusted\n p<\/jats:italic>\n = 0.640). Among the exploratory FSFI domains, only satisfaction remained significantly lower in the vNOTES group after Holm correction (AMD, -0.39; 95% CI, -0.61 to -0.17; Holm-adjusted\n p<\/jats:italic>\n &lt; 0.006). The unadjusted difference in lubrication did not remain significant after correction (Holm-adjusted\n p<\/jats:italic>\n = 0.055).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n vNOTES was associated with higher dyspareunia scores and lower satisfaction-domain scores at 6 months; however, no significant between-group differences were observed in total FSFI or QSES scores. These findings should be interpreted cautiously because of the retrospective, nonrandomized design and small sample size.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fmed.2026.1926568","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T05:36:20Z","timestamp":1787636180000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of sexual function outcomes after vNOTES and laparoscopic tubal sterilization"],"prefix":"10.3389","volume":"13","author":[{"given":"Begum","family":"Ertan","sequence":"first","affiliation":[{"name":"Department of Gynecology and Obstetrics, Saglik Bakanligi Akhisar Mustafa Kirazoglu Devlet Hastanesi","place":["Manisa, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gokce","family":"Aykanat","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Saglik Bakanligi Kinik Devlet Hastanesi","place":["\u0130zmir, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onur","family":"Yavuz","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, Dokuz Eyl\u00fcl \u00dcniversitesi","place":["\u0130zmir, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ufuk","family":"Atlihan","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, \u0130zmir Demokrasi \u00dcniversitesi","place":["\u0130zmir, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferruh","family":"Acet","sequence":"additional","affiliation":[{"name":"\u00d6zel Tavmergen IVF Clinic Infertilite ve T\u00fcp Bebek Merkezi","place":["\u0130zmir, T\u00fcrkiye"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"B1","volume-title":"Tubal Sterilization. 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Gynecol Surg"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1440","DOI":"10.1093\/jsxmed\/qdaf132","article-title":"Sexual functioning after vaginal natural orifice transluminal endoscopic surgery: combined results of two randomized controlled trials.","volume":"22","author":"Prekatsounaki","year":"2025","journal-title":"J Sex Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1007\/s00192-024-05969-z","article-title":"The effect of vaginal tightening surgery on sexual function: a systematic review.","volume":"36","author":"Alavi-Arjas","year":"2025","journal-title":"Int Urogynecol J"},{"key":"B7","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1080\/009262300278597","article-title":"The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function.","volume":"26","author":"Rosen","year":"2000","journal-title":"J Sex Marital Ther"},{"key":"B8","first-page":"393","article-title":"Kad\u0131n Cinsel \u0130\u015flev \u00d6l\u00e7e\u011fi\u2019nin T\u00fcrk\u00e7eye Uyarlamas\u0131 [the turkish adaptation of the female sexual function index].","volume":"25","author":"Aygin","year":"2005","journal-title":"Turkiye Klinikleri J Med Sci."},{"key":"B9","doi-asserted-by":"publisher","first-page":"2409","DOI":"10.1111\/jsm.12198","article-title":"The development and validation of a brief quality of sexual experience (QSE) scale: results from a nationally representative sample of men and women in the United States.","volume":"10","author":"Sanders","year":"2013","journal-title":"J Sex Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"48","DOI":"10.5455\/apd.41719","article-title":"The validity and reliability of the Turkish version of the Quality of Sexual Experience Scale.","volume":"21","author":"Yassa","year":"2020","journal-title":"Anatol J Psychiatry."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/00926230590475206","article-title":"The female sexual function index (FSFI): cross-validation and development of clinical cutoff scores.","volume":"31","author":"Wiegel","year":"2005","journal-title":"J Sex Marital Ther"},{"key":"B12","doi-asserted-by":"publisher","first-page":"913e","DOI":"10.1016\/j.jmig.2026.02.039","article-title":"Sexual quality of life after vNOTES surgery: a systematic literature review.","volume":"33","author":"Krull","year":"2026","journal-title":"J Minim Invasive Gynecol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"e202500062","DOI":"10.4293\/JSLS.2025.00062","article-title":"Comparison of transvaginal natural orifice surgery (vNOTES) and laparoscopic tubal ligation: effects on postoperative pain, sexual functions, and surgical outcomes.","volume":"29","author":"Genco","year":"2025","journal-title":"JSLS"},{"key":"B14","doi-asserted-by":"publisher","first-page":"3959","DOI":"10.3390\/jcm9123959","article-title":"Systematic review and meta-analysis on hysterectomy by vaginal natural orifice transluminal endoscopic surgery (vNOTES) compared to laparoscopic hysterectomy for benign indications.","volume":"9","author":"Housmans","year":"2020","journal-title":"J Clin Med"},{"key":"B15","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1002\/ijgo.15455","article-title":"Sexual quality of life and postoperative deep dyspareunia after vNOTES benign adnexal procedures.","volume":"166","author":"Berisha","year":"2024","journal-title":"Int J Gynaecol Obstet"},{"key":"B16","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1186\/s12905-023-02566-y","article-title":"Does transvaginal natural orifice transluminal endoscopic surgery affect female sexual function?: a prospective cohort 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