The SOMA (Subjective, Objective, Management, Analytic) – LENT (Late Effects of Normal Tissue) scoring system can be used to evaluate a woman with sexual dysfunction occurring as a complication following radiation and chemotherapy.
Subjective measures:
(1) dsypareunia
(2) dryness
(3) desire
(4) satisfaction
Objective measures:
(1) vaginal stenosis / length
(2) synechiae
(3) frequency
(4) orgasm
Management measures:
(1) dryness
(2) stenosis / synechiae
(3) dsypareunia
Analytic studies:
(1) Psychocial: To evaluate the quality of life and sexual satisfaction.
(2) Vaginal measurement: To evaluate the degree of vaginal stenosis.
If no toxicity is present, then the 0 points are assigned.
If a toxicity is present, then the grade indicates the number of points to assign.
|
|
Grade 1 |
Grade 2 |
Grade 3 |
Grade 4 |
|
dyspareunia |
occasional |
intermittent |
persistent |
refractory |
|
dryness |
occasional |
intermittent |
persistent |
refractory |
|
desire |
occasional |
intermittent |
seldom |
never |
|
satisfaction |
occasional |
intermittent |
seldom |
never |
|
vaginal stenosis/length |
> 2/3rds of normal length |
1/3 to 2/3 of normal length |
< 1/3rd normal length |
obliteration |
|
synechiae |
NA |
NA |
partial |
complete |
|
frequency |
NA |
decreased from normal |
rare |
never |
|
orgasm |
occasional |
intermittent |
seldom |
never |
|
dryness management |
hormone replacement |
artificial lubrication |
NA |
NA |
|
stenosis / synechiae management |
occasional dilation |
intermittent dilation |
persistent dilation |
surgical reconstruction |
|
dyspareunia management |
occasional hormone cream |
intermittent hormone cream |
persistent hormone cream |
NA |
where:
• I would imagine that the order for "occasional" and "intermittent" for desire and satisfaction should be different than dyspareunia and dryness. Perhaps "loss of desire" and "decrease in satisfaction" might work better.
• Synechiae = adhesions; complete = fusion
total score =
= SUM(points for all 11 items)
LENT score =
= (total score) / 11
Interpretation:
• maximum total score: 41
• minimum LENT score: 0
• maximum LENT score: 3.73
Specialty: Hematology Oncology, Obstetrics & Gynecology
