Results
A total of 130 patients were included in this study including 65 in the vNOTES group and 65 in the control group. Among them, 3 patients in the vNOTES group and 2 patients in the control group dropped out during the 3 months of follow-up due to incorrect phone numbers. Moreover, 1 patient in the vNOTES group was dropped out during the 6 months of follow-up, because she did not have sexual activity in the last month and refused to complete the questionnaire. Finally, 61 patients in the vNOTES group and 63 patients in the control group were followed up (Fig. 
Subject screening and completion flowchart
FSFI score of patients in control group pre- and post-operationThe average age of included patients was 31.70 ± 5.02 and 30.37 ± 5.74 years old in the vNOTES group and control group respectively, and there was no statistically significant difference between the two groups (P = 0.413). The average body mass index (BMI) of patients in the vNOTES group and control group was 21.76 ± 3.16 Kg/m2 and 23.30 ± 2.69 Kg/m2 respectively, with no significant difference between the two groups (P = 0.077). The preoperative FSFI score of patients in the vNOTES group and control group was 22.31 ± 2.25 and 21.55 ± 3.38 respectively, with no statistically significant difference (P = 0.143). There was no statistically significant difference between the two groups in terms of education level and surgical type (Table The total FSFI score of patients in the vNOTES group before surgery, 3 months after surgery, and 6 months after surgery was 22.31 ± 2.25, 22.06 ± 3.07, and 21.61 ± 3.22 respectively. There was no statistically significant difference in the total score of FSFI at 3 months and 6 months after surgery compared with the total score of FSFI before surgery (P = 0.085) (Table The total FSFI score of patients in the control group before surgery, 3 months after surgery, and 6 months after surgery was 21.55 ± 3.38, 21.00 ± 2.95, and 20.99 ± 3.26 respectively. There was no statistically significant difference in the total score of FSFI at 3 months and 6 months after surgery compared with the total score of FSFI before surgery (P = 0.228) (Table Compared with that in the control group, the total score of FSFI in the vNOTES group had no statistical difference at 3 months and 6 months after surgery. The time to start sexual life after surgery in the vNOTES group and control group was 39.34 ± 0.71 days and 37.86 ± 0.69 days respectively, with a significant difference (P = 0.001) (Table 
Comparison between vNOTES group and control group postoperation