Salonia Andrea, Zanni Giuseppe, Nappi Rossella E, Briganti Alberto, Dehò Federico, Fabbri Fabio, Colombo Renzo, Guazzoni Giorgio, Di Girolamo Valerio, Rigatti Patrizio, Montorsi Francesco
Divisione di Urologia, University Vita-Salute San Raffaele, Istituto Scientifico San Raffaele, Via Olgettina 60, 20132 Milano, Italy.
Eur Urol. 2004 May;45(5):642-8; discussion 648. doi: 10.1016/j.eururo.2003.11.023.
The aim of this study was to determine the prevalence of sexual dysfunctions in women with urinary incontinence and/or lower urinary tract symptoms as compared to a general female population.
We extensively evaluated 227 consecutive women (mean age 52; age range 19-66) complaining of urinary incontinence (UI) and/or lower urinary tract symptoms (LUTS) with a comprehensive history (including several validated questionnaires), a complete physical examination and a urodynamic multichannel evaluation. Two hundred and sixteen patients were eligible for sexual function investigation because 11 out of 227 (5%) were not interested in dealing with questions regarding their own sexuality and were thus excluded from the final evaluation results. A group of 102 age-matched women (mean age 54; age range 19-63) assessed for a yearly routine gynaecological evaluation and not complaining of urinary symptoms were enrolled as cross-sectional controls and investigated in accordance with the Female Sexual Function Index (FSFI).
Sexual dysfunction was diagnosed in 99 out of 216 patients (46%). Of these, 34 (34%) reported hypoactive sexual desire, 23 (23%) reported sexual arousal disorder; 11 patients (11%) complained of orgasmic deficiency, and 44 (44%) suffered from sexual pain disorder (e.g., dyspareunia or non-coital genital pain). Women reporting low sexual desire commonly suffered from stress incontinence (47%). We found that 60% of the women with sexual arousal disorders and 61% of those with sexual pain disorders also complained of recurrent bacterial cystitis. Forty-six percent of those complaining of orgasmic phase difficulties also reported a troublesome urge incontinence. The FSFI values in both groups scored as follows (patients versus controls; median value; p value): desire: 2.0 vs. 3.2 (p<0.01); arousal: 2.8 vs. 3.6 (p=n.s.); lubrication: 3.2 vs. 4.4 (p=0.01); orgasm: 4.1 vs. 4.4 (p=n.s.); sexual satisfaction: 2.7 vs. 4.0 (p<0.01); sexual pain: 1.8 vs. 4.0 (p<0.001).
Women reporting UI or LUTS also complained of sexual dysfunctions in a significantly higher number than a general, healthy female population not complaining of urinary symptoms. Investigation of female sexuality is suggested for these patients.
本研究旨在确定与普通女性人群相比，尿失禁和/或下尿路症状女性性功能障碍的患病率。
我们对连续227名主诉尿失禁（UI）和/或下尿路症状（LUTS）的女性（平均年龄52岁；年龄范围19 - 66岁）进行了全面评估，包括详细病史（包括几份经过验证的问卷）、完整的体格检查和尿动力学多通道评估。227名患者中有216名符合性功能调查条件，因为227名中有11名（5%）对涉及自身性方面的问题不感兴趣，因此被排除在最终评估结果之外。选取102名年龄匹配的女性（平均年龄54岁；年龄范围19 - 63岁）作为横断面对照，她们因每年的常规妇科检查前来评估且无尿路症状主诉，并根据女性性功能指数（FSFI）进行调查。
216名患者中有99名（46%）被诊断为性功能障碍。其中，34名（34%）报告性欲减退，23名（23%）报告性唤起障碍；11名患者（11%）主诉性高潮缺乏，44名（44%）患有性交疼痛障碍（如性交困难或非性交时生殖器疼痛）。报告性欲低下的女性通常患有压力性尿失禁（47%）。我们发现，60%的性唤起障碍女性和61%的性交疼痛障碍女性也主诉复发性细菌性膀胱炎。主诉性高潮期困难的患者中有46%也报告有急迫性尿失禁问题。两组的FSFI值得分如下（患者组与对照组；中位数；p值）：性欲：2.0对3.2（p<0.01）；性唤起：2.8对3.6（p=无统计学意义）；润滑：3.2对4.4（p=0.01）；性高潮：4.1对4.4（p=无统计学意义）；性满意度：2.7对4.0（p<0.01）；性交疼痛：1.8对4.0（p<0.001）。
与无尿路症状主诉的普通健康女性人群相比，报告有尿失禁或下尿路症状的女性性功能障碍主诉的人数明显更多。建议对这些患者进行女性性功能调查。
