Lewicky Christina E, Valentin Carl, Saclarides Theodore J
Section of Colon and Rectal Surgery, Rush University Medical Center, Chicago, Illinois, USA.
Dis Colon Rectum. 2004 Oct;47(10):1650-4. doi: 10.1007/s10350-004-0648-2.
Our goal was to evaluate sexual function following anal sphincteroplasty in women with third and fourth degree perineal tears secondary to birth trauma
Our study was performed using a retrospective cohort design in a group of women (n = 32) who had experienced either third-degree or fourth-degree perineal tears during labor and then elected to undergo sphincteroplasty for fecal incontinence. We surveyed our patients with a questionnaire that was developed by the Obstetrics and Gynecology Epidemiology Center at Harvard Medica School and was previously used to survey women with obstetric injuries. Self-reported presphincteroplasty and post sphincteroplasty degree of physical sensation, sexual satisfaction, and likelihood of achieving orgasm were measured Also measured were libido, partner satisfaction, and presence of emotional or physical inability to engage in sexual behavior.
Our results reaffirmed the findings of the Obstetrics and Gynecology Epidemiology Center's study that sexual function is compromised in women with third and fourth-degree perineal tears. For our patients with this degree of perineal tearing who underwent sphincteroplasty after primary repair, our survey showed consistent improvement in several parameters of sexual function. After sphincteroplasty, physical sensation was higher/much higher in 40 percent, sexual satisfaction was better/much better in 33.3 percent, and 28.6 percent of the patients were more/much more likely to reach orgasm. Libido was improved in 37.5 percent of the study population, and 20 percent reported increased partner satisfaction. Before surgery, 23.5 percent of patients were physically and 31.2 percent emotionally unable to participate in sexual activity because of fear of incontinence or intimacy; after surgery only 6.3 percent were physically unable and 0 percent were emotionally unable to engage in sexual activity. The response rate for our study was 18/32 (56 percent).
Anal sphincteroplasty for the treatment of incontinence in women with third- and fourth-degree perineal tears improves physical and emotional sexual well-being and function.
我们的目标是评估因分娩创伤导致会阴三度和四度撕裂的女性在接受肛门括约肌成形术后的性功能。
我们采用回顾性队列研究设计，对一组女性（n = 32）进行研究，这些女性在分娩期间经历了三度或四度会阴撕裂，随后因大便失禁而选择接受括约肌成形术。我们使用由哈佛医学院妇产科流行病学中心开发的问卷对患者进行调查，该问卷先前用于调查有产科损伤的女性。测量了自我报告的括约肌成形术前和术后的身体感觉程度、性满意度以及达到性高潮的可能性。还测量了性欲、伴侣满意度以及存在情感或身体上无法进行性行为的情况。
我们的结果再次证实了妇产科流行病学中心的研究结果，即会阴三度和四度撕裂的女性性功能受损。对于我们这组在初次修复后接受括约肌成形术的会阴撕裂程度如此的患者，我们的调查显示性功能的几个参数持续改善。括约肌成形术后，40%的患者身体感觉更高/高得多，33.3%的患者性满意度更好/好得多，28.6%的患者更有可能/更有可能达到性高潮。37.5%的研究人群性欲得到改善，20%的患者报告伴侣满意度增加。手术前，23.5%的患者因担心失禁或亲密关系而在身体上无法参与性活动，31.2%的患者在情感上无法参与；手术后，只有6.3%的患者在身体上无法参与，0%的患者在情感上无法参与性活动。我们研究的回复率为18/32（56%）。
对于治疗会阴三度和四度撕裂女性的大便失禁，肛门括约肌成形术可改善身体和情感方面的性健康及功能。
