Jeng Cherng-Jye, Yang Yuh-Cheng, Tzeng Chii-Ruey, Shen Jenta, Wang Lih-Rong
Department of Obstetrics, Cathay General Hospital, Taipei Medical University, Taiwan.
J Reprod Med. 2005 Sep;50(9):669-74.
To examine changes in sexuality after total vaginal hysterectomy (TVH) or transvaginal sacrospinous uterine suspension (SSUS)for uterine prolapse.
One hundred fifty-eight women with moderate to severe uterine prolapse undergoing TVH (78) or SSUS (80) were included in a prospective study from January 2001 to June 2002. All women were <50 years old and sexually active within the last 6 months before surgical intervention. None had major medical disorders. Sexual functioning before and 6 months after surgery was examined via a face-to-face questionnaire. Sexual interest, sexual satisfaction, frequency of sexual intercourse and frequency of orgasm were measured using an analogue scale.
Of women undergoing TVH, 5.1% had decreased sexual interest, and 21% had less frequent orgasms postoperatively. For women undergoing SSUS, 13% had decreased sexual interest, and 20% had less frequent orgasms postoperatively. Frequency of orgasm was the only parameter that changed significantly after surgery in the 2 groups. All women with less frequent orgasms said that they were afraid of wound disruption or disease recurrence and so refrained from vigorous or exciting sexual intercourse. About four-fifths of the women in both groups accepted or were satisfied with their sexuality after surgery. For women undergoing TVH, 2.6% had increased frequency of orgasm, and 5% had better overall sexual satisfaction postoperatively. For women undergoing SSUS, 10% had increased sexual satisfaction postoperatively. There was a 2.5% and 2.6% increase in postoperative sexual interest in the SSUS and TVH groups, respectively. The sexual functioning scores were not different before or after surgical intervention in either group.
There is a decrease in thefrequency of orgasm after both TVH and SSUS. However, there is no significant difference in postoperative sexual functioning between women with and without preservation of the uterus in correcting uterine prolapse.
研究因子宫脱垂接受全阴道子宫切除术（TVH）或经阴道骶棘韧带子宫悬吊术（SSUS）后性功能的变化。
2001年1月至2002年6月，158例中重度子宫脱垂患者纳入前瞻性研究，其中78例行TVH，80例行SSUS。所有患者年龄均小于50岁，术前6个月内有性生活。均无重大内科疾病。通过面对面问卷调查评估手术前后的性功能。使用视觉模拟量表测量性兴趣、性满意度、性交频率和性高潮频率。
TVH组中，5.1%的患者性兴趣降低，21%的患者术后性高潮频率降低。SSUS组中，13%的患者性兴趣降低，20%的患者术后性高潮频率降低。性高潮频率是两组术后唯一有显著变化的参数。所有性高潮频率降低的患者均表示担心伤口裂开或疾病复发，因此避免剧烈或刺激性的性交。两组中约五分之四的女性接受或对术后性功能感到满意。TVH组中，2.6%的患者性高潮频率增加，5%的患者总体性满意度提高。SSUS组中，10%的患者术后性满意度提高。SSUS组和TVH组术后性兴趣分别增加2.5%和2.6%。两组手术前后性功能评分无差异。
TVH和SSUS术后性高潮频率均降低。然而，在纠正子宫脱垂时，保留子宫和未保留子宫的女性术后性功能无显著差异。
