Giuseppe Paradiso Galatioto, Pace Gianna, Vicentini Carlo
University of L'Aquila-Surgery, Laquila, Italy.
University of L'Aquila-Surgery, Laquila, Italy.
J Sex Med. 2007 May;4(3):702-707. doi: 10.1111/j.1743-6109.2006.00318.x. Epub 2006 Oct 11.
Women's sexual dysfunctions (WSD) have been commonly associated with urinary incontinence (UI). Women with UI and who scored low on the Female Sexual Function Index (FSFI) showed an improvement in urinary leakage and also in their sexual life following treatment by transvaginal electrical stimulation (TES).
To determine the effects of TES in 37 women complaining of UI, of whom 23 also had WSD, and to compare the FSFI scores of women with UI and 43 women not affected by UI who underwent routine urologic evaluation.
Thirty-seven women complaining of UI were evaluated by voiding diary and with FSFI before and after 3 months of TES. All had a urogynecologic evaluation and urodynamic study.
In the voiding diary the women reported the types of liquid they ingested, urinary frequency, and episodes of urgency and urine leakage. The domain scores of the FSFI, including desire, arousal, lubrication, orgasm, satisfaction, and pain, were calculated. TES was conducted for 15-30 minutes, twice a week for 3 months, using biphasic intermittent current with a frequency of 50 Hz for stress UI (SUI) and 20 Hz for urge UI (UUI), and the most tolerable intensity of stimulation.
After TES, only two of the 10 women with UUI experienced a few leakage incidents; patients with SUI were completely dry during TES; and only three reported a few episodes of UI during intense activities. The five patients with mixed UI improved mainly as regards urgency. The FSFI scores of patients complaining of UI showed significantly lower desire and sexual satisfaction, and higher sexual pain than controls. After 3 months, the 23 women affected by WSD, of the 37 participants with UI, reported a remarkable improvement in their sexual life.
TES was found to be a safe and effective therapy for selected patients affected by mild to moderate UI. Because women with UI also complain of WSD compared with the general female population, an investigation of female sexuality is suggested for these patients.
女性性功能障碍（WSD）通常与尿失禁（UI）相关。患有尿失禁且女性性功能指数（FSFI）得分较低的女性，在接受经阴道电刺激（TES）治疗后，尿失禁及性生活均有所改善。
确定TES对37名主诉尿失禁的女性（其中23名也患有WSD）的影响，并比较患有尿失禁的女性与43名接受常规泌尿科评估且未受尿失禁影响的女性的FSFI得分。
通过排尿日记及FSFI对37名主诉尿失禁的女性在TES治疗3个月前后进行评估。所有患者均接受了泌尿妇科评估及尿动力学研究。
在排尿日记中，女性记录所摄入液体的类型、排尿频率、尿急及尿失禁发作情况。计算FSFI的各个领域得分，包括性欲、性唤起、润滑、性高潮、性满意度及性疼痛。使用双相间歇电流，频率为50Hz用于压力性尿失禁（SUI），20Hz用于急迫性尿失禁（UUI），以最能耐受的刺激强度进行TES，每次15 - 30分钟，每周两次，共3个月。
TES治疗后，10名UUI女性中只有2名经历了少量漏尿事件；SUI患者在TES期间完全无尿失禁；只有3名女性报告在剧烈活动时有少量尿失禁发作。5名混合性尿失禁患者在尿急方面有明显改善。主诉尿失禁的患者的FSFI得分显示，与对照组相比，性欲和性满意度显著降低，性疼痛更高。3个月后，37名患有尿失禁的参与者中，23名受WSD影响的女性报告其性生活有显著改善。
对于部分轻至中度尿失禁患者，TES是一种安全有效的治疗方法。由于与普通女性人群相比，患有尿失禁的女性也常主诉WSD，因此建议对这些患者进行女性性功能调查。
