Cohen Brian L, Barboglio Paholo, Gousse Angelo
University of Miami Miller School of Medicine, Department of Urology, Miami, FL, USA.
J Sex Med. 2008 Jun;5(6):1418-23. doi: 10.1111/j.1743-6109.2008.00818.x. Epub 2008 Mar 19.
Lower urinary tract symptoms (LUTS) is a common problem in women and frequently coexists with female sexual dysfunction (FSD). However, the relationship of LUTS and FSD is poorly characterized.
To evaluate the relationship of LUTS and urinary incontinence (UI) to FSD using a validated instrument, the female sexual function index (FSFI).
We performed an institutional review board-approved retrospective evaluation of 236 female patients over a 3-year time-period who completed an FSFI-validated questionnaire and underwent urodynamics (UDS) evaluation for LUTS or UI. Patients were categorized based upon history and physical exam into different LUTS groups. Additionally, the presence or absence of UI, detrusor overactivity (DO), stress urinary incontinence, and maximal cystometric capacity (MCC) > or <200 mL on UDS were used to further evaluate these patients. FSFI domain and total scores were compared between the different LUTS groups.
FSFI scores were evaluated for women with similar clinical LUTS diagnosis and UDS findings. The Kruskal-Wallis nonparametric test and the Dwass-Steel test determined statistical significance and performed multiple pairwise comparisons between the different voiding dysfunction groups and those with normal UDS (Leak-/DO-/urodynamic stress incontinence-).
The mean age of the cohort was 49.5 (range 18-69), and there was no statistically significant difference in mean age within each LUTS subgroup. MCC < 200 mL did not significantly impair female sexual function. Patients with clinical diagnosis of overactive bladder (OAB)-Dry had the highest sexual function while those with mixed urinary incontinence had the worst. Additionally, women with UI and DO had the greatest degree of FSD, which was significantly worse than those with normal UDS. Additionally, for women with or without UI, the presence of DO on UDS resulted in a trend toward worse sexual function.
The sexual function of women is negatively impacted by the presence of LUTS, with UI and DO causing the greatest degree of FSD. The sexual domains most affected are desire, lubrication, orgasm, and sexual satisfaction.
下尿路症状（LUTS）是女性常见问题，且常与女性性功能障碍（FSD）共存。然而，LUTS与FSD之间的关系尚未得到充分描述。
使用经过验证的工具——女性性功能指数（FSFI），评估LUTS和尿失禁（UI）与FSD之间的关系。
我们对236名女性患者进行了一项经机构审查委员会批准的回顾性评估，这些患者在3年时间内完成了一份经过FSFI验证的问卷，并接受了针对LUTS或UI的尿动力学（UDS）评估。根据病史和体格检查将患者分为不同的LUTS组。此外，根据UDS上是否存在UI、逼尿肌过度活动（DO）、压力性尿失禁以及最大膀胱测压容量（MCC）>或<200 mL来进一步评估这些患者。比较不同LUTS组之间的FSFI领域得分和总分。
对具有相似临床LUTS诊断和UDS结果的女性进行FSFI评分评估。Kruskal-Wallis非参数检验和Dwass-Steel检验确定统计学意义，并在不同排尿功能障碍组与UDS正常组（无漏尿/无DO/无尿动力学压力性尿失禁组）之间进行多次两两比较。
该队列的平均年龄为49.5岁（范围18 - 69岁），每个LUTS亚组内的平均年龄无统计学显著差异。MCC < 200 mL并未显著损害女性性功能。临床诊断为膀胱过度活动症（OAB）-无尿失禁的患者性功能最高，而混合性尿失禁患者性功能最差。此外，有UI和DO的女性FSD程度最高，显著比UDS正常的女性更差。此外，对于有或无UI的女性，UDS上存在DO导致性功能有变差的趋势。
LUTS的存在对女性性功能有负面影响，其中UI和DO导致的FSD程度最高。受影响最大的性领域是性欲、润滑、性高潮和性满意度。
