Handa Victoria L, Cundiff Geoffrey, Chang Howard H, Helzlsouer Kathy J
Department of Gynecology and Obstetrics, Johns Hopkins University, Baltimore, Maryland, USA.
Obstet Gynecol. 2008 May;111(5):1045-52. doi: 10.1097/AOG.0b013e31816bbe85.
To investigate the hypothesis that pelvic floor disorders are associated with female sexual problems, independently of other related factors.
The study population included 301 adult women seeking outpatient gynecologic and urogynecologic care. Pelvic floor disorders were assessed with the Pelvic Floor Disorders Inventory-20 (PFDI-20) and the pelvic organ prolapse quantification examination. Sexual function was assessed with the Personal Experiences Questionnaire. Using ordinal regression analysis, we identified characteristics and conditions associated with decreased libido, infrequent orgasm, decreased arousal, and dyspareunia.
Sexual function was poorer among 78 women (26%) without a current sexual partner than among 223 with a partner (P<.01). Among the 223 with a current partner, women with a high Pelvic Floor Disorders Inventory score were significantly more likely to report decreased arousal (P<.01), infrequent orgasm (P<.01), and increased dyspareunia (P<.01). A similar pattern was observed for the urinary, colorectal-anal, and prolapse scales of the Pelvic Floor Disorders Inventory, although some associations were marginally significant. Stage III-IV prolapse was significantly associated with infrequent orgasm (P=.02), but other sexual complaints were not more common with increasing prolapse stage.
Pelvic floor symptoms are significantly associated with reduced sexual arousal, infrequent orgasm, and dyspareunia. We conclude that sexual function is worse in women with symptomatic prolapse but not in women with asymptomatic prolapse.
II.
探讨盆底功能障碍与女性性功能问题相关这一假说，且独立于其他相关因素。
研究人群包括301名寻求门诊妇科和泌尿妇科护理的成年女性。采用盆底功能障碍量表-20（PFDI-20）和盆腔器官脱垂定量检查评估盆底功能障碍。使用个人经历问卷评估性功能。通过有序回归分析，我们确定了与性欲减退、性高潮不频繁、性唤起降低和性交困难相关的特征和情况。
78名（26%）目前没有性伴侣的女性的性功能比223名有性伴侣的女性更差（P<0.01）。在223名有性伴侣的女性中，盆底功能障碍量表得分高的女性更有可能报告性唤起降低（P<0.01）、性高潮不频繁（P<0.01）和性交困难增加（P<0.01）。盆底功能障碍量表的泌尿、结直肠-肛门和脱垂量表也观察到类似模式，尽管一些关联的显著性较弱。Ⅲ-Ⅳ期脱垂与性高潮不频繁显著相关（P=0.02），但随着脱垂阶段增加，其他性方面的主诉并不更常见。
盆底症状与性唤起降低、性高潮不频繁和性交困难显著相关。我们得出结论，有症状脱垂的女性性功能较差，而无症状脱垂的女性性功能则不然。
Ⅱ级。
