女性在透析期间和肾移植后的性功能障碍。

Sexual dysfunction in women during dialysis and after renal transplantation.

机构信息

University of Florence-Clinica Urologica II, Viale Pieraccini 18 Florence Italy 50137, Italy.

出版信息

J Sex Med. 2009 Nov;6(11):3125-31. doi: 10.1111/j.1743-6109.2009.01400.x. Epub 2009 Jul 21.

DOI:10.1111/j.1743-6109.2009.01400.x

PMID:19627463

Abstract

INTRODUCTION

Disorders of the reproductive system and menstrual abnormalities often associated with loss of libido and inability to reach orgasm are common in adults of both sexes with an end-stage renal disease. These symptoms may significantly contribute to depression and reduce the sexual activity of women.

AIM

To determine if sexual function, as well as hormonal status, improves after kidney transplantation, comparing a group of pre-menopausal women during dialysis and after a successful renal transplantation.

METHODS

We enrolled 58 women that received kidney transplantation. Patients included were 18-45 years old, on hemodialysis for more than 6 months following a fully functioning kidney transplantation, and on a stable corticosteroids immunosuppressive regimen for at least 6 months. All women underwent a general and urogynecological examination, a hormonal profile determination, and filled out the Female Sexual Function Index (FSFI) and a Beck Depression Inventory questionnaire administered during dialysis and 12 months after transplantation.

MAIN OUTCOME MEASURES

We evaluated the prevalence of Female Sexual Dysfunction according to the FSFI cutoff points, sexual hormonal status, and menstrual status during dialysis and 12 months after kidney transplantation.

RESULTS

Nineteen out of 58 women left the study prematurely. Thirty-nine women (mean age 36 +/- 5.9 years) completed the study. A total of 74% of the patients had menstrual disturbances during dialysis, as opposed to 45% after transplantation (P < 0.001). Sixteen out of 39 (41%) patients acknowledged having an active sexual life during dialysis. Thirty-four out of 39 (88%) transplanted patients acknowledged having an active sexual life (Fischer's exact test P = 0.000039). The hormonal profile and FSFI results improved significantly after transplantation.

CONCLUSION

This study demonstrates that a successful transplantation should improve the sexual life in women with chronic renal failure.

摘要

简介

生殖系统疾病和月经异常常伴有性欲减退和无法达到性高潮，在终末期肾病的男女患者中较为常见。这些症状可能会导致抑郁，并降低女性的性活动。

目的

通过比较透析期间和成功肾移植后的一组绝经前女性，确定肾功能衰竭女性患者的性功能和激素状态是否在肾移植后得到改善。

方法

我们纳入了 58 名接受肾移植的女性患者。入选患者年龄在 18-45 岁之间，在完全功能肾移植后接受血液透析超过 6 个月，并且在稳定的皮质类固醇免疫抑制方案下至少 6 个月。所有女性均接受了一般和泌尿妇科检查、激素谱测定，并在透析期间和移植后 12 个月填写了女性性功能指数（FSFI）和贝克抑郁量表问卷。

主要观察指标

根据 FSFI 截断值、性激素状态和月经状况，评估透析期间和肾移植后 12 个月女性性功能障碍的发生率。

结果

58 名女性中有 19 名提前退出研究。39 名女性（平均年龄 36 +/- 5.9 岁）完成了研究。74%的患者在透析期间存在月经紊乱，而移植后为 45%（P < 0.001）。39 名患者中有 16 名（41%）在透析期间承认有活跃的性生活。39 名移植患者中有 34 名（88%）承认有活跃的性生活（Fischer 确切检验 P = 0.000039）。移植后激素谱和 FSFI 结果显著改善。