女性肛门鳞癌经腹会阴联合切除术（APR）后的性功能，以及结肠切除术和垂直腹直肌肌皮瓣的具体影响。
Female sexual function after abdominoperineal resection for squamous cell carcinoma of the anus and the specific influence of colpectomy and vertical rectus abdominis myocutaneous flap.
机构信息
Department of Digestive Surgery, Hospital Saint-Antoine AP-HP, University Pierre et Marie Curie, Paris, France.
出版信息
Colorectal Dis. 2011 Jul;13(7):774-8. doi: 10.1111/j.1463-1318.2010.02285.x. Epub 2010 Apr 16.
AIM
Abdominoperineal resection (APR) is the only curative treatment for recurrent or persisting squamous cell carcinoma of the anus after radiochemotherapy. A vertical rectus abdominis myocutaneous (VRAM) flap reduces perineal morbidity. The sexual life (SL) of women after APR is unknown. Aims of this study were to evaluate SF of women after APR.
METHOD
47 women alive after APR performed between 1996 and 2007 were included. SL was evaluated using the female sexual function index (FSFI) score.
RESULTS
29 (62%) women answered the questionnaire: 15 (52%) had a VRAM and 16 (55%) a colpectomy. Among the 21 patients with SL before surgery, 16 (76%) still had intercourse with a mean FSFI score of 19.5 ± 10.9 [4.8-36]. Main difficulties reported were troubles of lubrication, orgasm, and dyspareunia. Confection of a VRAM did not influence the recovery of SL (P = 0.717). Colpectomy reduced return of SL (P = 0.026).
CONCLUSION
Among women who had SL before APR, 76% still had sexual intercourse after. Colpectomy seems to reduce SL.
目的
腹会阴联合切除术（APR）是放射化学治疗后复发或持续的肛门鳞状细胞癌的唯一治愈性治疗方法。垂直腹直肌肌皮瓣（VRAM）可减少会阴发病率。 APR 后女性的性生活（SL）尚不清楚。本研究的目的是评估 APR 后女性的 SF。
方法
纳入 1996 年至 2007 年间进行的 APR 后存活的 47 名女性。使用女性性功能指数（FSFI）评分评估 SL。
结果
29 名（62%）女性回答了问卷：15 名（52%）有 VRAM 和 16 名（55%）有阴道切除术。在 21 名术前有 SL 的患者中，16 名（76%）仍有性行为，平均 FSFI 评分为 19.5 ± 10.9 [4.8-36]。主要报告的困难包括润滑、 orgasm 和性交困难。制作 VRAM 并不影响 SL 的恢复（P=0.717）。阴道切除术降低了 SL 的恢复（P=0.026）。
结论
在 APR 前有 SL 的女性中，76%的人在手术后仍有性行为。阴道切除术似乎降低了 SL。
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