University Medical School of Halle/Wittenberg, Clinic for Urology and Kidney Transplantation Centre, Wittenberg, Germany.
J Sex Med. 2011 Mar;8(3):914-22. doi: 10.1111/j.1743-6109.2010.01959.x.
Although the use of transobturator mesh implants for pelvic organ prolapse repair has been shown to be safe and effective, concern exists that the presence of prosthetic material in the vagina may adversely affect sexual function.
To evaluate the impact of transobturator mesh implantation on sexual function using validated questionnaire.
Female Sexual Function Index (FSFI), a validated 19-item questionnaire that assesses six domains of sexual function (desire, arousal, lubrication, orgasm, satisfaction, and pain), was used. The questionnaire was administered preoperatively, and at 3, 6, 12, and 24 months postoperatively. Clinical data were also recorded at each time point.
Prospective nonrandomized study including 96 women with pelvic organ prolapse (cystocele, rectocele, vault prolapse). Transvaginal anterior or posterior wall repair using transobturator mesh implants with or without concomitant transobturator sling procedure.
Mean age was 51.4 ± 5.2 years. Mean operating time was 47.6 ± 23.4 minutes, and the mean hospitalization period was 3.8 ± 1.6 days. After initial decrease during the first 3 months, patients experienced a steady improvement in their sexual function. At 24 months postoperatively, the total mean FSFI score reached significantly higher values compared to the baseline (P = 0.023). Furthermore, pain-free intercourse improved during the follow-up reaching mean score of 4.27 ± 0.79 (P < 0.05) after 2 years. Pelvic floor examination at 2 years follow-up showed excellent surgical results with only 3.1% of the patients presenting with stage II vaginal wall prolapse.
Surgical repair of symptomatic pelvic organ prolapse using mesh implants results in improvement of major parameters of sexual function. A worsening in pain with intercourse during the initial months postoperatively lessens after 3 months as healing is completed.
尽管经闭孔网片植入物用于治疗盆腔器官脱垂已被证明是安全有效的，但人们担心阴道内存在假体材料会对性功能产生不利影响。
使用经过验证的问卷评估经闭孔网片植入物对性功能的影响。
采用经过验证的 19 项女性性功能指数（FSFI）问卷评估性功能的六个方面（欲望、唤起、润滑、性高潮、满意度和疼痛）。问卷在术前、术后 3、6、12 和 24 个月进行评估。每个时间点还记录临床数据。
前瞻性非随机研究纳入 96 例盆腔器官脱垂（膀胱膨出、直肠膨出、阴道穹隆脱垂）患者。采用经闭孔网片植入物行阴道前壁或后壁修补术，联合或不联合经闭孔吊带术。
平均年龄为 51.4 ± 5.2 岁。平均手术时间为 47.6 ± 23.4 分钟，平均住院时间为 3.8 ± 1.6 天。在最初的 3 个月内下降后，患者的性功能逐渐改善。术后 24 个月时，总平均 FSFI 评分与基线相比显著升高（P = 0.023）。此外，随访期间无痛性交得到改善，2 年后平均评分为 4.27 ± 0.79（P < 0.05）。2 年随访时的盆底检查显示手术效果极佳，仅 3.1%的患者出现 II 度阴道壁脱垂。
使用网片植入物治疗有症状的盆腔器官脱垂可改善性功能的主要参数。术后最初几个月性交疼痛加重，在 3 个月后愈合完成后减轻。
