Princess Anne Hospital, Southampton, UK.
J Sex Med. 2011 Feb;8(2):583-8. doi: 10.1111/j.1743-6109.2010.02101.x. Epub 2010 Nov 3.
Pelvic organ prolapse is a common condition among women with a prevalence of 11% and may affect the anterior, posterior, or apical compartment with a negative impact on sexual function.
Aim of the current study was to evaluate sexual function before and after surgical rectocele fascial repair in sexually active patients who suffer from symptomatic rectoceles.
Female Sexual Function Index (FSFI) and anatomical outcome after rectocele repair.
Between December 2000 and December 2009, we asked sexually active female patients who were to undergo rectocele fascial repair for symptomatic rectoceles to participate in this study. The patients were gynecologically examined before and after surgery and prolapse staging was performed using the ICS-Pelvic Organ Prolapse Staging. Patients were asked to fill in the FSFI before surgery and at 6 months follow-up. For statistical analysis, Graph Pad Prism version 5.0 for Windows was used (Graph Pad, La Jolla, CA, USA). Student's t-test was used after normality tests to compare groups and α was set 0.05.
Sixty-eight patients were included in this study. Median age was 72 years (range 47-91), median parity of 2 (range 0-3) and median body mass index was 29 kg/m2 (range 23-31). Main complaints preoperatively were painful prolapse feeling (n=52), dyspareunia (n=59), and a feeling of vaginal heaviness (n=39). One patient who had suffered from postoperative infection that resulted in excessive scar tissue of the posterior wall suffered from de novo dyspareunia. Statistical analyses (paired t-test) showed significant improvement for desire (P<0.001), satisfaction (P<0.0001), and pain (P<0.0001) and no significant changes for arousal (P=0.0897), lubrication (P=1), and orgasm (P=0.0893).
Posterior fascial repair improves some domains of sexual function but not all in sexually active patients with symptomatic rectoceles, and local oestrogene treatment may contribute to this finding.
盆腔器官脱垂是一种常见的女性疾病，患病率为 11%，可能会影响前、后或顶壁，对性功能产生负面影响。
本研究旨在评估患有症状性直肠膨出的活跃女性患者在接受手术直肠前壁修补术后的性功能。
女性性功能指数（FSFI）和直肠膨出修补术后的解剖学结果。
2000 年 12 月至 2009 年 12 月期间，我们要求接受直肠前壁修补术治疗症状性直肠膨出的活跃女性患者参与这项研究。患者在术前和术后均接受妇科检查，并使用国际尿控协会（ICS）盆腔器官脱垂分期进行脱垂分期。患者在术前和 6 个月随访时填写 FSFI。使用 Graph Pad Prism 版本 5.0 for Windows 进行统计分析（Graph Pad，La Jolla，CA，USA）。在进行正态性检验后，使用 Student's t 检验比较组间差异，α 值设定为 0.05。
本研究共纳入 68 例患者。中位年龄为 72 岁（范围 47-91），中位产次为 2（范围 0-3），中位体重指数为 29kg/m2（范围 23-31）。术前主要主诉为疼痛性脱垂感（n=52）、性交痛（n=59）和阴道沉重感（n=39）。1 例患者术后发生感染，导致后壁过度瘢痕形成，出现新发性交痛。统计分析（配对 t 检验）显示，性欲（P<0.001）、满意度（P<0.0001）和疼痛（P<0.0001）显著改善，而唤醒（P=0.0897）、润滑（P=1）和高潮（P=0.0893）无显著变化。
后壁筋膜修补术可改善患有症状性直肠膨出的活跃女性患者部分性功能领域，但并非所有领域，局部雌激素治疗可能有助于这一发现。
