Bolzano General Hospital, Urology Department, Bolzano, Italy.
J Sex Med. 2011 Apr;8(4):1147-55. doi: 10.1111/j.1743-6109.2010.02189.x. Epub 2011 Jan 26.
Lower urinary tract symptoms (LUTS) have a profound impact on physical, social, and sexual well-being. Sacral neuromodulation (SNM) may have a positive effect on sexuality, though few studies have so far evaluated its impact on female sexual function.
To prospectively assess changes in sexual function, clinical outcome and quality of life after SNM in female patients with overactive bladder (OAB) and their possible correlation with improvement in urinary symptoms and quality of life indexes.
Correlations between differences in Female Sexual Function Index (FSFI) scores and in clinical outcome and correlations between differences in FSFI, SF36, and IQoL scores were evaluated by Spearman's coefficient. Comparison between preoperative, midterm follow-up (MFU), and last follow-up (FFU) visits were performed by generalized linear model (GLM) for repeated measurements.
Between May 2003 and December 2008, 30 consecutive female patients (median age 53 years, range 35-79) with OAB underwent the two-stage procedure of SNM. Only 16 (53%) patients were considered eligible; these completed a bladder diary, the FSFI, the Status of Health questionnaire (SF36) and the Incontinence Quality of Life Index (IQoL) before implantation and on follow-up examinations.
The results were analyzed before implantation, on MFU (median MFU 22.5 months) and on FFU (median FFU period 36.3 months). Regarding sexuality, the mean improvement in the total FSFI score was 27.9% on MFU and 29.3% on FFU. Only four patients (25%) showed a >50% improvement in global FSFI score on MFU, and 3 (25%) on FFU. A significant correlation was found between clinical improvement and improvement in sexual function. No significant correlation was found between differences in FSFI and quality of life indexes (IQoL and SF36).
Our results demonstrate that improvement in the quality of sexual function in female patients with OAB correlates with improvement in urinary symptoms.
下尿路症状（LUTS）对身体、社交和性生活有深远影响。骶神经调节（SNM）可能对性生活有积极影响，但到目前为止，很少有研究评估其对女性性功能的影响。
前瞻性评估 SNM 对膀胱过度活动症（OAB）女性患者性功能、临床结局和生活质量的影响，并评估其与改善尿症状和生活质量指标的相关性。
采用 Spearman 系数评估女性性功能指数（FSFI）评分差异与临床结局的相关性，以及 FSFI、SF36 和 IQoL 评分差异的相关性。采用广义线性模型（GLM）进行重复测量比较术前、中期随访（MFU）和末次随访（FFU）。
2003 年 5 月至 2008 年 12 月，30 例连续的 OAB 女性患者（中位年龄 53 岁，范围 35-79 岁）接受了 SNM 的两阶段手术。仅 16 例（53%）患者符合条件；这些患者在植入前和随访检查时完成了膀胱日记、FSFI、健康状况问卷（SF36）和尿失禁生活质量指数（IQoL）。
分析结果在植入前、MFU（中位 MFU 22.5 个月）和 FFU（中位 FFU 期 36.3 个月）。关于性行为，MFU 时总 FSFI 评分平均改善 27.9%，FFU 时改善 29.3%。MFU 时有 4 例患者（25%）的全球 FSFI 评分改善>50%，FFU 时有 3 例患者（25%）。临床改善与性功能改善呈显著相关。FSFI 评分差异与生活质量指标（IQoL 和 SF36）无显著相关性。
我们的结果表明，OAB 女性患者性功能质量的改善与尿症状的改善相关。
