Department of Urogynaecology, Sheffield Teaching Hospitals NHS Foundation Trust, Jessop Wing, Tree Root Walk, UK.
J Sex Med. 2012 Jan;9(1):34-43. doi: 10.1111/j.1743-6109.2011.02366.x. Epub 2011 Jun 23.
Urinary incontinence has an adverse impact on sexual function. The reports on sexual function following the treatment of urinary incontinence are confusing.
To investigate the impact of surgery for stress incontinence on coital incontinence and overall sexual function.
Cochrane Incontinence Group Specialized Register of Controlled Trials, The Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE were searched for trials of incontinence surgery assessing sexual function and coital incontinence before and after surgery. Observational studies and randomized controlled trials investigating the impact of surgical correction of stress urinary incontinence on sexual function were included. Surgical interventions included tension-free vaginal tape (TVT), Tension Free Vaginal Tape-Obturator (TVT-O), transobturator tape (TOT), Burch, and autologous fascial sling (AFS). Studies that included patients undergoing concurrent prolapse surgery were excluded from the analysis. Data extraction and analysis was performed independently by two authors. Coital incontinence was analyzed separately and odds ratios (ORs) with 95% confidence intervals (CI ) calculated. The data were analyzed in Review Manager 5 software.
Changes in sexual function and coital incontinence following surgery for urinary incontinence.
Twenty-one articles were identified, which assessed sexual function and/or coital incontinence following continence surgery in the absence of prolapse. Results suggest evidence for a significant reduction in coital incontinence post surgery (OR 0.11; 95% CI 0.07, 0.17).
Coital incontinence is significantly reduced following continence surgery. There were several methodological problems with the quality of the primary research particularly related to heterogeneity of studies, use of different outcome measures, and the absence of well-designed randomized controlled trials.
尿失禁对性功能有不良影响。关于治疗尿失禁后性功能的报告令人困惑。
研究压力性尿失禁手术对性交失禁和整体性功能的影响。
检索 Cochrane 尿控组对照试验专库、Cochrane 中心对照试验注册库、MEDLINE 和 EMBASE，以寻找评估手术前后性功能和性交失禁的尿失禁手术试验。纳入研究压力性尿失禁手术矫正对性功能影响的观察性研究和随机对照试验。手术干预包括经阴道无张力吊带（TVT）、经阴道无张力吊带-闭孔器（TVT-O）、经闭孔吊带（TOT）、Burch 和自体筋膜吊带（AFS）。排除同时行脱垂手术的患者。由两名作者独立进行数据提取和分析。分别分析性交失禁，计算优势比（OR）及其 95%置信区间（CI）。数据在 Review Manager 5 软件中进行分析。
尿失禁手术后性功能和性交失禁的变化。
确定了 21 篇文章，评估了无脱垂情况下的控尿手术后性功能和/或性交失禁。结果表明，手术后性交失禁显著减少（OR 0.11；95%CI 0.07，0.17）。
控尿手术后性交失禁明显减少。初级研究的方法学问题较多，特别是研究的异质性、不同结局指标的使用以及缺乏精心设计的随机对照试验。
