Department of Surgery, Section of Gastrointestinal Surgery, Yale University School of Medicine, 40 Temple Street, Suite 7B, New Haven, CT 06510, USA.
J Gastrointest Surg. 2012 Jan;16(1):183-6; discussion 186-7. doi: 10.1007/s11605-011-1706-4. Epub 2011 Oct 14.
The impact of transvaginal natural orifice transluminal endoscopic surgery (NOTES) on female sexual function is unknown. We therefore performed a prospective cohort study of women undergoing pure transvaginal appendectomies (TVA) versus traditional laparoscopic appendectomies (LA). Using a validated, 19-point, female sexual function index questionnaire (FSFI) assessing six domains of sexual function (desire, arousal, lubrication, orgasm, satisfaction, and pain with intercourse), pre- and postoperative sexual function was compared.
Between August 2008 and August 2010, 42 patients with acute appendicitis were offered a pure TVA. Patients who did not wish to undergo a TVA underwent an LA and served as controls. Both groups were provided with an FSFI before surgery and at regular intervals for up to 1 year. Pre- and postoperative FSFI results were compared between cohorts using unpaired t tests, and between individuals within each cohort pre- and postoperatively using paired t tests.
Twenty-two underwent LA, 18 patients underwent a pure TVA, and 2 refused participation in this study. Preoperative and >60 days postoperative FSFI data were available for 21 patients (10 LA and 11 TVA). Baseline FSFI scores were not significantly different between groups (LA, 19.3 ± 0.9; TVA, 19.3 ± 0.8, p = 0.99). FSFI scores at greater than 60 days postoperatively did not differ significantly from FSFI scores preoperatively in either group (LA, 19.3 ± 0.9 to 19.7 ± 0.7; p = 0.87; TVA, 19.3 ± 0.8 to 19.4 ± 0.9; p = 0.97). No FSFI domain in either cohort was significantly changed postoperatively.
Neither LA nor TVA affected female sexual function scores. This suggests that TVA does not have negative effects on female sexual function. The results of this study may prove beneficial in consultations with patients concerning the sexual sequelae of transvaginal surgery.
经阴道自然腔道内镜手术（NOTES）对女性性功能的影响尚不清楚。因此，我们进行了一项前瞻性队列研究，比较了接受单纯经阴道阑尾切除术（TVA）与传统腹腔镜阑尾切除术（LA）的女性。使用经过验证的、包含 19 个问题的女性性功能指数问卷（FSFI）评估性功能的六个方面（性欲、唤起、润滑、性高潮、满意度和性交疼痛），比较了术前和术后的性功能。
2008 年 8 月至 2010 年 8 月，42 例急性阑尾炎患者接受了单纯 TVA。不愿接受 TVA 的患者接受了 LA，并作为对照组。两组患者均在术前和术后定期（最长 1 年）接受 FSFI 检查。使用配对 t 检验比较两组之间的术前和术后 FSFI 结果，使用配对 t 检验比较每组患者的术前和术后 FSFI 结果。
22 例患者接受了 LA，18 例患者接受了单纯 TVA，2 例患者拒绝参与本研究。有 21 例患者（LA 组 10 例，TVA 组 11 例）获得了术前和术后>60 天的 FSFI 数据。两组的基线 FSFI 评分无显著差异（LA 组 19.3±0.9；TVA 组 19.3±0.8，p=0.99）。两组患者术后>60 天的 FSFI 评分与术前相比均无显著差异（LA 组：19.3±0.9 至 19.7±0.7；p=0.87；TVA 组：19.3±0.8 至 19.4±0.9；p=0.97）。两组患者的任何 FSFI 维度均无显著术后变化。
LA 和 TVA 均未影响女性性功能评分。这表明 TVA 不会对女性性功能产生负面影响。本研究的结果可能有助于与患者讨论经阴道手术后的性功能后遗症。
