Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA.
Am J Obstet Gynecol. 2012 Nov;207(5):421.e1-6. doi: 10.1016/j.ajog.2012.06.053. Epub 2012 Jun 29.
The purpose of this study was to assess prospectively the effects of midurethral sling surgery on sexual function and activity.
Sexual activity and function was assessed in 597 women with stress urinary incontinence who were enrolled in a randomized equivalence trial of retropubic compared with transobturator midurethral slings. Repeated measures analysis of variance was used to assess changes in Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire scores over a 2-year period.
Significant, similar improvements in sexual function were seen in both midurethral sling groups. Mean Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire scores increased from 32.8 at baseline to 37.6 at 6 months and 37.3 at 24 months (P < .0001). Dyspareunia, incontinence during sex, and fear of incontinence during sex each significantly improved after surgery. Preoperative urge incontinence was associated with abstinence after surgery (P = .02); postoperative urge incontinence negatively impacted sexual function (P = .047).
Midurethral sling surgery for stress urinary incontinence significantly improves sexual function, although coexistent urge incontinence has a negative impact.
本研究旨在前瞻性评估尿道中段吊带手术对性功能和活动的影响。
对 597 例压力性尿失禁女性进行了随机等效试验，比较了耻骨后与经闭孔尿道中段吊带术，评估了她们的性行为和功能。采用重复测量方差分析评估了 2 年内盆腔器官脱垂/尿失禁性问卷评分的变化。
尿道中段吊带组均有显著且相似的性功能改善。盆腔器官脱垂/尿失禁性问卷评分从基线时的 32.8 分增加到 6 个月时的 37.6 分和 24 个月时的 37.3 分（P<0.0001）。性交痛、性交时失禁和对性交时失禁的恐惧均显著改善。术前急迫性尿失禁与术后禁欲有关（P=0.02）；术后急迫性尿失禁对性功能有负面影响（P=0.047）。
尿道中段吊带术治疗压力性尿失禁可显著改善性功能，但并存的急迫性尿失禁有负面影响。
