Virginia Commonwealth University School of Medicine, Richmond, Virginia 23223, USA.
Urology. 2013 Jan;81(1):50-4. doi: 10.1016/j.urology.2012.07.105. Epub 2012 Nov 30.
To examine the effect of the tension-free vaginal tape-obturator (TVT-O) on sexual function and vaginal symptoms. The effect of anti-incontinence surgery on vaginal symptoms and sexual function is controversial; these assessments are increasingly important given the Food and Drug Administration warning regarding the use of transvaginal surgical mesh.
A retrospective review of 42 patients undergoing TVT-O with a minimum 1-year follow-up data was performed. The outcomes were assessed at baseline and 1 year postoperatively using validated questionnaires, including the International Consultation on Incontinence Questionnaire-Vaginal Symptoms, a validated measure assessing the impact of vaginal symptoms and sexual matters on quality of life and treatment outcomes. The International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms and Incontinence Impact Questionnaire, Short Form were used to assess the incontinence and quality of life outcomes, respectively.
Statistically significant improvements were seen in the vaginal symptoms (from 9.7 to 6.0, P=.01), sexual matters (from 16.7 to 6.9, P=.01), and quality of life (from 3.0 to 1.1, P=.001) domains on the International Consultation on Incontinence Questionnaire-Vaginal Symptoms from the baseline to 1-year assessment. Of 20 sexually active patients at baseline, 18 reported continued sexual activity postoperatively, with 2 patients reporting an absence of sexual activity because of other factors. Six patients who were not sexually active at baseline because of vaginal symptoms had resumed sexual activity at 1 year. Statistically significant improvement in vaginal soreness and a trend toward improvement in the abdominal pain domain score were seen.
TVT-O sling placement was associated with symptom stability or improvement in validated measures of sexual function and vaginal symptoms. These data do not support the concerns regarding worsening sexual function and vaginal symptoms after TVT-O sling placement.
探讨经阴道无张力吊带术（TVT-O）对性功能和阴道症状的影响。抗失禁手术对阴道症状和性功能的影响存在争议；鉴于食品和药物管理局（FDA）对阴道手术网片使用的警告，这些评估变得越来越重要。
对 42 例行 TVT-O 术且至少有 1 年随访数据的患者进行回顾性研究。使用经过验证的问卷在基线和术后 1 年评估结果，包括国际尿失禁咨询问卷-阴道症状（评估阴道症状和性问题对生活质量和治疗结果的影响的有效测量工具）、女性下尿路症状国际咨询问卷-尿失禁和生活质量问卷、简短版。
国际尿失禁咨询问卷-阴道症状的阴道症状（从 9.7 分降至 6.0 分，P=.01）、性问题（从 16.7 分降至 6.9 分，P=.01）和生活质量（从 3.0 分降至 1.1 分，P=.001）领域的评分在基线至术后 1 年评估时均有显著改善。在基线时有 20 名有性生活的患者，其中 18 名报告术后仍有性生活，2 名因其他因素而无性生活。6 名因阴道症状在基线时无性生活的患者在术后 1 年恢复了性生活。阴道触痛明显改善，腹痛评分也有改善趋势。
TVT-O 吊带放置与性功能和阴道症状的经证实的测量指标的症状稳定或改善相关。这些数据不支持 TVT-O 吊带放置后性功能和阴道症状恶化的担忧。
