Panman Chantal McR, Wiegersma Marian, Talsma Marrit N, Kollen Boudewijn J, Berger Marjolein Y, Lisman-Van Leeuwen Yvonne, Dekker Janny H
University of Groningen, University Medical Centre Groningen, Department of General Practice, Groningen, The Netherlands.
Br J Gen Pract. 2014 Mar;64(620):e144-50. doi: 10.3399/bjgp14X677518.
Pelvic floor symptoms are common and are negatively associated with sexual function which, in turn, is an important aspect of quality of life. The majority of older women with pelvic floor symptoms are treated in general practice but evidence from studies in general practice on the sexual functioning of these women is scarce.
This study examined predictors of sexual inactivity in older women with pelvic floor symptoms in general practice and of sexual functioning in those women who are sexually active.
Cross-sectional study in women (aged ≥55 years) from 20 general practices who screened positive on a pelvic floor symptom questionnaire.
Logistic and linear regression analyses were used to determine predictors of sexual inactivity and sexual functioning (PISQ-12) by assessing their association with patient characteristics, symptoms (PFDI-20) and degree of prolapse (POP-Q).
A total of 639 women were included (sexually active n = 393, sexually inactive n = 246). Predictors of sexual inactivity were increasing age (odds ratio [OR] = 1.13; 95% confidence interval [CI] = 1.10 to 1.17) and lower education (OR = 2.31; 95% CI = 1.50 to 3.54; Nagelkerke R(2) = 0.208). In sexually active women, sexual functioning was associated with pelvic floor symptom distress (P<0.001) and pelvic floor surgery (P = 0.018; R(2) = 0.138).
In older women with pelvic floor symptoms, increasing age and lower educational level are predictors of sexual inactivity. Many of these older women are sexually active and pelvic floor symptom distress is negatively associated with sexual functioning. These results may encourage GPs to ask about sexual problems in women with pelvic floor symptoms.
盆底症状很常见，且与性功能呈负相关，而性功能又是生活质量的一个重要方面。大多数有盆底症状的老年女性在全科医疗中接受治疗，但全科医疗中关于这些女性性功能的研究证据很少。
本研究调查了全科医疗中有盆底症状的老年女性性活动缺乏的预测因素，以及性活跃女性性功能的预测因素。
对来自20家全科诊所的女性（年龄≥55岁）进行横断面研究，这些女性在盆底症状问卷筛查中呈阳性。
通过评估性活动缺乏和性功能（PISQ-12）与患者特征、症状（PFDI-20）和脱垂程度（POP-Q）的关联，采用逻辑回归和线性回归分析来确定预测因素。
共纳入639名女性（性活跃者n = 393，性活动缺乏者n = 246）。性活动缺乏的预测因素是年龄增加（比值比[OR]=1.13；95%置信区间[CI]=1.10至1.17）和教育程度较低（OR = 2.31；95%CI = 1.50至3.54；Nagelkerke R(2)=0.208）。在性活跃女性中，性功能与盆底症状困扰（P<0.001）和盆底手术（P = 0.018；R(2)=0.138）相关。
在有盆底症状的老年女性中，年龄增加和教育程度较低是性活动缺乏的预测因素。这些老年女性中有许多是性活跃的，且盆底症状困扰与性功能呈负相关。这些结果可能会促使全科医生询问有盆底症状女性的性问题。
