Di Donato Nadine, Montanari Giulia, Benfenati Arianna, Monti Giorgia, Bertoldo Valentina, Mauloni Maurizio, Seracchioli Renato
Minimally Invasive Gynaecological Surgery Unit, S. Orsola-Malpighi Hospital, University of Bologna, Via Massarenti, Bologna 13 40138, Italy.
Minimally Invasive Gynaecological Surgery Unit, S. Orsola-Malpighi Hospital, University of Bologna, Via Massarenti, Bologna 13 40138, Italy.
Eur J Obstet Gynecol Reprod Biol. 2014 Aug;179:69-74. doi: 10.1016/j.ejogrb.2014.05.022. Epub 2014 Jun 2.
OBJECTIVE(S): Sexual function is negatively influenced by endometriosis and women with endometriosis show less sexual and partnership satisfaction compared to patients with other gynaecological disorders. This study aims to compare sexual function between patients with deep infiltrating endometriosis (DIE) and healthy women using Sexual Health Outcomes in Women Questionnaire (SHOW-Q).
Case-control study including 182 patients with histological diagnosis of DIE and 182 healthy women, who referred to our tertiary care university hospital from 2010 to 2012. SHOW-Q was used to collect data concerning satisfaction, orgasm, desire and pelvic problem interference with sex. The un-paired t-test was performed to compare the means of a continuous variable between groups when the data were normally distributed; otherwise the Mann-Whitney test was used to check t-test results. Pearson's χ(2) test and Z-test for proportions - independent groups were performed to investigate the difference among grouping variables.
As described in a previous study, the prevalence of sexual dysfunction in women with endometriosis is around 61% and in women with other gynaecological disorders is 35%. Assuming 5% significance and 95% power, 106 women would be required for the study. Every area of sexual function investigated through the SHOW-Q questionnaire (satisfaction, desire, orgasm and pelvic problem interference) was significantly impaired compared to healthy women. Among patients with DIE, 58% (105/182) reported that pelvic pain severely affected sexual function, while only 1% (2/182) of healthy women (p<0.0001). Moreover, sexual desire was absent or less than one or two times per month in 45% (82/182) of women with DIE compared to 14% (26/182) of healthy women (p<0.0001).
CONCLUSION(S): DIE severely affects sexual function. Endometriosis is a global disease, which affects patients physically, psychologically and sexually. The potential sexual consequences of this disease need to be considered.
性功能会受到子宫内膜异位症的负面影响，与患有其他妇科疾病的患者相比，患有子宫内膜异位症的女性在性方面和伴侣关系方面的满意度较低。本研究旨在使用女性性健康结果问卷（SHOW-Q）比较深部浸润性子宫内膜异位症（DIE）患者和健康女性之间的性功能。
病例对照研究，纳入了182例经组织学诊断为DIE的患者和182例健康女性，这些患者和健康女性于2010年至2012年转诊至我们的三级大学附属医院。使用SHOW-Q收集有关满意度、性高潮、性欲以及盆腔问题对性生活干扰的数据。当数据呈正态分布时，采用非配对t检验比较两组间连续变量的均值；否则，使用曼-惠特尼检验来检验t检验结果。采用Pearson卡方检验和独立组比例Z检验来研究分组变量之间的差异。
如先前研究所述，子宫内膜异位症女性性功能障碍的患病率约为61%，其他妇科疾病女性的患病率为35%。假设显著性水平为5%，检验效能为95%，该研究需要106名女性。通过SHOW-Q问卷调查的性功能的各个方面（满意度、性欲、性高潮和盆腔问题干扰）与健康女性相比均有显著受损。在DIE患者中，58%（105/182）报告盆腔疼痛严重影响性功能，而健康女性中只有1%（2/182）（p<0.0001）。此外，45%（82/182）的DIE女性性欲缺乏或每月少于一到两次，而健康女性中这一比例为14%（26/182）（p<0.0001）。
DIE严重影响性功能。子宫内膜异位症是一种全球性疾病，会在身体、心理和性方面影响患者。需要考虑这种疾病潜在的性方面的后果。
