Department of Obstetrics and Gynaecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
J Sex Med. 2015 May;12(5):1275-82. doi: 10.1111/jsm.12860. Epub 2015 Mar 10.
Episiotomy remains commonly practiced in Thailand. There are limited data on its impacts on sexuality among Asian women during the first postdelivery year.
The aim was to study dyspareunia and sexual function at 3-12 months after vaginal delivery in Thai primiparous women with episiotomy.
A total of 190 participants were approached on Day 2 postpartum. Of these, 93 sexually active women were evaluated for dyspareunia and sexual function at 3 months by using 10-cm visual analog scale and the validated Thai version of Female Sexual Function Index (TFSFI). TFSFI < 26.5 was defined as having potential sexual dysfunction. At 6 and 12 months, sexual function was evaluated by telephone interview.
The prevalence of dyspareunia at 3 months and the changes of TFSFI scores during the first postdelivery year were the main outcome measures.
The average age of the participants, over 90% of whom were high school finishers, was 24. Their partners were around 3 years older, and the median partnership duration was 3 years. At 3 months, 30.1% of participants reported dyspareunia. There was no association between dyspareunia and the following characteristics: pre-pregnancy dyspareunia, newborn's head circumference and birthweight and breast-feeding (P > 0.05 for all). Sexual dysfunction was demonstrated in 66.7% at 3 months, 31.0% at 6 months, and 14.9% at 12 months. From 3 to 12 months, the median TFSFI scores in all domains increased significantly. There was no difference of the scores in all domains at 3 and 12 months between women with and without dyspareunia at 3 months. However, at 6 months, those without dyspareunia had better scores in pain, orgasm, satisfaction, and total scores (P < 0.05 for all).
Dyspareunia at 3 months is common in Thai primiparous women with episiotomy. Those with dyspareunia have a slower resumption of normal sexual function.
会阴切开术在泰国仍普遍施行。亚洲女性产后第一年的会阴切开术对其性生活影响的数据有限。
本研究旨在探讨行会阴切开术的泰国初产妇产后 3-12 个月时的性交痛和性功能。
在产后第 2 天共接触了 190 名产妇，其中 93 名有性生活的产妇在产后 3 个月时通过 10cm 视觉模拟量表和经过验证的泰国女性性功能指数（TFSFI）评估性交痛和性功能。TFSFI＜26.5 定义为存在潜在的性功能障碍。在 6 个月和 12 个月时通过电话访谈评估性功能。
主要观察指标为产后 3 个月时性交痛的发生率和产后第 1 年 TFSFI 评分的变化。
参与者的平均年龄为 24 岁（超过 90%为高中学历），其伴侣年长约 3 岁，伴侣关系持续时间中位数为 3 年。产后 3 个月时，30.1%的参与者报告有性交痛。性交痛与以下特征无相关性：孕前性交痛、新生儿头围和出生体重以及母乳喂养（所有 P＞0.05）。产后 3 个月时 66.7%的参与者存在性功能障碍，6 个月时为 31.0%，12 个月时为 14.9%。从产后 3 个月到 12 个月，所有领域的 TFSFI 评分中位数均显著增加。产后 3 个月和 12 个月时，无性交痛的参与者与有性交痛的参与者在所有领域的评分无差异。然而，在 6 个月时，无性交痛的参与者在疼痛、性高潮、满意度和总分方面的评分更好（所有 P＜0.05）。
行会阴切开术的泰国初产妇产后 3 个月时性交痛常见。有性交痛的产妇性功能恢复较慢。
