缩乳术后乳头乳晕复合体的敏感性及性功能
Sensitivity of the Nipple-Areola Complex and Sexual Function Following Reduction Mammaplasty.
作者信息
Garcia Edgard S, Veiga Daniela F, Sabino-Neto Miguel, Beraldo Cardoso Flávia N M, Batista Israel O, Leme Renata M, Cabral Isaias V, Novo Neil F, Ferreira Lydia M
机构信息
Dr Garcia is a PhD Student in the Translational Surgery Graduate Program at the Universidade Federal de São Paulo - UNIFESP, Brazil, and a Medical Assistant Preceptor in the Division of Plastic Surgery at the Universidade do Vale do Sapucaí - UNIVÁS, Pouso Alegre, MG, Brazil. Dr Veiga is an Associate Professor in the Translational Surgery Graduate Program at the Universidade Federal de São Paulo - UNIFESP, Brazil, and a Medical Assistant Preceptor in the Division of Plastic Surgery at the Universidade do Vale do Sapucaí - UNIVÁS, Pouso Alegre, Brazil. Dr Sabino-Neto is an Associate Professor in the Translational Surgery Graduate Program at the Universidade Federal de São Paulo - UNIFESP, Brazil. Dr Beraldo-Cardoso is Psychologist and PhD in Translational Surgery at Universidade Federal de São Paulo - UNIFESP, Brazil. Drs Batista and Cabral are Residents in the Division of Plastic Surgery; Dr Leme is a Resident in the Division of Gynecology and Obstetrics; and Dr Novo is a Full Professor in the Department of Biostatistics of the Universidade do Vale do Sapucaí - UNIVÁS, Pouso Alegre, Brazil. Dr Ferreira is a Full Professor in the Division of Plastic Surgery and the Translational Surgery Graduate Program of the Universidade Federal de São Paulo - UNIFESP, Brazil.
出版信息
Aesthet Surg J. 2015 Sep;35(7):NP193-202. doi: 10.1093/asj/sjv034.
BACKGROUND
The sensitivity of the nipple-areola complex (NAC) is very relevant to female sexuality.
OBJECTIVE
To evaluate NAC sensitivity and sexual function after breast reduction, and to assess whether altered NAC sensitivity is related to sexual dysfunction.
METHODS
The study included 80 patients, who were allocated to a control group with eutrophic breasts (CG, n = 20), a hypertrophy group without surgery (HG, n = 20), or a mammaplasty group (MG, n = 40). The MG was assessed preoperatively and 6 months postoperatively. The HG and CG were evaluated once. NAC sensitivity was assessed for touch, temperature, vibration, and pressure in four areola quadrants and the nipple. Sexual function was assessed with the Brazilian version of the Female Sexual Function Index, which has six domains (desire, arousal, lubrication, orgasm, satisfaction, and pain) and a total score that indicates the presence or absence of sexual dysfunction.
RESULTS
Compared to the CG, the MG had worse sensitivity to temperature and pressure in the nipple and areola medial quadrants postoperatively (P < 0.01). Compared to their preoperative assessment, the MG had reduced temperature and pressure sensitivity in the nipple and areola medial quadrants postoperatively (P < 0.05). Compared to the CG and HG, patients in the MG had higher postoperative scores of excitation (P = 0.0001), lubrication (P = 0.0004), orgasm (P < 0.0001), and satisfaction (P < 0.0001). There was an association between sexual dysfunction and low NAC sensitivity to temperature and vibration (P ≤ 0.041) in the MG's preoperative and postoperative scores, and to touch, temperature, and pressure across all three groups.
CONCLUSIONS
Breast reduction with a superomedial pedicle reduced NAC sensitivity but did not interfere with sexual function.
背景
乳头乳晕复合体（NAC）的敏感性与女性性功能密切相关。
目的
评估乳房缩小术后NAC的敏感性和性功能，并评估NAC敏感性改变是否与性功能障碍有关。
方法
该研究纳入80例患者，分为乳房正常对照组（CG，n = 20）、未手术的肥大组（HG，n = 20）或乳房整形组（MG，n = 40）。MG组在术前和术后6个月进行评估。HG组和CG组仅评估一次。在乳晕的四个象限和乳头处评估NAC对触摸、温度、振动和压力的敏感性。使用巴西版女性性功能指数评估性功能，该指数有六个领域（性欲、唤起、润滑、性高潮、满意度和疼痛），总分表示是否存在性功能障碍。
结果
与CG组相比，MG组术后乳头和乳晕内侧象限对温度和压力的敏感性较差（P < 0.01）。与术前评估相比，MG组术后乳头和乳晕内侧象限的温度和压力敏感性降低（P < 0.05）。与CG组和HG组相比，MG组患者术后兴奋（P = 0.0001）、润滑（P = 0.0004）、性高潮（P < 0.0001）和满意度（P < 0.0001）得分更高。在MG组术前和术后评分中，以及在所有三组中对触摸、温度和压力的评估中，性功能障碍与NAC对温度和振动的低敏感性之间存在关联（P≤0.041）。
结论
采用上内侧蒂的乳房缩小术降低了NAC的敏感性，但不影响性功能。
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