风险降低型输卵管卵巢切除术（RRSO）后性生活和性功能：激素替代疗法的影响。
Sexual activity and functioning after risk-reducing salpingo-oophorectomy: Impact of hormone replacement therapy.
机构信息
Department of Gynecology, Sørlandet Hospital Arendal, P.O. Box 783, 4809 Arendal, Norway; Research Unit, Sørlandet Hospital, P.O. Box 416, 4604 Kristiansand, Norway.
Department of Gynecology, Sørlandet Hospital Arendal, P.O. Box 783, 4809 Arendal, Norway; Research Unit, Sørlandet Hospital, P.O. Box 416, 4604 Kristiansand, Norway.
出版信息
Gynecol Oncol. 2016 Jan;140(1):101-6. doi: 10.1016/j.ygyno.2015.11.016. Epub 2015 Nov 18.
OBJECTIVE
To examine sexual activity and functioning in women after risk-reducing salpingo-oophorectomy (RRSO) compared with the general population (NORM).
METHODS
Retrospective cohort study. 294 women who underwent RRSO and 1228 women from the NORM group provided written information based on mailed questionnaires. Sexual pleasure and discomfort scores and frequency of sexual activity were evaluated using the Sexual Activity Questionnaire.
RESULTS
The RRSO group reported less sexual pleasure (10.5 vs. 11.9, P=0.009), more discomfort (1.9 vs. 0.83, P<0.001), and less frequent sex than did the controls. Significant associations were observed between a lower pleasure score and being in the RRSO group, older age, history of cancer, low body image, high level of role functioning, and low level of global quality of life (QoL). Further, significant associations were detected between more discomfort and being in the RRSO group, older age, history of cancer, poor body image, and low level of global QoL. Hormone replacement therapy (HRT) use had no impact on pleasure or discomfort score in regression analyses among all the sexually active women. However, in subanalyses of the RRSO group, users of systemic HRT reported less discomfort (1.2 vs. 2.4, P=0.001) than did the nonusers.
CONCLUSIONS
After RRSO, women reported significantly less sexual pleasure, more discomfort, and less frequent sex compared with the controls. In the RRSO group, systemic HRT users reported less discomfort than did the nonusers. Health care providers should be attentive to these issues when counseling before and after prophylactic surgery.
目的
与一般人群（NORM）相比，研究接受降低风险的输卵管卵巢切除术（RRSO）后女性的性行为和功能。
方法
回顾性队列研究。294 名接受 RRSO 的女性和 1228 名来自 NORM 组的女性通过邮寄问卷提供了书面信息。使用性活动问卷评估性愉悦和不适评分以及性行为频率。
结果
RRSO 组报告的性愉悦感较低（10.5 对 11.9，P=0.009），不适程度较高（1.9 对 0.83，P<0.001），性行为频率也较低。在 RRSO 组中，较低的愉悦评分与年龄较大、癌症病史、较低的身体形象、较高的角色功能水平和较低的整体生活质量（QoL）评分之间存在显著关联。此外，在 RRSO 组中，更多的不适与 RRSO 组、年龄较大、癌症病史、较差的身体形象和较低的整体 QoL 之间存在显著关联。在所有有性行为的女性中，回归分析表明，激素替代疗法（HRT）的使用对愉悦或不适评分没有影响。然而，在 RRSO 组的亚分析中，系统使用 HRT 的女性报告的不适程度较低（1.2 对 2.4，P=0.001）。
结论
与对照组相比，RRSO 后女性报告的性愉悦感显著降低，不适程度更高，性行为频率更低。在 RRSO 组中，系统使用 HRT 的女性报告的不适程度低于未使用者。在预防性手术前后咨询时，医疗保健提供者应关注这些问题。
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