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单纯性子宫切除术和根治性子宫切除术对生活质量的影响——盆底功能障碍各方面分析

Effect of simple and radical hysterectomy on quality of life - analysis of all aspects of pelvic floor dysfunction.

作者信息

Selcuk Selcuk, Cam Cetin, Asoglu Mehmet Resit, Kucukbas Mehmet, Arinkan Arzu, Cikman Muzaffer Seyhan, Karateke Ates

机构信息

Zeynep Kamil Training and Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey.

Zeynep Kamil Training and Research Hospital, Department of Obstetrics and Gynecology, Istanbul, Turkey.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2016 Mar;198:84-88. doi: 10.1016/j.ejogrb.2016.01.008. Epub 2016 Jan 11.

Abstract

OBJECTIVE

The impact of simple and radical hysterectomy on all aspects of pelvic floor dysfunctions was evaluated in current study.

STUDY DESIGN

This retrospective cohort study included 142 patients; 58 women (40.8%) who have undergone simple, 41 (28.8%) radical hysterectomy, and 43 (30.2%) women without any surgical intervention to serve as the control group. The validated versions of the Urogenital Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), Pelvic Floor and Incontinence Sexual Impact Questionnaire (PISQ-12), Wexner Incontinence Scale score and pelvic organ prolapse quantification (POP-Q) system were used in detailed evaluation of pelvic floor dysfunction. One-way ANOVA and Pearson's chi square tests were performed in statistical analysis.

RESULTS

It was found that there were significant differences in irritative and obstructive scores of UDI-6 between Type III hysterectomy group and Type I hysterectomy group. In addition, patients of Type I hysterectomy had significant higher irritative and obstructive scores than the control group. Type III hysterectomy had the most significant deteriorating effect on sexual life, based on scores of PISQ-12 compared to both Type I hysterectomy group and control group.

CONCLUSION

Hysterectomy results in detrimental effects on the quality of life (QoL) regarding all aspects of pelvic floor functions especially in women of radical hysterectomy. Urinary dysfunctional symptoms like urgency, obstruction and especially sexual problems are more bothersome and difficult to overcome. The impact of hysterectomy on QoL should be investigated as a whole and may be more profound than previously thought.

摘要

目的

本研究评估了单纯子宫切除术和根治性子宫切除术对盆底功能障碍各方面的影响。

研究设计

这项回顾性队列研究纳入了142例患者;58名女性(40.8%)接受了单纯子宫切除术,41名(28.8%)接受了根治性子宫切除术,43名(30.2%)女性未接受任何手术干预作为对照组。使用经过验证的泌尿生殖系统困扰量表(UDI-6)、尿失禁影响问卷(IIQ-7)、盆底与尿失禁性功能影响问卷(PISQ-12)、韦克斯纳尿失禁量表评分和盆腔器官脱垂定量(POP-Q)系统对盆底功能障碍进行详细评估。统计分析采用单因素方差分析和Pearson卡方检验。

结果

发现III型子宫切除术组和I型子宫切除术组在UDI-6的刺激性和梗阻性评分上存在显著差异。此外,I型子宫切除术患者的刺激性和梗阻性评分显著高于对照组。基于PISQ-12评分,与I型子宫切除术组和对照组相比,III型子宫切除术对性生活的恶化影响最为显著。

结论

子宫切除术对盆底功能的各个方面的生活质量(QoL)均产生不利影响,尤其是根治性子宫切除术的女性。尿急、梗阻等排尿功能障碍症状,尤其是性问题更令人困扰且难以克服。子宫切除术对生活质量的影响应作为一个整体进行研究,其影响可能比之前认为的更为深远。

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