Mbongo Jean Alfred, Mouanga Alain, Miabaou Didace Massamba, Nzelie Aya, Iloki Léon Hervé
Service de Gynécologie Obstétrique, CHU de Brazzaville, BP 32, Brazzaville, Congo.
Service de Psychiatrie, CHU de Brazzaville, BP 32, Brazzaville, Congo.
Pan Afr Med J. 2016 Oct 17;25:79. doi: 10.11604/pamj.2016.25.79.10085. eCollection 2016.
Any illness is viewed as inherently evil, so it must be eradicated because it often significantly affect the quality of life. Vaginal hysterectomy is indicated in patients with some severe gynecological conditions; it is beneficial but can also have a detrimental impact on women's quality of life. The aim of our study was to explore subjective experience of the disease and vaginal hysterectomy (VH) among women before and after surgery. We conducted a qualitative prospective study based on clinical data collection over a period of 12 months; it involved women who had undergone vaginal hysterectomy. Those who decided not to take part in this study or lack of phone contact were not enrolled. During their disease, women experienced: discomfort during sex 26/40 (65%); vaginal bleeding 12/40 (30%); 13/40 pelvic pain (32.5%). Postoperatively, transient dyspareunia 30/40 (75%); headache after anesthesia 4/40 (10%) were noted. Women's psychological experience before VH was dominated by surgery fear in all patients, sleep disorders 38/40 (95%), anxiety 30/40 (75%), feelings of shame related to difficulty in performing the sexual intercourse because of prolapse 26/40 (65%) and/or because of genital bleeding due to uterine fibroids 14/40 (35%). The feeling of loss of femininity was reported in 26/40 women with uterine prolapse (65%), changes in self-esteem in 26/40 (65%). These subjective assessments were improved in women undergoing VH, offsetting the loss of their reproductive organ. No information was given by women to their loved ones and family members before surgery, reflecting their feeling of embarrassment or shame. The cessation of symptoms was observed in all cases, although in one case (1.25%) a new complication (rectal lesion) was noted. As regards sexual activity, all couples declared their satisfaction after treatment. Women's dramatic experience of the disease and vaginal hysterectomy improved significantly after surgery.
任何疾病都被视为本质上是邪恶的，因此必须根除，因为它常常会显著影响生活质量。阴道子宫切除术适用于一些患有严重妇科疾病的患者；它有益，但也可能对女性的生活质量产生不利影响。我们研究的目的是探讨女性在手术前后对疾病和阴道子宫切除术（VH）的主观体验。我们基于12个月的临床数据收集进行了一项定性前瞻性研究；研究对象为接受过阴道子宫切除术的女性。那些决定不参与本研究或无法取得电话联系的女性未被纳入。在患病期间，女性经历了：性生活不适26/40（65%）；阴道出血12/40（30%）；盆腔疼痛13/40（32.5%）。术后，出现短暂性交困难30/40（75%）；麻醉后头痛4/40（10%）。在所有患者中，VH术前女性的心理体验主要是手术恐惧、睡眠障碍38/40（95%）、焦虑30/40（75%）、因子宫脱垂导致性交困难而产生的羞耻感26/40（65%）和/或因子宫肌瘤导致生殖器出血而产生的羞耻感14/40（35%）。26/40患有子宫脱垂的女性（65%）报告有女性特质丧失的感觉，26/40（65%）有自尊的变化。接受VH手术的女性这些主观评估得到改善，抵消了她们生殖器官的丧失。术前女性没有向她们的亲人和家庭成员透露任何信息，这反映了她们的尴尬或羞耻感。所有病例均观察到症状消失，尽管有一例（1.25%）出现了新的并发症（直肠损伤）。至于性活动，所有夫妻在治疗后都表示满意。女性对疾病和阴道子宫切除术的戏剧性体验在术后有显著改善。
