Cozzolino Mauro, Magro-Malosso Elena Rita, Tofani Lorenzo, Coccia Maria Elisabetta
Department of Biomedical, Experimental and Clinical Sciences - Division of Obstetrics and Gynecology, University of Florence, Italy; Instituto Valenciano de Infertilidad - IVI Madrid, Madrid, Spain.
Department of Biomedical, Experimental and Clinical Sciences - Division of Obstetrics and Gynecology, University of Florence, Italy.
Sex Reprod Healthc. 2018 Jun;16:6-9. doi: 10.1016/j.srhc.2017.12.005. Epub 2018 Jan 3.
The influence of deep infiltrating endometriosis (DIE) on sexual function has been poorly studied. The aim of this study was to evaluate the impact of DIE on sexual function by administering questionnaires to women.
Women with a clinical and ultrasound diagnosis of DIE and histological confirmation of endometriosis were included in the study. In interview, women were asked to rate five pain symptoms, dysmenorrhea, dyspareunia, dyschezia, dysuria and Cronic Pelvic Pain (CPP), on a visual analogue scale (VAS), and sexual function was assessed using the Female Sexual Function Index (FSFI).
A total of 170 women with DIE were identified. A VAS score of 7 or more was taken to indicate that a symptom was 'severe'. Dysmenorrhea was reported to be severe by 66.5% of the sample, dyspareunia by 41.8%, dyschezia by 32.4% and dysuria by 6.5%. Mean FSFI scores did not differ significantly between women with and without endometriosis lesions at particular sites, except for rectovaginal nodules, which were found to be associated with more impaired sexual activity and sexual function.
Women with DIE had significant impairment of sexual activity when a partial or total infiltration of the rectovaginal septum occurred. Particular attention should be given to women with this kind of lesion.
深部浸润性子宫内膜异位症(DIE)对性功能的影响研究较少。本研究旨在通过对女性进行问卷调查来评估DIE对性功能的影响。
本研究纳入了临床及超声诊断为DIE且经组织学证实为子宫内膜异位症的女性。在访谈中,要求女性使用视觉模拟量表(VAS)对痛经、性交痛、排便困难、排尿困难和慢性盆腔疼痛(CPP)这五种疼痛症状进行评分,并使用女性性功能指数(FSFI)评估性功能。
共识别出170例DIE女性。VAS评分7分及以上被视为症状“严重”。样本中66.5%的女性报告痛经严重,41.8%性交痛严重,32.4%排便困难严重,6.5%排尿困难严重。除直肠阴道结节外,有或无特定部位子宫内膜异位症病变的女性之间FSFI平均得分无显著差异,直肠阴道结节与性活动和性功能受损程度更高有关。
当直肠阴道隔发生部分或完全浸润时,DIE女性的性活动会受到显著损害。应特别关注有此类病变的女性。