Oiwa Yuko, Watanabe Toyohiko, Sadahira Takuya, Ishii Ayano, Sako Tomoko, Inoue Miyabi, Wada Koichiro, Kobayashi Yasuyuki, Araki Motoo, Nasu Yasutomo
Department of Urology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
Acta Med Okayama. 2019 Feb;73(1):21-27. doi: 10.18926/AMO/56455.
We measured basal clitoral blood flow by Doppler sonography to determine whether tension-free vaginal mesh(TVM) affects the clitoral blood flow and sexual function in women with pelvic organ prolapse (POP). We performed a prospective study of 22 patients who underwent TVM for POP. Clitoral blood flow was measured by Doppler ultrasound. The resistance index (RI), pulsatility index (PI), peak systolic velocity (PSV), and end-diastolic velocity (EDV) of the clitoral arteries were measured preoperatively and at 1, 3, and 6 months postoperatively. Female sexual function was also investigated with the Female Sexual Function Index (FSFI). The mean PI and RI were increased at 1 month and significantly decreased at 6 months postoperatively (p<0.05). In contrast, the mean PSV and EDV decreased at 1 month postoperatively and increased at 6 months postoperatively. These four parameters recovered to baseline levels at 6 months following surgery. Total FSFI scores improved significantly from 10.2±7.9 at baseline to 18.2±8.9 at 6 months postoperatively. Color Doppler ultrasonography is potentially useful in measuring clitoral blood flow in patients treated with TVM for POP. Prospective long-term studies are needed to evaluate the utility of this modality as a diagnostic and prognostic tool for female sexual dysfunction.
我们通过多普勒超声测量阴蒂基础血流，以确定无张力阴道网片（TVM）是否会影响盆腔器官脱垂（POP）女性的阴蒂血流和性功能。我们对22例行TVM治疗POP的患者进行了一项前瞻性研究。通过多普勒超声测量阴蒂血流。在术前以及术后1个月、3个月和6个月测量阴蒂动脉的阻力指数（RI）、搏动指数（PI）、收缩期峰值流速（PSV）和舒张末期流速（EDV）。还使用女性性功能指数（FSFI）对女性性功能进行了调查。平均PI和RI在术后1个月升高，在术后6个月显著降低（p<0.05）。相比之下，平均PSV和EDV在术后1个月降低，在术后6个月升高。这四个参数在术后6个月恢复到基线水平。FSFI总分从基线时的10.2±7.9显著提高到术后6个月时的18.2±8.9。彩色多普勒超声在测量接受TVM治疗POP的患者的阴蒂血流方面可能有用。需要进行前瞻性长期研究，以评估这种方法作为女性性功能障碍诊断和预后工具的效用。
