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盆底修复手术入路会影响女性性功能吗?

Does Surgical Approach in Pelvic Floor Repair Impact Sexual Function in Women?

作者信息

Zawodnik Astrid, Balaphas Alexandre, Buchs Nicolas Christian, Zufferey Guillaume, Robert-Yap Joan, Buhler Leo H, Roche Bruno, Ris Frédéric

机构信息

Department of Visceral Surgery, Geneva University Hospitals (HUG) and Medical School, Geneva, Switzerland.

Department of Visceral Surgery, Geneva University Hospitals (HUG) and Medical School, Geneva, Switzerland.

出版信息

Sex Med. 2019 Dec;7(4):522-529. doi: 10.1016/j.esxm.2019.08.004. Epub 2019 Sep 12.

Abstract

INTRODUCTION

Surgical routes used to correct complex pelvic floor disorders (CPFDs) may have a negative impact on women's sexual function. Currently, there is no evidence concerning the impact of a specific surgical procedure on postoperative sexual function in women.

AIM

The aim of this study was to compare an abdominal approach with rectopexy and sacrocolpopexy to a perineal procedure with abdominal rectopexy, regarding female sexual function in cases of CPFDs.

METHODS

Women who were operated for CPFDs between January 2003 and June 2010 were retrospectively asked to answer the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12, the Miller Score of Incontinence, and a urinary incontinence frequency score. We also questioned them about their sexual function and satisfaction before and after the operation using visual analogic scores.

MAIN OUTCOME MEASURE

We compared the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 before and after the surgery in both groups, and we made an intragroup comparison.

RESULTS

There were 334 women identified, but only 51 could be included. Globally, we found no statistically significant differences in terms of sexual function before and after surgery between the 25 groups. Intragroup comparison demonstrated that, within the perineal approach group, patients experienced a decrease in their sexual arousal after the procedure. The choice of surgical route for pelvic floor disorders does not seem to have an impact on the results of postoperative sexual function in women. This study adds to the limited literature on sexual outcomes of surgery for CPFD. It is limited principally due to its retrospective design and the small number of patients included.

CONCLUSION

Both surgical routes have very similar outcomes on most sexual questions. A perineal approach combined with abdominal rectopexy did, however, demonstrate a slight decrease in sexual arousal of the patients after the intervention. Zawodnik A, Balaphas A, Buchs NC, et al. Does Surgical Approach in Pelvic Floor Repair Impact Sexual Function in Women? Sex Med 2019;7:522-529.

摘要

引言

用于纠正复杂盆底功能障碍(CPFDs)的手术途径可能会对女性性功能产生负面影响。目前,尚无关于特定手术对女性术后性功能影响的证据。

目的

本研究的目的是比较在CPFDs病例中,腹部直肠固定术和骶骨阴道固定术与经会阴手术联合腹部直肠固定术对女性性功能的影响。

方法

回顾性地要求2003年1月至2010年6月间因CPFDs接受手术的女性回答盆底器官脱垂/尿失禁性功能问卷-12、尿失禁米勒评分和尿失禁频率评分。我们还使用视觉模拟评分法询问她们手术前后的性功能和满意度。

主要观察指标

我们比较了两组手术前后的盆底器官脱垂/尿失禁性功能问卷-12,并进行了组内比较。

结果

共识别出334名女性,但仅51名可纳入研究。总体而言,我们发现两组之间手术前后的性功能在统计学上无显著差异。组内比较表明,在经会阴手术组中,患者术后性唤起有所下降。盆底功能障碍的手术途径选择似乎对女性术后性功能结果没有影响。本研究补充了关于CPFDs手术性结局的有限文献。其局限性主要在于回顾性设计和纳入患者数量较少。

结论

两种手术途径在大多数性问题上的结果非常相似。然而,经会阴手术联合腹部直肠固定术在干预后确实显示患者性唤起略有下降。扎沃德尼克A、巴拉法斯A、布克斯NC等。盆底修复手术途径会影响女性性功能吗?性医学2019;7:522 - 529。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c04f/6963122/257b09383563/gr1.jpg

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