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经阴道子宫切除术联合双侧骶棘韧带固定术治疗原发性盆腔器官脱垂后生活质量和性生活。

Quality of life and sexuality after bilateral sacrospinous fixation with vaginal hysterectomy for treatment of primary pelvic organ prolapse.

机构信息

Department of Obstetrics and Gynecology, Istinye University, School of Medicine, Istanbul, Turkey.

Department of Gynecologic Oncology, Medical Park Hospital, Antalya, Turkey.

出版信息

Low Urin Tract Symptoms. 2020 Sep;12(3):206-210. doi: 10.1111/luts.12303. Epub 2020 Jan 31.

DOI:10.1111/luts.12303
PMID:32003546
Abstract

OBJECTIVE

To investigate the quality of life (QoL) and sexuality in women affected by pelvic organ prolapse (POP) and treated by bilateral sacrospinous ligament fixation (SSLF) with vaginal hysterectomy.

METHODS

This is a prospective observational study carried out at Isparta City Hospital from July 2017 to December 2018. A total of 26 sexually active women with symptomatic uterine prolapse POP-Q (Pelvic Organ Prolapse Quantification) stage II or higher requiring surgery were included in the study. Short Form Health Survey (SF-36) was used preoperatively and at 6 months to examine the impacts of vaginal reconstruction on QoL. To assess sexual functioning, the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) was used preoperatively and at 6 months.

RESULTS

A significant improvement of POP-Q landmarks was found between pre- and posttreatment at 6 months of follow-up. The patients reported QoL improvement at the follow-up for all the categories of physical functioning, bodily pain, physical health, general health, vitality, social activity, emotional state, and mental health with respect to the baseline values (P < .001). The results of PISQ-12 demonstrated a significant improvement for all the three fields: behavioral emotive factor, physical factor, and partner-related factor, and the total score at 6 months after surgery (P < .001).

CONCLUSION

This study clearly demonstrates that bilateral SSLF is able to significantly improve both QoL and sexual function in patients with POP. Improvement in sexuality and QoL after surgery may be explained by correction of avoidance of sexual intercourse due to prolapse and physical recovery.

摘要

目的

探讨经阴道子宫切除术双侧骶棘韧带固定术(SSLF)治疗盆腔器官脱垂(POP)女性的生活质量(QoL)和性生活。

方法

这是一项于 2017 年 7 月至 2018 年 12 月在伊兹塔市医院进行的前瞻性观察研究。共纳入 26 例有症状的子宫脱垂 POP-Q(盆腔器官脱垂量化)Ⅱ期或以上需手术的活跃女性。术前和术后 6 个月使用简明健康调查量表(SF-36)评估阴道重建对 QoL 的影响。术前和术后 6 个月使用盆腔器官脱垂/尿失禁性功能问卷(PISQ-12)评估性功能。

结果

在 6 个月的随访中,与术前相比,POP-Q 标志物在治疗后有显著改善。患者在随访时报告所有类别的生理功能、躯体疼痛、身体健康、总体健康、活力、社会活动、情绪状态和心理健康均较基线值有所改善(P <.001)。PISQ-12 的结果表明,在性行为、情感因素、身体因素和与伴侣相关因素以及术后 6 个月的总分方面均有显著改善(P <.001)。

结论

本研究清楚地表明,双侧 SSLF 能够显著改善 POP 患者的 QoL 和性生活。术后性生活和 QoL 的改善可能是由于脱垂导致的避免性生活和身体恢复的纠正。

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引用本文的文献

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J Clin Med. 2022 Dec 1;11(23):7166. doi: 10.3390/jcm11237166.
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Evaluation of the clinical effectiveness of modified sacrospinous ligament fixation the anterior vaginal wall path for pelvic organ prolapse: A feasibility report based on 50 patients.改良骶棘韧带固定术经阴道前壁路径治疗盆腔器官脱垂的临床疗效评估:基于50例患者的可行性报告
Front Surg. 2022 Nov 2;9:1010027. doi: 10.3389/fsurg.2022.1010027. eCollection 2022.
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Function, quality-of-life and complications after sacrospinous ligament fixation using an antegrade reusable suturing device (ARSD-Ney) at 6 and 12 months: a retrospective cohort study.
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Ann Transl Med. 2022 May;10(10):582. doi: 10.21037/atm-22-2150.
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Anterior bilateral sacrospinous ligament fixation with concomitant anterior native tissue repair: a pilot study.前双侧骶棘韧带固定联合前侧固有组织修复:一项初步研究。
Int Urogynecol J. 2022 Dec;33(12):3519-3527. doi: 10.1007/s00192-022-05092-x. Epub 2022 Feb 28.