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比较经阴道子宫切除术联合骶棘韧带固定术、腹腔镜子宫切除术联合骶骨阴道固定术和经腹子宫切除术联合骶骨阴道固定术患者的术后生活质量和性功能。

Comparison of patients undergoing vaginal hysterectomy with sacrospinous ligament fixation, laparoscopic hysterectomy with sacrocolpopexy and abdominal hysterectomy with sacrocolpopexy in terms of postoperative quality of life and sexual function.

机构信息

Department of Obstetrics and Gynaecology, University of Health Sciences, Adana City Training and Research Center, Adana, Turkey.

Department of Obstetrics and Gynaecology, Medistate Kavacık Hospital, Istanbul, Turkey.

出版信息

J Gynecol Obstet Hum Reprod. 2021 Apr;50(4):101977. doi: 10.1016/j.jogoh.2020.101977. Epub 2020 Nov 6.

Abstract

AIM

To investigate whether there is a significant difference among the patients who underwent vaginal hysterectomy with sacrospinous ligament fixation (VH + SSLF), laparoscopic hysterectomy with sacrocolpopexy (LH + SCP) and abdominal hysterectomy with sacrocolpopexy (AH + SCP) in terms of sexual function and quality of life.

MATERIAL AND METHOD

Sixty-five patients undergoing vaginal hysterectomy with sacrospinous ligament fixation (VH + SSLF), laparoscopic hysterectomy with sacrocolpopexy (LH + SCP) or abdominal hysterectomy with sacrocolpopexy (AH + SCP) participated in the study. The Quality of Life Scale and Sexual Function Scale Index (PISQ-12) were used to see whether there is a significant difference among the three groups (VH + SSLF, LH + SCP, AH + SCP) at least 1 year after surgery. The Pelvic Floor Distress Inventory-20 (PFDI-20) Scale consisting of Pelvic Organ Prolapse Distress Inventory (POPDI-6), Urinary Distress Inventory (UDI-6), and Colorectal-Anal Distress Inventory (CRADI-8) was used to evaluate the functional outcomes.

RESULTS

The participants had a mean age of 60 ± 8.79 years. The mean PFDI-20 score in the VH + SSLF groups is higher than that in the AH + SCP group (p = 0.047). There is no significant difference among three VH + SSLF, LH + SCP and AH + SCP groups regarding scores of POPDI-6, UDI-6, CRADI-8, and PISQ-12.

CONCLUSION

In the present study, it was concluded that AH + SCP group had a higher quality of life than the VH + SSLF group did while the sexual function was not affected significantly by the vaginal or abdominal surgical procedures. The pelvic surgeon should skillfully choose different prolapse surgical techniques to tailor the surgical treatment to the patient's needs.

摘要

目的

研究经阴道子宫切除术加骶骨固定术(VH + SSLF)、腹腔镜子宫切除术加骶骨阴道固定术(LH + SCP)和经腹子宫切除术加骶骨阴道固定术(AH + SCP)患者在性功能和生活质量方面是否存在显著差异。

材料和方法

65 例接受经阴道子宫切除术加骶骨固定术(VH + SSLF)、腹腔镜子宫切除术加骶骨阴道固定术(LH + SCP)或经腹子宫切除术加骶骨阴道固定术(AH + SCP)的患者参与了这项研究。使用生活质量量表和性功能量表指数(PISQ-12),至少在手术后 1 年评估三组(VH + SSLF、LH + SCP、AH + SCP)之间是否存在显著差异。使用包括盆腔器官脱垂窘迫量表(POPDI-6)、尿失禁窘迫量表(UDI-6)和肛肠窘迫量表(CRADI-8)的盆腔窘迫量表-20(PFDI-20)量表评估功能结果。

结果

参与者的平均年龄为 60 ± 8.79 岁。VH + SSLF 组的平均 PFDI-20 评分高于 AH + SCP 组(p = 0.047)。在 POPDI-6、UDI-6、CRADI-8 和 PISQ-12 评分方面,三组(VH + SSLF、LH + SCP 和 AH + SCP)之间无显著差异。

结论

本研究得出结论,AH + SCP 组的生活质量高于 VH + SSLF 组,而性功能不受阴道或腹部手术的显著影响。盆腔外科医生应熟练选择不同的脱垂手术技术,根据患者的需求定制手术治疗。

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