腰椎间盘突出症手术前后的性交疼痛：一项多中心观察性研究。
Pain During Sex Before and After Surgery for Lumbar Disc Herniation: A Multicenter Observational Study.
机构信息
Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
Department of Neurosurgery, St. Olavs Hospital, Trondheim, Norway.
出版信息
Spine (Phila Pa 1976). 2020 Dec 15;45(24):1751-1757. doi: 10.1097/BRS.0000000000003675.
STUDY DESIGN
Observational multicenter study.
OBJECTIVE
The aim of this study was to evaluate changes in pain during sexual activity after surgery for lumbar disc herniation (LDH).
SUMMARY OF BACKGROUND DATA
There are limited data available on sexual function in patients undergoing surgery for LDH.
METHODS
Data were retrieved from the Norwegian Registry for Spine Surgery. The primary outcome was change in pain during sexual activity at one year, assessed by item number eight of the Oswestry disability index (ODI) questionnaire. Secondary outcome measures included ODI, EuroQol-5D (EQ-5D), and numeric rating scale (NRS) scores for back and leg pain.
RESULTS
Among the 18,529 patients included, 12,103 (64.8%) completed 1-year follow-up. At baseline, 16,729 patients (90.3%) provided information about pain during sexual activity, whereas 11,130 (92.0%) among those with complete follow-up completed this item. Preoperatively 2586 of 16,729 patients (15.5%) reported that pain did not affect sexual activity and at 1 year, 7251 of 11,130 patients (65.1%) reported a normal sex-life without pain. Preoperatively, 2483 (14.8%) patients reported that pain prevented any sex-life, compared to 190 patients (1.7%) at 1 year. At baseline, 14,143 of 16,729 patients (84.5%) reported that sexual activity caused pain, and among these 7232 of 10,509 responders (68.8%) reported an improvement at 1 year. A multivariable regression analysis showed that having a life partner, college education, working until time of surgery, undergoing emergency surgery, and increasing ODI score were predictors of improvement in pain during sexual activity. Increasing age, tobacco smoking, increasing body mass index, comorbidity, back pain >12 months, previous spine surgery, surgery in two or more lumbar levels, and complications occurring within 3 months were negative predictors.
CONCLUSION
This study clearly demonstrates that a large proportion of patients undergoing surgery for LDH experienced an improvement in pain during sexual activity at 1 year.
LEVEL OF EVIDENCE
研究设计
观察性多中心研究。
目的
本研究旨在评估腰椎间盘突出症（LDH）手术后患者在性行为过程中疼痛的变化。
背景数据概要
关于接受 LDH 手术患者的性功能，目前数据有限。
方法
数据取自挪威脊柱手术登记处。主要结局是通过 Oswestry 残疾指数（ODI）问卷的第 8 项评估患者术后一年性行为过程中疼痛的变化。次要结局评估包括 ODI、EuroQol-5D（EQ-5D）和背部及腿部疼痛数字评分量表（NRS）评分。
结果
在纳入的 18529 例患者中，有 12103 例（64.8%）完成了 1 年随访。基线时，16729 例患者（90.3%）提供了性行为过程中疼痛的信息，而其中 11130 例（92.0%）完整随访患者完成了该项目。术前，16729 例患者中有 2586 例（15.5%）报告疼痛不影响性行为，1 年后，11130 例患者中有 7251 例（65.1%）报告无疼痛的正常性生活。术前，2483 例（14.8%）患者报告疼痛完全阻止了任何性行为，而 1 年后仅有 190 例（1.7%）患者报告如此。基线时，16729 例患者中有 14143 例（84.5%）报告性行为会引起疼痛，而在这其中，10509 例应答者中有 7232 例（68.8%）报告疼痛在 1 年后有所改善。多变量回归分析显示，有生活伴侣、大学学历、工作至手术前、急诊手术和 ODI 评分增加是性行为过程中疼痛改善的预测因素。年龄增加、吸烟、体重指数增加、合并症、背痛持续超过 12 个月、既往脊柱手术、两个或以上腰椎水平手术和术后 3 个月内发生并发症是负性预测因素。
结论
本研究清楚地表明，接受 LDH 手术的患者中，很大一部分患者在术后 1 年时性行为过程中的疼痛得到了改善。
证据水平
2 级。
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