Faculty of Medicine, University of Coimbra, Azinhaga de Santa Comba, 3000-354, Coimbra, Portugal.
Clinical Academic Centre of Coimbra, Coimbra, Portugal.
Int Urogynecol J. 2021 May;32(5):1273-1283. doi: 10.1007/s00192-021-04678-1. Epub 2021 Mar 15.
Knowledge about the impact of pelvic floor surgery on sexual function is limited and inconsistent. A prospective study assessed the impact of surgery for prolapse (POP) or stress urinary incontinence (SUI) on sexual function and determined the biopsychosocial predictors for changes in sexual function after surgery.
Sexually active women scheduled for correction of POP and/or SUI were recruited over a 6-month period. Consenting participants were asked to complete the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12) to evaluate sexual function. The King's Health Questionnaire and Prolapse Quality-of-Life Questionnaire were used to assess UI and POP symptoms and their impact on quality of life (QoL), respectively. Women were reviewed over a period of 1 year post-surgery.
Ninety-one patients were followed up over 1 year. After stratification into only or both SUI and POP surgery, global sexual function improved significantly in each group (p < 0.001). The improvement in the overall QoL score after pelvic surgery showed a significant correlation with the improvement in global sexual function (SUI group: r = - 0.38, p < 0.01; POP group: r = - 0.44, p < 0.05). For women undergoing SUI surgery, only educational level and prior hysterectomy had a significant association with improved sexual function. For women undergoing POP surgery with or without SUI surgical repair, no sociodemographic characteristics were preditive of improvement of sexual function.
Significantly improved sexual function was observed 1 year after pelvic floor surgery, and the improvement was predicted by other social and physical factors in addition to normal functional anatomy.
关于盆腔底手术对性功能影响的知识有限且不一致。一项前瞻性研究评估了脱垂（POP）或压力性尿失禁（SUI）手术对性功能的影响，并确定了手术后性功能变化的生物心理社会预测因素。
在 6 个月的时间内，招募了计划进行 POP 和/或 SUI 矫正的活跃女性。同意参与的参与者被要求完成盆腔器官脱垂/尿失禁性功能问卷（PISQ-12）以评估性功能。使用 King's 健康问卷和脱垂生活质量问卷分别评估尿失禁和 POP 症状及其对生活质量（QoL）的影响。女性在手术后进行为期 1 年的随访。
91 例患者随访 1 年。在仅 SUI 或 SUI 和 POP 手术分层后，每组的整体性功能均显著改善（p < 0.001）。盆腔手术后整体生活质量评分的改善与整体性功能的改善呈显著相关性（SUI 组：r = - 0.38，p < 0.01；POP 组：r = - 0.44，p < 0.05）。对于接受 SUI 手术的女性，只有教育水平和既往子宫切除术与性功能改善有显著关联。对于接受 POP 手术且伴有或不伴有 SUI 手术修复的女性，社会人口统计学特征与性功能改善无关。
盆腔底手术后 1 年观察到性功能显著改善，除正常功能解剖外，其他社会和身体因素也可预测性功能改善。
