Department of Obstetrics and Gynecology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA; and Chronic Pain and Fatigue Research Center, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48105, USA.
Department of Anesthesiology, University of Michigan, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA; and Chronic Pain and Fatigue Research Center, University of Michigan, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48105, USA.
Sex Health. 2022 Mar;19(1):46-54. doi: 10.1071/SH21153.
Our aims were to describe characteristics of sexual function prior to and 6months following benign hysterectomy in patients with three common surgical indications, and to identify preoperative factors that influence the magnitude and direction of change in sexual function after the procedure.
This prospective observational cohort study enrolled women (n =80) undergoing hysterectomy for benign indications. Patients were categorised into three groups according to surgical indication: (1) pelvic pain (PP), (2) abnormal uterine bleeding (AUB), and (3) pelvic organ prolapse (POP). Primary outcome was Female Sexual Function Index (FSFI), which patients completed preoperatively and 6months postoperatively.
The study included 80 patients, of whom 25.0% (n =20) had surgical indication of PP, 46.3% (n =37) of AUB, and 28.7% (n =23) of POP. PP patients experienced a significant improvement in overall sexual function, as well as orgasm and pain domains following hysterectomy. Significant improvements were not found in AUB and POP patients. In multivariate analysis, lower baseline sexual function (P <0.001), younger age (P =0.013), and pelvic pain<6months (P =0.020) were each independently associated with improvement in sexual function, but surgical indication was not significant.
Individual patient factors including younger age, lower baseline sexual function, and short duration of pelvic pain are associated with a higher likelihood of improvement in sexual function after hysterectomy. Surgical indication does not appear to be predictive of postoperative sexual function once accounting for other factors.
我们的目的是描述三种常见手术指征患者良性子宫切除术前和术后 6 个月的性功能特征，并确定术前因素对术后性功能变化的幅度和方向的影响。
这项前瞻性观察性队列研究纳入了因良性指征接受子宫切除术的女性患者（n=80）。根据手术指征将患者分为三组：（1）盆腔痛（PP），（2）异常子宫出血（AUB）和（3）盆腔器官脱垂（POP）。主要结局是女性性功能指数（FSFI），患者在术前和术后 6 个月完成。
该研究纳入了 80 名患者，其中 25.0%（n=20）的手术指征为 PP，46.3%（n=37）为 AUB，28.7%（n=23）为 POP。PP 患者在子宫切除术后整体性功能以及性高潮和疼痛领域均有显著改善。AUB 和 POP 患者则未发现显著改善。多变量分析显示，基线性功能较低（P<0.001）、年龄较小（P=0.013）和盆腔痛<6 个月（P=0.020）与性功能改善独立相关，但手术指征不显著。
包括年龄较小、基线性功能较低和盆腔痛持续时间较短在内的个体患者因素与子宫切除术后性功能改善的可能性更高相关。一旦考虑到其他因素，手术指征似乎不能预测术后性功能。
