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有和无压力性尿失禁女性的盆底肌肉力量、生物电活动与性功能:一项观察性横断面研究

Strength and Bioelectrical Activity of the Pelvic Floor Muscles and Sexual Function in Women with and without Stress Urinary Incontinence: An Observational Cross-Sectional Study.

作者信息

Ferreira Clicia Raiane Galvão, Soares Wenderk Martins, da Costa Priante Caren Heloise, de Souza Duarte Natália, Soares Cleuma Oliveira, Bittencourt Kayonne Campos, Melo Giovana Salomão, Nunes Erica Feio Carneiro, de Campos Gomes Fabiana, De Melo Neto João Simão, Rodrigues Cibele Nazaré Câmara

机构信息

Clinical and Experimental Research Unit of the Urogenital System (UPCEURG), Institute of Health Sciences, Federal University of Pará (UFPA), Belém 66075110, PA, Brazil.

CAFISIO Mulher, Belém 66075110, PA, Brazil.

出版信息

Healthcare (Basel). 2023 Jan 6;11(2):181. doi: 10.3390/healthcare11020181.

Abstract

Stress urinary incontinence (SUI) results from an increase in intravesical pressure, which exceeds the pressure at which the urethra remains closed. Symptoms cause social and sexual intercourse discomfort directly or indirectly, which affect health-related quality of life and are associated with pelvic floor muscle (PFM) dysfunction. We aimed to verify the variation in strength and PFM bioelectrical activity and sexual function in women with SUI. Additionally, we analyzed the impact of this dysfunction on quality of life. This was an observational cross-sectional study. Women aged 25−55 years with frequent sexual intercourse were included. Women with SUI were included in a study group (G2, n = 17), and those without any type of incontinence were included in a control group (G1, n = 16). Primary outcomes were level of strength and PFM bioelectrical activity and sexual function as determinants of worse SUI in the control group. Secondary outcomes were associated between the primary outcomes and severity of urinary loss, impact on daily life, and quality of life in women with SUI. In the domains evaluated in the Female Sexual Function Index (FSFI), only sexual desire was lower in women with SUI (G2) than in the controls (p = 0.033). During analysis of G1 variables, a positive and moderate correlation was observed between power/myoeletric activation and maximum voluntary contraction (MVC) (p < 0.01), peak (p < 0.01), and mean amplitudes (p = 0.017). There was a high positive correlation between sexual arousal and other variables, including vaginal lubrication, sexual orgasm, and total FSFI value (p < 0.001 for all analyses). During evaluation of G2 variables, the MVC was positively correlated with the peak and mean amplitudes (p < 0.0001). Additionally, there was a high and positive correlation between the mean amplitudes (%MVC) and personal relationships (KHQ) (p = 0.001); the same was observed between the total (ICIQ) and activities of daily living (ICIQ) (p < 0.0001). Therefore, women with SUI presented with lower sexual desire and bioelectric activity but were not related to PFM strength. Additionally, the domains of sexual function and certain variables of quality of life are aggravated by SUI.

摘要

压力性尿失禁(SUI)是由膀胱内压升高引起的,该压力超过了尿道保持闭合的压力。症状直接或间接导致社交和性交不适,影响与健康相关的生活质量,并与盆底肌(PFM)功能障碍有关。我们旨在验证SUI女性的力量、PFM生物电活动和性功能的变化。此外,我们分析了这种功能障碍对生活质量的影响。这是一项观察性横断面研究。纳入了年龄在25 - 55岁、有频繁性交的女性。患有SUI的女性被纳入研究组(G2,n = 17),没有任何类型尿失禁的女性被纳入对照组(G1,n = 16)。主要结局是力量水平、PFM生物电活动和性功能,作为对照组中更严重SUI的决定因素。次要结局是主要结局与尿失禁严重程度、对日常生活的影响以及SUI女性生活质量之间的关联。在女性性功能指数(FSFI)评估的领域中,只有SUI女性(G2)的性欲低于对照组(p = 0.033)。在分析G1变量时,观察到功率/肌电激活与最大自主收缩(MVC)(p < 0.01)、峰值(p < 0.01)和平均振幅(p = 0.017)之间存在正性且中等程度的相关性。性唤起与其他变量之间存在高度正相关,包括阴道润滑、性高潮和FSFI总评分(所有分析的p < 0.001)。在评估G2变量时,MVC与峰值和平均振幅呈正相关(p < 0.0001)。此外,平均振幅(%MVC)与人际关系(KHQ)之间存在高度正相关(p = 0.001);在尿失禁影响问卷总分(ICIQ)与日常生活活动(ICIQ)之间也观察到相同情况(p < 0.0001)。因此,SUI女性表现出较低的性欲和生物电活动,但与PFM力量无关。此外,性功能领域和生活质量的某些变量会因SUI而加重。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/782f/9859585/42d229c4c35f/healthcare-11-00181-g001.jpg

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