Department of Obstetrics and Gynecology, Del Ponte Hospital, University of Insubria, 21100 Varese, Italy.
Department of Obstetrics and Gynecology, EOC-Beata Vergine Hospital, 6850 Mendrisio, Switzerland.
Medicina (Kaunas). 2023 Mar 15;59(3):580. doi: 10.3390/medicina59030580.
: Stress urinary incontinence (SUI) negatively affects women's quality of life, including sexual function. The aim of the current study was to evaluate the effect of polydimethylsiloxane (Macroplastique) on sexual function in women of fertile age affected by SUI. Single-center prospective study. Sexually active women of fertile age with symptoms of pure SUI, which were urodynamically proven, were submitted to intraurethral Macroplastique injection. At 6-months follow-up, their sexual function was evaluated with Female Sexual Function Index (FSFI), while the SUI cure rate was objectively assessed through a negative stress test and subjectively by a Patient Global Impression of Improvement (PGI-I) score < 3. The difference of coital incontinence prevalence was assessed between the baseline and the 6-month follow-up. Peri- and postoperative complications of Macroplastique injection were recorded and classified according to the Clavien-Dindo system. Twenty-one women fulfilled inclusion criteria and were submitted to Macroplastique procedure. The concerning sexual function, desire, satisfaction, and overall FSFI score significantly improved. Since other domains were less impaired at the baseline, we could not assess significant improvement for all of them. We observed a complete regression of coital incontinence (0/21, 0%) in comparison with the baseline (5/21, 23.8%; = 0.04). The objective SUI cure rate was 76% (16/21), while the subjective SUI cure rate was 80.9% (17/21). One woman developed de novo overactive bladder, and two women developed postoperative voiding dysfunction (self-solved in 24 h). The Macroplastique urethral injection was demonstrated to be safe and effective in improving sexual function in sexually active women of fertile age affected by pure SUI, urodinamically proven at 6-months follow-up.
压力性尿失禁（SUI）会降低女性的生活质量，包括性功能。本研究旨在评估聚二甲基硅氧烷（Macroplastique）对生育期压力性尿失禁女性性功能的影响。
单中心前瞻性研究。纳入有单纯性压力性尿失禁症状且经尿动力学证实的生育期有性生活的女性，并进行尿道内注射 Macroplastique。在 6 个月的随访中，使用女性性功能指数（FSFI）评估她们的性功能，同时通过阴性压力试验客观评估 SUI 治愈率，并通过患者总体改善印象（PGI-I）评分<3 进行主观评估。评估基线和 6 个月随访时的性生活时尿失禁患病率差异。记录 Macroplastique 注射的围手术期并发症，并根据 Clavien-Dindo 系统进行分类。
21 名女性符合纳入标准并接受了 Macroplastique 手术。涉及的性功能、欲望、满意度和整体 FSFI 评分均显著改善。由于其他领域在基线时受损程度较轻，我们无法评估所有领域的显著改善。与基线相比（5/21，23.8%； = 0.04），我们观察到性生活时尿失禁完全消退（0/21，0%）。客观 SUI 治愈率为 76%（16/21），主观 SUI 治愈率为 80.9%（17/21）。1 名女性新发膀胱过度活动症，2 名女性出现术后排尿功能障碍（24 小时内自行缓解）。
Macroplastique 尿道注射在生育期有性生活的单纯性压力性尿失禁女性中显示出安全有效，可改善其性功能，在 6 个月随访时得到尿动力学证实。
