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女性替代尿道成形术后的长期性功能和生活质量。

Long-term Sexual Function and Quality of Life in Women Following Substitution Urethroplasty.

机构信息

Department of Urology, All India Institute of Medical Sciences, (AIIMS), 2nd Floor, AIIMS OPD Complex, Bhubaneswar, 751019, India.

出版信息

Int Urogynecol J. 2024 Feb;35(2):407-413. doi: 10.1007/s00192-023-05706-y. Epub 2024 Jan 3.

Abstract

PURPOSE

To assess the long-term quality of life (QOL) and sexual function (SF) in women who underwent either dorsal on-lay (DO) or ventral inlay (VI) urethroplasty for urethral stricture disease.

METHODOLOGY

Between January 2016 and September 2022, women who underwent either dorsal on-lay (DO) or ventral inlay (VI) urethroplasties and had at least a six-month follow-up been included. Using the Female Sexual Function Index (FSFI) and WHO-QOL bref questionnaires, the QOL and SF were evaluated. Scores were compared between the two groups after being examined for internal validity. A sub-group analysis was carried out based on the procedure's success.

RESULTS

With follow-up periods ranging from 6 to 86 months, 25 patients who received VI urethroplasty and 10 patients who underwent DO urethroplasty were included. Both scores demonstrated strong internal consistency. The cumulative QOL and FSFI scores were comparable in both groups (p = 0.53 and p = 0.83, respectively). Significantly high scores were noted in the physical health domain (76.5 ± 9.9 vs 62.33 ± 10.97; p = 0.03; (95% CI = 0.72-24.4)) and the environmental domain (75.75 ± 3.84 vs 66.00 ± 4.24; p = 0.01 (95% CI = 2.64-16.85) in patients with successful VI and DO urethroplasties respectively. Addictions, low socioeconomic status and protracted symptom duration were associated with low QOL scores. Old age was related to low FSFI scores.

CONCLUSION

Substitution urethroplasty, despite the approach, showed good QOL and SF scores. Long symptom duration, addictions, and poor socioeconomic status were associated with low QOL whereas old age independently influenced low FSFI scores.

摘要

目的

评估女性行尿道背侧黏膜瓣覆盖术(DO)或尿道腹侧黏膜瓣镶嵌术(VI)治疗尿道狭窄后长期的生活质量(QOL)和性功能(SF)。

方法

2016 年 1 月至 2022 年 9 月,纳入了行 DO 或 VI 尿道成形术且随访时间至少 6 个月的女性患者。采用女性性功能指数(FSFI)和世界卫生组织生活质量简表(WHO-QOL bref)问卷评估 QOL 和 SF。检查内部有效性后,比较两组之间的评分。根据手术成功率进行亚组分析。

结果

随访时间为 6 至 86 个月,纳入了 25 例行 VI 尿道成形术和 10 例行 DO 尿道成形术的患者。两组的评分均具有很强的内部一致性。两组患者的累积 QOL 和 FSFI 评分相似(p=0.53 和 p=0.83)。在生理健康领域(76.5±9.9 分比 62.33±10.97 分;p=0.03;95%置信区间[CI]为 0.72-24.4)和环境领域(75.75±3.84 分比 66.00±4.24 分;p=0.01;95%CI 为 2.64-16.85),VI 和 DO 尿道成形术成功的患者评分较高。不良嗜好、低社会经济地位和症状持续时间较长与 QOL 评分较低相关。高龄与 FSFI 评分较低有关。

结论

替代成形术(无论采用何种方法)均能获得较好的 QOL 和 SF 评分。较长的症状持续时间、不良嗜好和较差的社会经济状况与 QOL 较低有关,而高龄则与 FSFI 评分较低独立相关。

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