Molina-Barea Rocío, Slim Mahmoud, Calandre Elena P
Department of Surgery, Hospital Universitario de Jaén, 23007 Jaén, Spain.
Instituto de Neurociencias, Universidad de Granada, 18016 Granada, Spain.
Healthcare (Basel). 2024 Mar 15;12(6):668. doi: 10.3390/healthcare12060668.
Pelvic floor dysfunction comprises various disorders, including urinary incontinence, fecal incontinence, pelvic organ prolapse, and chronic pelvic pain. This study aimed to evaluate health-related quality of life (HRQoL), anxiety, depression, sleep disturbance, and sexual functioning in women with pelvic floor dysfunction of colorectal etiology compared with control women. Patients were recruited from a specialized colorectal unit and controls were selected from among the patients' friends and relatives. Sociodemographic and clinical data were collected. Pelvic floor dysfunction distress and impact, HRQoL, depression, anxiety, insomnia, and sexual functioning were assessed using the following validated questionnaires: Short-Form Pelvic Floor Distress Inventory (PFDI-20), Short Form Pelvic Floor Impact Questionnaire (PFIQ-7), 36-Item Short-Form Health Survey (SF-36), Beck Depression Inventory II (BDI-II), Beck Anxiety Inventory (BAI), Insomnia Severity Index (ISI), and Changes in Sexual Functioning Scale (CSFQ). Statistical analyses included Welch's -test, Fisher's exact test, and Spearman's correlation coefficients. Eighty-four patients and 57 controls were included. Compared with controls, patients were more likely to be obese or overweight, have had higher numbers of deliveries, more vaginal deliveries, more frequent use of forceps, and have had more associated comorbidities, mainly in the urinary, neurological, and psychiatric domains. As expected, patients scored significantly higher than controls on both the PFDI-20 and PFIQ-7 and their respective sub-scales, with the highest mean values in the patient group on the sub-scales related to the colorectal-anal domain. QoL, depression, anxiety, insomnia, and sexual functioning were significantly worse in patients than in controls ( < 0.0001 in every case). In patients, PFIQ-7 scores correlated significantly with HRQoL ( < 0.001 for the physical component and < 0.01 for the mental component), depression ( < 0.001), anxiety ( < 0.001), insomnia ( < 0.05), and sexual functioning scores ( < 0.05). Colorectal pelvic floor dysfunction had a markedly deleterious impact on the HRQoL, depression, anxiety, sleep disturbance, and sexual functioning of patients. It is concluded that colorectal pelvic floor dysfunction exerts a considerable burden on patients' lives. Addressing these issues in clinical settings could significantly improve patients' well-being.
盆底功能障碍包括多种疾病，如尿失禁、粪失禁、盆腔器官脱垂和慢性盆腔疼痛。本研究旨在评估结直肠病因导致的盆底功能障碍女性与对照女性相比的健康相关生活质量（HRQoL）、焦虑、抑郁、睡眠障碍和性功能。患者从专门的结直肠科招募，对照从患者的朋友和亲属中选取。收集社会人口统计学和临床数据。使用以下经过验证的问卷评估盆底功能障碍困扰和影响、HRQoL、抑郁、焦虑、失眠和性功能：简短盆底功能障碍困扰量表（PFDI - 20）、简短盆底功能影响问卷（PFIQ - 7）、36项简短健康调查（SF - 36）、贝克抑郁量表第二版（BDI - II）、贝克焦虑量表（BAI）、失眠严重程度指数（ISI）和性功能变化量表（CSFQ）。统计分析包括韦尔奇t检验、费舍尔精确检验和斯皮尔曼相关系数。纳入了84例患者和57例对照。与对照相比，患者更可能肥胖或超重，分娩次数更多，顺产更多，产钳使用更频繁，并且有更多相关合并症，主要在泌尿、神经和精神领域。正如预期的那样，患者在PFDI - 20和PFIQ - 7及其各自的子量表上的得分显著高于对照，患者组中与结直肠 - 肛门领域相关的子量表上的平均值最高。患者的生活质量、抑郁、焦虑、失眠和性功能明显比对照差（每种情况均P < 0.0001）。在患者中，PFIQ - 7得分与HRQoL（身体成分P < 0.001，心理成分P < 0.01）、抑郁（P < 0.001）、焦虑（P < 0.001）、失眠（P < 0.05）和性功能得分（P < 0.05）显著相关。结直肠盆底功能障碍对患者的HRQoL、抑郁、焦虑、睡眠障碍和性功能有明显的有害影响。结论是结直肠盆底功能障碍给患者的生活带来相当大的负担。在临床环境中解决这些问题可以显著改善患者的幸福感。
