马-罗氏综合征伴人工阴道患者的自尊、抑郁、焦虑和性功能：病例系列。

Self-esteem, depression, anxiety and sexual function in Mayer-Rokitansky-Küster-Hauser syndrome with neovagina: A case series.

机构信息

Department of Gynecology, Obstetrics and Gynecology Hospital of Fudan University, 128 Shenyang Road, Shanghai 200082, China.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2024 Jul;298:85-90. doi: 10.1016/j.ejogrb.2024.04.027. Epub 2024 Apr 23.

DOI:10.1016/j.ejogrb.2024.04.027

PMID:38733778

Abstract

BACKGROUND

The Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome is a rare condition with significant psychological implications. However, our understanding of its impact on postoperative sexual function and mental health is still limited.

AIM

Evaluate the mental health status and sexual functioning of women with MRKH syndrome after vaginoplasty surgery.

METHODS

We enrolled 53 cases with MRKH syndrome who underwent artificial vaginoplasty. The participants were asked to participate in a two-round survey conducted between February 2021 during the covid-19 period and March 2023. The survey included questionnaires to measure depression, anxiety, self-esteem, and sexual functioning. Differences between scores over time were analysed using a paired sample t-test, and we assessed the correlation between mental health and sexual functioning.

RESULTS

In the first round, patients' mean ± SD age at surgery was 23.6 ± 4.5 years old, and the mean ± SD time that had elapsed since surgery at the time of the survey was 34.2 ± 20.8 months. None of the patients reported low self-esteem, 45.3 % reported mild-to-moderate depression, and 34.0 % reported mild anxiety. Thirty patients have had vaginal intercourse during the last six months. The mean ± SD Female Sexual Functioning Index score was 24.6 ± 4.4, and 60.0 % had a score of 23.5 or higher, indicating high sexual functioning. The sexual functioning scores were positively correlated with self-esteem scores and negatively correlated with depression or anxiety scores (p < 0.05). There was no significant improvement in patient's mental health status and sexual function between the second round survey (71.3 ± 17.8 months after surgery) and the first round survey (p > 0.05). In contrast, the sexual arousal of FSFI were significantly higher in the second survey round (p < 0.05).

CONCLUSION

Most patients undergoing vaginoplasty reported persisting mental health challenges. However, the majority reported good sexual functioning.

摘要

背景

Mayer-Rokitansky-Küster-Hauser（MRKH）综合征是一种罕见的疾病，对患者的心理有重大影响。然而，我们对其术后性功能和心理健康影响的理解仍然有限。

目的

评估 MRKH 综合征患者阴道成形术后的心理健康状况和性功能。

方法

我们招募了 53 例接受人工阴道成形术的 MRKH 综合征患者。在 COVID-19 期间的 2021 年 2 月至 2023 年 3 月期间，参与者被要求参与两轮调查。调查包括测量抑郁、焦虑、自尊和性功能的问卷。使用配对样本 t 检验分析得分随时间的差异，并评估心理健康和性功能之间的相关性。

结果

第一轮调查中，患者的平均年龄为 23.6±4.5 岁，手术至调查时的平均时间为 34.2±20.8 个月。无患者报告低自尊，45.3%报告轻度至中度抑郁，34.0%报告轻度焦虑。30 例患者在过去 6 个月内有过阴道性交。女性性功能指数的平均分数为 24.6±4.4，60.0%的分数为 23.5 或更高，表明性功能较高。性功能评分与自尊评分呈正相关，与抑郁或焦虑评分呈负相关（p<0.05）。在第二轮调查（手术 71.3±17.8 个月后）与第一轮调查之间，患者的心理健康状况和性功能没有显著改善（p>0.05）。相比之下，第二轮调查的 FSFI 性唤起显著较高（p<0.05）。