Doğan Keziban, Öztoprak Mustafa Yasin, Dura Mustafa Cengiz, Aslan İlke Özer
Clinic of Obstetrics and Gynecology, University of Health Sciences Turkey, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey.
Clinic of Obstetrics and Gynecology, Karaman Training and Research Hospital, Konya, Turkey.
J Turk Ger Gynecol Assoc. 2024 Jun 13;25(2):96-101. doi: 10.4274/jtgga.galenos.2024.2023-1-13.
The objective of this study was to evaluate the sexual function and quality of life in female patients diagnosed with stress urinary incontinence (SUI) and pelvic organ prolapse (POP) after undergoing transobturator tape (TOT) or TOT with POP surgery and perineoplasty.
This prospective study population (n=86) consisted of sexually active women who had been diagnosed with SUI. Forty-six patients diagnosed with SUI with no POP (group 1) underwent TOT procedure only. Forty patients had a diagnosis of stage 2 and higher POP, based on POP quantification system with SUI (group 2). The second group was randomized as TOT-POP surgery (n=20) and TOT-POP surgery with perineoplasty (n=20). Prior to and six months after the surgical procedure, all female participants underwent assessment using the validated Urinary Distress Pre-Operative Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), and Pelvic Organ Prolapse Incontinence Sexual Questionnaire (PISQ).
Post-operative IIQ-7 and UDI-6 scores were significantly lower for all three groups compared to the preoperative period, while a significant increase was observed in PISQ scores (p<0.01). The dissimilarity in preoperative and postoperative IIQ-7 and UDI-6 scores exhibited comparable results across the groups, whereas the variance in PISQ scores was notably greater in the TOT + POP surgery + perineoplasty group (p=0.03).
Women with SUI or SUI with POP have better quality of life and sexual dysfunction after surgery. Perineoplasty may enhance sexual life in patients with perineal defect and vaginal enlargement.
本研究的目的是评估经闭孔尿道中段无张力悬吊术(TOT)或TOT联合盆腔器官脱垂(POP)手术及会阴成形术后,诊断为压力性尿失禁(SUI)和盆腔器官脱垂(POP)的女性患者的性功能和生活质量。
本前瞻性研究人群(n = 86)由已确诊为SUI的性活跃女性组成。46例诊断为无POP的SUI患者(第1组)仅接受TOT手术。根据POP量化系统,40例患者诊断为2期及以上POP合并SUI(第2组)。第2组随机分为TOT - POP手术组(n = 20)和TOT - POP手术联合会阴成形术组(n = 20)。在手术前和手术后6个月,所有女性参与者均使用经过验证的术前泌尿困扰量表(UDI - 6)、尿失禁影响问卷(IIQ - 7)和盆腔器官脱垂尿失禁性功能问卷(PISQ)进行评估。
与术前相比,所有三组术后IIQ - 7和UDI - 6评分均显著降低,而PISQ评分显著升高(p < 0.01)。各组术前和术后IIQ - 7及UDI - 6评分的差异显示出可比结果,而PISQ评分的差异在TOT + POP手术 + 会阴成形术组中尤为显著(p = 0.03)。
患有SUI或SUI合并POP的女性术后生活质量和性功能更佳。会阴成形术可能改善存在会阴缺陷和阴道扩张的患者的性生活。