Department of Urology, School of Medicine, University of California San Francisco, 400 Parnassus Ave, Box 0738, San Francisco, CA, 94143, USA.
Department of General Surgery, School of Medicine, University of California San Francisco, 400 Parnassus Ave, San Francisco, CA, 94143, USA.
Obes Surg. 2024 Nov;34(11):4146-4151. doi: 10.1007/s11695-024-07226-0. Epub 2024 Aug 19.
Women with obesity are more likely to experience bothersome urinary and sexual symptoms, but the long-term effect of metabolic and bariatric surgery (MBS) on these outcomes is poorly understood. We aimed to describe how MBS longitudinally impacted women's urinary and sexual health.
Patients who underwent MBS at the University of California, San Francisco Medical Center (UCSF) between 2009 and 2021 participated in a survey examining sexual health, pelvic organ prolapse (POP), and urinary health using three validated questionnaires: a modified version of the Female Sexual Function Index (FSFI), the Pelvic Organ Prolapse Distress Inventory 6 (POPDI-6), and the Urinary Distress Inventory 6 (UDI-6). All questions asked referenced two time points: before surgery and at the time of survey. Logistic regression identified predictors of symptom improvement.
Of 162 participants contacted, 118 (73%) had complete survey data. Mean body mass index (BMI) decreased from 52.4 ± 12.6 to 36.3 ± 9.7 kg/m (p < 0.01) with an average follow-up of 6 years. The mean UDI-6 score amongst women was 24 ± 24 prior to MBS and 24 ± 26 at the time of survey administration (p = 0.458). Mean modified FSFI scores amongst women were 15 ± 5 prior to surgery and 14 ± 7 at the time of survey administration (p = 0.005). The overall mean POPDI-6 score amongst women was 13 ± 15 prior to surgery and 9 ± 14 at the time of survey administration (p = 0.056).
Women who underwent MBS reported a high rate of sexual and urological dysfunction that did not improve longitudinally, despite significant weight loss.
肥胖女性更容易出现令人困扰的泌尿系统和性功能障碍，但代谢和减重手术（MBS）对这些结果的长期影响知之甚少。本研究旨在描述 MBS 如何对女性的泌尿系统和性功能产生纵向影响。
2009 年至 2021 年期间，在加利福尼亚大学旧金山医疗中心（UCSF）接受 MBS 的患者参与了一项调查，该调查使用三个经过验证的问卷评估了患者的性功能、盆腔器官脱垂（POP）和尿失禁健康状况：女性性功能指数（FSFI）的改良版、盆腔器官脱垂困扰问卷 6 （POPDI-6）和尿失禁困扰问卷 6（UDI-6）。所有问题都参考了两个时间点：手术前和调查时。逻辑回归确定了症状改善的预测因素。
在联系的 162 名参与者中，有 118 名（73%）完成了完整的调查数据。平均体重指数（BMI）从 52.4±12.6kg/m2 下降到 36.3±9.7kg/m2（p<0.01），平均随访时间为 6 年。女性的 UDI-6 平均得分为 24±24 分，MBS 前为 24±26 分，调查时为 24±26 分（p=0.458）。手术前，女性的改良 FSFI 平均得分为 15±5 分，而调查时的平均得分为 14±7 分（p=0.005）。女性的 POPDI-6 平均总分为 13±15 分，MBS 前为 9±14 分，调查时为 9±14 分（p=0.056）。
尽管体重显著减轻，但接受 MBS 的女性报告称性功能和尿失禁障碍发生率较高，且这些障碍并未随时间纵向改善。
