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经尿道中段吊带手术后女性的性功能与不适

Sexual Function and Discomfort in Women After Midurethral Sling Surgery.

作者信息

Bugnon Marie, Ricard Cécilia, Detayrac Renaud

机构信息

Department of Gynecology and Obstetrics, University Hospital of Grenoble, CHU Grenoble Alpes, Quai Yermoloff, 38700, La Tronche, France.

Department of Gynecology, Urogynecology Unit, University Hospital of Nîmes, CHU Caremeau, Place du Professeur-Robert-Debré, 30029, Nîmes, France.

出版信息

Int Urogynecol J. 2024 Nov;35(11):2181-2189. doi: 10.1007/s00192-024-05929-7. Epub 2024 Oct 10.

Abstract

INTRODUCTION AND HYPOTHESIS

The purpose of this study was to evaluate medium-term sexual function following midurethral sling (MUS) surgery.

METHODS

This was an ambidirectional observational study with a nested matched case-control study performed in a tertiary urogynecology referral center. We assessed sexual discomfort and function using the Pelvi-Perineal Surgery Sexuality Questionnaire (PPSSQ), pre- and postoperatively, in a patient cohort that comprised patients who underwent an MUS procedure between January 2014 and December 2019. We recruited a group of volunteers without a previous history of MUS surgery. The nested case-control study comprised a subgroup of cases from the patients' cohort matched to controls from the volunteer's cohort. Cases and controls were matched for age and menopausal status at a 1:1 ratio.

RESULTS

A total of 118 patients and 128 volunteers were recruited. Of these, 105 cases and 105 controls comprised the nested case-control study. There was no statistically significant difference in the mean discomfort and pain scores between cases and controls (19.8 ± 21.2 vs 15.4 ± 15.7 respectively; p = 0.19 primary outcome). Similarly, there was no difference in mean sexual health scores. However, the rate of reported sensation of an obstruction in the vagina was significantly more in cases (16%) than in controls (2.6%; p = 0.001). There were no significant differences between patient-reported sexual function at follow-up compared with their recollection before surgery.

CONCLUSION

Midurethral sling surgery does not seem to impair the quality of sexual life in the medium term.

摘要

引言与假设

本研究旨在评估经尿道中段吊带术(MUS)术后的中期性功能。

方法

这是一项双向观察性研究,并在一家三级泌尿妇科转诊中心进行了嵌套匹配病例对照研究。我们使用盆腔 - 会阴手术性问卷(PPSSQ),在2014年1月至2019年12月期间接受MUS手术的患者队列中,于术前和术后评估了性不适和性功能。我们招募了一组既往无MUS手术史的志愿者。嵌套病例对照研究包括患者队列中的一组病例亚组,与志愿者队列中的对照组进行匹配。病例和对照按1:1的比例匹配年龄和绝经状态。

结果

共招募了118名患者和128名志愿者。其中,105例病例和105例对照组成了嵌套病例对照研究。病例组和对照组之间的平均不适和疼痛评分无统计学显著差异(分别为19.8±21.2和15.4±15.7;p = 0.19,主要结局)。同样,平均性健康评分也没有差异。然而,报告阴道有梗阻感的病例发生率(16%)显著高于对照组(2.6%;p = 0.001)。与术前回忆相比,患者报告的随访期性功能无显著差异。

结论

经尿道中段吊带术在中期似乎不会损害性生活质量。

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