Martens L, Spath M A, van Beek M A, Willemsen W N P, Kluivers K B
Facts Views Vis Obgyn. 2024 Dec;16(4):457-464. doi: 10.52054/FVVO.16.4.049.
To enhance evidence-based knowledge about sexual function and the prevalence of sexual dysfunction after surgical therapy for congenital anomalies with menstrual outflow obstruction.
In this long-term case-control study, all patients underwent surgical correction of an obstructive Müllerian anomaly between 1980 and 2013. At the start of the case-control study, patients were at least 18 years old and were two years post their initial operation. The control group were women without current gynaecological problems. 38 patients (response rate 48.7%) and 54 controls were included. Chi-square test linear-by-linear Association, Fisher's Exact Test, Mann-Whitney U test and the unpaired sample t-test were used for statistical analysis.
The following questionnaires were used: the Female Sexual Function Index (FSFI), the Body Exposure during Sexual Activities Questionnaire (BESAQ), and the Endometriosis Health Profile Questionnaire (EHP-30).
The mean FSFI score in patients was 27.8 (SD5.4) versus 27.4 (SD6.8) in controls (p=0.858). A total FSFI score ≥26.55, indicating no sexual dysfunction was present in 70.6% of patients and 69.2% of controls (p=1.000). The mean BESAQ score in patients was 30.4 (18.5), compared to 38.3 (SD21.4) in controls (p=0.261), where lower scores denote better body image during intimate sessions. In the EHP-30, a statistically significant difference between patients and controls was found in all items on sexual intercourse. The subscale score of patients was 31.1 (SD26.2) versus 7.0 (SD11.1) in controls (p=<0.001), indicating better sexual functioning in controls.
WHAT IS NEW?: The study showed that a history of menstrual outflow obstruction had a negative influence on several domains of sexual function, yet the patients total scores on sexual function remained in the normal range. The FSFI score of patients' post-surgical treatment of obstructive congenital anomalies is similar to the control group.
增强关于性功能以及先天性月经流出道梗阻手术治疗后性功能障碍患病率的循证知识。
在这项长期病例对照研究中,所有患者于1980年至2013年间接受了梗阻性苗勒管异常的手术矫正。在病例对照研究开始时,患者至少18岁且距离初次手术已过去两年。对照组为无当前妇科问题的女性。纳入了38例患者(应答率48.7%)和54例对照。采用卡方检验的线性趋势分析、Fisher精确检验、Mann-Whitney U检验和非配对样本t检验进行统计分析。
使用了以下问卷:女性性功能指数(FSFI)、性活动期间身体暴露问卷(BESAQ)和子宫内膜异位症健康状况问卷(EHP - 30)。
患者的平均FSFI评分为27.8(标准差5.4),而对照组为27.4(标准差6.8)(p = 0.858)。FSFI总分≥26.55表明70.6%的患者和69.2%的对照不存在性功能障碍(p = 1.000)。患者的平均BESAQ评分为30.4(18.5),而对照组为38.3(标准差21.4)(p = 0.261),较低分数表示在亲密活动期间身体形象更好。在EHP - 30中,患者和对照在性交的所有项目上均存在统计学显著差异。患者的子量表评分为31.1(标准差26.2),而对照组为7.0(标准差11.1)(p < 0.001),表明对照组性功能更好。
该研究表明,月经流出道梗阻病史对性功能的多个领域有负面影响,但患者的性功能总分仍处于正常范围。梗阻性先天性异常手术后患者的FSFI评分与对照组相似。