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在女性盆底康复科如何处理女性性功能障碍

How to Approach Female Sexual Dysfunction in a Urogynecology Practice.

作者信息

Antosh Danielle D, Anand Mallika, Ossai Uchenna, Bergeron Sophie

机构信息

Division of Urogynecology, Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston, TX, USA.

Division of Urogynecology and Reconstructive Pelvic Surgery, Beth Israel Deaconess Medical Center, New York, NY, USA.

出版信息

Int Urogynecol J. 2025 Sep 8. doi: 10.1007/s00192-025-06254-3.

Abstract

INTRODUCTION AND HYPOTHESIS

Sexual dysfunction is prevalent among women with pelvic floor disorders presenting to urogynecologists.

METHODS

This review summarizes a workshop held at the 2024 annual International Urogynecology Association meeting and covers the treatment of common sexual dysfunction treatments in a urogynecology practice, how pelvic floor surgery can affect sexual health, and when to refer to a pelvic floor physical therapist or sexual health therapist.

RESULTS

For patients suffering from female sexual interest/arousal disorder and orgasmic disorder, medical management, pelvic floor physical therapy, sex therapy, and mechanical devices can be utilized. For women requiring surgery, sexual function either improves or remains unchanged after prolapse surgery and midurethral sling surgery. Dyspareunia rates are lower after all prolapse surgery types compared with preoperative dyspareunia. De novo dyspareunia ranged from 0 to 9% after prolapse repairs.

CONCLUSION

Management of pelvic floor disorders can have a positive impact on sexual function. Many treatments are multidisciplinary and may require referral to a pelvic floor physical therapist or sex therapist.

摘要

引言与假设

性功能障碍在向泌尿妇科医生就诊的盆底功能障碍女性中很常见。

方法

本综述总结了在2024年国际泌尿妇科协会年会上举办的一次研讨会,内容涵盖泌尿妇科实践中常见性功能障碍的治疗、盆底手术如何影响性健康以及何时转诊至盆底物理治疗师或性健康治疗师。

结果

对于患有女性性兴趣/唤起障碍和性高潮障碍的患者,可采用药物治疗、盆底物理治疗、性治疗和机械设备。对于需要手术的女性,脱垂手术和中段尿道吊带手术后性功能要么改善要么保持不变。与术前性交困难相比,所有类型的脱垂手术后性交困难发生率更低。脱垂修复术后新发性交困难的发生率在0%至9%之间。

结论

盆底功能障碍的管理可对性功能产生积极影响。许多治疗是多学科的,可能需要转诊至盆底物理治疗师或性治疗师。

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