OBJECTIVE:To analyze factors predictive for changes in sexual function after pelvic floor surgery and explore differences between stress urinary incontinence (SUI) and pelvic organ prolapse (POP) surgery. DESIGN:Prospective observational study. SETTING:St Olav Hospital, Trondheim University Hospital, Norway. SAMPLE:Of 346 mailed questionnaires for women scheduled for SUI and POP surgery, 65 questionnaires were available for analysis together with examination findings before and 1 year after surgery. METHODS:Postal questionnaires including Prolapse and Incontinence Sexual Function Questionnaire (PISQ 12), Hopkins Symptom Checklist 5 for psychological distress, questions from the validated Body Image Questionnaire, a general health question, questions addressing goals for improvement after surgery, clinical findings based on the Pelvic Organ Prolapse Quantification System and Brief Sexual Function Index for partners. Uni- and multivariate linear regressions adjusting for age were performed. MAIN OUTCOME MEASURES:Change in PISQ 12 score at follow-up. RESULTS:Sexual function significantly improved in the total group (p = 0.000). After stratification into SUI and POP surgery, improvement only remained significant after SUI surgery (p = 0.001). Improvement for the total group was predicted by good health or coital incontinence, whereas psychological distress or the goal of improved defecation predicted deterioration. For women undergoing SUI surgery, increasing age, parity or the goal of improving sexuality or body image predicted improvement, while for women undergoing POP surgery, menopausal status or anterior colporrhaphy predicted improvement. CONCLUSION:Significantly improved sexuality was observed after pelvic floor surgery. Predictive factors for change differed for women undergoing SUI surgery and and those undergoing POP surgery.

译文

目的:分析预测骨盆底手术后性功能改变的因素,探讨压力性尿失禁(SUI)和骨盆器官脱垂(POP)手术之间的差异。
设计:前瞻性观察研究。
地点:挪威特隆赫姆大学医院圣奥拉夫医院。
样本:在346份计划进行SUI和POP手术的女性邮寄调查表中,有65份调查表可用于分析手术前和手术后1年的检查结果。
方法:邮寄问卷,包括脱垂和失禁性功能问卷(PISQ 12),霍普金斯症状困扰清单5,心理困扰,经过验证的身体影像问卷,一般健康问题,解决手术后改善目标的问题,基于以下内容的临床发现伙伴的骨盆器官脱垂量化系统和简短的性功能指数。进行了针对年龄的单变量和多元线性回归。
主要观察指标:随访时PISQ 12评分改变。
结果:整个组的性功能显着改善(p = 0.000)。在分层进行SUI和POP手术后,只有在SUI手术后才有显着改善(p = 0.001)。总体状况的好转是由于身体健康或性交失禁所致,而心理困扰或改善排便的目标预示着情况将会恶化。对于接受SUI手术的女性,增加年龄,产次或改善性欲或提高身体形象的目标可望改善,而对于接受POP手术的女性,绝经期或前阴道炎则有望改善。
结论:骨盆底手术后性行为明显改善。进行SUI手术的妇女和进行POP手术的妇女的变化预测因素有所不同。

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