腹腔镜子宫骶骨固定术对年轻盆腔脏器脱垂患者性功能影响的调查分析-现代医学

腹腔镜子宫骶骨固定术对年轻盆腔脏器脱垂患者性功能影响的调查分析

单位：广西医科大学第四附属医院妇产科, 广西柳州 545005

分类号：R711.23

出版年·卷·期（页码）：2019·47·第八期（993-996）

摘要：

目的：对年轻盆腔脏器脱垂（POP）患者行腹腔镜下子宫骶骨固定术后盆底肌力变化及性功能改善情况进行调查分析。方法：收集32例在我院行腹腔镜下子宫骶骨固定术的POP年轻患者进行盆底电生理检测（包括盆底肌力、阴道动态压）及女性性功能指数问卷调查，对比手术前、术后3个月、6个月、1年盆底肌力变化和性生活质量评分。结果：术后盆底肌力、阴道动态压力较术前均逐步提高，其中术后6个月、1年与术前及术后3个月比较，差异有统计学意义（P<0.05）。32例患者术后均无新发尿失禁，16例在术后1个月左右恢复性生活，每月2~3次。30例在术后3个月内恢复性生活，每月2~3次。术前性功能障碍比率为93.75%（30/32），术后1年性生活质量显著提高，性功能障碍总发生率降为15.60%（5/32）。术后性欲（P=0.003）、主观性唤起（P=0.000）、性高潮（P=0.015）、性满意度（P=0.037）较术前显著改善。性欲、性唤起、性满意度术后3个月，6个月，1年之间比较无显著差异。术后6个月、1年性高潮评分明显高于术后3个月（P<0.05）。性交疼痛与阴道润滑度，术前及术后比较无显著差异。结论：腹腔镜下子宫骶骨固定术在解剖恢复的基础上，盆底肌力得到逐步提高，同时能在性欲、性唤起、性满意度、性高潮方面显著改善患者的性生活质量，适于年轻患者。

Objective:To investigate the sexual function in young patients who underwent laparoscopic sacrocolpopexy for pelvic organ prolapse.Methods:Thirty-two young patients who underwent laparoscopic sacrocolpopexy in our hospital were enrolled for pelvic floor electrophysiological tests (including pelvic floor muscle strength and vaginal dynamic pressure) and questionnaire on female sexual function index, comparisons were made on the sexual function quality scores between before and after operation.Results:Postoperative pelvic floor muscle strength and vaginal dynamic pressure were gradually increased compared to the preoperative period, and the difference were statistically significant in six months, 1 year after surgery than in 3 months and preoperative period.There was no emerging urinary incontinence after operation in 32 patients. 16 and 30 cases recovered sexual life in one month and three months after operation respectively. The incidence of sexual dysfunction was 93.75%(30/32) before surgery and decreased to 15.6%(5/32) 1 year after surgery. There was a significantly improvement on sexual desire (P=0.003), sexual arousal (P=0.000), orgasm (P=0.015) and sexual satisfaction (P=0.037) after operation. There were no significant difference on sexual desire, sexual arousal and sexual satisfaction between three months, half a year and 1 year after operation. Orgasm score is higher in 6 months and 1 year than 3 months after operation (P<0.05). There were no significant improvement on vaginal lubrication and sexual pain.Conclusion:Laparoscopic sacrocolpopexy based on anatomical recovery, strengthens pelvic floor muscle, at the same time significantly improves the quality of sexual life on sexual desire, sexual arousal, sexual satisfaction and orgasm, which is suitable for young patients.

参考文献：

[1] ROSEN R,BROWN C,HEIMAN J,et al.The female sexual function index (FSFI):A multidimensional self-report instrument for the assessment of female sexual function[J].J Sex Marital Ther,2000,26(2):191-208.
[2] WIEGEL M,MESTON C,ROSEN R.The female sexual function index (FSFI):Cross-validation and development of clinical cutoff scores[J].J Sex Marital Ther,2005,31(1):1-20.
[3] AMELINE A,HUGUIER J,Posterior suspension to the lumbo-sacral disk;abdominal method of replacement of the utero-sacral ligaments[J].Gynecol Obstet,1957,56(1):94-98.
[4] DORSEY J H,SHARP H T.Laparoscopic sacral colpopexy and other procedures for prolapse[J].Baillieres Clin Obstet Gynaecol,1995,9(4):749-756.
[5] COSTANTINI E,MEARINI L,LAZZERI M,et al.Laparoscopic versus abdominal sacrocolpopexy:A randomized,controlled trial[J].J Urol,2016,196(1):159-165.
[6] WANG L C,HU J C,LAUDANO M A,et al.,Trends in mesh use for pelvic organ prolapse repairfrom the medicare database[J].Urology,2015,86(5):885-891.
[7] WAGNER L,CHEVROT A,LLINARES E,et al.Long-term anatomic and functional results of laparoscopic sacrocolpopexy:A prospective study[J].Int Urol Nephrol,2019,51(5):795-802.
[8] 杨双祥.腹腔镜阴道骶骨固定术治疗重度子宫脱垂伴阴道壁脱垂[J].西南国防医药,2016,26(4):389-392.
[9] 常伟忠,纪妹.腹腔镜阴道骶骨固定术治疗中重度子宫脱垂的疗效分析[J].中国实用医刊,2015,42(12):41-43.
[10] LUGINBUEHL H,BAEYENS J P,TAEYMANS J,et al.Pelvic floor muscle activation and strength components influencing female urinary continence and stress incontinence:A systematic review[J].Neurourol Urodyn,2015,34(6):498-506.
[11] 李菊芳,刘瑞云,李国栋，等.中青年妇女子宫全切术后性生活质量影响因素分析[J].肿瘤研究与临床,2013,25(11):769-771.
[12] 叶然,张爱霞,徒文静，等.女性性功能障碍评估量表的研究进展[J].中国妇幼保健,2014,29(28):4686-4689.

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