经阴道前壁手术对女性性功能的影响

Effect of anterior vaginal wall surgery on sexual function of female patients

目的研究经阴道前壁手术对患者性生活的影响和随着术后时间延长性功能的变化趋势。方法2001年1月至2007年1月在我院接受经阴道无张力尿道中段悬吊术(TVT)、经闭孔无张力吊带术(TVT-O)、前路植入网带及整体植入网带术的患者共142例,109例同意参加本研究。采用改良Lemack问卷评估术前3个月、术后6～12个月及术后12个月以后患者性生活质量。结果109例患者中有48例是术前和(或)术后无性生活,余61例(56.0%)患者手术前后均有性生活。患者性生活的频率、对性生活的感觉、性高潮频率、性生活时是否感觉阴道存在吊带或网带及性伴不适症状术后与术前相比,差异均无统计学意义。根据患者对性功能的主观感受,21例(34.4%)自觉术后性功能下降,12例(19.7%)自觉改善,28例(45.9%)自觉无变化;术后12个月以后也无进一步改变。结论61例患者中有40例患者(65.6%)术后性功能未受损,术后12个月以后与术后6～12个月相比,性功能未发生进一步变化。

Objective To assess the effect of anterior vaginal wall surgery on female sexual function. Methods Total of 109 patients （mean age 57.3 years）,who underwent anterior vaginal wall surgery including TVT, TVT-O and synthetic mesh or tape embedded from January of 2000 to January of 2007, were enrolled in the study and received the mailed questionnaires at least one year after operation. Modified Lemack Questionnaire was used to evaluate sexual function of female patients at 3 months before operation, and at 6 to 12 months as well as 12 months after operation. Results Sixty-one （56.0%） of all patients had sexual life before and after operation,and no differences were found in frequency of intercourse, patients＇ perception of intercourse, frequency of orgasm, the importance of sexual life and partner discomfort, of them, 12 patients （19.7%） reported an improvement in intercourse satisfaction,and 21 patients （34.4%） complained of sexual function deterioration after operation.No significant difference in sexual function was found between postoperative 12 months and postoperative 6-12 months. Conclusion Sexual function of most patients （40, 65.6%） was not deteriorated after anterior vaginal wall surgery. No further changes in sexual function of patients were observed between postoperative 12 months and postoperative 6-12 months.