子宫全切与次全切对女性性生活质量及盆底功能的影响

The long-term effect of subtotal and total abdominal hysterectomy on the pelvic floor function and the quality of sexual life

目的探讨子宫全切与次全切两种手术方式对女性术后性生活质量及盆底功能的影响。方法回顾性问卷调查绵阳市人民医院2007～2008年收治的245例因非子宫脱垂的子宫良性疾病行子宫全切术及次全切除术的患者,实际随访200例:子宫全切组125例(62.5%)、子宫次全切除组75例(37.5%)。从阴道顶端脱垂、膀胱直肠膨出、压力性尿失禁、性生活满意度等方面比较两种术式术后对盆底及性功能的影响。结果术后发生盆底功能障碍疾病及性生活质量子宫次全切除组优于子宫全切组,两组比较差异有统计学意义(P<0.05)。结论从改善术后生活质量来看,在可以保留宫颈的情况下子宫次全切除手术是一种较为理想的手术方式。

Objective To evaluate the long-term effect of subtotal and total abdominal hysterectomy on the pelvic floor function and the quality of sexual life.Methods The retrospective questionnaire investigation was taken to 245 cases with total and subtotal abdominal hysterectomy.Actually 240 cases were followed-up including total abdominal hysterectomy with 125 cases（62.5%） and subtotal abdominal hysterectomy with 75 cases（37.5%）.The data about the effective of operation-style on pelvic floor function and sexual function including top-vaginal prolapse,bladder rectum bulge,stress incontinence,quality of sex life were analyzed and compared.Results The situation of pelvic floor dysfunction diseases and sexual life in subtotal abdominal hysterectomy were better than those in total abdominal hysterectomy and the difference was significant（P0.05）.Conclusion On the point of view to improve the postoperative quality of life,subtotal abdominal hysterectomy is an ideal route of approach if the cervical can retain.