非肌层浸润性膀胱癌病人在膀胱灌注化疗期间性功能状况的影响因素分析

Assessment of sexual function of patients with non-muscle invasive bladder cancer during intravesical treatment

目的调查分析非肌层浸润性膀胱癌病人在膀胱灌注化疗期间的性功能状况及相关影响因素。方法共纳入门诊行膀胱灌注化疗的非肌层浸润性膀胱癌病人198例,采用浅表性膀胱癌病人特异性量表(EORTC QLQ-NMIBC24)、女性性功能指数评分表(FSFI)、国际勃起功能评分表(IIEF-5)和配偶交流评估量表获得数据,分析浅表性膀胱癌病人在膀胱灌注化疗期间的性功能现状。结果84例病人灌注期间停止性生活,114例有性生活的病人性生活频率较灌注前减少。86.51%的男性及88.00%的女性病人存在不同程度的性功能障碍。灌注期间病人存在不同程度下尿路症状,得分为21.27±9.67,停止性生活的病人有较重的下尿路症状。47%的病人担心性生活会"污染"对方。7.5%的病人灌注期间性生活方面接受过医护人员指导。停止性生活的病人与有性生活的病人相比,性功能及性生活与配偶交流得分较低(0.69±0.55和1.75±1.08)。结论非肌层浸润性膀胱癌病人在膀胱灌注化疗期间的性功能受到较大影响,临床医护人员灌注前应告知病人相关治疗对性功能的影响,消除关于性生活会"污染"对方及影响疾病康复的错误认识,鼓励夫妻间就性生活问题交流,以提高病人的性生活质量。

Objective To investigate the sexual function of patients with non-muscle invasive bladder cancer during intravesical treatment,and analyze possible influencing factors.Method A total of 198 patients with non-muscle invasive bladder cancer were enrolled.After transurethral resection of bladder tumors,patients who underwent intravesical treatment.The European Organisation for Research and Treatment of Cancer-Non-Muscle-Invasiv Bladder Cancer Quality of Life Questionnaire(EORTC QLQ-NMIBC24),the Female Sexual Function Index(FSFI)for female,the national Sexual Function Index(IIEF-5)for male,Evaluation Scale for Communication with Spouse about cancer-related concerns was used to obtained data to analyze the status of sexual function in patients with non-muscle invasive bladder cancer during intravesical treatment.Result 84 patients stopped sexual activity during intravesical treatment,114 patients with sexual life have a lower frequency of sexual life than before intravesical treatment.86.51% of men and 88.00% of women have different degrees of sexual dysfunction.During intravesical treatment,the patients had different degrees of lower urinary tract symptoms(21.27±9.67).Patients who stop sex life have severe lower urinary tract symptoms.47% of patients worry that sexual activity will"contaminating"each other.Regarding sex life,7.5% of patients received medical staff guidance during intravesical treatment.Compared with patients with sexual life,patients who stopped sexual life had lower scores for sexual function and sexual communication with their spouses(0.69±0.55 vs 1.75±1.08).Conclusion The sexual function of patients with non-muscle invasive bladder cancer is negatively affected during intravesical treatment,Clinical staff should inform patients about the impact of related treatment on sexual function before intravesical treatment,eliminate the"contamination"of sexual life and affect disease rehabilitation Misunderstanding,encourage couples to communicate about sexual life issues in order to improve the quality of sexual life of patients.