女性压力性尿失禁合并阴道松弛症对女性性功能的影响

Effects of female stress urinary incontinence complicated with vaginal relaxation on sexual function

目的探讨女性压力性尿失禁合并阴道松弛症对女性性功能的影响。方法收集2021年1月-2021年7月期间在昆明医科大学第一附属医院因“女性盆底功能障碍性疾病”收治入院的158例患者临床资料。患者完成的详细问卷调查表,包括患者人口学特征、生育史、健康史、疾病史、手术史、绝经情况、性生活情况。应用患者主观症状用来评价患者的尿失禁严重程度。术前用盆腔脏器脱垂/尿失禁性功能问卷(Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire Short form,PISQ-12)评估患者是否因压力性尿失禁影响性功能。测量阴裂,询问患者是否自觉阴道松弛。对中度压力性尿失禁、阴道松弛症状明显、有规律性生活(>3次/月)26例患者及中度压力性尿失禁、阴道松弛症状不明显、有规律性生活(>3次/月)24例患者纳入研究。结果PISQ-12总分为(21.33±5.13)vs.(25.69±4.48)分,P<0.05,说明合并阴道松弛与否在一定程度上影响患者性功能。结论女性压力性尿失禁患者多有合并阴道松弛症,除却压力性尿失禁本身可能导致的性交失禁或担心性交失禁对患者及伴侣性功能带来负面影响。阴道松弛也在生理及心理层面影响患者及伴侣性功能。在常规抗尿失禁手术时,对于合并有阴道松弛症的患者应进行阴道缩窄术。

Objective To explore the effects of female stress urinary incontinence(SUI)complicated with vaginal relaxation on sexual function.Methods Clinical data of 158 patients admitted due to pelvic floor dysfunction during Jan.and July 2021 were collected.Patients were surveyed with a questionnaire including demographic characteristics,reproductive history,health history,disease history,surgical history,menopausal status,and sexual life status.Patients’subjective symptoms were used to evaluate the severity of urinary incontinence.Whether the sexual function was affected by SUI was assessed with Pelvic Organ Prolapse/urinary Incontinence Sexual Function Questionnaire short form(PISQ-12)before surgery.The vaginal fissure was measured and patients were inquired if they felt vaginal relaxation.A total of 26 patients with obvious symptoms of SUI and vaginal relaxation,and regular sex(>3 times/month),and 24 patients with moderate symptoms of SUI,unobvious vaginal relaxation,and regular sex(>3 times/month)were included in the study.Results The total score of PISQ-12 was(21.33±5.13)vs.(25.69±4.48)(P<0.05),indicating that the comorbidity of the two conditions affects the sexual function to a certain extent.Conclusion Most female SUI patients have vaginal relaxation.SUI itself may have a negative impact on the sexual function of patients and their partners.Vaginal relaxation also affects the sexual function of patients and their partners on the physical and psychological levels.In routine anti-urinary incontinence surgery,vaginal constriction should be considered.