Background. Dyspareunia is frequently associated with a psychiatric origin, particularly in patients with no obvious Sjogrens Sjogrens Sjogrens Sjogrens¨ Sjogrensvulvovaginal or pelvic disease. The aim ...Background. Dyspareunia is frequently associated with a psychiatric origin, particularly in patients with no obvious Sjogrens Sjogrens Sjogrens Sjogrens¨ Sjogrensvulvovaginal or pelvic disease. The aim of this study was to assess the frequency of dry syndrome in patients with dyspareunia and to evaluate the main clinical and biological features and follow-up data for women with dyspareunia and dry syndrome. Patients and methods. Twenty-two patients presenting chronici diopathic dyspareunia (without clear vulvovaginal dermatosis or infection) were included in this retrospective study. All patients underwent history-taking, gynecological examination, a Schirmer tear test, a sugar test, labial salivary gland biopsy assessment and immunological examination. A diagnosis of syndrome was considered where histological examination of the salivary glands showed a lymphocyte infiltration corresponding to stage 3 or 4 in the Chisholm classification. Diagnosis of dry syndrome without syndrome was made in patients with xerostomia and/or xerophthalmia without a specific histological picture of syndrome or immunological abnormalities at salivary gland biopsy. Results. Based on our criteria, 10 patients (45% ) had dry syndrome, including 4 with syndrome and 6 with dry syndrome without syndrome. 9 of these 10 patients presented either xerostomia (7 cases) and/or xerophthalmia (7 cases). Vaginal dryness was reported by 3 of the 10 women with dry syndrome but also by 4 of 12 women without dry syndrome. Examination of the vulva showed no particular clinical features and treatment with an emollient was not effective in all cases. Discussion. This study showed a high frequency of dry syndrome in patients with chronic “ idiopathic” dyspareunia. The incidence of the condition was even greater in women with functional conditions evocative of dry syndrome. Women presenting dyspareunia with no clearly related clinical causes should thus be carefully assessed for dry syndrome.展开更多
Objectives: The purpose of this study was to evaluate the influence of mode of delivery on sexual function. Design: One thousand six hundred and thirteen questionnaires containing 16 questions about sexual behavior an...Objectives: The purpose of this study was to evaluate the influence of mode of delivery on sexual function. Design: One thousand six hundred and thirteen questionnaires containing 16 questions about sexual behavior and dyspareunia before, during and after pregnancy were sent out to primiparous, ethnically homogeneous (fluent in German) patients who delivered in a large tertiary referral center between 6 months and 2.5 year before. The returned questionnaires were merged to clinical data from our obstetric database in an anonymous fashion. The patients were subdivided into four groups (A) “spontaneous without injuries (except minor labial laceration)”, (B) “c-section”, (C)-“episiotomy or perineal laceration”, and (D) “operative vaginal delivery”. Results: The response rate of primiparae was 41%(655/1613). Forty-seven percent of women resumed sexual intercourse (SI) within 8 weeks after delivery. Altogether 31%of the women did not experience any pain during the first SI post-partum whereas 49%of all patients noted significant pain (medium, considerable or severe), depending on the mode of delivery (p = 0.007). Persistence of dyspareunia longer than 6 months was 3.5%(4/115; groupA), 3.4%(2/58; group B), 11%(34/316; group C), and 14%(20/114; group D). Conclusions: Recently, female sexuality may not have been prominent in any discussion concerning possible advantages and disadvantages of different modes of childbirth. Our results should be taken into consideration when counseling patients antenatally regarding mode of delivery.展开更多
盆腔器官脱垂(pelvic organ prolapse,POP)是由各种原因导致的盆底支持组织薄弱,造成盆腔器官下降移位引发器官位置及功能异常的疾病。POP是中老年女性的常见病,患者可有阴道异物感、疼痛、性交困难等症状,严重影响其生活质量^([1])。PO...盆腔器官脱垂(pelvic organ prolapse,POP)是由各种原因导致的盆底支持组织薄弱,造成盆腔器官下降移位引发器官位置及功能异常的疾病。POP是中老年女性的常见病,患者可有阴道异物感、疼痛、性交困难等症状,严重影响其生活质量^([1])。POP女性患病率在3%~50%,且随年龄增长而增加,70~79岁为发病高峰^([2])。据报道^([3]),我国症状性POP占成年女性的9.6%,且大部分需要手术治疗。目前,生活质量被认为是评价POP治疗效果的关键指标之一^([4])。虽然,POP可通过体格检查、影像学检查或其他仪器设备来诊断或判断治疗效果,但这些方法无法评估POP症状严重程度对患者生活质量的影响,忽视了患者的主观感受,而评估工具则弥补了这一不足^([5])。现有评估工具众多,但每种工具的适用性、新颖性、评估侧重点不同。本研究对近年来POP患者生活质量评估工具的相关研究作综述,以期为临床医护人员选择合适的评估工具、开展相关研究提供参考。展开更多
文摘Background. Dyspareunia is frequently associated with a psychiatric origin, particularly in patients with no obvious Sjogrens Sjogrens Sjogrens Sjogrens¨ Sjogrensvulvovaginal or pelvic disease. The aim of this study was to assess the frequency of dry syndrome in patients with dyspareunia and to evaluate the main clinical and biological features and follow-up data for women with dyspareunia and dry syndrome. Patients and methods. Twenty-two patients presenting chronici diopathic dyspareunia (without clear vulvovaginal dermatosis or infection) were included in this retrospective study. All patients underwent history-taking, gynecological examination, a Schirmer tear test, a sugar test, labial salivary gland biopsy assessment and immunological examination. A diagnosis of syndrome was considered where histological examination of the salivary glands showed a lymphocyte infiltration corresponding to stage 3 or 4 in the Chisholm classification. Diagnosis of dry syndrome without syndrome was made in patients with xerostomia and/or xerophthalmia without a specific histological picture of syndrome or immunological abnormalities at salivary gland biopsy. Results. Based on our criteria, 10 patients (45% ) had dry syndrome, including 4 with syndrome and 6 with dry syndrome without syndrome. 9 of these 10 patients presented either xerostomia (7 cases) and/or xerophthalmia (7 cases). Vaginal dryness was reported by 3 of the 10 women with dry syndrome but also by 4 of 12 women without dry syndrome. Examination of the vulva showed no particular clinical features and treatment with an emollient was not effective in all cases. Discussion. This study showed a high frequency of dry syndrome in patients with chronic “ idiopathic” dyspareunia. The incidence of the condition was even greater in women with functional conditions evocative of dry syndrome. Women presenting dyspareunia with no clearly related clinical causes should thus be carefully assessed for dry syndrome.
文摘Objectives: The purpose of this study was to evaluate the influence of mode of delivery on sexual function. Design: One thousand six hundred and thirteen questionnaires containing 16 questions about sexual behavior and dyspareunia before, during and after pregnancy were sent out to primiparous, ethnically homogeneous (fluent in German) patients who delivered in a large tertiary referral center between 6 months and 2.5 year before. The returned questionnaires were merged to clinical data from our obstetric database in an anonymous fashion. The patients were subdivided into four groups (A) “spontaneous without injuries (except minor labial laceration)”, (B) “c-section”, (C)-“episiotomy or perineal laceration”, and (D) “operative vaginal delivery”. Results: The response rate of primiparae was 41%(655/1613). Forty-seven percent of women resumed sexual intercourse (SI) within 8 weeks after delivery. Altogether 31%of the women did not experience any pain during the first SI post-partum whereas 49%of all patients noted significant pain (medium, considerable or severe), depending on the mode of delivery (p = 0.007). Persistence of dyspareunia longer than 6 months was 3.5%(4/115; groupA), 3.4%(2/58; group B), 11%(34/316; group C), and 14%(20/114; group D). Conclusions: Recently, female sexuality may not have been prominent in any discussion concerning possible advantages and disadvantages of different modes of childbirth. Our results should be taken into consideration when counseling patients antenatally regarding mode of delivery.
文摘盆腔器官脱垂(pelvic organ prolapse,POP)是由各种原因导致的盆底支持组织薄弱,造成盆腔器官下降移位引发器官位置及功能异常的疾病。POP是中老年女性的常见病,患者可有阴道异物感、疼痛、性交困难等症状,严重影响其生活质量^([1])。POP女性患病率在3%~50%,且随年龄增长而增加,70~79岁为发病高峰^([2])。据报道^([3]),我国症状性POP占成年女性的9.6%,且大部分需要手术治疗。目前,生活质量被认为是评价POP治疗效果的关键指标之一^([4])。虽然,POP可通过体格检查、影像学检查或其他仪器设备来诊断或判断治疗效果,但这些方法无法评估POP症状严重程度对患者生活质量的影响,忽视了患者的主观感受,而评估工具则弥补了这一不足^([5])。现有评估工具众多,但每种工具的适用性、新颖性、评估侧重点不同。本研究对近年来POP患者生活质量评估工具的相关研究作综述,以期为临床医护人员选择合适的评估工具、开展相关研究提供参考。
