›› 2012, Vol. 32 ›› Issue (4): 423-.doi: 10.3969/j.issn.1674-8115.2012.04.012

• 专题报道(排尿功能障碍及盆底重建) • 上一篇    下一篇

经阴道无张力尿道中段吊带术对压力性尿失禁患者性生活质量的影响

宋海波, 陈慧兴, 冷 静, 吕坚伟, 薄隽杰, 刘东明   

  1. 上海交通大学 |医学院附属仁济医院泌尿外科 |上海交通大学尿失禁及盆底重建诊治中心, 上海 200001
  • 出版日期:2012-04-28 发布日期:2012-04-27
  • 通讯作者: 吕坚伟, 电子信箱: ljwass@126.com。
  • 作者简介:宋海波(1968—), 男, 副教授, 学士;电子信箱: shb5858@163.com。

Impact of tension-free vaginal tape procedure on quality of sexual life of women with stress urinary incontinence

SONG Hai-bo, CHEN Hui-xing, LENG Jing, LV Jian-wei, BO Juan-jie, LIU Dong-ming   

  1. Department of Urology, Renji Hospital, Center of Urinary Incontinence and Pelvic Reconstruction, Shanghai Jiaotong University School of Medicine, Shanghai 200001, China
  • Online:2012-04-28 Published:2012-04-27

摘要:

目的 研究经阴道无张力尿道中段吊带(TVT)术对压力性尿失禁(SUI)患者性生活质量的影响及相关因素。方法 94例接受过TVT术的SUI患者于术后6个月~3年接受随访,采用盆腔器官脱垂-尿失禁患者性功能问卷(PISQ)对患者进行评分(包括生理因素、情感因素和性伴侣因素);PISQ评分越高,提示性生活质量越高。共回收问卷86份,回收率为91.5%。结果 86例患者手术前后PISQ总评分比较差异无统计学意义(P>0.05);但术后情感因素评分较术前降低,生理因素评分较术前升高,差异均有统计学意义(P<0.05)。62例术后1年以内患者中,术后PISQ总评分、情感因素和性伴侣因素评分均显著低于术前(P<0.05),但手术前后生理因素评分差异无统计学意义(P>0.05)。24例术后1年以上患者中,手术前后PISQ总评分以及生理因素、情感因素和性伴侣因素评分比较,差异均无统计学意义(P>0.05)。术前性生活有溢尿的39例患者中,25例(64.1%)术后PISQ总评分升高;术前性生活无溢尿的47例患者中,10例(21.3%)术后PISQ总评分升高;两者性生活改善率比较差异有统计学意义(P<0.01)。结论 TVT术不会对患者的性生活造成顽固性损害。术后1年以内可能对患者的性生活产生一定负面影响,术后1年以后可逐渐恢复;性生活中不自主溢尿者,术后因症状缓解可提高性生活质量。

关键词: 压力性尿失禁, 经阴道无张力尿道中段吊带术, 性生活质量

Abstract:

Objective To investigate the impact of tension-free vaginal tape (TVT) procedure on quality of sexual life of female patients with stress urinary incontinence (SUI), and explore the related factors. Methods Ninety-four female patients with SUI received follow-up 6 months to 3 years after TVT procedure, and were investigated with Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ), including physiological factor, emotional factor and sexual partner factor. The higher PISQ score indicated better quality of sexual life. Eighty-six questionnaires were recovered, with the recovery rate of 91.5%. Results Among the 86 patients, there was no significant change in the total score of PISQ after surgery (P>0.05), while the emotional factor score significantly decreased, and the physiological factor score significantly increased after surgery (P<0.05). Among the 62 patients followed up within 1 year after surgery, the total score of PISQ, emotional factor score and sexual partner factor score were significantly decreased after surgery (P<0.05), while there was no significant change in the physiological factor score after surgery (P>0.05). Among the 24 patients followed up more than 1 year after surgery, there was no significant change in the total score of PISQ, physiological factor score, emotional factor score and sexual partner factor score after surgery (P>0.05). The total score of PISQ in 25 (64.1%) of the 39 patients with involuntary urine leakage in sexual life before surgery was increased after surgery, that in 10 (21.3%) of the 47 patients without involuntary urine leakage in sexual life before surgery was increased after surgery, and there were significant differences in the rates of improvement in quality of sexual life between them (P<0.01). Conclusion TVT procedure does not have consistent negative effects on sexual life of patients. There may be negative effect on sexual life of patients within one year after surgery, but it may gradually disappear later. The quality of sexual life of patients with involuntary urine leakage during sexual life before surgery may be improved after surgery due to the symptom alleviation.

Key words: stress urinary incontinence, tension-free vaginal tape procedure, quality of sexual life