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子宫全切除术后远期盆底功能及性生活状况调查

Survey of long term female pelvic floor function and sexual life status after total hysterectomy

摘要:

目的 了解子宫全切除术后远期盆底功能及性生活状况.方法 于2011年3月对2004年1至12月于北京大学人民医院因妇科良性疾病行子宫全切除术的92例患者进行随访调查,完成门诊妇科检查、盆底功能障碍问卷简表20 (PFDI-20)、盆底功能影响问卷简表7(PFIQ-7)及中国女性生活质量问卷.结果 92例患者子宫全切除术后6年,发生盆腔器官脱垂7例( 7/92,7.6%),尿失禁62例(62/92,67.4%);PFDI-20评分中位数4.67分;PFIQ-7评分中位数0分;盆底功能障碍症状集中在下尿路症状(咳嗽漏尿58例、点滴漏尿32例、尿频31例、尿急24例)及肠道症状(便秘26例、便急24例、无法排尽大便21例);68例患者性生活质量问卷总分平均(127 ±20)分,性生活质量问卷总分、性满意度、性交流与调适、性反应以及性体像与患者经济收入呈正相关(r= 0.432,P=0.007;r =0.356,P=0.028;r=0.475,P=0.003;r =0.421,P=0.009;r =0.324,P=0.047).结论 子宫全切除术可能对患者远期盆底功能及性生活质量存在影响,性生活质量与患者经济收入水平呈正相关.

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abstracts:

Objective To evaluate status of female pelvic floor function and sexual life after total hysterectomy.Methods From March 2001 to January 2004,92 patients with undergoing hysterectomy due to benign gynecological diseases were enrolled in this study.They were followed up at outpatient department,including pelvic examination,filling in female sexual quality questionnaire,pelvic floor distress inventory short form 20 ( PFDI-20 ),pelvic floor distress impact questionnaire short form 7 ( PFIQ-7 ) and quality of sexual life of chinese women questionnaire.Results At 6 years after total hysterectomy,it was observed that 7 cases (7/92,7.6% ) were pelvic organ prolapse and 62 cases (62/92,67.4% ) were urinary incontinence.A median score of PFDI-20 were 4.67.A median score of PFIQ-7 were 0.Symptoms of pelvic floor dysfunction concentrated in lower urinary tract ( 58 cases with cough leak,32 cases with spot urine leakage,31 cases with frequent micturition,24 cases with urgent urination)and bowel symptoms (26 cases with constipation,24 cases with defecation urgency,21 cases without fully drained stool).In the 68 patients filling in female sexual quality questionnaire,an average score were (127 ± 20) points.Female sexual quality questionnaire score,sexual satisfaction,sexual communication and adjustment,sexual response and sexual body image were positively correlated with the patients' income ( r = 0.432,P = 0.007 ; r = 0.356,P =0.028;r=0.475,P=0.003;r=0.421,P=0.009;r=0.324,P=0.047).Conclusions Hysterectomy may have long-term effect on female pelvic floor function and sexual life.Quality of sexual life in those patients was positively correlated with income.

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