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| 發表人 | 討論主題 | 發表時間 | 討論數 |
| 李建達 | 經閉孔吊帶治療女性應力性尿失禁後，對性功能的影響 | 2010/4/28 下午 04:34:13 | 0 |
| 原 文 | 題 目 | Sexual function after transobturator tape procedure for stress urinary incontinence. |
| 作 者 | Sentilhes L, Berthier A, Caremel R, Loisel C, Marpeau L, Grise P. | |
| 出 處 | Urology 2008, 71(6): 1074-1079. | |
| 出版日期 | June, 2008 | |
| 評 論 |
女性尿失禁在臨床上是十分常見的，而疾病的本身對於性生活有負面的影響。目前在治療上雖然有Burch及懸吊術多種方法，但是對於這些女性患者在術後的性功能探討文章並不多；然而這卻是在手術前，必須向病人說清楚、講明白的重要議題。 原文作者利用問卷的方式，收集了105位不含骨盆腔器官脫垂，僅接受經閉孔吊帶治療（含TVT-O及TOT兩種）應力性尿失禁後的婦女性功能調查；共追蹤完成了62位病患。其中48位在術前及術後還有從事性活動。術後8週，81.2%病患恢復正常性生活。其中15人改善了性交的滿意度，卻有5人埋怨性功能惡化，當中有2人產生了性交疼痛。62位病患中，有10位不滿意手術的結果。 所以綜合以上的結果，在治療女性應力性尿失禁手術之後的性功能改變有正面，亦可能有負面的後果。我們當然需要更大的病患數去追蹤探討；但是儘可能在手術之前，把性功能可能改變的議題說明清楚，以達知情同意後再手術。 |
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| abstract |
Objectives To assess the effect of the transobturator tape (TOT) procedure for stress urinary incontinence (SUI) on female sexual function. Methods All women who underwent a TOT outside-in or inside-out procedure for SUI with no concomitant prolapse repair from January 2002 to November 2005 were sent a questionnaire by mail. Results A total of 105 women fulfilled the inclusion criteria, 69 (65.7%) of whom returned the questionnaire. Of these 69 women, 66 (95.6%) agreed to participate in the study, although 4 did not complete the pre or postoperative questionnaire, for a follow-up of 62 women (59.0%). Of the 62 women, 48 were sexually active before and after surgery. No significant differences were found after surgery in the frequency and appreciation of intercourse, extent of sexuality, or the frequency of leakage during intercourse. A nonsignificant decrease of leakage was found after surgery (P = 0.06). Of the 48 women, 15 (31.2%) reported an improvement in intercourse satisfaction and 5 (10.4%) complained of sexual function deterioration after the anti-incontinence procedure. Partner discomfort remained unchanged. Of the 62 patients, 10 (16.1%) were unsatisfied with the surgical outcome because of persistent or recurrence of SUI in 6 and a deterioration of intercourse satisfaction after surgery in 4. Conclusions These results suggest that TOT procedures for SUI can have a positive, but also a negative, outcome on female sexual function. Additional and larger prospective studies are warranted to support these preliminary findings and to compare sexual function outcomes after transvaginal tape versus TOT procedures for SUI. |
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