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目的探讨阴式非脱垂子宫全切除术对患者盆底功能及性生活状态的影响。方法选取该院行阴式非脱垂子宫全切除术患者140例,于术后3、6、12及24个月门诊随诊,评估患者的压力性尿失禁、阴道顶端脱垂、盆底肌力、盆底功能影响问卷简表7(PFIQ-7)、盆底功能障碍问卷20(PFDI-20)、性生活质量问卷(PISQ)等指标的变化情况。结果 117例患者完成最终随访,术后压力性尿失禁的发生率明显升高,并随着时间的延长而逐渐加重(P<0.05)。术后阴道顶端最远点距处女膜缘的距离较术前明显降低(P<0.05),且术后24个月与术后3个月的差异有统计学意义(P<0.05)。术后患者的盆底肌力呈进行性降低趋势(P<0.05)。术后患者的PFIQ-7和PFDI-20评分均较术前明显升高(P<0.05),且随着时间的延长呈进行性升高趋势(P<0.05)。108例患者完成性生活质量问卷调查,术前及术后各时间点PISQ评分的差异均无统计学意义(P>0.05)。结论阴式非脱垂子宫全切除术能够造成盆底功能障碍,部分患者需临床干预以缓解症状,阴式非脱垂子宫全切除术对患者性功能无明显影响。
Objective To investigate the effect of vaginal non-prolapsed hysterectomy on pelvic floor function and sexual life. Methods Forty patients with vaginal non-prolapsed uterus hysterectomy were selected and followed up at 3, 6, 12 and 24 months postoperatively to evaluate stress urinary incontinence, vaginal apical prolapse, pelvic floor muscle (PFIQ-7), pelvic floor dysfunction questionnaire 20 (PFDI-20), quality of life questionnaire (PISQ) and other indicators were analyzed. Results The final follow-up of 117 patients was completed. The incidence of stress urinary incontinence was significantly increased and gradually increased with time (P <0.05). The distance between the furthest point of the vagina tip and the margin of the hymen was significantly lower than that before operation (P <0.05), and there was a significant difference between the postoperative 24 months and the postoperative 3 months (P <0.05). Postoperative pelvic floor muscle strength decreased progressively (P <0.05). The scores of PFIQ-7 and PFDI-20 in postoperative patients were significantly higher than those before operation (P <0.05), and increased progressively with time (P <0.05). 108 cases of patients completed quality of life questionnaire, PISQ score at all time points before and after surgery no significant difference (P> 0.05). Conclusions Vaginal non-prolapsed hysterectomy can cause pelvic floor dysfunction, and some patients need clinical intervention to relieve symptoms. Vaginal non-prolapsed hysterectomy has no significant effect on sexual function.