The impact of lower urinary tract symptoms and urinary incontinence on female sexual dysfunction using a validated instrument
The impact of lower urinary tract symptoms and urinary incontinence on female sexual dysfunction using a validated instrument
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DOI：
10.1111/j.1743-6109.2008.00818.x
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发表时间：
2008-06-01
影响因子：
3.5
通讯作者：
Gousse, Angelo
中科院分区：
文献类型：
--
作者：
Cohen, Brian L.;Barboglio, Paholo;Gousse, Angelo
介绍。下尿路症状（LUTS）是女性的常见问题，并且经常与女性性功能障碍（FSD）共存。然而，LUTS 和 FSD 之间的关系尚不清楚。使用经过验证的工具女性性功能指数 (FSFI) 评估 LUTS 和尿失禁 (UI) 与 FSD 的关系。方法。我们对 3 年时间内的 236 名女性患者进行了机构审查委员会批准的回顾性评估，这些女性患者完成了 FSFI 验证的问卷，并接受了 LUTS 或 UI 的尿动力学 (UDS) 评估。根据病史和体检将患者分为不同的 LUTS 组。此外，还使用 UDS 是否存在 UI、逼尿肌过度活动 (DO)、压力性尿失禁以及最大膀胱测压容量 (MCC) > 或 < 200 mL 来进一步评估这些患者。比较不同 LUTS 组之间的 FSFI 域和总分。主要结果测量。对具有相似临床 LUTS 诊断和 UDS 结果的女性进行 FSFI 评分评估。 Kruskal-Wallis 非参数检验和 Dwass-Steel 检验确定了统计显着性，并对不同排尿功能障碍组和 UDS 正常组（漏尿/DO-/尿动力学压力性尿失禁）进行了多重配对比较。结果。该队列的平均年龄为 49.5 岁（范围 18-69 岁），每个 LUTS 亚组内的平均年龄没有统计学上的显着差异。 MCC < 200 mL 不会显着损害女性性功能。临床诊断为膀胱过度活动症（OAB）-干性的患者性功能最高，而混合性尿失禁患者的性功能最差。此外，患有 UI 和 DO 的女性 FSD 程度最高，明显比患有正常 UDS 的女性更差。此外，对于有或没有 UI 的女性，UDS 上 DO 的存在会导致性功能恶化的趋势。结论。女性的性功能会因 LUTS 的存在而受到负面影响，其中 UI 和 DO 会导致最大程度的 FSD。最受影响的性领域是欲望、润滑、性高潮和性满足。
Introduction. Lower urinary tract symptoms (LUTS) is a common problem in women and frequently coexists with female sexual dysfunction (FSD). However, the relationship of LUTS and FSD is poorly characterized.Aim. To evaluate the relationship of LUTS and urinary incontinence (UI) to FSD using a validated instrument, the female sexual function index (FSFI).Methods. We performed an institutional review board-approved retrospective evaluation of 236 female patients over a 3-year time-period who completed an FSFI-validated questionnaire and underwent urodynamics (UDS) evaluation for LUTS or UI. Patients were categorized based upon history and physical exam into different LUTS groups. Additionally, the presence or absence of UI, detrusor overactivity (DO), stress urinary incontinence, and maximal cystometric capacity (MCC) > or < 200 mL on UDS were used to further evaluate these patients. FSFI domain and total scores were compared between the different LUTS groups.Main Outcome Measure. FSFI scores were evaluated for women with similar clinical LUTS diagnosis and UDS findings. The Kruskal-Wallis nonparametric test and the Dwass-Steel test determined statistical significance and performed multiple pairwise comparisons between the different voiding dysfunction groups and those with normal UDS (Leak-/DO-/urodynamic stress incontinence-).Results. The mean age of the cohort was 49.5 (range 18-69), and there was no statistically significant difference in mean age within each LUTS subgroup. MCC < 200 mL did not significantly impair female sexual function. Patients with clinical diagnosis of overactive bladder (OAB)-Dry had the highest sexual function while those with mixed urinary incontinence had the worst. Additionally, women with UI and DO had the greatest degree of FSD, which was significantly worse than those with normal UDS. Additionally, for women with or without UI, the presence of DO on UDS resulted in a trend toward worse sexual function.Conclusions. The sexual function of women is negatively impacted by the presence of LUTS, with UI and DO causing the greatest degree of FSD. The sexual domains most affected are desire, lubrication, orgasm, and sexual satisfaction.