Women's sexual activity and experiences following female genital fistula surgery.
Women's sexual activity and experiences following female genital fistula surgery.
复制标题
女性生殖器瘘管手术后女性的性活动和经历。
DOI：
10.1093/jsxmed/qdad010
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Barageine,JustusK
中科院分区：
文献类型：
--
作者：
ElAyadi,AlisonM;Nalubwama,Hadija;Miller,Suellen;Mitchell,Ashley;Korn,AbnerP;Chen,ChiChiungGrace;Byamugisha,Josaphat;Painter,Caitlyn;Obore,Susan;Barageine,JustusK
背景手术修复对受女性生殖器瘘影响的妇女的生活具有变革性的影响；然而，修复后可能会持续存在各种身体、社会和经济挑战，并妨碍完全重新融入人际关系和社区。需要对这些经历进行细致入微的调查，以便为符合妇女重返社会需求的规划提供信息。目的我们调查了生殖器瘘修复手术后一年内乌干达妇女的性活动恢复情况、经历和担忧。方法2014 年 12 月至 2015 年 6 月期间从穆拉戈医院招募妇女。我们收集了基线和 4 次术后关于社会人口特征和身体/心理状态的数据；我们还两次评估了性兴趣和满意度。我们对一部分参与者进行了深入采访。我们通过单变量分析对定量结果进行了分析，并对定性结果进行了编码和主题分析。 结果我们使用性活动、性疼痛、性兴趣/不兴趣以及性满意/不满意的定量和定性测量来评估女性生殖器瘘管手术修复后的性准备、恐惧和挑战。结果在 60 名参与者中，18% 在基线时性活跃，术后下降至 7%，并在 1 时增加至 55%。修复后一年。基线时有 27% 的人报告有性交困难，1 年时则有 10% 的人报告有性交困难；很少有人描述性交过程中的渗漏或阴道干燥。定性研究结果显示性经历存在很大差异。有些人在手术后很快就做好了性准备，有些人在一年后还没有准备好。对于所有人来说，恐惧包括瘘管复发和意外怀孕。结论这些发现表明，修复后的性经历差异很大，并且与瘘管修复和修复后的婚姻和社会角色存在有意义的交叉。除了身体修复之外，还需要持续的心理社会支持来全面重新融入社会并恢复所需的性行为。亮点女性生殖器瘘管手术修复后的性体验差异很大。女性生殖器瘘管修复术后的女性性活动在一年内增加。婚姻和社会角色与瘘管病周围的性经历相互交叉。女性在瘘管修复后重新融入社会需要心理社会支持。瘘管复发和意外怀孕仍然是女性对修复后恐惧的持续存在。
BackgroundSurgical repair has a transformative impact on the lives of women affected by female genital fistula; however, various physical, social, and economic challenges may persist postrepair and prevent complete reengagement in relationships and communities. Nuanced investigation of these experiences is needed to inform programming that aligns with women’s reintegration needs.AimWe investigated the sexual activity resumption, experiences, and concerns of women in Uganda during the year following genital fistula repair surgery.MethodsWomen were recruited from Mulago Hospital between December 2014 and June 2015. We collected data at baseline and 4 times postsurgery about sociodemographic characteristics and physical/psychosocial status; we also assessed sexual interest and satisfaction twice. We performed in-depth interviews with a subset of participants. We analyzed quantitative findings via univariate analyses, and qualitative findings were coded and analyzed thematically.OutcomesWe assessed sexual readiness, fears, and challenges following surgical repair of female genital fistula using quantitative and qualitative measures of sexual activity, pain with sex, sexual interest/disinterest, and sexual satisfaction/dissatisfaction.ResultsAmong the 60 participants, 18% were sexually active at baseline, which decreased to 7% postsurgery and increased to 55% at 1 year after repair. Dyspareunia was reported by 27% at baseline and 10% at 1 year; few described leakage during sex or vaginal dryness. Qualitative findings showed wide variance of sexual experiences. Some reported sexual readiness quickly after surgery, and some were not ready after 1 year. For all, fears included fistula recurrence and unwanted pregnancy.ConclusionThese findings suggest that postrepair sexual experiences vary widely and intersect meaningfully with marital and social roles following fistula and repair. In addition to physical repair, ongoing psychosocial support is needed for comprehensive reintegration and the restoration of desired sexuality.HighlightsSexual experiences vary widely following surgical repair of female genital fistula.Women’s sexual activity following fistula repair increases over the year postsurgery.Marital and social roles intersect with sexual experiences surrounding fistula.Psychosocial support is needed for women’s reintegration following fistula repair.Fistula recurrence and unwanted pregnancy persist as postrepair fears among women.