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首页> 外文期刊>The journal of sexual medicine >Effects of Vaginal Prolapse Surgery on Sexuality in Women and Men; Results from a RCT on Repair With and Without Mesh
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Effects of Vaginal Prolapse Surgery on Sexuality in Women and Men; Results from a RCT on Repair With and Without Mesh

机译：阴道脱垂手术对男女性行为的影响; RCT有无网格修复的结果

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Introduction. In pelvic organ prolapse (POP) repair, the use of synthetic mesh is not only increasing but also a subject of discussion. The focus shifts from anatomical toward functional outcome, with sexual function being an important parameter. One of the concerns with mesh usage in POP surgery is the possible negative effect on sexual function. Aim. To compare and assess sexual function in women and men after primary cystocele repair with or without trocar-guided transobturator mesh. Methods. One hundred twenty-five women with a symptomatic cystocele stage≥II were included in this multicenter randomized controlled trial and assessed at baseline and 6-month follow-up. Main Outcome Measures. Female sexual function was measured by the Female Sexual Function Index (FSFI) and male sexual function by the Male Sexual Health Questionnaire. A subgroup analysis of women with a participating partner was performed. Results. In the mesh group, 54/59 women vs. 53/62 in the anterior colporrhaphy group participated. In men, 29 vs. 30 participated. After surgery, FSFI scores were comparable for both treatment groups. However, within group analysis showed significant improvement on the domains pain (effect size=0.5), lubrication (effect size=0.4), and overall satisfaction (effect size=0.5) in the colporrhaphy group. This improvement was not observed in the mesh group. A subgroup of women with a participating partner reported significantly higher baseline domain scores as compared with other women and did not report a significant improvement of sexual functioning irrespective of treatment allocation. Worsening of baseline sexual function was reported by 43% of women in the mesh group compared with 18% in anterior colporrhaphy group (P=0.05). Male sexual functioning did not change in either group. Conclusions. Women after an anterior colporrhaphy report a significant and clinically relevant improvement of their sexual functioning, whereas women after a mesh procedure did not. Vollebregt A, Fischer K, Gietelink D, and van der Vaart CH. Effects of vaginal prolapse surgery on sexuality in women and men; results from a RCT on repair with and without mesh. J Sex Med 12;9:1200-1211.
机译：介绍。在盆腔器官脱垂（POP）修复中，合成网片的使用不仅在增加，而且是讨论的主题。关注点从解剖学转向功能性结局，而性功能是重要的参数。 POP手术中使用网片的问题之一是对性功能的负面影响。目标。比较和评估在有或没有套管针引导的经闭孔的膀胱原发性囊肿修复后男女的性功能。方法。该多中心随机对照试验纳入了125例有症状性膀胱膨大≥II期的女性，并在基线和6个月的随访中进行了评估。主要观察指标。女性性功能由女性性功能指数（FSFI）衡量，男性性功能由男性性健康问卷调查。与参与对象的女性进行了亚组分析。结果。在网状组中，有54/59名女性参加了这项研究，而在前阴道镜组中只有53/62名参加了这项研究。在男性中，有29对30。手术后，两个治疗组的FSFI评分相当。但是，在组内分析显示，在关节盂炎组中，疼痛（效果大小= 0.5），润滑（效果大小= 0.4）和总体满意度（效果大小= 0.5）有显着改善。在网状组中未观察到这种改善。与其他女性相比，有参与伙伴的女性亚组报告其基线领域得分显着更高，并且无论治疗分配如何，其性功能均未显着改善。据报道，网状组中43％的女性基线性功能恶化，而前肾盂肾盂炎组中则为18％（P = 0.05）。两组的男性性功能均未改变。结论。前阴道镜检查后的女性报告说其性功能得到了明显改善，并在临床上具有相关意义，而网状手术后的女性则没有。 Vollebregt A，Fischer K，Gietelink D和van der Vaart CH。阴道脱垂手术对男女性行为的影响; RCT修复有无网格的结果。 J Sex Med 12; 9：1200-1211。

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