根除性子宮切除術通常會引起短期性交及陰道問題


  Nov. 17, 2003--根據一項有關早期子宮頸癌病患的新研究結果顯示,雖然任何有關其他性方面或子宮的問題都會隨著時間慢慢消失,但是施行根除性子宮切除術(RH)似乎還是會妨礙病患的性趣及陰道的潤滑。
  
  這項發表於1月Cancer的研究結果,與馬里蘭婦女健康研究發現婦女在接受子宮切除術後會增進性慾、愉悅和性功能的結果形成強烈的對比。
  
  Rigshospitalet丹麥哥本哈根Pernille T. Jensen博士及同事在引言中表示,大部分的研究顯示RH對於接受這項手術病患的性功能不會有不良的影響,但是由於是異種樣品的組合,所以無法確定RH本身是否有性功能的影響。
  
  Jensen醫師團隊研究了173位淋巴結陰性、早期子宮頸癌且接受過RH及骨盆淋巴切除術的病患,在手術前到RH後24個月之間的不同時間點以有效的自我評量問卷來評估病患,研究人員將這些結果與一般人口中經年齡匹配的對照群作比較。
  
  與控制組比較,在手術後第一次的六個月期間,病患有嚴重的性高潮問題和性交不舒服,這些問題包含高潮困難、性交不適、性慾求不滿、由於縮小陰道尺寸導致性交時疼痛、完成性交困難、在消退期無法放鬆、及不滿意表現等。
  
  在RH手術後兩年內持續缺乏性趣及潤滑,且經手術後12個月及診斷為癌症之前的病患自我評量的變化而證實。
  
  然而,在診斷為癌症前性慾強的病患有91%在手術後12個月恢復了原有的性慾,進管評量中顯示性交頻繁減少。
  
  Jensen醫師及同事指出,RH對病患的性趣及陰道潤滑有持續性及負面影響,但大多數其他性方面及陰道的問題則隨時間而消失,他們建議臨床醫師應與病患商討在RH前後所出現短期及長期的性方面問題。

Radical Hysterectomy Causes Mo

By Emma Hitt, PhD
Medscape Medical News

Nov. 17, 2003 — Radical hysterectomy (RH) appears to interfere with patients' sexual interest and vaginal lubrication although most other sexual and vaginal problems disappear over time, according to results of a new study in patients with early-stage cervical carcinoma.

The results, in the January issue of Cancer, contrast with those from the Maryland Women's Health Study, indicating that after hysterectomy, women are likely to experience improved sexual desire, enjoyment, and sexual functioning.

Most studies suggest that RH "does not have an adverse impact on the sexual function of patients who received this procedure," note Pernille T. Jensen, MD, with the Rigshospitalet, in Copenhagen, Denmark, and colleagues in their introduction. However, they point out that because of pooled heterogeneous samples, "it has not been determined whether RH per se had an effect on sexual function."

Dr. Jensen's team studied 173 patients with lymph node-negative, early-stage cervical carcinoma who had undergone an RH and pelvic lymphadenectomy.

Patients were assessed prospectively using a validated self-assessment questionnaire administered at various time points up to 24 months after RH. The researchers compared the results with those of an age-matched control group from the general population.

Compared with controls, patients experienced severe orgasmic problems and uncomfortable sexual intercourse during the first six months after RH. These included orgasmic difficulties, dyspareunia, sexual dissatisfaction, distress due to a reduced vaginal size during intercourse, problems with completing sexual intercourse, and not feeling relaxed in the resolution phase, as well as dissatisfaction with appearance.

Lack of sexual interest and lubrication persisted throughout the first two years after RH, and this was confirmed by the patient's self-reported changes 12 months after RH compared with before the cancer diagnosis.

However, 91% of the patients who were sexually active before being diagnosed with cancer were sexually active again 12 months after surgery, although a decrease in sexual frequency was reported.

"RH had a persistent and negative impact on patients' sexual interest and vaginal lubrication whereas the majority of other sexual and vaginal problems disappeared over time," Dr. Jensen and colleagues conclude.

They recommend that clinicians discuss with patients the short- and long-term sexual problems that could arise before and after RH.

Cancer. 2004;100:000-000

Reviewed by Gary D. Vogin, MD

    
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