Pelvik Organ Prolapsusu ve Cinsel Yaşam Üzerine Etkileri
Bu derlemenin amacı; pelvik organ prolapsusunun cinsel yaşam üzerindeki etkilerini sunmaktır. Pelvikorgan prolapsusu, kadınların yarıya yakınını etkileyen biyopsikososyal bir sağlık sorunudur. Bu sağlıksorunu kadında; estetik kaygıya, fizyolojik ve psikolojik problemlere, disparoniye, cinsel istek, uyarılmave orgazm aşamalarında da olumsuz etkilere de neden olur. Kadının ilk değerlendirmesi, yönetimi vesürekli desteğine katkıda bulunmak için çok iyi bir konum olan uzman ebe/hemşireler tarafından alınanayrıntılı anamnez ve hekim tarafından uygulanan fizik muayene ve tanı testleri sonucunda konservatifveya cerrahi tedavi yöntem tercihi yapılır. Konservatif tedavi uygulanan kadınlarda kegel egzersizi ile ilgilidaha fazla çalışmaya ihtiyaç duyulurken, daha çok ileri yaşlarda kullanımı tercih edilen pesserin cinselaktivite sıklığında ve tatmin düzeylerinde artış sağladığı, tedavi sonrasında lubrikasyon ve istekte olumluetkilerinin olduğu bildirilmiştir. Cerrahi yöntem uygulanan hastalarla yapılan çalışmaların birçoğunda ise,cerrahi operasyonların beden imajı ve çekicilik hissinde artış sağlayabildiği fakat cinsel işlevlerde belirginbir iyileşmeye neden olmadığı bulunmuştur. Yapılan tüm bu teşhis ve tedavi süresince de uzman ebe/hemşirelerin, kadına ve ailesine psikolojik destek, eğitim ve danışmanlık vermesinin yanı sıra cinsel yaşamkonusunda da önerilerde bulunması önemlidir. Pelvik organ prolapsusu yaşayan kadınların olumsuz olaraketkilenen cinsel fonksiyonlarının dikkatle değerlendirilerek çözüme yönelik yaklaşımlarda bulunulmasıönemlidir.
Pelvic Organ Prolapse and Its Effects on Sexual Life
Pelvic organ prolapse is a biopsychosocial health problem that affects nearly half of the women on average. This health problem leads to aesthetic concerns, physiological and psychological problems, dyspareunia, and issues of sexual desire, arousal, and orgasm. The aim of this review is to present the effects of pelvic organ prolapse on sexual life. The specialist midwife/nurse is well placed to contribute to the initial assessment, management, and ongoing support of women with prolapse. A conservative or surgical treatment method is preferred according to the detailed history taken by the midwife/nurse and the physical examination and diagnostic tests performed by the physician for the women who present with complaints of pelvic organ prolapse. While more research on kegel exercise is needed in women treated conservatively, it has been reported that pessary use was preferred at older ages because it increases the frequency and satisfaction levels of sexual activity, improves lubrication after treatment, and produces favorable effects. In most of the studies that performed surgical methods, surgical operations were found to increase body image satisfaction and feeling of charm but did not cause a significant improvement in sexual function. It is also important that the specialist midwives/nurses provide psychological support, education, and counseling to the woman and her family and suggestions on sexual life during all these diagnoses and treatments. Negatively affected sexual function in women with pelvic organ prolapse should be evaluated carefully and problems should be resolved correctly.
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