Hatice KANSU ÇELİK, Burcu KISA KARAKAYA, Kuntay KOKANALİ, Orhan AKSAKAL, Özlem EVLİYAOĞLU

Vajinal histerektomi ile eş zamanlı yapılan midüretral sling cerrahisinin seksüel fonksiyon üzerine etkisi

Amaç: Vajinal histerektomi ile eş zamanlı yapılan midüretral sling cerrahisinin kadın seksüel fonksiyonlarına olan etkisini değerlendirmek. Gereç ve Yöntem: 42 seksüel olarak aktif semptomatik pelvik organ prolapsusu nedeniyle en az 6 ay öncesinde vajinal histerektomi yapılan hastalar, bu retrospektif çalışmaya dahil edildi. Hastaların 21`ine cerrahi öncesinde ürodinamik olarak kanıtlanmış stress inkontinans varlığı nedeniyle ek olarak miduretral sling Transobturator Tape yada Tension free Vaginal Tape cerrahisi yapıldı.Tüm kadınların cerrahi öncesi ve cerrahi sonrası seksüel fonksiyonları, telefonla aranarak Türkçe` ye uyarlanmış Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire-12 PISQ-12 anketi ile değerlendirildi. Bulgular: Her iki grup arasında operasyon öncesi karakteristikler açısından fark yoktu. Operasyon öncesi PISQ-12 skorları da benzer bulundu. Cerrahi sonrasında PISQ-12 skorları her iki grupta da iyileşmekle beraber gruplar arasında PISQ-12 skorları açısından istatistiksel olarak bir fark saptanmadı. Sonuç: Semptomatik uterin prolapsus nedeni ile yapılan vajinal histerektomi, kadın seksüel fonksiyonlarını iyileştirmektedir. Bu cerrahiye eş zamanlı eklenen miduretral slingler, cerrahi sonrasıkadın seksuel fonksiyonları üzerine olumsuz etki yapmamaktadır.

Anahtar Kelimeler:

Vajinal histerektomi, midüretral sling, seksüel fonksiyon

The impact of concomitant midurethral sling procedures with vaginal hysterectomy on sexual activity

Aim: To evaluate the impact of concomitant midurethral sling procedures with vaginal hysterectomy on female sexual function. Methods: 42 sexually active women who underwent vaginal hysterectomy for symptomatic uterine prolapse with a minimum of 6 month-postoperative-follow up data were included in this retrospective study. Twenty one of these women were also underwent an additional midurethral sling procedure Transobturator Tape or Tension free Vaginal Tape due to urodynamically proven stress urinary incontinance. Preoperative and postoperative sexual functions of all women were assessed via a phone interview using Turkish validated Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire-12 PISQ-12 form. Results: Between the groups, there were no significant difference regarding the preoperative characteristics Table 1 . Preoperative total PISQ-12 scores were also similar. After the surgery, PISQ-12 scores were significantly improved for both groups, however the difference of postoperative PISQ-12 scores did not reach statistically significance Table 2 . Conclusion: Vaginal hysterectomy due to symptomatic uterine prolapse improves female sexual function. And midurethral sling procedures concomitant to this operation do not have negative impact on postoperative sexual activity.

Keywords:

Vaginal hysterectomy, midurethral sling, sexual function,

PDF

___

1. Wallwiener M, Taran FA, Rothmund R, Kasperkowiak A, Auwarter G, Ganz A, Kraemer B, Abele H, Schönfisch B, Isaacson KB, Brucker SY. Laparoscopic supracervical hysterectomy (LSH) versus total laparoscopic hysterectomy (TLH): An implementation study in 1,952 patients with an analysis of risk factors for conversion to laparotomy and complications, and of procedure-specific re-operations. Arch Gynecol Obstet 2013;288:1329–1339.
2. Lethaby A, Mukhopadhyay A, Naik R. Total versus subtotal hysterectomy for benign gynaecological conditions. Cochrane Database Syst Rev 2012;4:CD004993.
3. Lepine LA, Hillis SD, Marchbanks PA, Koonin LM, Morrow B, Kieke BA, Wilcox LS. Hysterectomy surveillance—United States, 1980–1993. MMWR CDC Surveill Summ 1997;46:1–15.
4. Özdedeli K, Yükselİ. Pelvik Taban Bozuklukları ve Kadın Cinsel Fonksiyon Bozukluğu. Kadın ve İşlevsel Üroloji Dergisi 2014; 3:73-77
5. Thakar R. Is the Uterus a Sexual Organ? SexualFunction Following Hysterectomy. Sex Med Rev. 2015; 3(4):264-278.
6. Filocamo MT, Serati M, Frumenzio E et al. The impact of mid-urethral slings for the treatment of urodynamic stress incontinence on female sexual function: a multicentre prospective study. J Sex Med 2011; 8(7):2002–2008
7. Pauls RN, Berman JR Impact of pelvic floor disorders and prolapse on female sexual function and response. Urol Clin North Am 2002; 29:677–683
8. Brubaker L, Chiang S, Zyczynski H, Norton P, Kalinoski DL, Stoddard A, Kusek JW, Steers W The impact of stress incontinence surgery on female sexual function. Urinary Incontinence Treatment Network
9. Baden WF, Walker TA, Lindsday HJ. The vaginal profile. Tex Med J. 1968;(64):56–58
10. ACOG Committee Opinion No. 444: choosing the route of hysterectomy for benign disease Obstet Gynecol. 2009; 114(5):1156-1158
11. Bradley SL, Weidner AC, Siddiqui NY, Gandhi MP, Wu JM. Shifts in national rates of inpatient prolapse surgery emphasize current coding inadequacies.Female Pelvic Med Reconstr Surg. 2011; 17(4):204-208.
12. Abdelmonem AM.Vaginallength and incidence of dyspareunia after total abdominal versus vaginal hysterectomy. Eur J Obstet Gynecol Reprod Biol. 2010; 151(2):190-2.
13. Siddiqui NY, Fulton RG, Kuchibhatla M, Wu JM.Sexual function after vaginal ver sus nonvaginal prolapse surgery.Female Pelvic Med Reconstr Surg. 2012; 18(4):239-242
14. Radosa JC, Meyberg-Solomayer G, Kastl C, Radosa CG, Mavrova R, Gräber S, Baum S, Radosa. Influences of Different Hysterectomy Techniques on Patients’ Postoperative Sexual Function and Quality of Life J Sex Med 2014;11:2342–2235
15. El-Toukhy TA1, Hefni M, Davies A, Mahadevan S. The effect of different types of hysterectomy on urinary and sexual functions: a prospective study.J Obstet Gynaecol. 2004; 24(4):420-425.
16. Thakar R. Is the Uterus a Sexual Organ? SexualFunction Following Hysterectomy.Sex Med Rev. 2015; 3(4):264-278.
17. Ercan Ö, Özer A, Köstü B, Bakacak M, Kıran G, Avcı F.Comparison of postoperative vaginal length and sexual function after abdominal, vaginal, and laparoscopic hysterectomy. Int J Gynaecol Obstet. 2016; 132(1):39-41
18. Uçar MG, İlhan TT, Şanlıkan F, Çelik Ç. Sexual functioning before and after vaginal hysterectomy to treat pelvic organ prolapse and the effects of vaginal cuff closure techniques: a prospective randomised study. Eur J Obstet Gynecol Reprod Biol. 2016; 206:1-5.
19. Abrams P, Cardoza L, Khoury AE, Wein A, editors. International consultation on urinary incontinence. 5th ed. Plymbridge, UK: Health Publications Ltd; 2013. p. P1897
20. Thiagamoorthy G, Srikrishna S, Cardozo L. Sexual function after urinary incontinence surgery. Maturitas. 2015; 81(2):243-247.
21. Bekker MD, Beck JJ, Putter H, van Driel MF, Pelger RC, Weijmar Schultz WC, Lycklama à Nijeholt GA, Elzevier HW. Sexual experiences of men with incontinent partners. J Sex Med. 2010; 7(5):1877-1882.
22. Jha S, Ammenbal M, Metwally M. Impact of incontinence surgery on sexual function: a systematic review and meta-analysis. J Sex Med 2012;9:34-43.
23. Zyczynski HM1, Rickey L, Dyer KY, Wilson T, Stoddard AM, Gormley EA, Hsu Y, Kusek JW, Brubaker L; Urinary Incontinence Treatment Network. Sexual activity and function in women more than 2 years after midurethral sling placement. Am J Obstet Gynecol. 2012; 207(5):421.e1-6.
24. Lin SN, Klapper AS, Wong P, Shalom DF, Winkler HA.Quality of life after treatment with midurethral sling and concomitant prolapse repair in patients with mixed versus stress urinary incontinence. Neurourol Urodyn. 2011; 30(8):1507-1511.

Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Maltepe Üniversitesi

Arşiv