Kyra Bonasia, Susan Luong, Jocelyn Stairs, Aisling Clancy
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引用次数: 0
Abstract
Introduction and hypothesis: Obstetric anal sphincter injuries (OASIs) are associated with increased risk of postpartum complications, including short- and long-term dyspareunia and sexual dysfunction. The primary aim of this analysis is to evaluate whether engagement in a telehealth urogynecology consultation was associated with decreased sexual health concerns after OASIs.
Methods: This is an analysis of sexual health data, secondary outcomes from a prospective study comparing standard postpartum care versus standard postpartum care plus a telehealth urogynecology consultation. The analyzed outcomes were Female Genital Self-Image Scale (FGSI) and Female Sexual Function Index (FSFI-6) scores at 16 weeks postpartum. Chi-squared and t tests were used to compare groups.
Results: A total of 119 participants with OASIs completed the study (control group n = 62, intervention group n = 57). The intervention group had significantly improved FGSI scores (18.9 vs 20.4, p = 0.02). There was no significant difference on the FSFI-6 (12.0 vs 12.1, p = 0.90), with 77% of the control group and 81% of the intervention group (p = 0.66) classified as having female sexual dysfunction by the FSFI-6. In the telehealth consult group, only 28% of participants (n = 16) had resumed sexual activity, with 88% of those participants endorsing dyspareunia. Interventions reviewed during the telehealth consult included vaginal estrogen, use of lubricants, and pelvic floor physiotherapy.
Conclusions: A postpartum telehealth urogynecology consultation was associated with improved genital self-image but did not reduce sexual dysfunction as measured on the FSFI. These results highlight the significant impact that OASIs can have on sexual function, and the importance of postpartum evaluation and care to support patients after severe obstetric perineal trauma.
简介和假设：产科肛门括约肌损伤（OASIs）与产后并发症的风险增加有关，包括短期和长期的性交困难和性功能障碍。本分析的主要目的是评估参与远程泌尿妇科咨询是否与OASIs后性健康问题的减少有关。方法：这是一项比较标准产后护理与标准产后护理加远程医疗泌尿妇科咨询的前瞻性研究的性健康数据和次要结果的分析。分析结果为产后16周女性生殖器自我形象量表（FGSI）和女性性功能指数（FSFI-6）评分。组间比较采用卡方检验和t检验。结果：共有119名OASIs患者完成了研究（对照组n = 62，干预组n = 57）。干预组FGSI评分显著提高（18.9 vs 20.4, p = 0.02）。FSFI-6没有显著差异（12.0 vs 12.1, p = 0.90）， 77%的对照组和81%的干预组（p = 0.66）被FSFI-6分类为女性性功能障碍。在远程医疗咨询组中，只有28%的参与者（n = 16）恢复了性活动，其中88%的参与者认同性交困难。在远程保健咨询期间审查的干预措施包括阴道雌激素、润滑剂的使用和盆底物理治疗。结论：通过FSFI测量，产后远程泌尿妇科咨询与生殖器自我形象的改善有关，但并没有减少性功能障碍。这些结果强调了OASIs对性功能的重要影响，以及产后评估和护理对支持严重产科会阴创伤患者的重要性。
期刊介绍：
The International Urogynecology Journal is the official journal of the International Urogynecological Association (IUGA).The International Urogynecology Journal has evolved in response to a perceived need amongst the clinicians, scientists, and researchers active in the field of urogynecology and pelvic floor disorders. Gynecologists, urologists, physiotherapists, nurses and basic scientists require regular means of communication within this field of pelvic floor dysfunction to express new ideas and research, and to review clinical practice in the diagnosis and treatment of women with disorders of the pelvic floor. This Journal has adopted the peer review process for all original contributions and will maintain high standards with regard to the research published therein. The clinical approach to urogynecology and pelvic floor disorders will be emphasized with each issue containing clinically relevant material that will be immediately applicable for clinical medicine. This publication covers all aspects of the field in an interdisciplinary fashion
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