女性膀胱过度活跃与性不满意密切相关


  May 11, 2004 (旧金山) -- 根据美国泌尿科学会年度会议中的一项研究报告指出,女性膀胱过度活跃更有可能经历各种类型的性功能障碍。
  
  研究负责人Ankur Patel,BS表示,泌尿科专家需要询问膀胱过度活跃的妇女,她们的性生活情况,因为她们可能不会自己提起,特别是,那些上了年纪的妇女更不会主动提起;他们将开始一个临床研究,调查膀胱过度活跃和性功能障碍之间的关系,以了解治疗泌尿功能是否可改善性功能。Dr. Patel是匹兹堡大学(University of Pittsburgh)的研究助理。
  
  研究对象是78名在过去12个月被诊断为膀胱过度活跃的妇女,她们完成两份书面的问卷调查,Urinary Distress Inventory (UDI)问卷和Personal Experiences Questionnaire (PEQ);UDI是评估压力症状和紧急性尿失禁(例如渗尿,排空困难,下腹疼痛等症状。)的出现和程度以及因此导致的不安;PEQ则是测量性功能,包括性频率、兴奋度、性高潮的频率、性交疼痛及对性伴侣的感觉等。
  
  受试者为平均年龄50岁的妇女,有50%的妇女已婚,剩下的未婚妇女,14.1%单身,12.8%离婚,11.5%寡居,大多数(87%) 是白人妇女;研究结果发现,有74%的研究对象经历频尿。
  
  在有应答者中,65%经历紧急性尿失禁,76%有压力性尿失禁;研究发现,紧急性尿失禁和性活动之间「相当有关」 (.23; P < .05),频尿和性贫乏也相关(.24; P < .05);内心不安与紧急性尿失禁相关的程度与享受性生活的能力有关 (-.27; P < .05);同样的, 应答者受到腹部或生殖器疼痛影响的程度,与享受性生活的能力呈现十分负相关(-.35; P < .05),与性念头或幻想也呈负相关(.36; P < .05)。
  
  Ms. Patel表示,结果显示经历频尿、紧急性尿失禁,或者二者皆有的女性,性生活比较不活跃;受到紧急性尿失禁困扰者不太可能享受性生活,因为腹部或生殖器疼痛引起更大程度的不安不太可能享受性生活,但是更有可能出现性想法或幻想。
  
  未参加研究的Kristene Whitmore博士向Medscape表示,这些初步的结果显示,膀胱过度活跃的妇女有不同类型的性生活不满意的情形;Dr. Whitmore是费城总医院的泌尿科主任,同时也是宾州大学泌尿科临床副教授。
  
  Dr. Whitmore 表示,当医生治疗膀胱过度活跃的妇女时,因为病人并不会主动告知是否性生活受到影响,因此需要直接询问病人,特别是那些年纪大的病人,她们不太可能提起这些事情。

Overactive Bladder, Sexual Dis

By Paula Moyer
Medscape Medical News

May 11, 2004 (San Francisco) — Women with overactive bladder are more likely to experience various types of sexual dysfunction, according to findings presented here at the annual meeting of the American Urological Association.

"Urologists need to ask women with overactive bladder about their sex lives, because they may not bring it up themselves," principal investigator Ankur Patel, BS, said. "In particular, older women may not bring it up. As a result of our findings we'll be starting a clinical study of women with overactive bladder and sexual dysfunction, to see if treatment for their urinary condition improves sexual function." Dr. Patel is a research assistant at the University of Pittsburgh in Pennsylvania.

The investigators recruited 78 women who had been diagnosed with overactive bladder within the past 12 months. The women completed two written questionnaires, the Urinary Distress Inventory (UDI) questionnaire and the Personal Experiences Questionnaire (PEQ). The UDI evaluated the presence and degree to which women were distressed by the symptoms of stress and urge incontinence, such as leakage, difficulty emptying the bladder, and pain in the lower abdominal area. The PEQ measures sexual function, including sexual frequency, arousal, frequency of orgasm, pain during intercourse, feelings towards one's partner, and the partner's ability to perform.

Of the participants, 74% experienced urinary frequency. The women were an average of 50 years old, and 50% of them were married. Of the remaining unmarried women, 14.1% were single, 12.8% were divorced, and 11.5% were widowed. The vast majority (87%) were white.

Of the respondents, 65% experienced urge incontinence and 76% experienced stress incontinence. The investigators documented a "fair correlation" between the presence of urge incontinence and infrequent sexual activity (.23; P < .05). This correlation was also documented between urinary frequency and infrequent sex (.24; P < .05). The degree of distress related to urge incontinence correlated somewhat with the ability to enjoy sexual activity (-.27; P < .05). Similarly, the degree to which respondents were bothered by abdominal or genital pain was fairly negatively correlated with the ability to enjoy sexual activity (-.35; P < .05) and the frequency of sexual thoughts or fantasies (.36; P < .05).

"The findings show that women who experienced urinary frequency, urge incontinence, or both, were less sexually active," Ms. Patel said. "Women who were bothered significantly by urge incontinence were less likely to enjoy sexual activity. Women who expressed a greater degree of distress related to abdominal or genital pain were less likely to enjoy sexual activity but were more likely to experience sexual thoughts or fantasies."

"These initial findings show that women with overactive bladder have an increased risk of different types of sexual dissatisfaction," Kristene Whitmore, MD, told Medscape in an interview. Dr. Whitmore is chief of urology at Graduate Hospital in Philadelphia and a clinical associate professor of urology at the University of Pennsylvania. She was not involved in the study.

"When physicians treat women with overactive bladder, they need ask directly about whether their sex lives are affected, because this information often isn't volunteered, particularly with older patients, who are even less likely to bring these issues up," Dr. Whitmore said.

AUA 99th Annual Meeting: Abstract 342. Presented May 8, 2004.

Reviewed by Gary D. Vogin, MD

    
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