Zusammenfassung
Die sexuelle Funktion kann bei Frauen sowohl durch Beckenbodenfunktionsstörungen wie Deszensus und Inkontinenz als auch durch deren Behandlung beeinflusst werden. Chirurgische Maßnahmen können zu einer Verbesserung des sexuellen Erlebens führen. Sie können aber auch schwere sexuelle Funktionsstörungen bis hin zur Unmöglichkeit des Sexualverkehrs zur Folge haben. Vor einem chirurgischen Eingriff sollte deshalb eine Sexualanamnese erstellt werden, und die Patientin sollte über die möglichen Folgen einer Operation aufgeklärt werden. Größere Studien zur Bewertung der klassischen und der neueren Operationsverfahren im Hinblick auf die sexuelle Funktion sind wünschenswert.
Abstract
Female sexual function can be affected by pelvic disorders such as incontinence and prolapse or their treatment. Surgery can improve sexuality but also result in functional impairment, all the way to precluding intercourse. For that reason sexual function should be evaluated before surgery, and the patient thoroughly advised on possible results before any surgery for prolapse or incontinence. There is a need for larger studies assessing both classic and newer surgical methods in respect to effects on sexual activity.
Literatur
Abdel-Fattah M, Ramsay I, Pringle S et al (2010) Evaluation of transobturator tapes (E-TOT) study: randomised prospective single-blinded study comparing inside-out vs. outside-in transobturator tapes in management of urodynamic stress incontinence: short term outcomes. Eur J Obstet Gynecol Reprod Biol 149:106–111
Altman D, Elmer C, Kiilholma P, Kinne I et al (2009) Sexual dysfunction after trocar-guided transvaginal mesh repair of pelvic organ prolapse. Obstet Gynecol 113:127–133
Bader AA, Tamussino KF, Moinfar F et al (2005) Isolated recurrence at the residual uterine cervix after abdominal radical trachelectomy for early cervical cancer. Gynecol Oncol 99:785–787
Bekker M, Beck J, Putter H, Venema P et al (2009) Sexual function improvement following surgery for stress incontinence: the relevance of coital incontinence. J Sex Med 6:3208–3213
Brubaker L, Chiang S, Zyczynski H, Norton P et al (2009) The impact of stress incontinence surgery on female sexual function. Am J Obstet Gynecol 200:562–567
Butrick CW (2010) Do guns kill people or …? The mesh dilemma. Int Urogynecol J Pelvic Floor Dysfunct 21:133–134
Claerhout F, De Ridder D, Roovers JP, Rommens H et al (2009) Medium-term anatomic and functional results of laparoscopic sacrocolpopexy beyond the learning curve. Eur Urol 55:1459–1467
Feiner B, Gietelink L, Maher C (2010) Anterior vaginal mesh sacrospinous hysteropexy and posterior fascial plication for anterior compartment dominated uterovaginal prolapse. Int Urogynecol J Pelvic Floor Dysfunct 21:203–208
Gauruder-Burmester A, Koutouzidou P, Rohne J et al (2007) Follow-up after polypropylene mesh repair of anterior and posterior compartments in patients with recurrent prolapse. Int Urogynecol J Pelvic Floor Dysfunct 18:1059–1064
Jha S, Radley S, Farkas A, Jones G (2009) The impact of TVT on sexual function. Int Urogynecol J Pelvic Floor Dysfunct 20:165–169
Kahn MA, Stanton SL (1997) Posterior colporrhaphy: its effects on bowel and sexual function. Br J Obstet Gynaecol 104:82–86
Kammerer-Doak DN (2009) Assessment of sexual function in women with pelvic floor dysfunction. Int Urogynecol J Pelvic Floor Dysfunct 20(suppl 1):S45–S50
Komesu YM, Rogers RG, Kammerer-Doak DN et al (2007) Posterior repair and sexual function. Am J Obstet Gynecol 197:101–106
Kuhn A, Brunnmayr G, Stadlmayr W et al (2009) Male and female sexual function after surgical repair of female organ prolapse. J Sex Med 6:1324–1334
Laumann EO, Paik A, Rosen RC (1999) Sexual dysfunction in the United States: prevalence and predictors. Jama 281:537–544
Maher C, Baessler A, Glazener CM et al (2008) Surgical managment of pelvic organ prolapse in women: a short version Cochrane review. Neurourol Urodyn 27:3−12
Moreira ED Jr, Hartmann U, Glasser DB, Gingell C (2005) A population survey of sexual activity, sexual dysfunction and associated help-seeking behavior in middle-aged and older adults in Germany. Eur J Med Res 10:434–443
Nicolosi A, Buvat J, Glasser DB, Hartmann U et al (2006) Sexual behaviour, sexual dysfunctions and related help seeking patterns in middle-aged and elderly Europeans: the global study of sexual attitudes and behaviors. World J Urol 24:423–428
Nieminen K, Hiltunen KM, Laitinen J et al (2004) Transanal or vaginal approach to rectocele repair: a prospective, randomized pilot study. Dis Colon Rectum 47:1636–1642
North CE, Ali-Ross NS, Smith AR, Reid FM (2009) A prospective study of laparoscopic sacrocolpopexy for the management of pelvic organ prolapse. BJOG 116:1251–1257
Paraiso MF, Barber MD, Muir TW, Walters MD (2006) Rectocele repair: a randomized trial of three surgical techniques including graft augmentation. Am J Obstet Gynecol 195:1762–1771
Rosen R, Brown C, Heiman J, Leiblum S et al (2000) The Female Sexual Function Index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function. J Sex Marital Ther 26:191–208
Sarlos D, Brandner S, Kots L et al (2008) Laparoscopic sacrocolpopexy for uterine and post-hysterectomy prolapse: anatomical results, quality of life and perioperative outcome-a prospective study with 101 cases. Int Urogynecol J Pelvic Floor Dysfunct 19:1415–1422
Sentilhes L, Berthier A, Loisel C, Descamps P et al (2009) Female sexual function following surgery for stress urinary incontinence: tension-free vaginal versus transobturator tape procedure. Int Urogynecol J Pelvic Floor Dysfunct 20:393–399
Serati M, Salvatore S, Uccella S, Zanirato M et al (2009) The impact of the mid-urethral slings for the treatment of stress urinary incontinence on female sexuality. J Sex Med 6:1534–1542
Sigusch V (2007) Sexuelle Störungen und ihre Behandlung, 4. Aufl. Thieme, Stuttgart New York, S 104–124
Smith AR, Daneshgari F, Milani R, Miller K et al (2005) Surgery for urinary incontinence. Incontinence 1297–1370
Thornton MJ, Lam A, King DW (2005) Bowel, bladder and sexual function in women undergoing laparoscopic posterior compartment repair in the presence of apical or anterior compartment dysfunction. Aust N Z J Obstet Gynaecol 45:195–200
Interessenkonflikt
Keine Angaben
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Peschers, U., Hußlein, E. Sexualität nach Beckenbodenchirurgie. Gynäkologe 43, 679–684 (2010). https://doi.org/10.1007/s00129-010-2554-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00129-010-2554-0