هیسترکتومی و پیامدهای جنسی بعد از آن (مرور سیستماتیک)

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشجوی PhD بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شاهرود، شاهرود، ایران.

2 استادیار بهداشت باروری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

3 دانشیار زنان و مامایی، مرکز تحقیقات سلامت زنان، دانشکده پزشکی، دانشگاه علوم پزشکی مشهد، مشهد، ایران.

چکیده

مقدمه: دسترسی به درمان های جایگزین هیسترکتومی برای خونریزی های غیر طبیعی رحمی انگیزه ای برای ارزیابی دوباره اثر هیسترکتومی بر روی کیفیت زندگی زنان شده است. از آنجا که یکی از جنبه های مهم کیفیت زندگی زنان، عملکرد جنسی آنان می باشد. در این مقاله شواهد مربوط به اثر هیسترکتومی بر روی "پیامد جنسی" مورد بررسی قرار می گیرد.




روش‌کار: جستجوی الکترونیکی در مقالات انگلیسی با واژه های: تمایلات جنسی، رضایتمندی جنسی، پیامد جنسی، هیسترکتومی، لذت جنسی و ارگاسم در پایگاه های اطلاعاتی Pub Med، EMBASE، Science Direct و Scopus انجام شد. 23 مطالعه شامل 11 مطالعه آینده نگر، 5 مطالعه گذشته نگر و 7 کارآزمایی بالینی به دست آمد. به جز تعداد کمی از مقالات، کیفیت روش کار اکثر مطالعات ضعیف بود اما به دلیل کمبود اطلاعات در مورد این موضوع مهم، تصمیم گرفتیم که تمام مطالعات بررسی شوند.




یافته‌ها: ارزیابی کیفیت روش کار مطالعات با استفاده از یک سیستم نمره دهی که در متن مقاله توصیف شده است، انجام شد. ابزار اندازه گیری پیامدها، معمولاً معتبر نبوده و بیشتر مطالعات عوامل مخدوش کننده مهم را در نظر نگرفته بودند. نتیجه بیشتر مطالعات در این مرور سیستماتیک، نشان دهنده عدم تغییر یا افزایش تمایلات جنسی در زنانی که تحت عمل هیسترکتومی قرار گرفته اند، بود.




نتیجه‌گیری: اکثر مطالعات ارزیابی شده در مورد اثر هیسترکتومی بر پیامد جنسی به صورت ضعیف طراحی شده بودند. شواهد در دسترس بیانگر افزایش کیفیت زندگی جنسی بیشتر زنانی است که تحت عمل هیسترکتومی قرار می گیرند و هیسترکتومی اثر مخربی بر روی پیامد جنسی زنان ندارد. مطالعات آینده نگر باید عوامل مخدوش کننده با اثر بالقوه منفی یا مثبت بر روی پیامد جنسی که غیر وابسته به هیسترکتومی می باشند را در نظر بگیرند.

کلیدواژه‌ها

عنوان مقاله [English]

Sexuality after Hysterectomy (A Systematic Review)

نویسندگان [English]

  • Raheleh Babazadeh 1
  • Khadijeh Mirzaeei 2
  • Farideh Akhlaghi 3
1 PhD Student of Reproductive Health, Faculty of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.
2 Assistant Professor of Reproductive Health, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Associate Professor of Obstetrics and Gynecology, Women’s Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
چکیده [English]

Introduction: The availability of alternative therapies of abnormal gynecologic bleeding has prompted a reexamination of the impact of hysterectomy on a woman’s quality of life. This paper examines the evidence about the impact of hysterectomy on quality of life and sexual function.
 
Methods: Electronic searching of English language literature was conducted using the search terms: sexuality, sexual satisfaction, sexual function, hysterectomy, sexual desire and orgasm in PubMed, EMBASE, Science Direct and Scopus. Additional papers found in the bibliographies of these papers were also reviewed. 23 studies were found: 11 prospective, 5 retrospective and 7 RCT. With few exceptions, the methodologic quality of the studies was poor, but we continued to review all of the studies given the paucity of data on this important subject.
 
Results: The studies were evaluated for methodologic quality using a scoring system described in the paper. Outcome measures were usually not validated and most studies did not consider important confounding factors. Most studies in this review showed either no change or an enhancement of sexuality in women who had undergone hysterectomy.
 
Conclusion: The majority of researches evaluating the effect of hysterectomy on sexual function were poorly designed. The available evidence showed that quality of life is improved for most women who had hysterectomy and that hysterectomy did not adversely affect sexual function. A number of confounding factors with the potential positive or negative impact on sexual function, independent of hysterectomy, should be taken into account in future studies

کلیدواژه‌ها [English]

  • Hysterectomy
  • Sexuality
  • Sexual function
  • Sexual Satisfaction and systematic review

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مجله زنان، مامایی و نازایی ایران
دوره 14، شماره 7 - شماره پیاپی 7
بهمن ماه 1390
بهمن 1390
صفحه 51-68

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