| Abstract: | 懷孕中骨盆底部的壓力持續增加，生產過程陰道壁周圍肌肉結締組織和神經均可能受傷害，若產後未能好好調養，會妨礙骨盆結構的復原，易造成日後的尿失禁。本研究主要目的在評估尿失禁對婦女性生活之影響，協助其解決改善尿失禁的困擾，並進一步提昇其性生活的品質。本研究採類實驗研究法設計，以尿失禁婦女為實驗組，無尿失禁同年齡或上下差2歲之婦女為對照組，各組收案120名，進行結構式問卷訪談收集資料。有尿失禁的婦女均做尿道動力學檢查（Urodynamics examination）以為診斷的依據，由醫師判斷，將病患依尿失禁嚴重程度分級，並做適切的治療，治療後六個月再對實驗組婦女做後側，以評估治療之成效，而治療後的六個月內給予衛生教育指導及追蹤，或接受個案諮詢相關問題，而對照組無治療情形，故無後測之需要。第一年前測完成，其結果顯示兩組婦女在基本特質中，除年齡及婚姻外，教育程度、職業、肥胖指數等均有統計上顯著差異（p<0.01），疾病史中，曾接受婦科手術者實驗組是對照組的4倍，經醫師診斷有慢性病者實驗組是對照組之3倍。在懷孕及生產史中，實驗組之懷孕、生產及自然產次數均比對照組大，且呈顯著差異（p<0.01）；而人工流產則實驗組比對照組大約2倍；對照組之剖腹產情形則比實驗組大約2倍。實驗組已停經者比對照組大2.5倍強。在性生活資訊來源中，實驗組較會個人揣摩，不會尋求文獻，證據顯示被動不積極；而對照組正好相反，較主動且積極尋找可根據之知識來源。尿失禁之嚴重度第一級最多佔57.5％；第二級35.0％，而第三、四級共7.5％。婦女自覺尿失禁造成生活不便或困擾者，在20個項次中，佔7.34項；而造成性生活之不便或困擾者，在12個項次中，佔3.39項。兩組婦女以性生活做比較，在高潮次數中，對照組比實驗組平均每10次多1.9次，具統計上的差異（p<0.01），而性慾望頻率、性生活頻率及性生活滿意度雖未達顯著差異，但對照組都比實驗組的平均值高。而實驗組以尿失禁前後自行做比較，則性慾望頻率、性生活頻率及性生活高潮次數均顯示尿失禁後比失禁前差，且三項均達統計上的顯著差異（p<0.01）。以實驗組尿失禁嚴重度和性生活情形做比較，在性生活滿意度顯示第三、四級較第一、二級差，並呈現統計上的顯著差異（p<0.01）。
There is an increase of pressure on pelvic base during pregnancy, and in the process of delivering a baby, it is possible that tissue around perivaginal muscle and nerve could be injured. These factors could cause female urinary incontinence (UI) on women's sex life. This study recruited 240 subjects of similar ages (four-year difference in their ages), half of them suffered from UI as the experimental group and the other half as the control group. A structured questionnaire was administered for data collection. The experimental group was underwent urodynamics examination, provided with appropriate treatment. Six months after the treatment, the experimental group was evaluated for the effectiveness of the treatment and offered with hygiene education or individual counseling. The results showed that two groups illustrated significant differences in their level of education, occupation and body mass index (BMI) (p<0.01). Furthermore, with regard to their case history, more subjects had gynecology operations in the experimental group, four times the number in the control group, and more subjects in the control group were conflicted with chronic diseases, three times the number in the control group. The control group showed more experiences in pregnancy, laboring and nature labor, significant different from the control group. Furthermore, the experimental group had two times of artificial abortion than the control group; whereas, the control group had two times of cesarean than the counterpart. The experimental group who were menopause 2.5 times of the control group. For information resource about sex, the experimental group was passive in looking up references; on the contrary, the control group was more active. For the severity degree of UI, the majority of them were the first degree (57.5%); 35.9% the second degree and 7.5% the third an fourth degree. The subjects who suffered from UI reported inconvenience in daily life in 7.34 items out of 20 items. They also reported a negative impact on their sexual life in 3.39 items out of 12 items. There was a significant difference in times of high-tide feeling of intercourse between the experimental group and control group. Although there was no significant difference in libido frequency, sexual intercourse frequency and satisfaction in sex between two groups, the control group's mean score was higher than the experimental group. The experimental group reported less frequency in libido, sexual intercourse, and high-tide feeling on intercourse after UI, showing significant difference in these three items before and after UI (p<0.01). In terms of the effects of severity degree of UI on sex, subjects diagnosed as the third and fourth degree reported less satisfaction in sex than those as the first and second and the difference between them was significant difference (p<0.01). |
