电视腹腔镜治疗子宫内膜异位症178例疗效观察

目的探讨电视腹腔镜治疗子宫内膜异位症的疗效。方法回顾性分析178例子宫内膜异位症患者采用电视腹腔镜治疗后的效果。结果本组178例中,镜下手术成功166例,成功率93．3％,术后患者痛经和性交痛症状均有明显缓解。结论电视腹腔镜是治疗子宫内膜异位症的一种较安全、有效的方法。     

腹腔镜治疗子宫内膜异位症109例临床观察

目的 探讨腹腔镜治疗子宫内膜异位症的疗效.方法 回顾性分析109例子宫内膜异位症患者采用腹腔镜治疗后的效果.结果 本组术后志者痛经和性交痛症状均有明显缓解.结论 腹腔镜是治疗子宫内膜异位症的一种较安全、有效的方法.     

体质量对子宫内膜异位症保守性手术治疗患者术后用药疗效的影响

目的探讨体质量对子宫内膜异位症保守性手术治疗患者术后用药疗效的影响。方法选取2014年1月-2016年1月该院收治的采用保守性手术治疗子宫内膜异位症60例患者为研究对象,按照体质量的不同分为低体质量组(38例)和高体质量组(22例)。所有患者术后均给予促性腺激素释放激素激动剂(GnRH-a)治疗,比较两组患者的治疗效果、治疗后的相关疼痛程度变化(痛经、慢性盆腔痛、性交痛)、性激素水平的变化。结果高体质量组治疗3个月后痛经评分、慢性盆腔痛评分、性交痛评分及性激素E_2、FSH及LH水平高于低体质量组。(P0.05);两组停止治疗后6个月时的疼痛情况以及性激素水平比较差异无统计学意义(P0.05)。高体质量组停止治疗后6个月时的总有效率低于低体质量组,复发率高于低体质量组,月经复潮时间短于低体质量组,差异均有统计学意义(均P0.05)。结论 GnRH-a是保守性手术治疗子宫内膜异位症术后重要的辅助治疗方法,患者的体质量对术后GnRH-a的疗效有一定影响,在给予用药治疗时应结合患者的体质量给予个性化的治疗方案。     

影响子宫内膜异位症患者术后自然妊娠的危险因素Logistic回归分析

目的探讨影响子宫内膜异位症患者术后自然妊娠的危险因素。方法选择2015年8月-2018年5月在温州医科大学附属第二医院行手术治疗的子宫内膜异位症患者124例术后给予12～24个月随访,统计一般资料、手术及妊娠情况,并经Logistic多元回归分析法分析影响子宫内膜异位症患者术后自然妊娠的危险因素。结果随访发现124例子宫内膜异位症患者术后自然妊娠91例,自然妊娠率73.39%。单因素结果显示子宫内膜异位症患者术后自然妊娠与年龄、月经来潮持续时间、临床病理类型、r-AFS分期、术后应用GnRH-a、合并妇科炎症密切相关(P0.05);多因素Logistic回归分析结果显示患者年龄≥35岁、月经来潮持续时间3d、临床病理类型、r-AFS分期、术后应用GnRH-a、合并妇科炎症为影响子宫内膜异位症患者术后自然妊娠的危险因素(P0.05)。结论年龄大、月经不规律、术后未辅以药物治疗及合并妇科炎症是影响子宫内膜异位症患者自然妊娠率的重要因素,需实施针对性干预治疗,以改善术后妊娠结局。     

子宫内膜异位症复发的相关因素研究

目的:分析子宫内膜异位症复发的相关因素。方法:选择2008年1月～2010年12月在吉林大学第二医院妇产科手术治疗的子宫内膜异位症术后2年内复发的患者60例,采用单因素与多因素Logistic回归分析方法,分析可能影响患者术后复发的相关因素。结果:经单因素与多因素Logistic回归分析,子宫内膜异位症患者的痛经史、手术分期、后穹窿触痛结节、术后药物治疗、盆腔炎、子宫腺肌病和术后孕次等7个临床指标均与术后复发密切相关(P<0.05)。结论:子宫内膜异位症患者行手术治疗时,应根据其痛经史、手术分期、后穹窿触痛结节、术后药物治疗、盆腔炎、子宫腺肌病和是否有生育要求等选用创伤小、能彻底清除病灶的个体化治疗方案,术后短期应用抑制卵巢功能的药物可以减少复发。     

子宫内膜异位症伴不孕症患者临床特征及术后妊娠结局的影响因素分析

目的 分析子宫内膜异位症伴不孕症患者临床特征及术后妊娠结局的影响因素。方法 选取2020年5月—2022年5月丽水市中心医院收治的112例子宫内膜异位症伴不孕症患者为研究对象，统计患者的临床相关信息，且在入院后均行宫腔镜手术予以治疗，观察患者的临床相关症状及妊娠结局，应用单因素分析及多因素logistics回归分析探讨影响患者术后妊娠失败的主要因素。结果 112例患者均进行宫腔镜手术诊治，且所有的患者均顺利完成，未有一例患者中途转为剖宫产，术后也未有不良并发症状出现。后经随访调查显示，术后有72例妊娠成功，成功率为64.29%,有40例患者妊娠失败，失败率为35.71%。单因素分析显示，子宫内膜异位症伴不孕症患者术后妊娠结局与年龄、体质量指数(BMI)、不孕时长、盆腔术史、痛经剧烈、病灶的性质及术后的辅助服药无关(P>0.05);而与子宫内膜异位症囊肿的直径、子宫内膜异位症分期表(R-AFS分期)、接受促排卵的诊治、输卵管顺畅状况、卵泡刺激素(Follicle-stimulating Hormone, FSH)、雌二醇(estradiol 2,E₂)水平变化...     

子宫内膜异位症相关不孕的治疗进展

子宫内膜异位症是引起育龄女性不孕的重要因素之一,引起不孕可能的原因有:患者腹腔液性质的改变、盆腔解剖结构异常、卵巢功能下降和子宫内膜容受性降低等。目前手术仍是主要的治疗方式,手术时机、手术方式、子宫内膜异位症手术分期及不同类型、程度子宫内膜异位症对术后妊娠结局均有影响,手术应尽可能在子宫内膜异位症早期进行,腹腔镜手术作为首选,子宫内膜异位症生育指数(EFI)评分能较好地评估患者的生育能力。而药物治疗作为术后辅助治疗,并不能提高患者的生育能力,只能延缓复发,因而对有生育要求的子宫内膜异位症合并不孕患者,手术后不推荐药物治疗。当手术治疗失败或因持续性输卵管因素导致不孕时,辅助生殖技术对于提高患者的生育能力是必要的。     

子宫内膜异位症复发相关因素的研究

目的:分析子宫内膜异位症复发的相关因素,为临床治疗提供参考及达到合理选择治疗方法的目的.方法:选择2011年3月-2014年3月本科室手术治疗的子宫内膜异位症手术后2年内复发的患者200例,采用回归分析的方法,分析影响患者术后复发的可能相关因素.结果:子宫内膜异位症患者的手术分期、盆腔炎等7个临床指标都与术后复发相关.结论:临床治疗时应根据复发的相关因素,运用各种方法防止其复发,争取彻底治疗的目的.     

子宫内膜异位症临床分析

目的：了解手术与子宫内膜异位症的发生关系。方法：选自1994年2月-2004年2月手术治疗子宫内膜异位症患者共51例。通过手术与子宫内膜异位症发生的关系及术后发生子宫内膜异位症的时间来判定，均有病理诊断为依托。结果：10年间共手术治疗子宫内膜异位症62例，占同期妇产科手术981例的6．32%，其中既往有妇产科手术史者51例，占同期子宫内膜异位症的82．25％。结论：子宫内膜异位症的发生率与妇产科手术率的增加成正比，严格掌握手术指征是降低本病的关键所在。     

子宫内膜异位症患者术后自我管理行为与社会支持相关性研究

目的研究子宫内膜异位症患者术后的自我管理行为与社会支持的相关性。方法应用社会支持量表和自行设计的自我管理行为量表对120例子宫内膜异位症术后患者进行调查。结果子宫内膜异位症患者术后的自我管理行为处于中等水平,自我管理行为总分为（53.02±10.56）分。自我管理行为与社会支持之间呈正相关。结论子宫内膜异位症患者术后的自我管理行为需要改善,并受社会支持的影响。     

Correlates of Increased Sexual Satisfaction

Comparisons of nationally representative survey data of the population ages 18–54 years in 1971 (N = 2252) and 1992 (N = 1718) from Finland show that sexual satisfaction has greatly increased particularly among women. Some predictors of sexual satisfaction of men and women are examined on the basis of the 1992 survey data on people ages 18–74 years (N = 2250). Correlations between social background factors, sexual ideas and assertiveness, optional relationships, sexual practices, orgasm, and satisfaction with sexual intercourse were calculated. To control the simultaneous effect of the variables explaining satisfaction, path analyses were conducted. Results show that young age, a sexually unreserved and a nonreligious childhood home, early start of sexual life, high education, sexual assertiveness, considering sexuality important in life, reciprocal feeling of love, use of sex materials, frequent intercourse, many-sided (versatile) sexual techniques, and frequent orgasm correlate with finding sexual intercourse pleasurable. There were some gender differences in the connections between the independent factors and satisfaction with coitus. The importance of sexuality in life, love, and the use of sexual materials were connected directly to physical sexual satisfaction among men but only indirectly among women. For women, but not for men, young age and early start of sexual life correlated with enjoyment of intercourse. The greater sexual dissatisfaction of women compared to men, which still prevails, may be due to their late start of sexual life, conservative sexual attitudes, unimportance of sexuality in life, lack of sexual assertiveness, and use of restricted sexual techniques. The emancipation of women may change these ideas and practices of women. This might lessen the gender gap in physical sexual satisfaction.     

The Sexual Activity Questionnaire: A measure of women's sexual functioning

Sexual activity is an important dimension of quality of life. Therefore it is important to assess the impact that any treatment may have on sexual functioning so that patients can be warned of possible side effects and interventions offered to help ameliorate these. The Sexual Activity Questionnaire (SAQ) was developed to investigate the impact of long-term tamoxifen on the sexual functioning of women at high risk of developing breast cancer. It was also tested on a sample of women with no such risk. The majority of variance in sexual functioning can be explained by three factors: pleasure from sexual intercourse, discomfort during sexual intercourse and habit. We found that the frequency of sexual activity decreased steadily with age. Furthermore, pleasure dropped and discomfort increased in women aged over 55. We report psychometric data showing that the SAQ is a valid, reliable and acceptable measure for describing the sexual functioning of women in terms of activity, pleasure and discomfort. It is quick and easy to administer and has good face validity discriminating between the sexual functioning of pre- and post-menopausal women.The CRC provided financial support for this study. Dr. Amanda Rameriz was involved in the development of the SAQ.     

Sexual Coercion and Behavior Among a Sample of Sexual Minority Women

Sexual coercion may affect the sexual experiences of sexual minority women differently. Women (n = 445) aged 18 to 71 years (Mean = 30.38) answered an online survey on sexual orientation, lifetime coercion, and sexual history. Sexual minority women (45.8%, n = 204) were more likely to report having been coerced into unwanted sexual behavior (56.5%) than heterosexual women (44.8 %; p = 0.010). Coerced sexual minority women reported earlier ages of initiation into performing oral sex (p = 0.016), penile-vaginal (p = 0.024), and penile-anal (p = 0.027) intercourse. In multiple logistic regression models, currently being in a partnered relationship was the sole factor related to lifetime engagement in penile-vaginal intercourse and receiving oral sex from partners. Having at least a graduate degree was the only characteristic related to engagement in lifetime penile-anal intercourse. Sexual coercion was not related to any lifetime sexual behavior outcomes. The nature of sexual initiation and coercion should be explored further among sexual minority women, with the goal of incorporating their experiences into prevention and treatment initiatives.     

家庭因素对青少年婚前性行为及危险性行为的影响

目的:探索家庭因素对未婚青少年首次性行为以及危险性行为的影响。方法:采用多阶段抽样方法抽取上海市15～24岁青少年进行匿名电子问卷调查。结果:调查的6023名未婚青少年中12.7%有过性行为(男16.8%、女8.7%),其中首次性行为发生在≤18岁、首次性行为未使用安全措施、有过商业性行为、与陌生人、与吸毒人员发生过性行为的比例分别为29.9%、55.2%、4.3%、12.2%和0.5%;多因素分析结果显示,出生年代越早、与父母同住、青春期早期家庭支持评分较高及父母反对婚前性行为的青少年发生婚前性行为的可能性和危险性行为评分均较低;家庭因素对性行为的影响存在性别差异,女性性行为的发生受家庭因素的影响比较大,而男性更多地受人口学特征的影响。结论:青少年婚前性行为的发生趋于年轻化。家庭因素可能影响青少年的婚前性行为及危险性行为的发生,并且这种影响作用存在性别差异。     

Sexual interest and behavior in healthy 80- to 102-year-olds

Sexual interest and behavior of 100 white men and 102 white women ranging in age from 80–102 were studied using an anonymous 117-item questionnaire. Subjects were healthy and upper middle-class, and living in residential retirement facilities; 14% of the women and 29% of the men were presently married. For both men and women, the most common activity was touching and caressing without sexual intercourse, followed by masturbation, followed by sexual intercourse. Of these activities, only touching and caressing showed a significant decline from the 80s to the 90s, with further analyses revealing a significant decline in this activity for men but not for women. Except for past enjoyment of sexual intercourse and of touching and caressing without sexual intercourse, all analyses revealed sex differences reflecting more activity and enjoyment by men. Current income and past guilt over sexual feelings showed very low but significant correlations with some frequency and enjoyment measures, and marital status, extramarital sex, and church attendence were significantly associated with continuing to perform and enjoy some sexual behaviors. Past importance of sex was significantly correlated with present frequency and enjoyment of both sexual intercourse and touching and caressing without sexual intercourse. Correlations between past and present frequency of sexual behaviors were substantial and significant for all but frequency of sexual intercourse, suggesting that current physical and social factors play an overriding role in this area.A part of the data in this paper was presented by the authors at the 6th World Congress of Sexology, Washington DC, May 1983, and submitted by the first author to the faculty of San Francisco State University in partial fulfillment of the requirements for the Master of Arts degree, August 1983.     

Sexual attitudes and risk-taking behaviors of high school students in Turkey

BACKGROUND: The risk of sexually transmitted diseases is high but opportunities of sexual education for adolescents are limited in Turkey. The aim of this study was to evaluate sexual attitudes and behaviors and to determine the predictors of sexual initiation among adolescents. METHODS: A questionnaire designed by the researchers was administered to 861 senior year high school students in their classrooms. RESULTS: The rates of masturbation and sexual intercourse and the median partner numbers among males were higher than females. The rates of having negative feelings after the first sex among females were higher than males. The rates of having sexual intercourse and the mean age at first sexual intercourse among males were similar to developed countries. However, the use of a condom at first intercourse was low. Lower academic performance and grade repetition experience among males and cigarette smoking among both gender groups were related to having sexual intercourse. CONCLUSIONS: This is one of the first studies about sexual risk-taking behaviors among high school students in Turkey. Differences found between gender groups regarding attitudes and behaviors reflect the social structure in Turkey. These findings may be helpful in producing effective solutions for improving education and preventive health care.     

Sexual Attitudes and Number of Partners in Young British Men

The relationship between sexual attitudes and number of heterosexual partners in a survey-based and nationally representative random sample of 551 British men aged 16–25 years was examined. The main predictor of the number of partners in the last 5 years was the time since the first sexual intercourse, whereas age, marital status, education, social class, smoking, and alcohol consumption contributed on a smaller but significant level. Sexual attitudes were summarized in terms of three underlying dimensions which could be described as permissiveness, attitudes toward sexual relations of same-sex partners, and importance of orgasm for sex. None of these was a significant predictor of the number of partners in the last 5 years. Both permissiveness and number of partners were associated with the age of first sexual intercourse and other background variables indicating opportunities for social contact. In conclusion, common factors of sexual attitudes and the number of sexual partners are not directly related but rather jointly predicted by a very similar set of background variables such as age, time since first sexual intercourse, social class, smoking, and alcohol consumption. Given the absence of a significant relationship between sexual attitudes and number of young men's partners, promoting safer sex may be a more sensible strategy than trying to change these attitudes.     

High Rates of Sexual Behavior in the General Population: Correlates and Predictors

We studied 2450, 18–60-year-old men and women from a 1996 national survey of sexuality and health in Sweden to identify risk factors and correlates of elevated rates of sexual behavior (hypersexuality) in a representative, non-clinical population. Interviews and questionnaires measured various sexual behaviors, developmental risk factors, behavioral problems, and health indicators. The results suggested that correlates of high rates of intercourse were mostly positive, whereas the correlates of high rates of masturbation and impersonal sex were typically undesirable. For both men and women, high rates of impersonal sex were related to separation from parents during childhood, relationship instability, sexually transmitted disease, tobacco smoking, substance abuse, and dissatisfaction with life in general. The association between hypersexuality and paraphilic sexual interests (exhibitionism, voyeurism, masochism/sadism) was particularly and equally strong for both genders (odds ratios of 4.6–25.6). The results held, with a few exceptions, when controlling for age, being in a stable relationship, living in a major city, and same-sex sexual orientation. We conclude that elevated rates of impersonal sex are associated with a range of negative health indicators in the general population.     

Effect of Renal Transplantation on Sexual Function

This investigation was conducted to determine whether renal transplantation can improve sexual function in male patients with chronic renal failure. The authors retrospectively studied 121 men undergoing renal transplantation who complained of any type or degree of sexual dysfunction pre-operatively. Sexual function was evaluated by questionnaire which included erectile, ejaculative, and orgasmic functions. Pre- and postoperative frequency of sexual intercourse was also recorded. Patient characteristics, laboratory data, and endocrinologic profiles were analyzed to identify factors that might influence sexual function. In patients with hormonal determinations, results essentially normalized after transplantation. However, only 43 patients (35.5%) reported improvement of overall sexual function after renal transplantation, while 34 (28.1%) reported worsening. Although frequency of sexual intercourse was unaffected by transplantation, 15 of 20 patients who had no intercourse before transplantation initiated intercourse afterward. These 15 patients all underwent transplantation before 40 years of age. Comparisons of variables by sexual function showed significant differences for type of immunosuppressive treatment, interval after renal transplantation, and serum concentration of hemoglobin A1c. It is concluded that renal transplantation cannot improve sexual function in allpatients, although hormonal profiles were largely normalized, and that renal transplantation should be encouraged at a younger age.     

Family and Peer Influences on Sexual Behavior Among Female College Students in Wuhan,China

The prevalence of sexually transmitted infections in China has increased dramatically over the last 20 years, and heterosexual transmission is rapidly becoming the primary route of HIV transmission. Despite this growing epidemic, little is known about the correlates of sexual behavior in young Chinese women. The objective of this study was to assess family and peer factors related to sexual behavior in Chinese female college students. Anonymously completed questionnaires were received from 4,769 unmarried female college students, recruited using randomized cluster sampling by type of university and students' major and grade. Items captured socio-demographic, family, and peer factors. To examine factors associated with sexual behavior, multiple logistic regression was used, yielding odds ratios and 95% confidence intervals. Over 18% of female students participating reported ever having sexual intercourse, of whom 31.52% had their first sexual intercourse at the age of 18 or younger with more than 50% at an age less than 20 years. Several socio-demographic, family, and peer factors were associated with ever having intercourse. Those more likely to engage in premarital sex were older; majored in art; were from one-child, richer and/or divorced families; had a mother with university or above education; had parents with a strict disciplinary style;, had middle-school close friends falling in love; and had current close friends living with boyfriends. Interventions to protect young women from sexually transmitted diseases need to target early sex education and address peer and parents influences.