PDF(Pubmed)
Abstract：
UNASSIGNED: 46,XX patients with classic congenital adrenal hyperplasia (CAH) are exposed to elevated androgens in utero causing varying levels of virilization. The majority undergo feminizing genitoplasty early in life, with potential impact on sexual function and health-related quality of life (HRQoL).
UNASSIGNED: We aimed to determine how sexual and lower urinary tract function, body image, and global HRQoL differs between patients with classic CAH and controls and to characterize how gynecologic anatomy contributes to outcomes.
UNASSIGNED: 36 patients with classic CAH and 27 control women who were matched for age, race, and marital status underwent standardized gynecological examination and validated questionnaires. The responses were analyzed in relation to gynecological measurements, genotype, and disease status.
UNASSIGNED: Compared with controls, patients with CAH were more likely to have sexual dysfunction (P = 0.009), dyspareunia (P = 0.007), and other pelvic pain (P = 0.007); were less likely to be heterosexual (P = 0.013) or ever have been sexually active (P = 0.003); had poorer body image independent of body mass index (P < 0.001); and had worse HRQoL in the areas of general health (P = 0.03) and pain (P = 0.009). The patients with CAH had smaller vaginal calibers and perineal body lengths and larger clitoral indexes when compared with controls (P < 0.001). A larger vaginal caliber in CAH patients was associated with better overall sexual function (P = 0.024), increased sexual satisfaction (P = 0.017), less pain (P < 0.001), and greater number of sexual partners (P = 0.02).
UNASSIGNED: 46,XX patients with CAH have increased rates of sexual dysfunction, poor body image, and poor HRQoL, which is mitigated by having a larger vaginal caliber. Management aimed at optimizing vaginal caliber might improve sexual function.
UNASSIGNED: We aimed to determine how sexual and lower urinary tract function, body image, and global HRQoL differs between patients with classic CAH and controls and to characterize how gynecologic anatomy contributes to outcomes.
UNASSIGNED: 36 patients with classic CAH and 27 control women who were matched for age, race, and marital status underwent standardized gynecological examination and validated questionnaires. The responses were analyzed in relation to gynecological measurements, genotype, and disease status.
UNASSIGNED: Compared with controls, patients with CAH were more likely to have sexual dysfunction (P = 0.009), dyspareunia (P = 0.007), and other pelvic pain (P = 0.007); were less likely to be heterosexual (P = 0.013) or ever have been sexually active (P = 0.003); had poorer body image independent of body mass index (P < 0.001); and had worse HRQoL in the areas of general health (P = 0.03) and pain (P = 0.009). The patients with CAH had smaller vaginal calibers and perineal body lengths and larger clitoral indexes when compared with controls (P < 0.001). A larger vaginal caliber in CAH patients was associated with better overall sexual function (P = 0.024), increased sexual satisfaction (P = 0.017), less pain (P < 0.001), and greater number of sexual partners (P = 0.02).
UNASSIGNED: 46,XX patients with CAH have increased rates of sexual dysfunction, poor body image, and poor HRQoL, which is mitigated by having a larger vaginal caliber. Management aimed at optimizing vaginal caliber might improve sexual function.
摘要：
■46，患有经典先天性肾上腺增生（CAH）的XX患者在子宫内暴露于升高的雄激素，导致不同程度的男性化。大多数人在生命早期接受女性化生殖器成形术，对性功能和健康相关生活质量（HRQoL）有潜在影响。
■我们的目的是确定性和下尿路功能，身体形象，和整体HRQoL在经典CAH患者和对照组之间存在差异，并表征妇科解剖学如何影响结局。
■36名经典CAH患者和27名年龄相配的对照女性，种族,和婚姻状况进行了标准化妇科检查和验证问卷。分析了与妇科测量相关的反应，基因型，和疾病状态。
■与对照组相比，CAH患者更容易出现性功能障碍(P=0.009),性交困难（P=0.007），和其他盆腔疼痛（P=0.007）；异性恋的可能性较小（P=0.013）或曾经性活跃（P=0.003）；与体重指数无关的身体形象较差（P<0.001）；在一般健康（P=0.03）和疼痛（P=0.009）领域的HRQoL较差。与对照组相比，CAH患者的阴道口径和会阴体长较小，阴蒂指数较大（P<0.001）。CAH患者较大的阴道口径与较好的整体性功能相关(P=0.024)。性满意度提高（P=0.017），疼痛减轻（P<0.001），和更多的性伴侣（P=0.02）。
■46,XXCAH患者性功能障碍发生率增加,身体形象不佳，和可怜的HRQoL，这可以通过更大的阴道口径来缓解。旨在优化阴道口径的管理可能会改善性功能。
■我们的目的是确定性和下尿路功能，身体形象，和整体HRQoL在经典CAH患者和对照组之间存在差异，并表征妇科解剖学如何影响结局。
■36名经典CAH患者和27名年龄相配的对照女性，种族,和婚姻状况进行了标准化妇科检查和验证问卷。分析了与妇科测量相关的反应，基因型，和疾病状态。
■与对照组相比，CAH患者更容易出现性功能障碍(P=0.009),性交困难（P=0.007），和其他盆腔疼痛（P=0.007）；异性恋的可能性较小（P=0.013）或曾经性活跃（P=0.003）；与体重指数无关的身体形象较差（P<0.001）；在一般健康（P=0.03）和疼痛（P=0.009）领域的HRQoL较差。与对照组相比，CAH患者的阴道口径和会阴体长较小，阴蒂指数较大（P<0.001）。CAH患者较大的阴道口径与较好的整体性功能相关(P=0.024)。性满意度提高（P=0.017），疼痛减轻（P<0.001），和更多的性伴侣（P=0.02）。
■46,XXCAH患者性功能障碍发生率增加,身体形象不佳，和可怜的HRQoL，这可以通过更大的阴道口径来缓解。旨在优化阴道口径的管理可能会改善性功能。
