현성 요실금이 한국 중 · 노년 여성의 성기능에 미치는 영향
THE IMPACT OF SYMPTOMATIC URINARY INCONTINENCE ON FEMALE SEXUAL FUNCTION IN MIDDLE- TO OLD-AGED KOREAN WOMEN
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목적본 연구는 현성 요실금이 한국 중 · 노년 여성의 성기능에 미치는 영향을 평가하기 위함이었다. 연구방법2009년 5월부터 2010년 1월까지 서울대학교 헬스케어시스템 강남센터를 방문한 만 40세 이상 여성 건강검진 수진자 중 성적으로 활발하고 본 연구에 동의한 773명을 대상으로, 병력청취(Beck’s Depression Inventory 설문 포함), 신체검진, 혈액검사, Pelvic Floor Distress Inventory-20 (PFDI-20) 및 Female Sexual Function Index (FSFI) 설문조사를 시행하였다. 현성 요실금은 PFDI-16 또는 17 문항에 ‘예’라고 답하고 ‘약간 이상의 성가심’이 있다고 답한 경우로 정의하였고, 성기능장애는 FSFI 총점이 26.55점 이하인 경우로 정의하였다결과설문에 응한 총 773명의 여성 중 318명(41.14%)에서 현성 요실금이 있었다. 현성 요실금이 있는 군은 그렇지 않은 군에 비해 성기능장애의 빈도가 유의하게 높았다(62.26% vs. 49.45%, P ＜0.05). 다중선형회귀분석 결과 현성 요실금은 나이, 폐경 여부, 경제력, 흡연 유무, 확장기혈압, 우울증과 더불어 FSFI 총점에 유의한 영향을 미치는 인자로서 나타났다(standardized β = -0.108, P ＜0.05). 임상적 위험인자들을 보정한 FSFI 총점 평균은 현성 요실금이 있는 군에서 그렇지 않은 군에 비해 유의하게 낮았으며(24.59 vs. 25.74, P ＜0.05), 각 영역별 점수 역시 윤활액분비(4.70 vs. 4.84, P = 0.056)를 제외한 나머지 영역, 성욕(2.88 vs. 3.05), 성적흥분(3.75 vs. 3.96), 오르가즘(4.11 vs. 4.36), 성적만족도(4.15 vs. 4.33), 성교통(4.99 vs. 5.20)에서 모두 유의하게 낮았다(P ＜0.05). 결론한국 중 · 노년 여성에 있어서 현성 요실금은 성기능에 영향을 미치는 중요한 위험인자이며, 요실금 치료 후 성기능이 개선되는지에 대한후속 연구가 필요하다.
Abstract
Objective To evaluate the impact of symptomatic urinary incontinence (UI) on sexual function in middle- to old-aged Korean women. Methods From May 2009 to January 2010, a cross-sectional study was performed including middle- to old-aged, sexually active women who visited comprehensive screening clinic. We performed history taking, biometry, pelvic examination, laboratory test, Pelvic Floor Distress Inventory (PFDI)-20, and Female Sexual Function Index (FSFI). Symptomatic UI was said to be present when the score for the problem-specifi c PFDI-16/17 questions were ≥2. Participants obtaining a total FSFI score of 26.55 or less were defi ned as having female sexual dysfunction (FSD). Results Among 773 enrolled women, 318 (41.14%) had symptomatic UI. FSD was signifi cantly frequent in symptomatic UI group than normal group (62.26% vs. 49.45%, P < 0.05). Symptomatic UI was associated signifi cantly with a total FSFI score in multiple linear regression model (standardized ß = -0.108, P < 0.05). After adjustment of clinical risk factors for FSD by analysis of covariance analyses, symptomatic UI group had signifi cantly lower scores than those of normal groups (24.59 vs. 25.74, P < 0.05), and this was observed in all sub-domains (desire 2.88 vs. 3.05; arousal 3.75 vs. 3.96; orgasm 4.11 vs. 4.36; satisfaction 4.15 vs. 4.33; pain 4.99vs. 5.20, P < 0.05) except lubrication domain (4.70 vs. 4.84, P = 0.056). Conclusion Symptomatic UI is a risk factor for sexual dysfunction of middle- to old-aged women. Further studies should be followed to evaluate whether the treatment of symptomatic UI could restore the impaired sexual function.
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