子宮切除後的性適應

國內婦女接受子宮切除的人數愈來愈多，而子宮切除後婦女的性生活適應，會影響到其自我認同與人際關係，是需要被重視的議題。本研究目的即在於了解子宮切除婦女性生活的一般經驗，並找出影響術後性生活適應的因素，並進一步以女性主義觀點檢視之。84位良性診斷子宮切除的婦女，在術後3-9個月後接受訪視，其中65位已婚且手術前仍有性生活。結果發現術後有九成的婦女已恢復性生活，其中7.8%的人有點不滿意。比較手術前後對性生活滿意度的改變情形，有3.9%變好，13.7%變差，82.4%不變。19.7%的人在術後第八週開始性行爲，14.8%在第十二週，最早的在第二週，最晚的在第二十四週，中位數是第十週，術後第一次性行爲85.2%是由先生提出。關於術後的性交不適，有28人陰道乾燥，8人性慾減低，4人性交疼痛，4人性恐懼，3人體力不佳無法維持，3人性感不良。對術後性生活的看法，15人認爲會破壞陰道傷口，11人覺得會傷害身體的復原。經迴歸分析後，影響術後性生活滿意的因素有術後親密行爲滿意度、術前性行為滿意度與性交痛。本研究結果破除「子宮切除則無性」的迷思，強調夫妻相互面對性調適的重要，同時也發現醫病溝通在性議題上不清楚的缺失。建議在子宮切除醫病溝通上要加入術後性生活影響的議題，協助婦女面對術後性生活適應的問題，醫療人員應扮演主動的角色，在手術前後提供衛教與諮詢，釐清夫妻間對子宮與性的錯誤觀念，鼓勵夫妻共同面對問題，尋找解決之方法。

關鍵字

子宮切除；性適應

並列摘要

The impacts of hysterectomy on women's sexual identity and sexual relation ship are very important, but have not been given adequate attention in the medical and public health area. This study examines the recovery of sexual behavior after hysterectomy of women in Taiwan from a feminist perspective. 84 women from two hospitals who have had a hysterectomy in the past 3-9months were home interviewed by a trained interviewer. The results were based on 65 married women who have had an active sexual life with their spouse prior to surgery. 90% of the women had resumed sexual activity atter the surgery. Among these 90%, 19.7% resumed sexual activity 8 weeks after surgery and 14.8% after 12 weeks. The earliest to resume activity was two weeks, the latest was 24 weeks, and the median time was 10 weeks. 85.2% resumed activity after initiation by spouse. Regarding satisfaction with sexual life after surgery as compared to before surgery, 3.9% reported increased satisfaction, 13.7% reported decreased satisfaction, 82.4% reported no difference, and 7.8% reported dissatisfaction. The following complaints regarding intercourse were reported: 28 women complained of vaginal dryness, 8 reported decreased sexual drive, 4 reported pain during intercourse, 4 reported sex phobia, 3 reported physical weakness, and 3 felt dyspareuria. In examining attitudes toward sexual life, 15 women believed that intercourse would damage the wound, and 11 women thought it would delay their physical recovery. After stepwise multiple regression analysis, the predicted variables contributing to satisfaction with sexual intercourse were found to be satisfaction with intimacy in the relationship, sexual satisfaction prior to hysterectomy, and less pain in intercourse. This study dissolves the myth of ”no sex after hysterectomy” and emphases the mutual understanding and communication between spouses as well as reveals inadequate patient-physician communication in the clinic on the issues concerning sexual behavior after hysterectomy. A woman-oriented health counseling program concerning sexual identity and sexual relationship which also incorporates spousal participation is needed.

並列關鍵字

Hysterectomy ； Sexuality

國際替代計量

子宮切除後的性適應

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