Sexual Function in Patients with Lumbar and Cervical Discopathy: A Case-Control Study

To investigate the effects of surgical modalities for isolated acetabular fractures on the sexual functions of patients and their partners. Prospective. Level I trauma centre. Sixty-five patients who had undergone open reduction and internal fixation because of isolated acetabular fractures who were sexually active before, together with their partners. Patients operated on for isolated acetabular fractures were divided into 3 groups according to surgical approaches: the Kocher-Langenbeck approach (n = 36), ilioinguinal approach (n = 16), and modified Stoppa approach (n = 13). Sexual functions of patients and their partners were evaluated with the 5-item version of the International Index of Erectile Function score and Female Sexual Function Index score preoperatively and at the postoperative first year after the rehabilitation period. The mean age of the patients was 41.8 ± 13.0 (18-69) years. In male patients, the mean 5-item version of the International Index of Erectile Function score had changed from 24.3 to 20.0 at the postoperative first year and the decrease in sexual function scores was less with the Kocher-Langenbeck approach. In female patients, the Female Sexual Function Index scores had decreased statistically significantly from 24.9 to 18.3 at the postoperative first year, but there was no statistically significant difference between surgical groups. Both male and female patients' partners' sexual function scores were also decreased at the postoperative first year. As a result of our study, it was observed that the posterior approach is more advantageous than anterior approaches in preserving the sexual functions of male patients in acetabular fracture surgery. However, the surgical approach did not affect the sexual functions of female patients. Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

Improvement in Sexual Functioning in Patients with Interstitial Cystitis/Painful Bladder Syndrome

In recent years, the treatment of pulmonary arterial hypertension (PAH) has gradually increased, including new drugs and surgical methods, the mortality rate of PAH patients has significantly decreased, and the average survival rate has significantly improved. However, there was no obvious improvement in sexual health, mental health, and quality of life (QoL) in patients with PAH.Although an important dimension of QoL, little is known about sexual health and sexual health-related QoLof patients with PAH in China. In this study, the female sexual function index (FSFI)scale, the Symptom Checklist-90 (SCL-90), and emPHasis-10 were used to evaluate PAH associated with congenital heart disease (CHD-PAH) patients' sexual function, mental health, and QoL. The score of sexual function in female CHD-PAH patients ranged from 4.40 to 34.80 points, and the average score was 26.80 (19.00-27.80) points. The detection rate of sexual dysfunction was 48.30%. The FSFIscore of all dimensions of the sexual dysfunction group was significantly lower than that of the nonsexual dysfunction group. In addition, the scores of SCL-90 and emPHasis-10 were significantly higher than that of the nonsexual dysfunction group (p < 0.01). The sexual function was negatively correlated with mental health (r = -0.58,p < 0.01) and QoL (r = -0.62,p < 0.01) in female CHD-PAH patients. The sexual function of female patients with CHD-PAH is not optimistic. Sexual health may impact mental health and overall QoL in female PAH patients. Reasonable intervention measures should be taken to improve their sexual health, so as to improve their overall QoL.

Sexual dysfunction in patients with allergic rhinoconjunctivitis

BackgroundPatients who undergo treatment for hematologic malignancies may experience a decline in sexual health, alterations in sexual functioning, and reproductive capacity during survivorship.AimThis study investigated the prevalence of sexual dysfunction and factors influencing sexual activity and functioning in patients with hematologic malignancies, to identify potential targets for interventions in clinical practice.MethodsThis nationwide cross-sectional study included adult patients diagnosed with a hematologic malignant disease in Denmark in the period from January 20, 2013, to August 20, 2022. Eligible participants received electronic questionnaires through their officially assigned digital mailbox.OutcomesOutcomes included the Female Sexual Function Index, International Index of Erectile Function, Female Sexual Distress Scale–Revised, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire–Sexual Health, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire.ResultsA total of 362 patients, on average 5.7 ± 3.4 years postdiagnosis, completed the questionnaires. Of these, 52.5% women and 73.2% men reported sexual dysfunction, with more women (40.9%) than men (34.1%) being sexually inactive. Across gender, this was significantly more prevalent in patients >65 years of age and in those with a low quality of life. In addition, for women a significant association with fatigue and sleep difficulties was observed. In total, 40.3% reported sexual-related personal distress, with the highest proportion among patients 40 to 65 years of age. Most patients (98.7%) with sexual dysfunction had not discussed sexual issues with their healthcare professional.Clinical implicationsIt is hoped that knowledge from this study will help healthcare professionals in clinical practice and encourage them to proactively address and discuss sexual health issues with their patients, irrespective of age.Strengths and LimitationsSexually inactive participants may reduce the overall score of sexual function in the scoring of both the Female Sexual Function Index and International Index of Erectile Function. We therefore analyzed sexual function in a subgroup analysis in only those being sexually active to emphasize that level of dysfunction persists in sexually active participants.ConclusionPatients report a high prevalence of sexual dysfunction, sexual distress, and gender-specific sexual symptoms following diagnosis and treatment of a malignant hematologic disease, impacting their quality of life.Sexual Health in Patients With Hematologic Malignancies; NCT05222282; https://clinicaltrials.gov/study/NCT05222282.

87 Background: Following radiation therapy (RT), gynecologic oncology patients report high rates of sexual dysfunction. However, little is known regarding communication of sexual health among these patients and their healthcare providers. The aim of this study was to assess the beliefs/attitudes of patients regarding sexual history taking. Methods: Survey results were obtained from 75 women who presented for follow up care for gynecologic cancers in the radiation oncology department. The surveys assessed patient beliefs about sexual health and its impact on overall quality of life, the role practitioners should play in obtaining an accurate sexual history, and preferences and level of embarrassment regarding sexual history collection. Overall level of sexual functioning was assessed using the Female Sexual Function Index (FSFI). Chi-squared tests were used to analyze categorical variables and logistic regression modeling was used to predict agreement with survey statements. Results: Most subjects were white and married with a mean FSFI score of 9.9 [(SD = 10.3) sexual dysfunction is defined as &lt; 26.5]. 78.7% agreed that sexual function is an important component of overall health, and only 12.0% reported embarrassment about discussing their sexual health with healthcare providers. 62.79% agreed that medical providers should take a sexual history on a regular basis. However, 58.7% and 22.7% of women report never or almost never being asked about their sexual health by their primary care physician or Ob/Gyn, respectively. Approximately two-thirds of women expressed a preference to have a female provider obtain their sexual health history. Conclusions: Gynecologic cancer patients s/p RT report low sexual function scores. A majority agree that sexual function is essential to overall health. They report little embarrassment regarding discussions of sexual health, yet, note limited discussion about the topic with their healthcare providers. This work highlights the need for improvements in communication about sexual health. We suggest that healthcare providers caring for women with gynecologic cancers should more regularly inquire about their patients’ sexual health and function.

To evaluate the impact of perianal Crohn's disease (PCD) activity on quality of life (QoL), fecal continence, and sexual function in patients with Crohn's disease (CD), and to identify factors associated with impaired patient-reported outcomes. A cross-sectional analytical study was conducted, from an existing database of patients with CD at Shaare Zedek Medical Center who diagnosed with and without perianal disease and were seen in IBD clinic between June 2023 and August 2024. The patients agreed to participate and answered validated questionnaires that assessed QoL (SIBDQ), fecal incontinence (WEXNER), and sexual function (IIEF for men, FSFI for women). A total of 150 patients with CD were recruited, including 47 with PCD (active and non-active) and 103 without PCD. Patients with active PCD had significantly lower QoL compared to those with non-active PCD and without PCD (p = 0.001). Two major risk factors for decreased QoL were identified: age over 40 (p = 0.024) and only conservative treatment (without chronic medication) (p = 0.031). Although no significant difference was found in fecal incontinence between groups, 64.2% of patients with CD reported some degree of incontinence. Sexual function scores were lower in patients with CD, particularly women, though the difference was not statistically significant. Active PCD significantly reduces QoL in patients with CD, with older age and absence of chronic treatment contributing to poorer outcomes. These findings highlight the need for optimized treatment strategies to improve patient well-being. Further research should explore additional clinical and psychological aspects affecting patients with CD with perianal involvement. What is already known? Perianal Crohn's disease is a severe phenotype linked to high morbidity and healthcare use. Its impact on quality of life is known, but the roles of disease activity, incontinence, and sexual function remain unclear. What is new here? Active perianal disease significantly worsens quality of life, unlike inactive disease. Older age and lack of maintenance therapy further reduce patient-reported outcomes. How can this study help patient care? Distinguishing active from inactive disease is crucial. Early detection, ongoing therapy, and structured assessment of continence and sexual health can improve quality of life.

ObjectivesTo date, there is almost no information concerning the sexual health of patients with idiopathic inflammatory myopathies (IIM). This cross-sectional study aimed to compare sexual function in patients with IIM to age-/sex-matched healthy controls (HC) and determine the potential impact of clinical features on sexual function.MethodsIn total, 122 women (61 with IIM, 61 age-matched HC) and 22 men (11 with IIM, 11 age-matched HC) aged 18–80 years completed gender-specific selection of 7 well-established and validated questionnaires assessing sexual health and function (Female Sexual Function Index, Brief Index of Sexual Function for Women, Sexual Function Questionnaire, Sexual Quality of Life Questionnaire–Female, International Index of Erectile Function, Male Sexual Health Questionnaire, Sexual Quality of Life Questionnaire–Male). Results were compared between patients and HC and correlated with selected disease-related features.ResultsThe prevalence of sexual dysfunction in IIM was 59% in women (vs 40% in HC), and 64% (vs 9% in HC) in men. Men and women with IIM reported significantly impaired sexual function compared with sex-/age-matched HC. Decreased sexual function was associated with muscle weakness, disability, physical inactivity, fatigue, depression and decreased quality of life.ConclusionsOur results suggest that sexual dysfunction is common among IIM patients and more attention should be paid to this aspect of the disease.

To investigate the effect of passive pedaling with mini bike on sexual function in patients under hemodialysis. This study was a randomized clinical trial. Thirty-seven patients undergoing hemodialysis were assigned to the intervention (n=20) and control (n=17) groups by the stratified block randomization method. The intervention group exercised with a mini bike that was automatic and tuned for patients during the first 2 h of dialysis, twice a week for 20 min each time, for 3 months. The International Index of Erectile Function and Female Sexual Function Index were used to assess the sexual function in the first, second, and third months during the intervention and one month after the intervention. A higher score indicates a better sexual function. Repeated measure ANOVA, Chi-square and Fisher exact tests, independent t, and Mann-Whitney U tests were used for data analysis. The SPSS software version 22 was used for data analysis. Sexual function scores of the intervention group were 35.9 at the beginning of the study, 34.1 in the first month, 37.4 in the second month, 34.8 in the third month, and 31.7 one month after the study. There was no significant difference in the scores of sexual function in the intervention group during the study. The mean scores of sexual function in the control group were 34.5, 34.4, 34.9, 33.8, and 33.9 at the beginning of the study, in the first month, in the second month, in the third month, and one month after the study, respectively (p > 0.05). There was no significant difference between the two groups in terms of sexual function scores during and after the intervention (p > 0.05). Passive pedaling with mini-bike had no effect on sexual function of hemodialysis patients.

Assessment of Female Sexual Function in Patients with Psoriasis

Response to Commentary by Spielmans

Background: There is evidence that many cancer survivors live with sexual dysfunction that impacts their quality of life. It is essential to identify factors that influence the development of sexual symptoms and understand their trajectory over time in order to guide potential interventions to treat sexual dysfunction. Most studies to date have been cross-sectional and longitudinal studies are needed to understand the change of sexual function over time. This study aims to investigate and describe the factors that impact sexual health and dysfunction in breast cancer patients during and after their cancer treatment. Methods: A longitudinal prospective trial is being conducted in premenopausal women 18-50 years of age with breast cancer being treated at MSKCC. Validated questionnaires on sexual health and function were administered to patients after they were diagnosed with breast cancer, but before they initiated cancer treatment and at one-year follow-up after initiation of primary breast cancer therapy. Demographic and treatment information was also collected. The female sexual function index (FSFI) total and individual domain scores were calculated. Baseline and 12-month scores were compared using paired t-tests. Multivariable linear regression was used to assess individual variable associations with 12-month FSFI total scores controlling for baseline scores. Results: 127 women were eligible for analysis at the time of this abstract and had a median age of 41. Eighty-nine percent of tumors were estrogen receptor positive and 24.4% were HER-2 overexpressing. Eighty-nine percent of patients received chemotherapy, 61.4% received Tamoxifen and 23% received a LHRH agonist in combination with an aromatase inhibitor. Mean FSFI total score was 20.4 at baseline and 21.2 at 12-months post diagnosis. More than half of women met FSFI criteria for sexual dysfunction (FSFI score&amp;lt;26) at baseline (57.5%) and 12-months (55.2%). Small increases in sexual activity were seen with 27.8% of patients inactive at baseline compared to 23.2% at 12 months. Similarly, women engaging in sexual activity more than once a week increased from 9.5% to 16.8%. Desire (libido) significantly improved (p = 0.023) from baseline to 12 months. Controlling for baseline score, younger age and treatment with tamoxifen were associated with better 12-month scores (p &amp;lt; 0.05). Conclusions: Mean FSFI scores in our patients with breast cancer before and after treatment are consistent with scores from other studies looking at cancer patients and are lower than those of healthy women. In the peri-diagnosis period patients had worse sexual function that showed signs of small improvements 12 months after initiation of treatment, especially in the desire domain. Patients are being followed to see if sexual function continues to improve over time, to better understand the factors causing sexual dysfunction in these patients and to determine the best time to intervene in order to improve symptoms. Citation Format: Goldfarb SB, Kamer S, Baser R, Quistorff J, Gemignani ML, Dickler M. Improvement in sexual function over time in premenopausal women with breast cancer [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-12-12.

Introduction: In recent years, Iran has witnessed a considerable increase in the number of women with human immunodeficiency virus (HIV). People living with HIV are the main subject in sexual health behavior, but the focus is more on the risks that are associated with their sexual behavior, and aspects such as their sexual satisfaction, which is one the most important components of quality of life, is often ignored. Disregarding these important aspects may lead to an increase to the prevalence of the disease. This study aimed to investigate the effect of counseling based on PLISSIT model on sexual function of HIV-positive married women. Material and methods: This clinical trial study was conducted on 60 HIV-positive married women (30 in the intervention group and 30 in the control group) with impaired sexual function. Female Sexual Function Index (FSFI) was used to measure a sexual function of these women. All participants in both groups, if did not have a depression (the score less than 14 in Beck Depression Inventory BDI questionnaire and score less than 28 in FSFI questionnaire), were considered as women with sexual disorder. The samples were randomly divided into two intervention and the control groups. Sampling was done using table of random numbers. Counseling sessions in the intervention group was based on the steps of PLISSIT models, and the sessions were conducted by the researchers with an interval of one week for 3 hours in average. Sexual function in three stages (before intervention, one month, and three months after the intervention) was measured. The software SPSS version 20 was used for data analysis. Results: According to the results, score of sexual function before the intervention in both groups did not differ significantly (p > 0.05). At the end of the first month, the sexual function score increased in the intervention group and reduced in the control group, and differences between the two groups compared to baseline in each group were statistically significant (p < 0.05). The increase in the sexual function score in the intervention group and decrease of the sexual function score in the control group led to a statistically significant difference in the measurement at the third month (p < 0.05). Changes in sexual function scores between the first and third months in the intervention group were statistically significant (p < 0.05). Conclusions: According to the findings of this study, counseling based on PLISSIT model positively affected the sexual function of HIV-positive women. Therefore, this model as a cost-effective and simple counseling method can be used to improve health and quality of life of these women. © Termedia Publishing House Ltd. All rights reserved.

Radical vaginal trachelectomy (RVT) offers low complication rate, good survival, and possibility for future childbearing for young women with early stage cervical cancer. However, the literature on quality of life (QOL) and sexual functioning in patients undergoing RVT is scarce. The aims of this study were to prospectively assess sexual function after RVT and to compare scores of sexual function in patients operated by RVT and radical abdominal hysterectomy (RAH) with those of age-matched control women from the general population. Eighteen patients with early stage cervical cancer operated with RVT were prospectively included and assessed preoperatively, and 3, 6, and 12 months postoperatively using validated questionnaires. RAH patients were included consecutively and assessed once at 12 months postsurgery, while an age-matched control group of 30 healthy women was assessed once. Sexual dysfunction total score as measured by the Female Sexual Function Index (FSFI) was the main outcome measure. During the 12 months posttreatment, RVT patients tended to have persistent sexual dysfunction as measured by FSFI (mean overall score <26.55 at each assessment) and Female Sexual Distress Scale (mean overall score > 11). Sexual worry (P < 0.001) and lack of sexual desire (P = 0.038) were more frequently reported among patients in both treatment groups compared with control women. Sexual activity increased significantly during the observation time for the RVT group (P = 0.023) and reached that of healthy women. Global Health Status score improved over time for the RVT group but never reached that of healthy control women (P = 0.029). Our data suggest that patients treated with RVT for early stage cervical cancer experience persistent sexual dysfunction up to one year post surgery influencing negatively on their QOL.

Longitudinal Impact of Social Restrictions on Sexual Health in the Italian Population