The impact of inflammatory bowel disease on sexual health in men: A scoping review.

Sara Ma,Paul Galdas,Amanda Mason‐Jones,Steven Ersser,Martin Veysey

doi:10.1111/jocn.15418

Abstract

To review the literature on the impact of inflammatory bowel disease on the sexual health of men and make recommendations for nursing practice and research. Inflammatory bowel disease is a chronic condition of the gastrointestinal tract, causing symptoms that may impact upon sexual health. Specialist nurses are well positioned to assess and manage sexual health, but there is a lack of clinical guidance, especially in relation to men. A systematic scoping review following the Arksey and O'Malley (International Journal of Social Research Methodology, 8, 2005, 19) framework reported in line with the PRISMA-ScR checklist (Tricco et al., Annals of Internal Medicine, 169, 2018, 467). OVID MEDLINE ALL [R], OVID EMBASE [R], OVID PsychINFO, EBSCO CINAHL Complete, The Cochrane Library and ProQuest were searched. Inclusion and exclusion criteria were applied independently by two reviewers. Data were extracted, charted and summarised from eligible studies. Thirty-one studies met the inclusion criteria. These were synthesised under three categories: mediators, moderators and descriptors of sexual health. Depression, disease activity and surgery were the most commonly cited disease-related factors to affect sexual health in men. The most commonly used assessment tool was The International Index of Erectile Function. Descriptors of function included frequency of intercourse, libido and the ability to maintain a desired sexual role. The effect of inflammatory bowel disease on sexual health in men involves a complex interaction of physical and psychosocial factors. Researchers must explore areas outside of erectile function to understand how the disease impacts sexuality, sexual well-being and masculinity. This can be achieved through qualitative exploration of patient, partner and health professional experiences. A holistic nursing assessment of men with inflammatory bowel disease should include sexual health. Developing understanding of how the disease influences sexual interaction and expression will facilitate support that is relevant, accessible and of value to men living with the disease.

Highlights

Inflammatory bowel disease (IBD) is a chronic, relapsing and remitting condition of the gastrointestinal tract
We have reported our findings in line with the PRISMA extension for scoping reviews (PRISMA-ScR) (Tricco et al, 2018); the checklist can be found in Appendix S1
We have sought to understand the potential impact of IBD on male sexual health and identify whether there is scope for nursing intervention and research

Summary

Introduction

Inflammatory bowel disease (IBD) is a chronic, relapsing and remitting condition of the gastrointestinal tract. Prevalence ranges from 0.21%– 0.44% in Western Europe and North America (Büsch et al, 2014). Peak onset of the disease is between the ages of 15 to 30 years (Meier, 2019). IBD is associated with distressing and embarrassing physical symptoms such as faecal urgency, incontinence, bloody diarrhoea, abdominal pain, fatigue and malnutrition. Extra-intestinal presentations can affect the joints, liver, skin and eyes. The disease can cause a psychological burden from attempting to live a normal life while living in fear of symptoms (Kemp, Griffiths, & Lovell, 2012)

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