Changes In Sexual Activity Research Articles

Evaluation of Sexual Function Before and After Hip Arthroscopic Surgery for Symptomatic Femoroacetabular Impingement

Background: It is unknown if chronic hip pain due to femoroacetabular impingement (FAI) may cause sexual difficulties. Available evidence suggests that hip arthroscopic surgery may be effective for the treatment of symptomatic FAI; however, sexual function before and after hip arthroscopic surgery has not been reported. Purpose/Hypothesis: The purpose of this study was to determine the presence and significance of sexual difficulties in patients with chronic hip pain due to symptomatic FAI both before and after hip arthroscopic surgery. The hypotheses were that (1) chronic hip pain due to symptomatic FAI has a negative effect on sexual function, (2) hip arthroscopic surgery improves the level of sexual function postoperatively, (3) the characteristics of sexual difficulties may be dependent on sex or age, (4) patients lack knowledge of potential sexual activity changes in the preoperative and postoperative periods, and (5) patients desire a greater level of discussion regarding potential changes in sexual function. Study Design: Case series; Level of evidence, 4. Methods: A 23-item Likert-style questionnaire assessing preoperative and postoperative sexual function and a modified Harris Hip Score questionnaire were administered to 305 consecutive patients who underwent hip arthroscopic surgery for FAI with a minimum 1-year follow-up. Comparative analysis was performed between sexes and age groups (young: <40 years; old: >40 years). Results: Of 131 respondents, preoperative sexual difficulties were reported by 66%, occurring 30.8 ± 49.1 days after the onset of FAI symptoms. Primary causes of difficulty included pain (77.9%), stiffness (47.1%), and loss of interest (21.4%). Sexual activity resumed 29.2 ± 20.1 days postoperatively, while sex with minimal pain occurred at 48.8 ± 40.6 days. Female patients and older patients (>40 years old) resumed sexual activity later (female: 34.8 ± 23.2 days; male: 21.0 ± 10.7 days; P < .0001) (young: 26.3 ± 21.7 days; old: 35.7 ± 13.5 days; P = .017). The frequency of sexual activity increased in 32.3%, decreased in 16.9%, and was unchanged in 48.5%. Among patients who reported an increase in the frequency of sexual activity, there was a greater proportion of male patients and younger patients (female: 38.1%; male: 61.9%; P < .0001) (young: 78.6%; old: 21.4%; P < .0001). More female patients reported alterations in sexual positioning (female: 82.3%; male: 17.7%; P < .0001). To obtain information on sexual function, 77.4% of patients preferred a discussion with the surgeon, and 67.4% preferred a booklet on the subject. Relief of pain after arthroscopic surgery was experienced by 88.9%, and only 10.8% reported current sexual difficulties. Conclusion: This study demonstrates the prevalence of sexual difficulties among the majority of patients with symptomatic FAI, the significant effect that these difficulties may have on quality of life, and the ability of hip arthroscopic surgery to improve sexual function postoperatively. While further studies are required to elucidate what specific factors are associated with sexual difficulties, the current study suggests that this is an important topic to explore.

A Comparative Study of Sexual Dysfunction in Schizophrenia Patients Taking Aripiprazole Versus Risperidone

Sexual dysfunction due to antipsychotics is a significant problem encountered with first-generation antipsychotics. Even the second-generation antipsychotics like risperidone are not free of sexual dysfunction due to its D2 blocking properties leading to hyperprolactinaemia. Newer antipsychotic aripiprazole, partial dopamine agonist, with neutral effect on prolactin level or even decreasing it, is associated with avoidance of sexual dysfunction. To assess the effect of risperidone and aripiprazole on sexual function of schizophrenic patients. This was an open-label, cross-sectional, observational study conducted at College of Medical Sciences, Bharatpur. Schizophrenic patients attending OPD and inpatient, taking risperidone or aripiprazole for at least two months were included in this study. Forty one patients, without chronic medical illness and sexual dysfunction before starting drugs, with informed consent were studied during Jan 2012 and Aug 2012. Changes in sexual activity was found in 11(55%) of those taking risperidone while, only 3(14.3%) had any kind of sexual difficulty. This was statistically significant (p=0.006). Majority, 92.7% of the patients did not report about changes in sexual activity spontaneously. Sexual dysfunction was statistically significantly higher in those taking risperidone. Prevalence of sexual dysfunction was low with aripiprazole. Except those having poor sexual functions due to the drugs, the majority had to be specifically inquired about the effects of drug on sex life.

Change in sexual activity after a cardiac event: the role of medications, comorbidity, and psychosocial factors

AimThe aim of this study was to examine change in sexual activity before and after cardiac diagnosis in men and women by medication class. BackgroundDecline in sexual activity after cardiac diagnosis frequently occurs, with adverse effects of medications believed to play a role, although literature by subclass of drugs are conflicting. MethodsMixed methods approach was used to evaluate cardiac patients' (N=211) self-reported medications and changes in sexual activity before and after cardiac diagnosis via mailed survey. Chi square, logistic regression, and thematic analysis were used. ResultsFirst and third generation beta blockers, class 1 calcium channel blockers, vasodilators, diuretics, and loop diuretics adversely affected sexual activity. Significant predictors of change in sexual activity were number of medications, education level, and income; the overall model predicted 25.7% of the variance in sexual activity. ConclusionsSexual assessment and discussion of sexual concerns and side effects of medications by nurses are important to support sexual function.

Teenagers' Risky Health Behaviors and Time Use During the Great Recession

This paper uses individual-level data from both the 2003-2011 American Time Use Survey and Youth Risk Behavior Survey and state-level unemployment rates to examine the effects of a weakening economy during the Great Recession on U.S. teenagers’ activities. I present results by gender and by race/ethnicity within gender groups. Over the period, I find changes in sexual activity for black males associated with changes in time spent with parents. In addition, Hispanic males were more likely to be obese when the economy weakened, which corresponded to a decrease in time spent playing sports and an increase in time watching TV. Female teenagers, on the other hand, made greater educational investments while spending less time working. However, there were signs that female teenagers were stressed by the weak economic conditions, because they slept less and were more likely to smoke regularly. In addition, black females consumed more alcohol.

Risk factors for negative impacts on sexual activity and function in younger breast cancer survivors.

We aim to examine changes in sexual activity and function among younger breast cancer survivors who were sexually active before diagnosis and to investigate risk factors for negative impacts on them. An observational cohort study enrolled 304 premenopausal and sexually active women diagnosed with early stage breast cancer. Questionnaires were completed, and sexual activity was measured at two time points: after surgery, to assess sexual activity and function before diagnosis, and then at least 12 months after the completion of chemotherapy or endocrine therapy. For each domain of the Female Sexual Function Index, a score below 3 was classified as indicative of a sexual problem. Each sexual problem was considered to be dysfunctional if it was associated with distress. The median age at the last survey was 46.0 years (range: 23-57). Of the participants, 35 (11.5%) became sexually inactive after treatment. Among the 269 women who remained sexually active, 31.6% were currently experiencing sexual dysfunction, which was significantly higher compared with the frequency before diagnosis. In the multivariate logistic regression model, chemo-related menopause, thyroid dysfunction, and depression were independent risk factors for sexual inactivity. Chemo-related menopause was a significant risk factor for sexual dysfunction. Chemo-related menopause was significantly associated with both sexual inactivity and dysfunction after treatment. Thyroid dysfunction and depression were risk factors for sexual inactivity in younger breast cancer survivors.

The longitudinal relationship of sexual function and androgen status in older men: the Concord Health and Ageing in Men Project.

It is unclear whether declining sexual function in older men is a cause or consequence of reduced androgen status. Longitudinal associations were examined between reproductive hormones and sexual function in older men. Men aged 70 years and older from the Concord Health and Ageing in Men Project study were assessed at baseline (n = 1705) and 2-year follow-up (n = 1367), with a total of 1226 men included in the final analyses. At both visits, serum testosterone (T), dihydrotestosterone (DHT), estradiol (E2), and estrone (E1) were measured by liquid chromatography-tandem mass spectrometry, and SHBG, LH, and FSH were measured by immunoassay. Sexual functions (erectile function, sexual activity, and sexual desire) were self-reported via standardized questions. In longitudinal analyses, although baseline hormones (T, DHT, E2, and E1) did not predict decline in sexual function, the decline in serum T (but not DHT, E2, or E1) over 2 years was strongly related to the change in sexual activity and desire (but not erectile function). For each 1-SD decrease in T from baseline to 2-year follow-up, there was a multivariate-adjusted odds ratio of 1.23 (95% confidence interval, 1.12-1.36) for an additional risk of further decline in sexual activity. However, the magnitude of the decrease in serum T was strikingly small (<10%). Similar associations were found for changes over 2 years in serum T and decline in sexual desire, but not for erectile function. We found a consistent association among older men followed over 2 years between the decline in sexual activity and desire, but not in erectile function, with a decrease in serum T. Although these observational findings cannot determine causality, the small magnitude of the decrease in serum T raises the hypothesis that reduced sexual function may reduce serum T rather than the reverse.

Impact of breast cancer diagnosis and treatment on sexual dysfunction.

125 Background: Sexual dysfunction is a common and under acknowledged disorder in women with breast cancer. Sexual dysfunction in this scenario may be related to multiple factors: psychological distress due to diagnosis, physical decline due to treatment, change in hormonal milieu and/or poor body image. Methods: We assessed the changes in sexual activity after breast cancer diagnosis and treatment in 45 women using an anonymous questionnaire. Data was analyzed via descriptive statistics and paired sample t-test. Results: The age of women in our study ranged between 33-73 years with an average age of 51.6 years. Most of the subjects (89%) had completed chemotherapy and/or radiation therapy however 52% were still on hormonal treatment. Women who were more sexually active prior to breast cancer diagnosis were more likely to experience sexual dysfunction (p = 0.001). Overall, 45% of the women with breast cancer experienced a decline in their sexual health. A greater decline occurred after breast cancer treatment (chemotherapy and/or hormonal therapy) than after diagnosis (p &lt; 0.05). Fifty percent had a decrease in libido and sexual arousal, 40.5% had difficulty in reaching sexual orgasm, and 29% had dyspareunia. Sexual difficulties were addressed by the treating oncologist in 3 out of the 45 women. Conclusions: The data reveals that sexual dysfunction is prevalent in breast cancer survivors. Its onset in concomitance with the diagnosis of breast cancer reflects the psychosocial impact of such a diagnosis. The further decline in sexual health after treatment emphasizes the important adverse effects of chemotherapy and hormone therapy in terms of vaginal dryness, dysparunia and sexual well-being. Despite its prevalence, sexual dysfunction is not commonly addressed in women with breast cancer. [Table: see text]

Testosterone dose-response relationships in hysterectomized women with or without oophorectomy

This study aims to determine the dose-dependent effects of testosterone on sexual function, body composition, muscle performance, and physical function in hysterectomized women with or without oophorectomy. Seventy-one postmenopausal women who previously underwent hysterectomy with or without oophorectomy and had total testosterone levels less than 31 ng/dL or free testosterone levels less than 3.5 pg/mL received a standardized transdermal estradiol regimen during the 12-week run-in period and were randomized to receive weekly intramuscular injections of placebo or 3, 6.25, 12.5, or 25 mg of testosterone enanthate for 24 weeks. Total and free testosterone levels were measured by liquid chromatography-tandem mass spectrometry and equilibrium dialysis, respectively. The primary outcome was change in sexual function measured by the Brief Index of Sexual Functioning for Women. Secondary outcomes included changes in sexual activity, sexual distress, Derogatis Interview for Sexual Functioning, lean body mass, fat mass, muscle strength and power, and physical function. Seventy-one women were randomized; five groups were similar at baseline. Sixty-two women with analyzable data for the primary outcome were included in the final analysis. The mean on-treatment total testosterone concentrations were 19, 78, 102, 128, and 210 ng/dL in the placebo, 3-mg, 6.25-mg, 12.5-mg, and 25-mg groups, respectively. Changes in composite Brief Index of Sexual Functioning for Women scores, thoughts/desire, arousal, frequency of sexual activity, lean body mass, chest-press power, and loaded stair-climb power were significantly related to increases in free testosterone concentrations; compared with placebo, changes were significantly greater in women assigned to the 25-mg group, but not in women in the lower-dose groups. Sexual activity increased by 2.7 encounters per week in the 25-mg group. The frequency of androgenic adverse events was low. Testosterone administration in hysterectomized women with or without oophorectomy for 24 weeks was associated with dose and concentration-dependent gains in several domains of sexual function, lean body mass, chest-press power, and loaded stair-climb power. Long-term trials are needed to weigh improvements in these outcomes against potential long-term adverse effects.

Relationship satisfaction predicts sexual activity following risk-reducing salpingo-oophorectomy

Changes in sexual function are a common outcome following risk-reducing salpingo-oophorectomy (RRSO), a prophylactic surgery for women at high risk of ovarian and other gynecologic cancers. Despite the known importance of sexuality in patients' quality of life and satisfaction with surgery, little is known about what predicts sexual activity following RRSO. The present study examined how mental and physical health variables predicted sexual activity before and after RRSO. We conducted a secondary analysis of quality of life measures collected in 85 women at high risk for ovarian cancer. Participants completed validated measures of mental, physical, and relationship health 1–2 weeks before surgery, and 2, 6 and 12 months following surgery. Across analyses, relationship satisfaction emerged as the most significant predictor of change in sexual activity: women with high relationship satisfaction were more likely to continue to have regular sexual activity following RRSO, even in the presence of vaginal menopausal symptoms. The effect of depression, anxiety and overall physical health on sexual activity was non-significant when controlling for relationship satisfaction. When counseling women about RRSO and its impact on sexual activity, clinicians should discuss the effect of the patient's relationship health on this outcome.

The Effects of the Great Recession on Teenagers' Risky Health Behaviors and Time Use

This paper uses individual-level data from both the 2003-2011 American Time Use Survey and Youth Risk Behavior Survey and state-level unemployment rates to examine the effects of the Great Recession on teenagers' activities. I present results by gender and gender by race/ethnicity. Over the period, I find changes in sexual activity for males associated with changes in time spent with parents; but results vary significantly by race. In addition, Hispanic males gained weight during the recession, due perhaps to a decrease in time spent playing sports. Hispanic females, on the other hand, made greater educational investments while spending less time working. All females significantly decreased TV viewing during the Great Recession. However, there were signs that female teenagers were stressed as they slept less and were more likely to smoke regularly.

Use of Aphrodisiacs amongst women in Kano, northern Nigeria

Background: An aphrodisiac is a substance that increases sexual desire. Many foods, drinks, and behaviors have had a reputation for making sex more attainable and/or pleasurable. Men and women alike have continued to use aphrodisiacs whether or not these drugs have any scientific basis of truly improving sexual satisfaction without regards to their composition. Objective: To look at the use of medications to enhance sexual performance among women attending gynaecology clinic in Aminu Kano Teaching Hospital, Kano Nigeria. Results: 500 clients were interviewed, 220 use some medications to enhance their sexual performance (44.0%). The mean age of the respondents was 27 years, SD 5.37, mean parity was 2.6 with a SD 2.43.There is a statistically significant relationship between age and parity (P=0.05). Women in monogamous relationship were found to use medication to enhance sexual satisfaction compared to those in polygamous relationship. The herbalist/traditional houses were the major source of these medications (40.96%) followed by peer influence (30.91%), while health workers contribute only 2.27%.Thirty percentof the users felt more vaginal wetness with the use of the medications, however 37% of users felt no change in sexual activity. The medications did not meet the expectations of 49% of the users. Conclusion: The major sources of such medications are the traditionalists who never disclose the constituents of such medications.

La propensione alla contraccezione in una ricerca sulle adolescenti molisane

After tracing the salient aspects of the changes in sexual activity and birth control practices in Italy among recent generations, this paper examines the dichotomies used to classify contraception methods, especially in light of the recently availability of hormone-based emergency contraception pills. Using the data collected from self-administered structured questionnaires completed by four hundred girls, ages fourteen to sixteen, in the Molise region of Italy, this paper comments on their choices and knowledge about different options to prevent pregnancy and the acceptance of emergency contraception as part of their contraceptive behaviour.

Sexual Activity after Total Hip Replacement in Korean Patients: How They Do, What They Want, and How to Improve

BackgroundConcerns of patients on sexual activity after total hip arthroplasty have not been well studied in Asian patients. This study aimed to determine the following: (1) what are the concerns of patients related to sexual activity after total hip arthroplasty? (2) what are the changes in sexual activity after total hip replacement in Korean patients?MethodsDetails of sexual activity and concerns were obtained using a questionnaire designed specifically for the study. The questionnaire was administered to 64 patients in a face-to-face interview at an outpatient clinic.ResultsPreoperatively, 53.1% of patients experienced difficulties, primarily due to hip pathology and limitations of motion. The median time to the resumption of sexual activity was 3 months postoperatively, and most patients had no increase in the frequency of sexual activity after the total hip replacement. In 39.1% of patients were seen having difficulties with leg positioning following total hip replacement, and they were likely to change coital positions. The most common concern regarding sexual activity of patients was the fear of dislocation. Furthermore, patients with a higher stress level had lower satisfaction rates. Most patients were unable to obtain information on sexual activity following the total hip arthroplasty, and they did not consult with a physician due to the private nature of the topic.ConclusionsDislocation was the most common concern of patients during sexual activity following a total hip arthroplasty, and a higher stress level was found to be associated with a lower satisfaction rate. Because most patients were unprepared to consult a physician, the provision of appropriate information before a consultation might be beneficial.

Vaginal Hysterectomy and Sacrospinous Colpopexy for Uterovaginal Prolapse : Anatomical and Functional Outcomes = استئصال الرحم بطريق المهبل و تثبيت المهبل للرباط العجزي الشوكي في حالات تدلي الرحم المهبلي : النتائج التشريحية و الوظيفية

Objective: The surgical management of pelvic organ prolapse requires a combination of techniques. This study evaluated the anatomical outcomes, functional outcomes and complications of vaginal hysterectomy and sacrospinous colpopexy in women with uterovaginal prolapse. Methods: We retrospectively evaluated 85 women who underwent vaginal hysterectomy and sacrospinous colpopexy over a period of 3 years. The primary outcome measures included anatomical outcome success rates (as assessed by pelvic organ prolapse quantification, POP-Q), pelvic floor function outcomes and complication rates. Results: At a mean follow-up duration of 35 months (range: 12-60), the overall objective success (for all compartments) was 81% (69/85), while the objective success rates for the anterior, posterior and apical compartments were 82% (70/85), 89% (76/85) and 92% (78/85). Respectively, there were no stage 3 or 4 recurrences at any site. Overactive bladder (OAB) symptoms improved significantly following the surgery, while new-onset stress urinary incontinence occurred in 5 patients. There was no significant change in sexual activity or dyspareunia. Surgical complications were minor. Conclusions: The combination of vaginal hysterectomy and sacrospinous colpopexy for the treatment of uterovaginal prolapse is reasonably effective in restoring pelvic anatomy and results in favourable pelvic function with an acceptable complication rate.

Satisfação sexual na demência

CONTEXTO: A demência pode resultar em comprometimento da intimidade e sexualidade de casais idosos. OBJETIVOS: Avaliar alterações na atividade sexual, bem como os fatores de satisfação e/ou insatisfação sexual de casais nos quais um dos parceiros possua demência. MÉTODO: Busca nas bases de dados ISI, PubMed/Medline e SciELO de artigos sobre sexualidade na demência, entre janeiro de 1990 e março de 2012, utilizando as palavras-chave: "demência", "satisfação sexual", "intimidade" e "sexualidade". RESULTADOS: Foram encontrados 12 artigos. A sobrecarga de cuidados e a alteração de papéis na relação conjugal foram consideradas as principais causas para o declínio da atividade sexual. A disfunção erétil em pacientes e cônjuges, a capacidade decisória para o consentimento da relação sexual por parte do paciente demenciado e os problemas referentes à idade e à saúde (física e emocional) do cônjuge e/ou paciente foram os fatores associados à insatisfação sexual. CONCLUSÃO: A intimidade e a atividade sexual dos casais em que um dos parceiros é portador de demência são influenciadas negativamente pela relação de cuidados decorrente da doença e pela sobrecarga dos cônjuges. Por outro lado, a atividade sexual pode ser positivamente substituída por demonstrações de carinho e empatia entre os cônjuges.

Sexual Activity–Related Outcomes After Human Papillomavirus Vaccination of 11- to 12-Year-Olds

Previous surveys on hypothesized sexual activity changes after human papillomavirus (HPV) vaccination may be subject to self-response biases. To date, no studies measured clinical markers of sexual activity after HPV vaccination. This study evaluated sexual activity-related clinical outcomes after adolescent vaccination. We conducted a retrospective cohort study utilizing longitudinal electronic data from a large managed care organization. Girls enrolled in the managed care organization, aged 11 through 12 years between July 2006 and December 2007, were classified by adolescent vaccine (HPV; tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis, adsorbed; quadrivalent meningococcal conjugate) receipt. Outcomes (pregnancy/sexually transmitted infection testing or diagnosis; contraceptive counseling) were assessed through December 31, 2010, providing up to 3 years of follow-up. Incidence rate ratios comparing vaccination categories were estimated with multivariate Poisson regression, adjusting for health care-seeking behavior and demographic characteristics. The cohort included 1398 girls (493 HPV vaccine-exposed; 905 HPV vaccine-unexposed). Risk of the composite outcome (any pregnancy/sexually transmitted infection testing or diagnosis or contraceptive counseling) was not significantly elevated in HPV vaccine-exposed girls relative to HPV vaccine-unexposed girls (adjusted incidence rate ratio: 1.29, 95% confidence interval [CI]: 0.92 to 1.80; incidence rate difference: 1.6/100 person-years; 95% CI: -0.03 to 3.24). Incidence rate difference for Chlamydia infection (0.06/100 person-years [95% CI: -0.30 to 0.18]) and pregnancy diagnoses (0.07/100 person-years [95% CI: -0.20 to 0.35]), indicating little clinically meaningful absolute risk differences. HPV vaccination in the recommended ages was not associated with increased sexual activity-related outcome rates.

Changes in sexual activity and risk behaviors among PLWHA initiating ART in rural district hospitals in Cameroon – Data from the STRATALL ANRS 12110/ESTHER trial

The continued scaling-up of antiretroviral therapy (ART) in Sub-Saharan Africa provides an opportunity to further study its impact on sexual behaviors among people living with HIV/AIDS (PLWHA). We explored time trend and correlates of sexual activity among PLWHA initiating ART in Cameroon and compared sexual risk behaviors between patients sexually active before and after initiating ART and those resuming sexual activity after ART initiation. Analyses were based on longitudinal data collected within the randomized trial (n = 459) conducted in nine rural district hospitals in Cameroon. Sexual activity was defined as reporting at least one sexual partner during the previous 3 months. Inconsistent condom use (ICU) was defined as reporting to have “never,” “sometimes,” or “nearly always” used condoms at least once with a partner(s) either HIV-negative or of unknown HIV status during the same period. Mc Nemar tests were used to assess time trend, while mixed-effect logistic regressions were conducted to analyze the effect of time since ART initiation on sexual activity. The proportion of sexually active patients significantly increased over time: from 31.8% at baseline to 40.2 and 47.1% after 6 and 12 months of ART, respectively (p=0.001), to 55.9% after 24 months (p=0.02). After adjustment for behavioral and psychosocial factors, time since ART initiation was independently associated with reporting sexual activity (AOR [95% CI] = 1.30 [1.17–1.46] per 6-month increase, p=0.001). ICU was more frequent among patients sexually active both before and after ART initiation than among those who resumed sexual activity after ART initiation (82 vs. 59%, p<0.001). To conclude, while ART initiation fosters resumption of sexual activity in patients who are inactive before starting treatment; unsafe sexual behaviors remain less frequent in this population than in patients who are already sexually active before starting ART. Risk reduction programs should be reinforced among PLWHA in the context of ART scaling-up.

2142 SEXUAL CHANGES AFTER POP REPAIR. IS HYSTERECTOMY A KEY ELEMENT ?

You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Pelvic Prolapse1 Apr 20122142 SEXUAL CHANGES AFTER POP REPAIR. IS HYSTERECTOMY A KEY ELEMENT ? Elisabetta Costantini, Massimo Lazzeri, Luigi Mearini, Emanuela Frumenzio, Vittorio Bini, and Alessandro Zucchi Elisabetta CostantiniElisabetta Costantini Perugia, Italy More articles by this author , Massimo LazzeriMassimo Lazzeri Perugia, Italy More articles by this author , Luigi MeariniLuigi Mearini Perugia, Italy More articles by this author , Emanuela FrumenzioEmanuela Frumenzio Perugia, Italy More articles by this author , Vittorio BiniVittorio Bini Perugia, Italy More articles by this author , and Alessandro ZucchiAlessandro Zucchi Perugia, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2313AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Incontinence and pelvic organ prolapse (POP) impact upon sexuality but reported data are controversial. In this study we want to evaluate changes in sexual activity after POP repair and the impact of uterus preservation. METHODS This is a prospective longitudinal study including 107 patients with severe prolapse, mean age 58 years (r.27-76), who underwent an integral pelvic floor reconstruction with or without hysterectomy (61 hysterectomy and colposacropexy (HY+CSP) and 46 uterus-sparing surgery (HSP)) between January 2006 and Feb 2011:. Inclusion criteria: patients who consent to respond to the FSFI questionnaire, before and after surgery. Pre-operative evaluation included: detailed case history, complete urogynaecological examination, urodynamic assessment, UDI-6 and IIQ-7 questionnaires. At 1 year follow-up patients repeated the FSFI questionnaire and underwent a clinical check-up. Primary outcome is the change of sexual activity after surgery and secondary outcome was to compare 1 year-post-operative sexual activity in patients who underwent hysterectomy or uterus sparing surgery. The Mann-Whitney test and Wilcoxon test for unpaired and paired data respectively, were used to compare questionnaire scores. The level of statistical significance was set at p < 0.05. Data analysis was carried out with Predictive Analytic Software (PASW) release 17.0.2, SPSS Inc., Chicago, USA, 2009. RESULTS 27/107 pts. who were not active before and after surgery (7 HSP; 20 HY+CSP) and 12 pts. who incompletely filled the questionnaire were excluded from the evaluation. Finally 32 pts in the HSP group, mean age 53 years (r. 27-72) and 36 pts. in the HY+CSP group , mean age 58 (r. 40-71) were evaluated. The median pre-operative FSFI scores were comparable in the two groups (p=ns). 21 pts. who were sexually inactive before surgery became active (13 HY+CSP and 8 HSP) and only 2 pts. (1 for each group) worsened and became not active after surgery. Overall FSFI scores showed a statistical improvement after surgery (p<0.05). Furthermore the median post-operative scores of each domains showed a significant improvement in uterus-sparing group comparing with the hysterectomy group: desire (median 3.9 (range 1.2-6) vs. 3 (range 1.2-6); p<0.05), arousal (median 4 (range 0-6) vs. 3.6 (range 0-5.7); p<0.05) and orgasm (median 4.4 (range 0-6) vs. 4 range (1.2-5-2); p<0.05). CONCLUSIONS Our data demonstrated POP repair improves sexual activity. Although the role of hysterectomy on sexual well-being is still not clearly defined, our results showed uterus sparing surgery was associated with improved sexual activity. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e865 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Elisabetta Costantini Perugia, Italy More articles by this author Massimo Lazzeri Perugia, Italy More articles by this author Luigi Mearini Perugia, Italy More articles by this author Emanuela Frumenzio Perugia, Italy More articles by this author Vittorio Bini Perugia, Italy More articles by this author Alessandro Zucchi Perugia, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Changes in Sexual Activity After Menopause Unrelated To Gynecologic Conditions

Changes in Sexual Activity After Menopause Unrelated To Gynecologic Conditions

P-446 - Sexual satisfaction in mild and moderate alzheimer's disease patients and their spouses

Introduction Alzheimer's Disease affects the total quality of the marital relationship and the couple's sexual intimacy. Objectives To study changes in sexual activity and satisfaction between AD patients and their spouses. Methods Couples whose spouses were diagnosed with mild and moderate AD (n = 36) were included. Instruments:MMSE, CDR, APID, CORNELL, Questionnaire on Sexual Experience and Satisfaction, ZARIT. Results Presence of sexual activity was reported by patients (63.8%) and spouses (55.5%); 34.7% of the male patients and 34.0% of the female patients reported sexual dissatisfaction. Interruption of the sexual activity was reported by 44.4% of the spouses and by 36.8% of the patients. There was no significant difference between CDR1 and CDR2 patients’ sexual satisfaction (p = 0.47). Spouses were sexually dissatisfied with significant statistical differences between severity of disease groups (p = 0.049). Spouses presented a moderate rate of burden of care (48.77 ± 20.13). Feelings of burden related to sexual dissatisfaction were reported by 37.5% of the spouses. Awareness of disease was impaired in 72.2% of AD patients. There was no significant relationship between sexual dissatisfaction and awareness of disease. Conclusion AD has an impact in couples’ sexual activity and satisfaction. Spouses of mild patients AD are more sexual dissatisfied than the moderate group.