Sexual Activity In Patients Research Articles

Men in Marital Relationships with Women Undergoing Breast Cancer Treatment: A Qualitative Study

Objective Sexual health is an essential part of overall health and well-being. Breast cancer affects the marital relationships and sexual activity of patients and their sexual partners. The present qualitative study was conducted to discover the experiences of women undergoing breast cancer treatment and their husbands regarding marital relationships after breast cancer. Methods Semi-structured interviews were conducted with the 37 women undergoing breast cancer, their husbands, and healthcare providers. Recorded interviews were transcribed and analyzed using a qualitative content analysis approach. Results Four categories of ‘Utilization of couple-based approach,’ ‘Consequences of relationship breakdown,’ and ‘A need for the spouse’s support and compassion’ were revealed. Conclusion The present study showed that the husbands of women undergoing breast cancer treatment played a dual role in marital relationships. It seems that using couple-based approaches, such as mental and sexual health counseling, should be considered by healthcare providers.

Fertility and sexual activity in patients with Triple A syndrome.

Triple A syndrome, caused by autosomal recessively inherited mutations in the AAAS gene is characterized by alacrima, achalasia, adrenal insufficiency, and neurological impairment. To the best of our knowledge, no patients of both sexes have been reported to have offspring. Our aim was to assess the causes of infertility in male patients with this multisystemic syndrome, and to present a female patient that spontaneously conceived a child. Cross-sectional study. Six males aged 19-48 years were included. Gonadotropins, testosterone, DHEAS, androstenedione, inhibin B, anti-Mullerian hormone measurements and testicular ultrasound were performed. All six male patients had impaired general health and neurological symptoms including erectile and ejaculatory dysfunction. None of them had an offspring. The only demonstrated cause of infertility in our male patients was erectile and ejaculatory dysfunction which precludes sexual intercourse. Our patients had normal libido but were sexually abstinent. Except for low adrenal androgen levels, the concentrations of all measured hormones as well as testicular ultrasound were normal which may indicate the possibility of spermatogenesis in male patients with triple A syndrome. Little is known about fertility in female patients, but based on our observations spontaneous pregnancies seem to be possible. Our results contribute to still scarce knowledge on fertility in patients with Triple A syndrome and as well represents a foundation for further research on causes of infertility and possible treatment options.

(226) Wearable Devices for Monitoring Sexual Encounter Physiology in Patients with Psychogenic Erectile Dysfunction

Abstract Introduction Understanding the physiological changes during sexual arousal and function in males with psychogenic erectile dysfunction remains an area of limited comprehension, despite a well-established understanding of erection physiology. To bridge this gap, we conducted a prospective study employing both qualitative and quantitative methods, to investigate the utility of wearable devices in measuring and identifying the physiological changes among males diagnosed with psychogenic sexual dysfunction. Objective This study aims to leverage wearable device technology to precisely measure and analyze physiological parameters, including heart rate, during sexual encounters in individuals diagnosed with psychogenic erectile dysfunction. Methods Individuals diagnosed with psychogenic erectile dysfunction were asked to wear a FitBit Versa 3 for a period of six weeks. Encrypted, de-identified data from the Fitbit was sent via the Fitbit app on subject’s smartphones to a single member of the research team. Subjects were asked to log the number, type (penetrative/oral/erogenous touch/masturbation), and timing of sexual encounters. Subjects also logged whether orgasm was achieved, and their satisfaction with the encounter. Results Over the course of the study, data from twenty unique sexual encounters were analyzed. Patients’ heart rate during both masturbation and sexual intercourse were recorded and normalized to their resting heart rate. During both sexual intercourse and masturbation, patterns of heart rate variability emerged, with an excitement phase (initial rise in heart rate), plateau phase, orgasm (peak heart rate), and resolution phase (decrease back to baseline heart rate), in line with our previous findings in individuals without sexual dysfunction. The data also indicate that these physiologic responses are similar regardless of if the patient is engaging in intercourse with a partner, or engaging in masturbation via self-stimulation. Conclusions We have previously shown that wearable device technology can be used to delineate patterns of heart rate variability during sexual encounters in healthy patients without sexual dysfunction. Data from our current study further highlights the feasibility of wearable device technology for conveniently and accurately measuring physiological parameters during sexual activity in patients with psychogenic erectile dysfunction. Furthermore, our data is the first to show that heart rate variability is consistent between masturbation and sexual activity with a partner in patients diagnosed with psychogenic erectile dysfunction. These findings contribute to the limited existing literature on objective physiologic measurements during sexual activity and emphasize the potential of wearable technology in monitoring physiological changes in sexual encounters. This study has further implications for both research and clinical settings for psychogenic erectile dysfunction. In research, Fitbits and other wearable devices may provide a convenient and non-invasive method for studying sexual satisfaction and further characterizing psychogenic erectile dysfunction, while in a clinical setting these devices may help healthcare professionals Disclosure No.

The effect of duloxetine on female sexual functions in the treatment of stress incontinence.

Stress urinary incontinence (SUI) is defined as urinary incontinence that occurs with coughing, sneezing, and physical exercise. It is frequently observed in women after middle age and has a negative impact on their sexual function. Duloxetine as one of the Serotonin-noradrenaline reuptake inhibitors (SNRIs) is commonly used in the non-surgical treatment of SUI. The aim of our study is to investigate the effect of duloxetine, which is used in the treatment of SUI, on sexual functions in female patients. The study included 40 sexually active patients who received duloxetine 40mg twice a day for the treatment of SUI. All patients had female sexual function index (FSFI), Beck's depression inventory (BDI), and incontinence quality of life score (I-QOL) applied before and 2months after starting duloxetine treatment. FSFI total score significantly increased from 19.9 to 25.7 (p < 0.001). In addition, significant improvement was observed in all sub-parameters of FSFI, including arousal, lubrication, orgasm, satisfaction, and pain/discomfort (p < 0.001, for each FSFI subtotal score). BDI significantly decreased from 4.5 to 1.5 (p < 0.001). I-QOL score significantly increased from 57.6 to 92.7 after the duloxetine treatment. Although SNRIs carry a high risk of sexual dysfunction, duloxetine may have an indirect positive effect on female sexual activity, both through its stress incontinence treatment and its antidepressant effect. In our study, Duloxetine, one of the treatment options for stress urinary incontinence and an SNRI, has a positive effect on stress urinary incontinence, mental health, and sexual activity in patients with SUI.

(338) Factors Associated with Sexual Inactivity in Patients Diagnosed with Benign Prostatic Hyperplasia

Abstract Introduction Benign prostatic hyperplasia is a common pathology in patients over 40 years of age, with an important role in male sexual health due to its association with sexual dysfunction, with an elevated proportion of patients with sexual inactivity. Objective The objective of this study is to evaluate the factors associated with sexual activity in patients over 40 years of age with a diagnosis of benign prostatic hyperplasia Methods A retrospective cross-sectional study of 331 patients with a confirmed diagnosis of benign prostatic hyperplasia between January 2021 and November 2021. Both sociodemographic and clinical data were evaluated to associate them to the IIEF questionnaire15 Results Of the 331 patients diagnosed with BPH, 68.5% had erectile dysfunction: severe ED 119 (36%) moderate ED 14.2%, Mild/moderate ED 10.6% andMild in 7.9%. Of the 226 patients with ED, only 50 patients (22.1%) treated their erectile dysfunction. In addition, 33.2% had low sexual desire and the overall prevalence of sexual inactivity in more than 1 month was 43%. Sexual inactivity was classified: in 1-3 months: 29, 5%, 3-6 months 15.4%, 12% more than 6 months and 42.9% more than 12 months. The independent predictors related variables of sexual inactivity were: age over 60 years (PR 1.5), not having a sexual partner (PR 3.2), IEEF-15 (Erectile dysfunction RP 9.2) dissatisfaction with the partner (PR 4.9), low sexual desire (PR 2.9), and lack of confidence (PR 2.5), Severity of IPSS (RP 1.7) and urethral catheter carrier (RP 2.4) Conclusions Sexual inactivity is common in patients diagnosed with BPH and is associated with age and sexual desire. Independently lack of confidence, erectile dysfunction, not having a sexual partner or dissatisfaction with the partner. Of the specific variables related to prostatic hyperplasia, the only ones related were being a carrier of urethral catheter and IPSS severity, the latter associated with decreased sexual frequency and erectile dysfunction. Cardiovascular risk factors had no independent association unlike what was found in other studies. Disclosure No

The effect of pelvic organ prolapse and various options for its correction on female sexual function: A review

The sexual activity of patients before and after the treatment of pelvic organ prolapse (POP) largely determines their quality of life and satisfaction with the intervention. This review analyzes current data on the nature of changes in sexual function in various pelvic organ prolapse correction methods. Particular attention is paid to a comparative assessment of the effect of available surgical techniques with abdominal and vaginal access on the risk of de novo dyspareunia. Based on the results of clinical studies and systematic reviews, the most optimal ways of correcting POP have been established; tools for assessing their effectiveness in routine clinical practice have been proposed; the importance of an interdisciplinary approach to the treatment of POP with the involvement of medical psychologists has been noted due to the significant role of emotional and behavioral factors in sexual dysfunction.

The Application of Hyaluronic Acid Injections in Functional and Aesthetic Andrology: A Narrative Review

Hyaluronic acid (HA) is a glycosaminoglycan widely utilised in different fields of medicine. We aimed to provide a comprehensive overview of the scientific evidence on the use of HA in andrology. A review of the literature to identify pertinent studies concerning the use of HA in andrology was carried out on the Medline, EMBASE, and the Cochrane databases, with no time restriction up to December 2022. Penile girth enlargement (PGE) using HA proved to be safe and effective in enhancing the diameter of the penis, with durable and satisfactory outcomes in long-term follow-up. Injection of HA in the glans seems to represent an alternative treatment option for those patients with premature ejaculation (PE) who fail to respond to conventional medications. HA intra-plaque injections represent a valid option which may contribute to restore sexual activity in patients with Peyronie's disease (PD). The adoption of HA filler injections should always be tailored to the patient's peculiar anatomy and underlying condition. More robust evidence is required to achieve a uniformed consensus regarding the use of HA in andrology, and further efforts should continue to improve the current injection techniques and HA products.

Sexual function and sexual activity in young total hip arthroplasty Chinese patients: A retrospective cohort study.

As an essential component of quality of life, there is limited evidence of sexual function (SF), especially for young patients, before and after total hip arthroplasty (THA). This study aims to enhance the understanding of SF status and assess patient perspectives before and after THA. A total of 109 patients who received THA were enrolled into our retrospective cohort study. To assess the SF status before and after THA, patients were required to fill out a standardized SF questionnaire [female sexual function index (FSFI) or brief sexual function inventory (BSFI) for males] and a specifically designated questionnaire regarding perspectives toward sexual activity and attitudes to sexual-related information. Total average scores of both FSFI and BSFI were higher post-THA. For female patients, the FSFI scores were significantly higher in the domain of desire, orgasm, and satisfaction (p < 0.05). For male patients, the BSFI scores were also improved in the sex drive and satisfaction domain post-operation (p < 0.05). A large proportion of the patients (64.22%) reported difficulty in sexual activity preoperatively, primarily due to restricted motion (82.86%) and hip pain (74.29%). After a successful procedure, there was a reduction in difficulty in patients' sexual activity post-THA (39.45%), mainly attributed to less pain (72.09%) and greater mobility (79.07%). In addition, subgroup analysis results indicated that gender and severity of hip stiffness and pain were crucial factors that could affect the patient's SF status. Furthermore, the majority of patients reported that they desired information concerning sexual activity, but only 12.84% of patients were informed well. Patients' preferred channels to acquire sexual-related information was a booklet (65.59%, n = 61), followed by informing a surgeon and a nurse. The most concerning questions regarding the sexual activity of patients were the time to recovery (90.32%) and safe postures (76.34%). The majority of men and women who underwent THA reported their SF status return to baseline or have improved, mainly attributable to less pain and greater mobility. Age and severity of hip pain/stiffness were the factors that could affect patients' SF status. Sexual education for young THA patients is needed due to the lack of related information during hospitalization.

Quality of Life Following Pelvic Organ Prolapse Treatments in Women: A Systematic Review and Meta-Analysis.

Introduction: Quality of life (QoL) improvement is one of the main outcomes in the management of pelvic organ prolapse as a chronic illness in women. This systematic review aimed to investigate the impact of surgical or pessary treatment for pelvic organ prolapse (POP) on quality of life. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was applied. Electronic databases, including PubMed, Scopus, and Web of Science, were searched for original articles that evaluated the QoL before and after surgical interventions or pessary in pelvic organ prolapse from 1 January 2012 until 30 June 2022 with a combination of proper keywords. Included studies were categorized based on interventions, and they were tabulated to summarize the results. Results: Overall, 587 citations were retrieved. Of these, 76 articles were found eligible for final review. Overall, three categories of intervention were identified: vaginal surgeries (47 studies), abdominal surgeries (18 studies), and pessary intervention (11 studies). Almost all interventions were associated with improved quality of life. The results of the meta-analysis showed a significant association between the employment of surgical approach techniques (including vaginal and abdominal surgeries) and the quality of life (Pelvic Floor Distress Inventory (PFDI) (MD: −48.08, 95% CI: −62.34 to −33.77, p-value < 0.01), Pelvic Floor Impact Questionnaire (PFIQ) (MD: −33.41, 95% CI: −43.48 to −23.34, p < 0.01)) and sexual activity of patients with pelvic organ prolapse (Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ) (MD: 4.84, 95% CI: 1.75 to 7.92, p < 0.01)). Furthermore, narrative synthesis for studies investigating the effect of the pessary approach showed a positive association between the use of this instrument and improvement in the quality of life and sexual activity. Conclusions: The results of our study revealed a significant improvement in the women’s quality of life following abdominal and vaginal reconstructive surgery. The use of pessary was also associated with increased patient quality of life.

How do cardiologists assess their patients' sexual activity?

Patients with coronary heart disease and their families often face numerous changes in their lives. Recommendations on sexual activity (SA) should be included in the management of these patients. The objective of this study was to evaluate the degree of knowledge and professional attitude regarding the patient's SA. A descriptive and analytical cross-sectional study was carried out. The data were obtained from a structured, virtual and anonymous survey that was carried out among cardiologists. Three hundred forty-five surveys were analyzed. In total, 63.8% considered sexual dysfunction as a cardiovascular risk marker. Likewise, 68.1% considered it relevant or very relevant to ask patients about SA. Regarding counseling, it is believed that it should be initiated primarily by the cardiologist. A more active attitude regarding the re-initiation of SA after a cardiovascular event, a greater interest in SA training, more testosterone orders and more indications of phosphodiesterase inhibitors were observed in professionals older than 60 years and male compared to younger or female physicians, respectively. This study showed that the degree of knowledge of the patients about the aspects related to SA was poor. Given the relevance of the topic, we consider it important to strengthen medical education in all areas.

Sexual activity after short-stem total hip arthroplasty. Does stem size matter?

BackgroundSexual activity is an important component of quality of life. To date, no studies have examined the impact of stem design on return to sexual activity (RTS) and quality of sex life after total hip arthroplasty (THA).MethodsA questionnaire was designed to assess preoperative and postoperative sexual habits, joint awareness and physical activity in working-age patients undergoing short-stem (n = 176) or straight-stem (n = 97) THA.ResultsNo differences were noted in time until RTS based on the stem design (short stems vs. straight stems; 6 [IQR: 4–10] vs. 6 [4–10] weeks; p = 0.996). Multivariate analysis revealed that higher patient BMI (p = 0.04), female gender (p < 0.001) and lower FJS-12 (p = 0.006) were significantly associated with delayed RTS. Improved hip mobility and reduced pain mainly contribute to improved quality of sexual activity postoperatively.ConclusionThis study, hence, indicates that stem design has no impact on time until resumption of sexual activity in patients < 65 years. Female obese individuals who are aware of their artificial joint in daily life are at increased risk of delayed RTS after surgery.Level of evidenceLevel III, retrospective cohort study.

Évaluation de la qualité de vie sexuelle après une arthroplastie totale bilatérale de la hanche

BackgroundPatients experience limitation of hip joint movement due to coxarthrosis, such limitation may affect the quality of sexual activity in patients. We aimed at investigating the postoperative quality of sexual life and evaluating the clinical satisfaction of patients who underwent bilateral total hip arthroplasty. HypothesisPostoperative sexual life quality improvement in patients undergoing bilateral total hip arthroplasty increases clinical satisfaction. MethodsThe study included patients who underwent staged bilateral total hip arthroplasty surgery between June 2016 and January 2019. Each patient was evaluated using the sexual quality of life-female (SQOL-F) or Sexual quality of life-male (SQOL-M) questionnaire containing similar questions for both genders regarding sexual satisfaction. ResultsAmong all the individuals, 32 were sexually active (13 females, 19 males), and seven were not sexually active (6 females, 1 male) before the surgery. Among the 29 individuals (18 females, 11 males) who thought that their sexual life was negatively affected even before the surgery, 10 (1 female, 9 males) were found not to be negatively affected. Moreover, the sexual life of 18 females was negatively affected 27.93±14.5months (range: 12–43) before hip arthroplasty and 11 males was negatively affected 19.5±11.0months (range: 8–31) before the surgery as well. Twenty (10 females, 10 males) individuals stated an improvement in their sexual life, 13 (6 females, 7 males) individuals stated no change. Unfortunately, 6 (3 females, 3 males) individuals stated a degradation of their sexual activity after hip arthroplasty. Patients gained more than 60 degrees of hip range of motion and experienced significant reduction in pain after hip joint movements after surgery. DiscussionIn our study, we evaluated sexual limitations before and after total hip arthroplasty surgery and postoperative sexual quality of life. Due to the increased range of motion of patients after surgery, the proportion of sexually active individuals increased and the sexual quality of life reached a satisfactory level. Level of evidenceIII; retrospective cohort study.

Evaluation of sexual quality of life after bilateral total hip arthroplasty surgery

BackgroundPatients experience limitation of hip joint movement due to coxarthrosis, such limitation may affect the quality of sexual activity in patients. We aimed at investigating the postoperative quality of sexual life and evaluating the clinical satisfaction of patients who underwent bilateral total hip arthroplasty. HypothesisPostoperative sexual life quality improvement in patients undergoing bilateral total hip arthroplasty increases clinical satisfaction. MethodsThe study included patients who underwent staged bilateral total hip arthroplasty surgery between June 2016 and January 2019. Each patient was evaluated using the sexual quality of life-female (SQOL-F) or Sexual quality of life-male (SQOL-M) questionnaire containing similar questions for both genders regarding sexual satisfaction. ResultsAmong all the individuals, 32 were sexually active (13 females, 19 males), and seven were not sexually active (6 females, 1 male) before the surgery. Among the 29 individuals (18 females, 11 males) who thought that their sexual life was negatively affected even before the surgery, 10 (1 female, 9 males) were found not to be negatively affected. Moreover, the sexual life of 18 females was negatively affected 27.93±14.5 months (range, 12–43) before hip arthroplasty and 11 males was negatively affected 19.5±11.0 months (range, 8–31) before the surgery as well. Twenty (10 females, 10 males) individuals stated an improvement in their sexual life, 13 (6 females, 7 males) individuals stated no change. Unfortunately, 6 (3 females, 3 males) individuals stated a degradation of their sexual activity after hip arthroplasty. Patients gained more than 60 degrees of hip range of motion and experienced significant reduction in pain after hip joint movements after surgery. DiscussionsIn our study, we evaluated sexual limitations before and after total hip arthroplasty surgery and postoperative sexual quality of life. Due to the increased range of motion of patients after surgery, the proportion of sexually active individuals increased and the sexual quality of life reached a satisfactory level. Level of EvidenceIII; retrospective cohort study.

Sexual Disorder in Men and Its Therapy with the Use of Phosphodiesterase Inhibitor Type 5 Eroton (Sildenafil Citrate)

The study investigated the clinical efficacy of the drug Eroton in the treatment of sexual disorders, shows the effect of the study drug on the state of the sexual functions of patients; the degree of patient satisfaction with treatment was assessed; studied the tolerability and possible side effects of the study drug in men in a group of 110 patients. After a course of one month of treatment, all the integrative indicators of ICEF significantly increased in patients. The indicator «erectile function» increased from 12.54±0.87 to 25.12±1.32 (p&lt;0,01), «satisfaction with intercourse» from 7.97±0.40 to 14.63±0.84 (p&lt;0,01), «orgasm» – from 4.52±0.18 to 9.02±0.32 (p&lt;0.01), «general satisfaction» – from 4.03±0.22 up to 8.27±0.46 (p&lt;0,01).&#x0D; The clinical efficacy of the treatment of erectile dysfunction showed «excellent» and «good» results in 92.7 % of patients. When studying the effect of the drug Eroton on the hormonal background in patients, there is a certain tendency to an increase in the content of testosterone in the serum of peripheral blood. This, from our point of view, is due to an improvement in the quality of sex life and an increase in its frequency. The indicator of «sex drive» of the ICEF questionnaire increased by 63.2 %. Improvement of the data on the ejaculatory component of sexual intercourse, which was assessed by the indicator of premature ejaculation in 61 men with this pathology, the clinical effectiveness of the course of treatment was 88.5 %. The time of the refractory period of sexual intercourse in patients decreased, which made it possible to carry out repeated sexual intercourse during the day in 34.5 % at the age of 22 to 34 years, and in 11.8 % of patients aged 22–29 years, 3 sexual intercourses were performed during the day. The frequency of sexual activity in patients with ED increased 2.1–2.4 times, and the quality of life index improved 3.8 times.&#x0D; Patients well tolerated treatment with Eroton. The drug Eroton can be considered as a first-line drug in the treatment of erectile dysfunction.

The Effect of Renal Transplant on Hypogonadism and Erectile Dysfunction due to End-stage Renal Disease.

Hypogonadism is common in patients with chronic kidney disease especially for end-stage renal disease (ESRD), which is referred to as uremic hypogonadism. Men with ESRD are prone to reproductive and sexual disorders such as sexual desire loss, abnormalities in orgasm, sexual dysfunction, and erectile dysfunction (ED). The mechanism of this complex disorder is not well known. Considering the above, we decided to study the effect of renal transplantation on hypogonadism and sexual activity in patients with ESRD. This study was performed on 45 patients with ESRD undergoing renal transplantation. Patients were included into two groups of live donor (24) and cadaveric (21), according to the type of kidney donors. The International Index of Erectile Function-5 (IIEF5) questionnaire was filled out for evaluation of erectile and sexual status. Laboratory parameters were assessed before the renal transplant in a single and valid laboratory including blood urea nitrogen, creatinine, thyroid function tests, luteinizing hormone, follicle-stimulating hormone, testosterone, and prolactin. We refilled the ED questionnaire and checked the laboratory tests again three and six months after transplantation. The mean age of the patients was 51.7 ± 8.0. The mean blood testosterone level in the live group was 347.1 ± 64.9 before transplantation, which reached 413.1 ± 25.9 in six months after transplantation. The same variable for the cadaveric group was 306 ± 56.2 and 355.3 ± 56.9, respectively. The IIEF5 scores before and six months after transplantation were 17.2 ± 4.5 and 24.6 ± 3.3 respectively for the live group and 10.8 ± 2.4 and 13.9% ± 4.1% for the cadaveric one, all of which were statistically significant. Renal transplantation significantly improves the condition of hypogonadism and ED in patients with ESRD. This improvement is not related to the type of donation.

Longitudinal evaluation of the frequency of sexual intercourse and sexual activity in patients after nerve-sparing robot-assisted laparoscopic radical prostatectomy.

To evaluate the frequency of sexual intercourse and sexual activity of patients after nerve-sparing (NS) robot-assisted laparoscopic radical prostatectomy (RARP). We prospectively obtained 2-years longitudinal Expanded Prostate Cancer Index Composite (EPIC) and Sexual Health Inventory for Men (SHIM) score data from 99 patients. We classified the frequency of sexual intercourse and sexual activity as 'none', 'less than once a week', 'about once a week', 'several times a week', and 'daily'. The percentages of patients who took part in sexual activity before and at 3, 6, 9, 12, 18, and 24months after NS RARP were 55.6%, 27.9%, 38.8%, 42.5%, 44.4%, 41.7%, and 42.1%, respectively. The percentages of patients who took part in sexual intercourse before and at 3, 6, 9, and 12, 18, and 24months after NS RARP were 41.4%, 9.0%, 13.3%, 16.3%, 16.7%, 22.2%, and 23.7%, respectively. Preoperative sexual status was classified into two groups: those who had sexual intercourse or those who only had sexual activity except sexual intercourse. Sexual function (SF) was investigated longitudinally using the EPIC and SHIM data between the two groups. The SHIM data showed an improvement in SF in the sexual intercourse group, but did not do so in the sexual activity except sexual intercourse group. On the other hand, SF in the EPIC data might reflect the postoperative improvement of SF in the sexual activity except sexual intercourse group. There was a large discrepancy between the percentages of patients taking part in sexual intercourse and sexual activity; therefore, surveys of postoperative SF are recommended to include not only sexual intercourse but also sexual activity.

Sexual activity in patients after proctocolectomy with ileal pouch-anal anastomosis.

&lt;b&gt;Introduction:&lt;/b&gt; Proctocolectomy with ileal pouch-anal anastomosis is the gold standard in the surgical treatment of patients with ulcerative colitis, familial adenomatous polyposis and other colorectal diseases requiring colectomy. The treatment consists in removing the large intestine and creating an intestinal reservoir from the last ileum loop and then anastomosing the intestinal reservoir with the anal canal. Like any surgical procedure, RPC-IPAA also carries the risk of complications, both early and late. Late postoperative complications include sexual dysfunction. &lt;br&gt;&lt;b&gt;Aim:&lt;/b&gt; The main goal of the following work is to assess the quality of life and sexual activity in patients having undergone the RPC-IPAA procedure at the General and Colorectal Surgery Clinic. &lt;br&gt;&lt;b&gt;Material and methods:&lt;/b&gt; The study group consisted of patients aged 19-79 who had been subjected to RPC-IPAA procedures at the General and Colorectal Surgery Clinic in years 2010-2019. The study was conducted on the basis of a survey consisting of 50 questions about the social and mental condition, medical history and previous treatment as well as the quality of sexual life before and after surgery. The scale used for the assessment of the quality of sex life consisted of 5 grades: very low, low, medium, high, very high. Thirty subjects (21 men and 9 women) took part in the survey. Ulcerative colitis (86.6%) was the most common reason for qualification for restorative proctectomy among the examined patients; less common reasons included familial adenomatous polyposis (13.3%) and synchronous colorectal cancer (3.3%). A vast majority of the surgeries had been performed after 10 years' duration of ulcerative colitis, and the intestinal reservoir had been functioning for over a year at the time of the examination. In addition, the effect of taking steroids and the impact of early postoperative complications on the quality of sex life of patients was assessed. &lt;br&gt;&lt;b&gt;Results:&lt;/b&gt; High or very high sexual activity before surgery was reported by 46% of patients whereas low or very low quality was reported by 13%. The rest of the responders assessed their pre-operative sexual activity as average. After surgery, 23% of patients rated their sexual activity as high or very high while 36.6% of patients rated it as low or very low (P = 0.07). It was also noted that taking corticosteroids before surgery decreased the quality of sex life after surgery (P = 0.07 for activity, P = 0.04 for quality). None of the women surveyed used artificial moisturizing of intimate places during sex. Only 1 person stated that they started using artificial moisturization of intimate places after the procedure (P = 0.5). None of the men surveyed had used pharmacological agents to help them obtain an erection before surgery while as many as 33% of responders reported the need for their use after surgery (P = 0.008). Other postoperative sexual dysfunctions were also registered, such as dyspareunia (13.3%), sensory disorder within the intimate region, fecal incontinence, and urinary incontinence. &lt;br&gt;&lt;b&gt;Conclusions:&lt;/b&gt; To sum up, sexual activity and quality of sexual life deteriorated after RPC-IPAA in our patients.

Pharmacological treatment and inappropriate prescriptions for patients with erectile dysfunction.

Background Erectile dysfunction is associated with old age, some morbidities and the use of certain medications. Objective To identify the treatments and drugs related to worsening sexual activity in patients with erectile dysfunction. Setting Patients diagnosed with erectile dysfunction during 2018. Methods This cross-sectional study of a population database identified all drug prescriptions of patients with erectile dysfunction during 2018. Main outcome measure The identification of other comorbidities and potentially inappropriate drugs that could worsen erectile dysfunction. Results A total of 2999 patients with erectile dysfunction (mean age 59.6 ± 12.1years) were identified. A total of 88.2% received pharmacological treatment for erectile dysfunction, mainly tadalafil (70.5%). A total of 47.6% of all patients received at least one medication associated with worsening erectile dysfunction, especially hydrochlorothiazide (17.0%), metoprolol (7.9%) and sertraline (6.7%). Residing in Cali (OR 1.86; 95% CI 1.52-22.27) or Bucaramanga (OR 2.23; 95% CI 1.39-33.58), having 3 or more chronic comorbidities (OR 1.52; 95% CI 1.04-2.24) and presenting psychiatric (OR 5.5; 95% CI 3.70-8.17), cardiovascular (OR 3.48; 95% CI 2.79-4.33), genitourinary (OR 1.31; 95% CI 1.05-1.64) pathologies or chronic kidney failure (OR 1.84; 95% CI 1.18-2.21) elevated the probability of receiving these prescriptions. Conclusions The pharmacological treatment of erectile dysfunction was in accordance with the recommendations of clinical practice guidelines, but the high proportion of potentially inappropriate prescriptions makes it necessary to promote educational and pharmacovigilance strategies that improve the prescription habits of physicians involved in caring for this group of patients.

Limitations of sexual activity in patients with chronic heart failure

Abstract Background Limitation of sexual activity may potentially have a great impact in the quality of life of patients with chronic heart failure (HF), although the burden of sexual limitation and its clinical drivers are not completely understood. We aimed to characterize the impact of sexual limitation and how it relates to different measures of HF severity, in patients with HF. Methods We prospectively selected a cohort of patients followed in our ambulatory HF Clinics, with HF and currently or previously documented left ventricular ejection fraction (LVEF) ≤40%, aged between 18 and 80 years, with NYHA class I-IV. Clinical, laboratorial, imaging and ergometric data was collected. A questionnaire characterizing sexual activity of the patient was filled by her/himself before consultation with the physician, while alone in a private room. Results A total of 65 patients were selected, 75% of which were male, with mean age 61±11 years, 32% were in NYHA I or II, and 21% had a resynchronization system. Mean BNP was 520±850 pg/mL, LVEF was 39±12% and peak oxygen consumption (pVO2) was 17.2±5.3 mL/min/m2. Limitations of sexual activity were reported in 40 (62%) patients, including erectile dysfunction (25%), fatigue (11%), reduction of libidum (8%), fear of HF symptoms during sexual activity (5%), absence of sexual partner (5%), and other reasons (8%). Of these 40 patients, 22 (55%) reported severe or very severe sexual limitation. Only 2 (3%) patients actively searched for clinical aid. Patients with sexual limitations were older (63±12 vs 56±11 years), were in higher NYHA classes (One-Way ANNOVA), had higher levels of BNP (775±1051 vs 181±212 pg/mL) and lower glomerular filtration rates (66±19 vs 86±23 mL/min) (all p&amp;lt;0.05). Other major variables such as ischemic etiology, diabetes, resynchronization therapy, LVEF and pVO2 were not associated with the presence or severity of sexual limitations, although there was a numerical trend for lower pVO2 (16.5±5.8 vs 19.0±4.0 mL/l/min/m2, p=0.20). NYHA class ≥II (β 6.5, 95% CI 0.4–10.5) and BNP levels (β 1.03, 95% CI 1.01–1.06) were independent predictors of sexual dysfunction. Conclusions Sexual limitation was highly prevalent among patients with HF, was often severe and the most frequent reason was erectile dysfunction. Simple and highly accessible parameters, such as age, NYHA class, BNP levels and renal function, are related to the presence of sexual limitation. More attention should be payed to sexual limitation in patients with HF considering the high burden and the large room for improvement. Funding Acknowledgement Type of funding source: None

Perceived influence of health status on sexual activity in patients with psoriatic arthritis

Objective: To examine the prevalence of self-reported problems with sexual activity among psoriatic arthritis (PsA) patients, and to explore potential associations of such problems with various demographic, musculoskeletal, and dermatological disease variables. Method: Consecutive PsA patients were recruited from an outpatient clinic. Data collected included demographics, measures of musculoskeletal and skin disease activity, and treatments. Perceived effect of health status on sexual activity was assessed using question number 15 from the health-related quality of life instrument 15D; this was explored in univariate and multivariate logistic regression analyses. Results: The study assessed 135 patients (mean age 52.1 years, disease duration 8.7 years, 51.1% male). Mean scores included Maastricht Ankylosing Spondylitis Enthesitis Score (MASES) 2.9, Disease Activity index for PSoriatic Arthritis (DAPSA) 18.2, patient global assessment (PGA) 36.0 mm, pain 33.7 mm, fatigue 45.1 mm, modified Health Assessment Questionnaire (mHAQ) 0.42, Psoriasis Area Severity Index (PASI) 2.5, and Dermatology Life Quality Index (DLQI) 3.4. Twenty-four patients (17.8%) reported that their health status had a large negative effect and 111 (82.2%) that it had no or little effect on their sexual activity. In univariate analyses, a statistically significant association with impaired sexual activity was found for longer disease duration and higher MASES, DAPSA, PGA, fatigue, and mHAQ scores, but not for demographic variables or variables reflecting skin psoriasis involvement (PASI, DLQI). In adjusted analyses, only PsA disease duration remained independently associated with impaired sexual activity. Conclusion: One in five PsA patients perceived that their health status had a negative impact on sexual activity. Disease duration and measures reflecting musculoskeletal involvement, but not measures reflecting skin psoriasis involvement, appeared to be associated with impaired sexual activity.