Sexual Dysfunction In Patients Research Articles

Sexual Dysfunction in Patients with Peripheral Nervous System Disorders

Sexual Dysfunction in Patients with Peripheral Nervous System Disorders

Long-Term Functional Outcomes Following Nonradiated Vesicovaginal Repair

We investigated the long-term impact on bladder and sexual symptoms in women with prior vesicovaginal fistula repair, particularly those previously treated before referral. After receiving institutional review board approval we reviewed the charts of women who underwent nonradiated vesicovaginal fistula repair for demographics, surgical approach (vaginal or abdominal) and functional outcomes with a minimum 6-month followup. Patients lost to followup were reached by a structured phone interview and/or mailed validated lower urinary tract questionnaires, including the UDI-6 (Urogenital Distress Inventory-6), IIQ-7 (Incontinence Impact Questionnaire-7) and FSFI (Female Sexual Function Index). Three surgical groups were compared, including naïve-no prior repair, recurrent-1 prior repair and other-more than 2 repairs with the hypothesis of worse outcomes with more repairs. From 1996 to 2011 vesicovaginal fistula repair was performed in 66 patients, including in 42 as primary treatment (vaginal vs abdominal approach in 31 vs 11), in 14 as secondary treatment, and in 10 who underwent more than 2 repairs. Mean patient age was 45 years (range 24 to 87), mean body mass index was 29 kg/m(2) (range 19 to 43) and mean followup was 55 months (range 6 to 198). The overall repair success rate was 97%. There was no difference in functional outcomes in questionnaire responders among the 3 groups for lower urinary tract symptoms (62% on UDI-6/IIQ-7). However, for FSFI (33% of patients) there was female sexual dysfunction in patients who underwent transabdominal repair and in women with 2 repairs. Long-term followup of patients with vesicovaginal fistula repair indicated no differences in lower urinary tract outcomes at a mean 7-year followup between primary and recurrent repairs. There was a difference in sexual function, although it was not statistically significant. Sexual activity among responders was low.

AB0863 Prevalence of sexual dysfunction in patients with ankylosing spondylitis

ObjectivesAnkylosing Spondylitis (AS) is a chronic, systemic and inflammatory disease affecting spine, peripheral joints and periarticular area causing movement restriction in axial joints. AS itself does not affect sexual functions...

25 years after Prozac

Twenty-fi ve years ago, Eli Lilly’s Prozac (fl uoxetine) became the fi rst selective serotonin reuptake inhibitor (SSRI) to hit the market, where it quickly gained popularity for the treatment of depression. Soon, the drug was earning more than a billion dollars in revenues—at a time when the average American’s income was around $25,000. A quarter of a century later, treatments for depression are no more effective, but they are safer. Much has happened since the advent of fl uoxetine, but as many as half of patients still do not receive relief in the idealized situations studied in clinical trials. Why was fl uoxetine so successful? According to John Markowitz, PharmD, Professor of Pharmacy at the

Erectile Dysfunction

Erectile Dysfunction

303 Urinary symptoms and sexual dysfunction in patients affected by Multiple Sclerosis

303 Urinary symptoms and sexual dysfunction in patients affected by Multiple Sclerosis

Subjective Quality of Life and Sexual Dysfunction in Outpatients With Schizophrenia or Schizoaffective Disorder

The objective of this research was to examine the association between sexual dysfunction and subjective quality of life in outpatients with schizophrenia and schizoaffective disorder. The authors evaluated a sample of 238 adult outpatients with diagnoses of schizophrenia or schizoaffective disorder who took quetiapine, olanzapine, or risperidone at study entry with a 1-time rating of the Arizona Sexual Experience Scale and the general life satisfaction scale item of the Quality of Life Index. The authors used multiple linear robust regression and Spearman partial correlation coefficient to examine the relation between subjective quality of life (measured by the general life satisfaction scale item) and sexual functioning (measured by the Arizona Sexual Experience Scale). The authors found a significant negative linear relation between the Arizona Sexual Experience Scale total score and the general life satisfaction scale item for the overall sample (r s = –0.16, p = .01), but not separately for men or women. Sexual dysfunction in men and women with schizophrenia and schizoaffective disorder is associated with decreased subjective quality of life, although the magnitude of the effect size was relatively small. Improving clinicians’ awareness of the importance of sexual dysfunction in patients may improve tolerability and subsequent treatment outcomes.

2005 – Sexual dysfunction in patients with schizophrenia treated with antipsychotics

The relationship between sexuality and schizophrenia is complex. The prevalence of sexual dysfunctions is higher in persons with mental disorders and may be related to both the psychopathology and the pharmacotherapy. On one hand the negative symptoms of schizophrenia limit the capability for interpersonal and sexual relationships; on the other hand several mechanisms can cause sexual dysfunction during antipsychotic therapy. Although it is a troublesome side effect, information on antipsychotic-induced sexual dysfunction is limited. The aim of this study was to evaluate the sexual dysfunction and its impact in patients with a psychotic disorder treated with various antipsychotics under routine clinical conditions. Subjects included were sexually active male and female patients 18 years of age or older with the diagnosis of Schizophrenia, Schizophreniform disorder, Schizoaffective disorder or other psychotic disorder. In addition to sexual functioning, was recorded demographic data, psychiatric diagnosis and medication history. The instrument of evaluation used was the Pyschotropic-Related Sexual Dysfunction Questionnaire (PRSexDQ-SalSex). All the analyses were performed in the 101 evaluable patients. Most patients were males (76%) and the most common diagnosis was Schizophrenia.Overall, the patients exhibited sexual dysfunction according to the assessment with the SalSex. Among the patients exhibiting sexual dysfunction, a third reported to have poor tolerance to the disturbance. Sexual dysfunction is very common in patients receiving long-term treatment with antipsychotics and it is associated with a great impact in a substantial proportion of patients.

1298 – Analysis of sexual dysfunctions in patients with psoriasis compared with patients with other chronic dermatological diseases

Introduction Psoriasis is a chronic disease with major importance for society. The extent of impaired functioning of patients with psoriasis is comparable with the extent of impairment of patients with cancer or heart disease. Patients with this illness show the highest intensification of various psychiatric disorders among patients suffering from dermatological diseases. Objectives To estimate the prevalence of sexual dysfunction among patients with psoriasis compared with patients with other chronic dermatological diseases. An attempt to link sexual dysfunction with selected factors. Methods The study included 32 patients diagnosed with psoriasis. A questionnaire, consisting of four parts, has been used: I- used for the assessment of dermatological condition of patient, II - Questionnaire for the valuation of the indicator of the impact of skin conditions on quality of life (DLQI), III - Beck Scale - for the assessment of depression (BDI), IV - Mell-Krat Scale for the assessment of sexual disorders. Part I has been filled by the interviewer, other - by the tested person independently. The results were compared with the control group (people suffering from other chronic dermatological diseases), matched in terms of sex and age. Results None of the persons belonging to the control or tested group has declared taking advice from a sexologist, despite the presence of sexual dysfunction in both groups (identified by Mell-Krat scale). Conclusions The above findings are results of a pilot study and it is needed to confirm them in a larger group of patients.

Sexual dysfunction and cardiovascular diseases: a systematic review of prevalence

The aim of this study was to conduct a systematic review of the literature regarding the prevalence of sexual dysfunction in patients with cardiovascular diseases. An article search of the ISI Web of Science and PubMed databases using the search terms "sexual dysfunction”, “cardiovascular diseases”, “coronary artery disease", “myocardial infarct" and “prevalence” was performed.In total, 893 references were found. Non-English-language and repeated references were excluded. After an abstract analysis, 91 references were included for full-text reading, and 24 articles that evaluated sexual function using validated instruments were selected for this review. This research was conducted in October 2012, and no time restrictions were placed on any of the database searches. Reviews and theoretical articles were excluded; only clinical trials and epidemiological studies were selected for this review.The studies were mostly cross-sectional, observational and case-control in nature; other studies used prospective cohort or randomized clinical designs. In women, all domains of sexual function (desire, arousal, vaginal lubrication, orgasm, sexual dissatisfaction and pain) were affected. The domains prevalent in men included erectile dysfunction and premature ejaculation and orgasm.Sexual dysfunction was related to the severity of cardiovascular disease. When they resumed sexual activity, patients with heart disease reported significant difficulty, including a lack of interest in sex, sexual dissatisfaction and a decrease in the frequency of sexual activity.

Female sexual dysfunction in patients with substance-related disorders

OBJECTIVE:To estimate the prevalence of female sexual dysfunction symptoms and the associated risk factors in a sample of patients with substance-related disorders admitted to a specialized in-patient care unit.METHODS:This study used a cross-section design, with eight months of data collection, conducted with substance-dependent women using structured questionnaires to collect socio-demographic data and identify their drug of choice. The Drug Abuse Screening Test, Short Alcohol Dependence Data questionnaire, Fagerström Test for Nicotine Dependence, and Arizona Sexual Experience Scale were also administered.RESULTS:The sample consisted of 105 women who had a mean age of 34.8 years (SD = 12.1, range = 18-65) and were predominantly heterosexual (74.3%), single (47.6%), Caucasian (50.5%), catholic (36.2%), and educated only to the level of primary education (40%), with a monthly family income of up to one minimum salary (37.5%). In 42.9% of the patients, crack was the drug of choice; 47.6% of the sample qualified for the Drug Abuse Screening Test (substantial problems related to drugs), 43.8% exhibited Short Alcohol Dependence Data (moderate or severe dependency), 47.6% exhibited Fagerström Test for Nicotine Dependence (high or very high nicotine dependence). The prevalence of sexual dysfunction symptoms was 34.2% (95% CI = [25.3, 44.1]), and a high level of nicotine dependence and low income increased the chances of having sexual dysfunction by 2.72-fold and 2.54 fold, respectively. An association was also observed between female sexual dysfunction symptoms and schooling and levels of drug dependence.CONCLUSIONS:Female sexual dysfunction symptoms were common among this sample and primarily associated with high levels of nicotine use.

Sexual dysfunction in patients with multiple sclerosis

BackgroundSexual dysfunction (SD) is a common complaint in female and male patients with multiple sclerosis (MS) and can arise at anytime during the course of the disease even in patients with low disability. Increasing neurological and physical impairment, psychological factors, and medication side effects are thought to increase rates of SD. ObjectiveTo determine the prevalence of various SD symptoms among MS patients, their impact on patient self-reported sexual activity and satisfaction (SAS), and to examine the rates at which symptomatic patients utilize therapies for their complaints. MethodsResults from the Spring, 2006 North American Research Committee on Multiple Sclerosis (NARCOMS) Project were reviewed. Participants were asked to answer the Multiple Sclerosis Intimacy and Sexuality Questionaire-19 (MSISQ-19) and to indicate which symptomatic therapy they used to alleviate SD. Symptoms were grouped as severe (they impacted SAS always or almost always), moderate (occasionally), and mild (never or almost never). Primary end point was the prevalence of SD symptoms and their impact on patient SAS. ResultsOf 17,883 surveys mailed, 9861 (55.1%) responses were returned. Of these, 6739 (68.3%) answered the questions on sexuality. Respondents were primarily female (76.7%), Caucasian (87.8%), with average age of 38.4 (±9.6), and time since diagnosis of 13.9 years (±9.3). 38.6% of male subjects and 34.8% of female subjects experienced at least 5 different types of severe symptoms. Also, 14.3% of males and 12.9% of females complained of at least 10 severe symptoms that affected their SAS. The most common severe symptoms were shared by both sexes: too long to achieve orgasm/climax (37.8%), inadequate lubrication/difficult erection (36.5%), less intense or pleasure with orgasm/climax (35.2%), lack of interest or desire (32.1%), problems moving the body (29.1%), less feeling or numbness in genitals (28.8%), feeling less confident (25.5%), and body less attractive (24.8%). The severe symptoms positively correlated with time since diagnosis, Patient Determined Disease Steps Score, bladder disability score, and spasticity score. Few patients with at least one severe symptom used therapies to improve their SD (vibrators 19.1%, phosphodiesterase-5 enzyme inhibitors 14.2%, other medications 0.6%, counseling 4.1%, penile device 1.0%, intracorporeal therapy 0.7%, sex surgery 0.5%, and clitoral device 0.3%). ConclusionSD in patients with MS is multifactorial and very similar in men and women. Despite increasing therapeutic options, many patients with MS do not seek treatment for their SD complaints. It is very important for the physicians caring for patients with MS to initiate discussion of potential SD to allow earlier diagnosis and treatment.

Una aproximación a la realidad de la sexualidad en pacientes con traumatismo craneoencefálico (TCE)

Los traumatismos craneoencefálicos (TCE) constituyen una causa importante de minusvalía neurológica persistente que afecta con mayor frecuencia a personas relativamente jóvenes, con diferentes grados de incapacidad durante muchos años. La respuesta y la expresión sexual, puede verse alterada por las secuelas físicas, neuropsicológicas, emocionales y conductuales. La atención y educación de estos aspectos, por parte del personal de Enfermería es fundamental. Objetivos General: Conocer el estado de salud sexual de las personas con TCE. Objetivo Específicos: 1) Describir las características socio-demográficas y los datos relativos al accidente; 2) Describir si hay alteraciones sexuales tras el TCE; 3) Valorar las relaciones interpersonales anteriores y posteriores al TCE; 4) Conocer si durante la rehabilitación han recibido educación sexual. Metodología: Estudio descriptivo transversal. Datos: Cuestionario anónimo validado. Población: Asociaciones adscritas a la Federación Española de Daño Cerebral (FEDACE). 488 afectados. Contestan 70 pacientes (14,3%, 52 varones y 18 mujeres entre 16 y 46 años). Resultados: La causa más frecuente de TCE es accidente de tráfico. La mayoría después del TCE tienen afectada la sexualidad negativamente, no tienen pareja estable, han notado cambios a nivel de su vida social, afecto, autoestima y confianza, no han recibido educación sexual. Conclusiones: Después de un TCE, la sexualidad se ve alterada en la mayoría de los pacientes, siendo fundamental que el personal de enfermería aborde el tema y dé respuestas a estas necesidades y para ello, han de tener una formación previa en sexualidad, a fin de abordar y actuar de manera correcta ante tal situación.

P01.35. Antidepressant effects of Gastrodia elata Bl. at the genomic level

Purpose Depression has been a serious issue as the annual worldwide suicide rate has been constantly increasing, according to the statistics published by WHO. In fact, WHO predicts that it will be the leading psychological disease by year 2020. Antidepressants in general, however, demonstrate serious side effects such as anxiety disorders, gastrointestinal problems, and sexual dysfunction in patients; therefore, it is important to find an effective way to prevent the occurrence of depression. Gastrodia eleta Bl., an Oriental herb that has been shown to demonstrate an anti-depression effect, was investigated in the form of water extraction.

Lumbar disk herniation presented with cauda equina syndrome in a pregnant woman

Despite low back pain being common in pregnancy, cauda equina syndrome is rare. Misdiagnosis and delay in treatment may cause neurological sequelae including urinary and fecal incontinence, sexual dysfunction in patients. A case of cauda equina syndrome in a pregnant woman at 25-week gestation is presented here. The patient underwent an emergency, standard lumbar microdiscectomy under general anesthesia on prone position. Neither the patient nor the baby had any complication related to surgery.

Female Sexual Dysfunction in Patients Treated with Antidepressant—Comparison between Escitalopram and Fluoxetine

Selective serotonin reuptake inhibitor is one of the most widely used antidepressant and commonly associated with female sexual dysfunction (FSD). This study compares the prevalence of FSD between patients on escitalopram and fluoxetine. The risk factors for FSD were also examined. A cross-sectional study involved 112 female depressed patients (56 each group) who were in remission (as defined in the fourth edition of Diagnostic and Statistical Manual of Mental Disorders [DSM-IV] during the past 2 months with no significant signs or symptoms of the disturbance and Montgomery-Asberg Depression Rating Scale score of ≤10) from the psychiatric clinic in a university hospital. The rates of sexual dysfunction between the two groups were compared. The subjects were interviewed by using Structured Clinical Interview for DSM-IV. Sexual dysfunction was assessed with the Malay Version of the Female Sexual Function Index. The prevalence of FSD was 44.6% for all patients, 55.4% for the fluoxetine group, and 33.9% for the escitalopram group. Multivariate logistic regression analysis showed no significant difference in the risk of FSD between the two groups. Moderate to high dosing was the only significant associated factor for FSD (odds ratio = 4.89, 95% confidence interval = 1.94-12.33). There was no significant difference in the risk of having FSD between patients treated with fluoxetine or escitalopram. Patients on higher dosage of antidepressant have higher risk of having FSD.

Sexual Dysfunction in Male Subjects Receiving Trifluoperazine, Risperidone, or Olanzapine

To assess the rate and typology of sexual dysfunction in male subjects receiving trifluoperazine, risperidone, or olanzapine using the Arizona Sexual Experience Scale (ASEX), the Psychotropic Related Sexual Dysfunction Questionnaire (PRSexDQ), and the sexual function section of the modified Udvalg for Kliniske Undersøgelser Side Effect Rating Scale (UKU). The sample included 100 men with psychotic disorders (F2 category of the ICD-10) and receiving trifluoperazine (n = 20), risperidone (n = 30), or olanzapine (n = 50) for at least 3 months' duration. Subjects with a history of sexual dysfunction prior to antipsychotic intake or chronic medical illness were excluded. A cross-sectional design was employed, and data were collected over a 1½-year period from March 2009 to August 2010. The rate of sexual dysfunction varied from scale to scale among the 100 subjects. The rate of sexual dysfunction was 25% on the ASEX, 37% on the PRSexDQ, and 40% on the UKU. Sexual dysfunction in the trifluoperazine, risperidone, and olanzapine groups was 20%, 43%, and 16%, respectively, on the ASEX; 35%, 50%, and 30%, respectively, on the PRSexDQ; and 40%, 50%, and 34%, respectively, on the UKU. The most common sexual dysfunction as assessed on all scales was decreased libido, except for the risperidone group on the ASEX. Sexual dysfunction is quite prevalent in subjects receiving antipsychotic medications. In our study, rate of sexual dysfunction was highest for risperidone, followed by trifluoperazine and olanzapine. However, the rate of sexual dysfunction varied from scale to scale. Hence, there is a need for a comprehensive instrument to assess sexual dysfunction in patients receiving antipsychotics.

Mo1716 Significant Sexual Dysfunction in Patients With Perianal Crohn's Disease Improves With Multimodality Treatment

Mo1716 Significant Sexual Dysfunction in Patients With Perianal Crohn's Disease Improves With Multimodality Treatment

Sexuality after treatment of head and neck cancer: Findings based on modification of sexual adjustment questionnaire

Evaluate sexual dysfunction in patients after treatment for head and neck cancer. Single-institution cross-sectional study. Our modified Sexual Adjustment Questionnaire was administered to 42 patients (mean age, 55.1 years) and included seven questions (total score, 7-35). Based on sexual satisfaction ratings, we categorized three groups as unsatisfied (7-16), satisfied (17-25), and very satisfied (26-35). Clinical information was obtained by reviewing medical records. Bivariate analysis tested associations between sexual satisfaction and patient-related factors (e.g., sex, age, site/cancer stage, treatment, time between treatment and survey, partner, alcohol/tobacco consumption). Pearson correlation was used to analyze two continuous variables, and multivariate logistic regression analysis was used to evaluate the independent impact of each factor. All 42 patients rated that head and neck cancer negatively impacted their sexual relationships, including 21 (50%) rating effects as negative or extremely negative. Men reported higher satisfaction scores with sexual function (mean ± standard deviation) than women (19.9 ± 5.0 vs. 16.3 ± 6.5, respectively; P = .06). Respondents with partners reported higher scores than those without partners (19.9 ± 5.3 vs. 14.1 ± 4.4, respectively; P = .01). When the survey was administered (median, 12 months; range, 4-33 months) after the first treatment, mean score was 19; 57% of respondents were sexually satisfied, 31% were unsatisfied, and 12% were very satisfied. Instrument reliability was .82 (Cronbach alpha). Patients who are male and ≤ 60 years have a higher probability of sexual satisfaction during recovery. Our sexual dysfunction questionnaire will be administered in further prospective studies in patients with head and neck cancer.

Hormonal Association and Sexual Dysfunction in Patients with Impaired Fasting Glucose: A Cross-Sectional and Longitudinal Study

The category of impaired fasting glucose (IFG) denotes a state of nondiabetic hyperglycemia, considered a risk factor for the further development of diabetes mellitus (DM) and cardiovascular (CV) diseases. The aim of the present study is to evaluate the impact of IFG on sexual health in men. In addition, its effect on CV morbidity and mortality will also be addressed. A consecutive series of 3,451 men (mean age 57.3 ± 10.1 years) attending our outpatient clinic for sexual dysfunction was retrospectively studied. A subset of this sample (N = 1,687) was enrolled in a longitudinal study. Several clinical, biochemical (including testosterone), and instrumental (penile color Doppler ultrasound) factors were evaluated. IFG was defined by fasting glucose concentrations between 5.6 and 6.9 mmol/L (100-125 mg/dL). A higher threshold (6.1-6.9 mmol/L, 110-125 mg/dL) was also considered. Among the patients studied, 747 (21.7%) had DM. In addition, 659 (19.1%) subjects were classified as IFG. Patients with IFG, however defined, more often had severe ED, reduced penile blood flow, and overt hypogonadism when compared with patients with normal glucose levels. In addition, men with ED and IFG show poorer blood pressure and lipid profile with an overall increase in CV risk. Unadjusted incidence of major adverse CV events was significantly associated with baseline DM, whereas there was a trend toward higher risk also for IFG, but this did not reach statistical significance. Conversely, both IFG and DM were significantly associated with a higher risk of fatal and nonfatal cerebral events. Checking glucose and testosterone levels is mandatory in subjects with ED because testosterone substitution in impotent IFG subjects might ameliorate not only their sexual life but also their overall health.