性功能障碍(SD),包括勃起(ED)和射精功能障碍,与UCPPS(慢性前列腺炎/慢性盆腔疼痛综合征(CP/CPPS)和/或间质性膀胱炎/膀胱疼痛综合征(IC/BPS))男性的生活质量(QoL)下降相关。
我们试图比较患有UCPPS的男性患者的SD,其他慢性疼痛状况(阳性对照,PC),和健康对照(HC)没有慢性疼痛,并评估合并症的关联,社会心理因素,3组均为SD的泌尿外科因素。
男性UCPPS参与者的基线数据,PC(肠易激综合征,慢性疲劳综合征,纤维肌痛)和HC参加了慢性盆腔疼痛研究(MAPP)研究网络流行病学和表型研究的多学科方法。使用国际勃起功能-勃起功能域指数(IIEFEF)和射精功能量表(EFS)评估性功能。男性ED定义为复合IIEF-EF评分<21。较高的EFS评分表明性功能障碍较差;EFS没有确定定义SD的阈值。多变量逻辑和线性回归用于调查合并症的关联,社会心理因素,和泌尿外科因素与ED和射精,分别。
合并症,生殖器疼痛,在整个研究人群中,心理社会因素与SD相关,UCPPS男性患者ED和射精功能障碍发生率较高.
有191名男性患有UCPPS;44PC;和182HC。与PC和HC相比,UCPPS男性的SD较差,包括较低的平均IIEF-EF评分,更大程度的射精功能障碍,和较低的性关系质量。在所有三个队列中,抑郁症,压力,在单变量和多变量分析中,疼痛与ED相关,糖尿病也是如此。生殖器疼痛,泌尿症状的严重程度,抑郁症,压力,在单变量和多变量分析中,儿童性创伤史与射精功能障碍相关。
解决已确定的SD危险因素的多学科方法可能会改善UCPPS男性的整体QoL。
我们的研究通过使用经过验证的,患者报告问卷和纳入健康和阳性对照。我们对IC在这项研究中的作用的理解是有限的,因为研究中只有1名患者有IC/BPS作为唯一的诊断。
与健康对照组和其他慢性疼痛患者相比,UCPPS男性的SD程度较高,包括勃起和射精功能障碍。Loh-DoyleJC,斯蒂芬斯-希尔兹AJ,罗尔斯顿R,etal.泌尿系统慢性盆腔疼痛综合征(UCPPS)中男性性功能障碍的预测因素,其他慢性疼痛综合征,慢性盆腔疼痛(MAPP)研究网络多学科研究中的健康对照。JSexMed2022;19:1804-1812。
Sexual dysfunction (SD), including erectile (ED) and ejaculatory dysfunction, is associated with diminished quality of life (QoL) in men with UCPPS (chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and/or interstitial cystitis/bladder pain syndrome (IC/BPS)).
We sought to compare SD among male patients with UCPPS, other chronic pain conditions (positive controls, PC), and healthy controls (HC) without chronic pain, and to evaluate the association of comorbidities, psychosocial factors, and urologic factors of SD in all 3 groups.
Baseline data from male UCPPS participants, PC (irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia) and HC enrolled in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network Epidemiology and Phenotyping
Study were included in the analysis. Sexual function was assessed using the International Index of Erectile Function-Erectile Function Domain (IIEFEF) and Ejaculatory Function Scale (EFS). Male ED was defined as a composite IIEF-EF score <21. Higher EFS score indicated worse sexual dysfunction; no threshold to define SD was identified for the EFS. Multivariable logistic and linear regression was used to investigate associations of comorbidities, psychosocial factors, and urologic factors with ED and ejaculatory, respectively.
Comorbidities, genital pain, and psychosocial factors are associated with SD across the
study population and male patients with UCPPS had a high prevalence of ED and greater ejaculatory dysfunction.
There were 191 males with UCPPS; 44 PC; and 182 HC. Males with UCPPS had worse SD compared to PC and HC including lower mean IIEF-EF scores, greater degree of ejaculatory dysfunction, and lower quality of sexual relationships. Among all 3 cohorts, depression, stress, and pain were associated with ED in univariable and multivariable analysis, as was diabetes mellitus. Pain in the genitalia, severity of urinary symptoms, depression, stress, and history of childhood sexual trauma were associated with ejaculatory dysfunction in univariable and multivariable analysis.
A multidisciplinary approach that addresses the identified risk factors for SD may improve overall QoL in males with UCPPS.
Our
study is strengthened by its use of validated, patient-reported questionnaires and inclusion of healthy and positive controls. Our understanding of the role of IC in this
study is limited because only 1 patient in the
study had IC/BPS as a sole diagnosis.
When compared to healthy controls and patients with other chronic pain conditions, males with UCPPS experience higher degrees of SD, including erectile and ejaculatory dysfunction. Loh-Doyle JC, Stephens-Shields AJ, Rolston R, et al. Predictors of Male Sexual Dysfunction in Urologic Chronic Pelvic Pain Syndrome (UCPPS), Other Chronic Pain Syndromes, and Healthy Controls in the Multidisciplinary Approach to the
Study of Chronic Pelvic Pain (MAPP) Research Network. J Sex Med 2022;19:1804-1812.