Cosgrove Daniel J, Gordon Zachary, Bernie Jonathan E, Hami Shadha, Montoya Daniel, Stein Murray B, Monga Manoj
Division of Urology, University of California, San Diego, Medical Center, San Diego, California 92103-8897, USA.
Urology. 2002 Nov;60(5):881-4. doi: 10.1016/s0090-4295(02)01899-x.
To evaluate the prevalence, clinical correlates, and severity of sexual dysfunction in combat veterans with and without post-traumatic stress disorder (PTSD) using a validated instrument for assessing sexual function. The results of recent studies have suggested that combat veterans with PTSD experience a higher rate of sexual dysfunction than do those without PTSD.
We administered the International Index of Erectile Function (IIEF) and a demographic and health questionnaire to male combat veterans undergoing treatment for PTSD and to age-comparable male combat veterans without PTSD.
The mean total IIEF score was significantly lower in the 44 patients with PTSD than in the 46 controls (26.38 versus 40.86; P = 0.035). With respect to the individual IIEF domains, patients with PTSD had poorer scores on overall satisfaction and orgasmic function and showed trends toward poorer scores on intercourse satisfaction and erectile function. No statistically significant difference was observed for sexual desire. The rate of erectile dysfunction was 85% in patients with PTSD and 22% in controls. Moderate to severe erectile dysfunction was present in 45% of the patients with PTSD and in only 13% of controls. Significantly more patients with PTSD (57%) than controls (17%) were using psychotropic medications.
Combat veterans with PTSD experience a significantly higher rate of sexual dysfunction than do veterans without PTSD and show impairment in some, but not all, specific domains of sexual function. The IIEF may be useful in evaluating the response to treatment of erectile dysfunction. Clinicians should proactively address the sexual concerns of combat veterans with PTSD.
使用一种经过验证的性功能评估工具，评估患有和未患有创伤后应激障碍（PTSD）的退伍军人性功能障碍的患病率、临床相关性及严重程度。近期研究结果表明，患有PTSD的退伍军人性功能障碍发生率高于未患PTSD的退伍军人。
我们对正在接受PTSD治疗的男性退伍军人以及年龄相仿、未患PTSD的男性退伍军人进行了国际勃起功能指数（IIEF）及一份人口统计学和健康调查问卷的评估。
44例患有PTSD的患者的IIEF总分均值显著低于46例对照组患者（分别为26.38和40.86；P = 0.035）。就IIEF各个领域而言，患有PTSD的患者在总体满意度和性高潮功能方面得分较低，在性交满意度和勃起功能方面得分也有较低的趋势。在性欲方面未观察到统计学上的显著差异。患有PTSD的患者勃起功能障碍发生率为85%，对照组为22%。45%患有PTSD的患者存在中度至重度勃起功能障碍，而对照组仅为13%。服用精神药物的患有PTSD的患者（57%）明显多于对照组（17%）。
患有PTSD的退伍军人性功能障碍发生率显著高于未患PTSD的退伍军人，且在某些但并非所有特定性功能领域存在损害。IIEF可能有助于评估勃起功能障碍的治疗反应。临床医生应积极关注患有PTSD的退伍军人的性问题。
