Department of Medicine, Harvard Medical School, Crohn's and Colitis Center, Brigham and Women's Hospital, Boston, MA, USA.
Aliment Pharmacol Ther. 2014 May;39(10):1085-94. doi: 10.1111/apt.12720. Epub 2014 Mar 24.
Knowledge of the extent and the impact of sexual dysfunction and interpersonal relationships in men with inflammatory bowel disease is scarce.
The aim of this review article was to summarise the current literature on sexual function in male patients with IBD and to provide a critical review of the IBD-related medical, surgical and psychological complications that can result in impaired quality of sexual health.
To collect relevant articles, PubMed/Medline and Embase searches were performed using Boolean search phrases.
Reported rates of sexual dysfunction in male IBD patients range from 10% to 50%. Thirty-three to fifty per cent of patients report that sexual desire and satisfaction deteriorated after IBD diagnosis. Of those patients who were sexually inactive, half of these attributed lack of intercourse to underlying IBD. A striking finding reproduced in numerous studies is that disease activity relates strongly to impaired psychological function, and the most consistently reported risk factor for sexual problems in IBD patients is co-existing mood disorders. Hypogonadism is a complication of IBD and its therapies, the role of testosterone deficiency should be further explored as a potentially treatable and reversible factor in sexual dysfunction.
By understanding what factors contribute to poor sexual functioning in our patients, we can strive to minimise adverse psychosocial events. Further insight into this complex relationship requires an IBD-specific measure of sexual function in male patients. We recommend screening for and treating co-morbid depression, testosterone deficiency and striving for clinical remission to prevent psychosexual dysfunction in male patients with inflammatory bowel disease.
目前对于炎症性肠病（IBD）男性患者性功能障碍及其对人际关系影响的了解甚少。
本文旨在总结目前有关 IBD 男性患者性功能的文献，并对可能导致其性健康质量受损的与 IBD 相关的医学、手术和心理并发症进行批判性综述。
为了收集相关文献，我们使用布尔搜索短语在 PubMed/Medline 和 Embase 上进行了检索。
报告的 IBD 男性患者性功能障碍发生率为 10%至 50%。33%至 50%的患者报告称，IBD 诊断后性欲和性满意度下降。在那些没有性生活的患者中，有一半人将缺乏性生活归因于潜在的 IBD。许多研究中都重复出现了一个显著的发现，即疾病活动度与心理功能受损密切相关，而 IBD 患者发生性功能问题的最一致的报告风险因素是共存的情绪障碍。性腺功能减退是 IBD 及其治疗的并发症，睾酮缺乏的作用应进一步探讨，因为它可能是性功能障碍的一个可治疗和可逆转的因素。
通过了解哪些因素导致患者的性功能下降，我们可以努力减少不良的社会心理事件。要进一步深入了解这种复杂的关系，需要有针对 IBD 男性患者的特定性功能评估。我们建议对合并的抑郁、睾酮缺乏进行筛查和治疗，并努力实现临床缓解，以预防炎症性肠病男性患者的性心理功能障碍。
