Salonia A, Clementi M C, Ventimiglia E, Colicchia M, Capogrosso P, Castiglione F, Castagna G, Boeri L, Suardi N, Cantiello F, Damiano R, Montorsi F
Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy; Research Doctorate Program in Urology, Magna Graecia University, Catanzaro, Italy.
Andrology. 2014 Sep;2(5):702-8. doi: 10.1111/j.2047-2927.2014.00236.x. Epub 2014 Jun 13.
Prevalence and risk factors of concomitant primary low sexual desire/interest (LSD/I) and subsequent new-onset erectile dysfunction (ED) in men have been only partially investigated. We looked at the sociodemographic and clinical predictors of the concomitant condition of primary LSD/I - defined as the reduction in the usual level of SD/I which precedes ED or another sexual dysfunction - and new-onset ED (LSD/I + ED) in a cohort of consecutive Caucasian-European patients seeking their first medical help for sexual dysfunction at a single outpatient clinic in the everyday clinical practice setting. Data from 439 sexually active patients were analysed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Patients' LSD/I were evaluated according to the findings of a comprehensive sexual history. Moreover, patients completed the International Index of Erectile Function (IIEF). Descriptive statistics and logistic regression models tested the prevalence and predictors of LSD/I + ED as compared with ED only. Of the 439 men, LSD/I + ED was observed in 33 (4.2%) individuals. One of three men with LSD/I + ED was younger than 40 years. Patients complaining of LSD/I + ED or ED alone did not differ in terms of hormonal milieu. No significant differences emerged between groups in terms of sexual orientation, rates of stable sexual relationships, educational status, recreational habits and comorbid sexual dysfunctions. Patients with LSD/I + ED had significantly lower IIEF-sexual desire and IIEF-overall satisfaction scores than ED-only individuals (all p ≤ 0.003). At multivariable analysis younger age and severe CCI scores emerged as independent predictors of LSD/I + ED (all p ≤ 0.04). These findings showed that primary LSD/I is concomitant with new-onset ED in less than 5% of men seeking first medical help. Younger age and severe CCI emerged as independent predictors of LSD/I + ED. Patients with both conditions reported an impaired overall sexual satisfaction.
男性原发性性欲低下/兴趣缺乏（LSD/I）与随后新发勃起功能障碍（ED）的患病率及危险因素仅得到了部分研究。我们在日常临床实践环境中的一家门诊诊所，对一组连续的白种欧洲患者进行了研究，这些患者因性功能障碍首次寻求医疗帮助，我们观察了原发性LSD/I（定义为在ED或其他性功能障碍之前出现的SD/I正常水平降低）与新发ED（LSD/I + ED）合并情况的社会人口统计学和临床预测因素。分析了439名性活跃患者的数据。使用查尔森合并症指数（CCI）对具有健康意义的合并症进行评分。根据全面性病史的结果评估患者的LSD/I。此外，患者完成了国际勃起功能指数（IIEF）。描述性统计和逻辑回归模型测试了LSD/I + ED与仅患有ED相比的患病率和预测因素。在439名男性中，33名（4.2%）个体出现了LSD/I + ED。患有LSD/I + ED的男性中，三分之一年龄小于40岁。抱怨LSD/I + ED或仅患有ED的患者在激素环境方面没有差异。在性取向、稳定性关系率、教育程度、娱乐习惯和合并的性功能障碍方面，各组之间没有显著差异。与仅患有ED的个体相比，患有LSD/I + ED的患者的IIEF-性欲和IIEF-总体满意度得分显著更低（所有p≤0.003）。在多变量分析中，年龄较小和CCI评分较高是LSD/I + ED的独立预测因素（所有p≤0.04）。这些发现表明，在首次寻求医疗帮助的男性中，不到5%的人原发性LSD/I与新发ED并存。年龄较小和CCI评分较高是LSD/I + ED的独立预测因素。患有这两种疾病的患者报告总体性满意度受损。
