Department of Urology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China.
Department of Urology, The Second Affiliated Hospital of Bengbu Medical College, Bengbu 233000, China.
Asian J Androl. 2019 Mar-Apr;21(2):156-162. doi: 10.4103/aja.aja_86_18.
There has been increasing interest in the psycho-socio-relational and sexual disorders of infertility, as the risk of psychological burden among infertile men with sexual dysfunctions is significant. The purpose of this study was to develop and to validate a predictive model to estimate individual psychological burden among infertile men with sexual dysfunction and study the association between them. Comprehensive data were collected for infertile men (n = 480) who sought treatment for infertility in a reproductive medicine center between June 2012 and December 2013. Using independent predictors of psychological burden from the least absolute shrinkage and selection operator, univariable and multivariable analyses were developed into two models. Predictive accuracy was compared between the models. We explored the association between sexual dysfunction and psychological burden. A total of 480 patients were analyzed using 10-fold cross-validation. Independent predictors of psychological burden were incorporated into a model to measure anxiety (corrected-area under curve (AUC): 77.3%) and a model to measure depression (corrected-AUC: 70.2%). Anxiety and depression were both associated with erectile dysfunction (P < 0.05), with anxiety demonstrating the strongest association. Only anxiety was associated with premature ejaculation (P < 0.05). Premature ejaculation was not found to be associated with depression (P > 0.05). Predictive models for psychological burden among infertile men with sexual dysfunction are presented, and we found that there is an association between psychological burden and sexual dysfunction. According to the models, proper counseling and treatment of sexual dysfunction in infertile men may reduce the psychological burden, help attain natural pregnancy, and improve the quality of life.
人们对不孕不育的心理-社会-关系和性障碍越来越感兴趣，因为患有性功能障碍的不育男性面临着巨大的心理负担风险。本研究旨在开发和验证一个预测模型，以评估患有性功能障碍的不育男性的个体心理负担，并研究两者之间的关联。综合数据收集于 2012 年 6 月至 2013 年 12 月期间在生殖医学中心寻求不孕不育治疗的 480 名不育男性。使用最小绝对收缩和选择算子的心理负担独立预测因子，进行单变量和多变量分析，并将其纳入两个模型中。比较模型之间的预测准确性。我们探讨了性功能障碍与心理负担之间的关联。使用 10 倍交叉验证对 480 例患者进行了分析。将心理负担的独立预测因子纳入模型以测量焦虑症（校正面积下曲线（AUC）：77.3%）和抑郁症（校正-AUC：70.2%）。焦虑症和抑郁症均与勃起功能障碍相关（P<0.05），且焦虑症的相关性最强。只有焦虑症与早泄相关（P<0.05）。未发现早泄与抑郁症相关（P>0.05）。本研究提出了患有性功能障碍的不育男性心理负担的预测模型，并且发现心理负担与性功能障碍之间存在关联。根据模型，适当的咨询和治疗不育男性的性功能障碍可能会减轻心理负担，有助于实现自然妊娠并提高生活质量。
