Department of Medicine, University of California, Riverside, Riverside, California, USA.
Division of Gastroenterology and Hepatology, VA Loma Linda Health Care System, Loma Linda, California, USA.
Am J Gastroenterol. 2020 Apr;115(4):526-534. doi: 10.14309/ajg.0000000000000515.
Half of patients with inflammatory bowel disease (IBD) are men, yet less attention has been focused on their sexual issues despite higher rates of sexual dysfunction and infertility than the general population. Depression and IBD disease activity are the most consistently reported risk factor for sexual dysfunction among men with IBD. Methotrexate and sulfasalazine have been rarely associated with impotence. Sulfasalazine reversibly reduces male fertility. No other medications used in IBD significantly affect fertility in humans. There is no increase in adverse fetal outcomes among offspring of fathers with IBD. Patients with IBD seem to be at a higher risk for prostate cancer; therefore, screening as recommended for high-risk patients should be considered.
炎性肠病（IBD）患者中有一半是男性，但尽管他们的性功能障碍和不育率高于一般人群，却较少关注他们的性问题。抑郁和 IBD 疾病活动是 IBD 男性性功能障碍最常报告的危险因素。甲氨蝶呤和柳氮磺胺吡啶很少与阳痿有关。柳氮磺胺吡啶可使男性生育力可逆降低。IBD 中使用的其他药物对人类生育力无明显影响。IBD 父亲的后代不良胎儿结局并无增加。IBD 患者似乎患前列腺癌的风险更高；因此，应考虑按照高危患者的建议进行筛查。
