Department of Stroke, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1PB, UK.
Int J Clin Pract. 2020 Jul;74(7):e13496. doi: 10.1111/ijcp.13496. Epub 2020 Mar 5.
Poststroke sexual dysfunction (PSSD) is widespread and underrecognised, affecting over half of stroke patients with significant effects on a patients' quality of life. We reviewed the postulated factors contributing to PSSD and explore the underrecognition by presenting a questionnaire study as well as examining existing literature.
A literature search between January 1980 and December 2019 in electronic databases such as EMBASE, MEDLINE and PubMed was conducted. The questionnaire study involved all adult stroke patients attending the outpatient clinic over a 6-month period, containing multiple choice and open questions relating to prevalence, impact and provision provided for patients with PSSD.
Poststroke sexual dysfunction is unlikely attributed solely to the physical effects of stroke. We present a biopsychosocial model summarising the wide range of factors which can contribute to PSSD. Less than 10% of patients receive any advice despite 90% of patients hoping for advice relating to sexual dysfunction in stroke.
A multidisciplinary, proactive involvement in screening and managing PSSD is required to successfully manage a commonly forgotten complication of stroke. As part of the wider theme of managing lifestyle factors poststroke (eg, smoking, driving advice, dietary advice, alcohol), the 'sexual function aspect' of patients' lives must not be ignored.
脑卒中后性功能障碍（PSSD）广泛存在但未被充分认识，影响超过半数的脑卒中患者，对患者的生活质量有重大影响。我们综述了导致 PSSD 的各种假定因素，并通过问卷调查研究以及对现有文献的考察，探讨了其未被充分认识的原因。
对 1980 年 1 月至 2019 年 12 月期间电子数据库（如 EMBASE、MEDLINE 和 PubMed）中的文献进行了检索。问卷调查研究纳入了在 6 个月期间内到门诊就诊的所有成年脑卒中患者，其中包含与 PSSD 的患病率、影响和患者服务提供相关的多项选择题和开放性问题。
脑卒中后性功能障碍不太可能仅归因于脑卒中的身体影响。我们提出了一个包括广泛因素的生物心理社会模型，这些因素可能导致 PSSD。尽管 90%的患者希望获得有关脑卒中后性功能障碍的建议，但只有不到 10%的患者得到了任何建议。
需要多学科、积极主动地参与 PSSD 的筛查和管理，以成功管理脑卒中这一常见且被遗忘的并发症。作为管理脑卒中后生活方式因素（如吸烟、驾驶建议、饮食建议、饮酒）这一更广泛主题的一部分，患者生活的“性功能方面”不应被忽视。
