Department of Urology, University of Michigan, Ann Arbor, MI, USA.
Center for Reconstructive Urology and Men's Health, University of Utah, Salt Lake City, UT, USA.
Int J Impot Res. 2021 Jan;33(1):59-66. doi: 10.1038/s41443-020-0242-8. Epub 2020 Mar 10.
In this study, we sought to determine the burden and characteristics of orgasmic dysfunction (OD) and concomitant erectile dysfunction (ED) in men with type 1 diabetes (T1D) enrolled in the Epidemiology of Diabetes Interventions and Complications (EDIC) study. In 2010, we assessed orgasmic and erectile function using the International Index of Erectile Function (IIEF). Sociodemographic, clinical, and diabetes characteristics were compared by OD status (OD only, OD and ED, no ED or OD). Age-adjusted associations between risk factors and OD status were examined. OD and ED information was available from 563 men. Eighty-three men (14.7%) reported OD of whom 21 reported OD only and 62 reported OD and ED. Age-adjusted odds ratios demonstrated that men who reported OD only had higher odds of depression, low sexual desire, and decreased alcohol use compared with men reporting no dysfunction. Men with OD concomitant with ED had greater odds of elevated hemoglobin A1C, peripheral and autonomic neuropathy, and nephropathy. Men reporting both dysfunctions were also more likely to report smoking, lower urinary tract symptoms, and had greater odds of androgen deficiency than men with no sexual dysfunction. Men with longstanding T1D suffer from an increased burden of OD. Psychogenic factors predominate in men reporting OD only while men who present with concomitant ED report increased burden of diabetes severity, characteristics previously observed with incident ED. ED may be the central impediment to sexual function in men with OD and ED. Longitudinal studies to characterize OD and ED experience over time are warranted.
在这项研究中,我们试图确定 1 型糖尿病(T1D)患者中勃起功能障碍(ED)和伴随的性高潮功能障碍(OD)的负担和特征,这些患者参加了糖尿病及其并发症的流行病学(EDIC)研究。2010 年,我们使用国际勃起功能指数(IIEF)评估了性高潮和勃起功能。通过 OD 状态(仅 OD、OD 和 ED、无 ED 或 OD)比较了社会人口统计学、临床和糖尿病特征。检查了危险因素与 OD 状态之间的年龄调整关联。共有 563 名男性提供了 OD 和 ED 信息。83 名男性(14.7%)报告了 OD,其中 21 名报告了仅 OD,62 名报告了 OD 和 ED。年龄调整后的比值比表明,报告仅 OD 的男性与报告无性功能障碍的男性相比,抑郁、性欲低下和饮酒减少的可能性更高。同时报告 OD 和 ED 的男性,糖化血红蛋白(HbA1C)升高、周围和自主神经病变以及肾病的可能性更高。同时报告两种性功能障碍的男性,更有可能报告吸烟、下尿路症状,并且雄激素缺乏的可能性也更高,而无性功能障碍的男性则更低。患有长期 T1D 的男性承受着更高的 OD 负担。在报告仅 OD 的男性中,心理因素占主导地位,而同时报告 ED 的男性则报告了更高的糖尿病严重程度负担,这与新发 ED 之前观察到的特征一致。ED 可能是伴有 OD 和 ED 的男性性功能障碍的主要障碍。需要进行纵向研究以描述 OD 和 ED 在一段时间内的体验。