School of Medicine, Duke University Medical Center, Durham, NC.
Division of Urology, Duke University Medical Center, Durham, NC.
Urology. 2021 Oct;156:308-319. doi: 10.1016/j.urology.2021.03.042. Epub 2021 Apr 27.
To conduct a systematic review of self-reported experiences of sexual function and dysfunction in individuals with spina bifida (SB).
Medline, Embase, and Web of Science were systematically searched. Studies included contained self-reported data from SB patients on one or more of the following sexual function domains: Genital sensitivity, orgasm, erectile function, ejaculation, lubrication, and/or dyspareunia. Two authors independently assessed eligibility, extracted data, and cross-checked results, with disagreements resolved by consensus. Studies included contained self-reported data from SB patients on one or more of the following sexual function domains: Genital sensitivity, orgasm, erectile function, ejaculation, lubrication, and/or dyspareunia.
Systematic search yielded 23 studies representing 1441 patients (816 males, 625 females). Eight utilized questionnaires validated in non-SB adults; the remainder used semi-structured interviews and non-validated instruments. Eleven assessed dysfunctions in both sexes, 10 in males, and 2 in females. Erectile function and orgasm were the most commonly assessed outcomes in males and females respectively. 12%-88% of males experienced erectile dysfunction; a majority (51%-90%) reported normal ejaculatory function. Many females were unable to experience orgasm (28%-63%).
Males with SB report significant erectile and ejaculatory dysfunction. Both sexes report impaired orgasms and genital sensitivity. SB-specific instruments assessing sexual dysfunction are needed in order to improve multidisciplinary care for this population.
对脊髓裂(SB)患者的性功能和性功能障碍的自我报告体验进行系统评价。
系统检索了 Medline、Embase 和 Web of Science。纳入的研究包含了 SB 患者在以下一个或多个性功能领域的自我报告数据:生殖器敏感度、性高潮、勃起功能、射精、润滑和/或性交困难。两位作者独立评估合格性、提取数据并交叉检查结果,意见分歧通过共识解决。纳入的研究包含了 SB 患者在以下一个或多个性功能领域的自我报告数据:生殖器敏感度、性高潮、勃起功能、射精、润滑和/或性交困难。
系统搜索产生了 23 项研究,代表了 1441 名患者(816 名男性,625 名女性)。8 项研究使用了在非 SB 成年人中验证过的问卷;其余的使用半结构化访谈和非验证性工具。11 项研究评估了两性的性功能障碍,10 项研究评估了男性,2 项研究评估了女性。勃起功能和性高潮分别是男性和女性最常评估的结果。12%-88%的男性经历了勃起功能障碍;大多数(51%-90%)报告了正常的射精功能。许多女性无法达到性高潮(28%-63%)。
患有 SB 的男性报告存在显著的勃起和射精功能障碍。两性都报告了性高潮和生殖器敏感度受损。需要 SB 特异性的性功能障碍评估工具,以改善对这一人群的多学科护理。