Hospital Universitario Fundación Santa Fe de Bogotá and Universidad de los Andes School of Medicine; Department of Urology, Fundació Puigvert, Barcelona, Spain.
Hospital Universitario Fundación Santa Fe de Bogotá and Universidad de los Andes School of Medicine.
J Sex Med. 2021 Jun;18(6):1065-1074. doi: 10.1016/j.jsxm.2021.02.009. Epub 2021 May 13.
BACKGROUND: Female sexual dysfunction and erectile dysfunction (FSD/ED) have been linked with lower urinary tract symptoms (LUTS), from both epidemiological data and basic research studies, but few studies have been conducted in Latin America addressing these issues and most of them do not include the young population. AIM: To determine the prevalence of FSD/ED and its association with LUTS in Colombia. METHODS: Sub-analysis of a cross-sectional, population-based study conducted in subjects ≥18 years old to evaluate LUTS/OAB. The estimated sample size was 1,054. ED was defined as ≤21 points in the SHIM and FSD as ≤19 in the FSFI-6. For LUTS/OAB, we used the 2002 ICS and 2010 IUGA/ICS definitions and validated questionnaires. Descriptive and inferential statistics were employed. OUTCOMES: Prevalence of FSD/ED and association of FSD/ED and LUTS. RESULTS: We included 1,060 participants; the median age was 40 (IQR 27-54) years. Fifty-seven (11.4%) men and 182 (32.7%) women were sexually inactive. The prevalence of FSD/ED in sexually active participants was 47% (men 52.9%, women 38.9%). The most common FSD/ED symptoms were diminished/absent lubrication in women (42%) and diminished erection maintenance after penetration in men (13%). Individuals with FSD/ED had higher rates of various LUTS. The multivariable logistic regression model found that the city of residence (OR = 0.4, 95% CI 0.2-0.9), diabetes mellitus (DM) (OR = 8.4, 95% CI 1.4-48.7), menopause (OR=3.5, 95% CI 1.9-6.2), urge urinary incontinence (UUI) (OR=1.9, 95% CI 1.1-3.3) and nocturia ≥2 (OR = 2.2, 95% CI 1.2-4.2) were associated with FSD. In men, age 40-59 (OR = 2.3, 95% CI 1.4-3.7) and ≥60 (OR = 5.5, 95% CI 2.4-12.5), the city of residence (OR = 0.2, 95% CI 0.1-0.3), less than a high-school diploma vs higher education (OR = 2.0, 95% CI 1.2-3.2), depression (OR = 4.6, 95% CI 1.8-11.5), UUI (OR = 3.2, 95% CI 1.1-10.2) and feeling of incomplete bladder emptying (OR = 2.1, 95% CI 1.3-3.5) were associated with ED. CLINICAL IMPLICATIONS: This study underlines the importance of assessing LUTS in women and men of all affected age groups who present with symptoms of FSD/ED and vice versa, which could help achieve a better approach for these patients. STRENGTHS & LIMITATIONS: This is the first study in Colombia and one of the few in Latin America that addresses both FSD/ED and LUTS in men and women aged 18 years and older. Limitations include being a sub-analysis of a study aiming to determine the prevalence of LUTS/OAB and not FSD/ED. CONCLUSIONS: Regardless of age, LUTS were observed more frequently in patients with FSD/ED. Various LUTS were associated with FSD/ED. Bravo-Balado A, Trujillo CG, Caicedo JI, et al. Assessment of Female Sexual Dysfunction and Erectile Dysfunction and Its Association with Lower Urinary Tract Symptoms in Women and Men Over 18 Years Old: Results From the COBaLT Study. J Sex Med 2021;18:1065-1074.
背景：女性性功能障碍和勃起功能障碍（FSD/ED）与下尿路症状（LUTS）有关，这既有流行病学数据，也有基础研究的支持，但拉丁美洲开展的此类研究较少，且多数研究都未纳入年轻人群。
目的：在哥伦比亚确定 FSD/ED 的流行情况及其与 LUTS 的关系。
方法：对一项横断面、基于人群的研究进行了亚分析，该研究纳入了≥18 岁的受试者，以评估 LUTS/OAB。估计样本量为 1054 人。ED 定义为 SHIM 评分≤21 分，FSD 定义为 FSFI-6 评分≤19 分。对于 LUTS/OAB，我们使用了 2002 年国际尿控协会（ICS）和 2010 年国际女性下尿路症状研究协会/ICS 定义和经过验证的问卷。采用描述性和推断性统计方法。
结果：我们纳入了 1060 名参与者；中位年龄为 40（IQR 27-54）岁。57 名男性（11.4%）和 182 名女性（32.7%）为性功能障碍者。在有性行为的参与者中，FSD/ED 的患病率为 47%（男性 52.9%，女性 38.9%）。最常见的 FSD/ED 症状为女性的阴道润滑减少/缺失（42%）和男性勃起维持时间减少（13%）。有 FSD/ED 的个体有更高的各种 LUTS 发生率。多变量逻辑回归模型发现，居住地（OR=0.4，95%CI 0.2-0.9）、糖尿病（DM）（OR=8.4，95%CI 1.4-48.7）、绝经（OR=3.5，95%CI 1.9-6.2）、急迫性尿失禁（UUI）（OR=1.9，95%CI 1.1-3.3）和夜间排尿≥2 次（OR=2.2，95%CI 1.2-4.2）与 FSD 相关。在男性中，40-59 岁（OR=2.3，95%CI 1.4-3.7）和≥60 岁（OR=5.5，95%CI 2.4-12.5）、居住地（OR=0.2，95%CI 0.1-0.3）、低于高中学历与高等教育（OR=2.0，95%CI 1.2-3.2）、抑郁（OR=4.6，95%CI 1.8-11.5）、UUI（OR=3.2，95%CI 1.1-10.2）和膀胱排空不完全感（OR=2.1，95%CI 1.3-3.5）与 ED 相关。
临床意义：本研究强调了评估所有受影响年龄组的女性和男性的 LUTS 的重要性，这些患者有 FSD/ED 的症状，反之亦然，这有助于为这些患者提供更好的治疗方法。
优势与局限性：这是哥伦比亚的第一项研究，也是拉丁美洲为数不多的同时研究男性和女性 18 岁及以上的 FSD/ED 和 LUTS 的研究之一。局限性包括作为一项旨在确定 LUTS/OAB 而非 FSD/ED 患病率的研究的亚分析。
结论：无论年龄大小，有 LUTS 的患者中 FSD/ED 更为常见。各种 LUTS 与 FSD/ED 相关。
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