Romano Lorenzo, Fonticelli Mariano, Miranda Agnese, Priadko Kateryna, Napolitano Luigi, Crocetto Felice, Barone Biagio, Arcaniolo Davide, Spirito Lorenzo, Manfredi Celeste, Gravina Antonietta Gerarda, Sciorio Carmine, Compare Debora, Melina Raffaele, Sgambato Dolores, Orlando Ambrogio, Calderone Silvia, Nardone Olga Maria, Nardone Gerardo, Caruso Paola, Esposito Katherine, De Sio Marco, Romano Marco, Maiorino Maria Ida
Department of Neurosciences, Reproductive Sciences and Odontostomatology and Urology Unit, Federico II University, Naples, Italy.
Department of Woman, Child and General and Specialized Surgery and Urology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.
Andrology. 2024 Nov 3. doi: 10.1111/andr.13791.
Dietary factors and chronic gastrointestinal diseases are frequent determinants of sexual dysfunctions (SD). Whether inflammatory bowel diseases (IBD) are associated with SD is not well known as well as the role of diet and quality of life (QoL).
To evaluate the prevalence of SD in a cohort of IBD patients and assess the role of clinical-demographic variables, adherence to Mediterranean diet (MD) and QoL.
This is a cross-sectional observational study involving 301 patients (134 females and 167 males); 119 had Crohn's Disease and 182 had ulcerative colitis. SD were assessed through the Female Sexual Function Index (FSFI) and the International Index of Erectile Function (IIEF). Adherence to MD was evaluated by the MD Score. QoL was investigated by the 12-item Short-Form Health Survey (SF-12) which yields summary scores of physical (PCS) and mental (MCS) health. Multiple logistic regression was used to identify predictors of SD.
Prevalence of SD in females was 61.9%, while 52.1% of males had erectile dysfunction. No differences in the prevalence of SD were found between CD and UC in both males and females. IBD activity, as defined by patient-reported outcomes, was significantly associated with SD in both sexes. In females, MD adherence score (OR 0.8, 95% CI 0.653-0.974, p = 0.027), PCS (OR = 0.936, CI 95% = 0.891-0.983, p = 0.008), and MCS (OR 0.9, 95% CI 0.906-0.985, p = 0.008) were protective against SD, whereas in males a higher PCS was associated with a lower probability of SD (OR 0.9, 95% CI 0.891-0.978, p = 0.004) DISCUSSION: IBD patients had a significant prevalence of SD which occurred more frequently in females than in males. Disease activity is associated with a higher likelihood of SD in both sexes, whereas dietary factors are differentially associated with SD in males and females. A better QoL is associated with a lower risk of SD.
SD is prevalent among men and women with IBD. Adherence to MD, PCS and MCS in females as well as PCS in males were protective against SD. The assessment of sexual function in IBD patients could be relevant in order to reach an early diagnosis and a timely treatment.
饮食因素和慢性胃肠疾病是性功能障碍（SD）的常见决定因素。炎症性肠病（IBD）是否与SD相关以及饮食和生活质量（QoL）的作用尚不清楚。
评估一组IBD患者中SD的患病率，并评估临床人口统计学变量、对地中海饮食（MD）的依从性和QoL的作用。
这是一项横断面观察性研究，涉及301名患者（134名女性和167名男性）；119例患有克罗恩病，182例患有溃疡性结肠炎。通过女性性功能指数（FSFI）和国际勃起功能指数（IIEF）评估SD。通过MD评分评估对MD的依从性。通过12项简短健康调查（SF - 12）调查QoL，该调查得出身体（PCS）和心理（MCS）健康的汇总评分。使用多元逻辑回归来确定SD的预测因素。
女性SD的患病率为61.9%，而52.1%的男性有勃起功能障碍。在男性和女性中，CD和UC之间SD的患病率没有差异。根据患者报告的结果定义的IBD活动与两性的SD均显著相关。在女性中，MD依从性评分（OR 0.8，95% CI 0.653 - 0.974，p = 0.027）、PCS（OR = 0.936，CI 95% = 0.891 - 0.983，p = 0.008）和MCS（OR 0.9，95% CI 0.906 - 0.985，p = 0.008）对SD有保护作用，而在男性中，较高的PCS与较低的SD概率相关（OR 0.9，95% CI 0.891 - 0.978，p = 0.004）。讨论：IBD患者中SD的患病率很高，女性比男性更常见。疾病活动与两性中较高的SD可能性相关，而饮食因素与男性和女性的SD有不同的关联。更好的QoL与较低的SD风险相关。
SD在患有IBD的男性和女性中普遍存在。女性对MD的依从性、PCS和MCS以及男性的PCS对SD有保护作用。评估IBD患者的性功能可能有助于早期诊断和及时治疗。
