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首页> 外文期刊>The journal of sexual medicine >Determinants of sexual impairment in multiple sclerosis in male and female patients with lower urinary tract dysfunction: Results from an italian cross-sectional study
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Determinants of sexual impairment in multiple sclerosis in male and female patients with lower urinary tract dysfunction: Results from an italian cross-sectional study

机译：男性和女性下尿路功能障碍的多发性硬化症中性功能障碍的决定因素：一项意大利横断面研究的结果

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Introduction: Sexual dysfunction (SD) is prevalent in multiple sclerosis (MS) patients and affects quality of life. Furthermore, lower urinary tract dysfunction (LUTD) is common in MS patients. Aims: This study aims to evaluate the relationship between SD, neurological disability, depression, anxiety, and urodynamic alterations in patients with MS and LUTD. Methods: From January 2011 to September 2013, 135 consecutive patients with MS in remission phase and LUTD underwent first urodynamic examination, according to the International Continence Society criteria. Depression and anxiety were evaluated with the Hamilton Depression Scale (HAM-D) and the Hamilton Anxiety Scale (HAM-A), neurological impairment was assessed using the Expanded Disability Status Scale (EDSS), and SD was investigated with the Female Sexual Function Index (FSFI) or the International Index of Erectile Function (IIEF-15). Main Outcome Measures: Multivariate logistic regression analyses were carried out to identify variables for predicting female sexual dysfunction (FSD) (FSFI<26.55), male SD (IIEF-15<60), or moderate-severe erectile dysfunction (IIEF-EF≤16), after adjusting for confounding factors. Results: Total IIEF-15 and all subdomains (all P<0.01), total FSFI, FSFI-arousal, FSFI-lubrication, and FSFI-orgasm (all P<0.05) were lower in subjects with EDSS≥4.5. We found inverse relationship between IIEF-15 and relative subdomains with EDSS (all P<0.01) and between FSFI and relative subdomains with EDSS (all P<0.01), HAM-D (all P<0.01), and HAM-A (all P<0.01). Continuous EDSS (odds ratio [OR]=1.54; P=0.03) and categorical EDSS (≥4.5) (OR=6.0; P=0.03), HAM-D (OR=4.74; P=0.03), and HAM-A (OR=4.10; P=0.02) were significantly associated with FSD (FSFI<26.55). Detrusor overactivity (DO) was an independent predictor of moderate-severe ED (IIEF-EF≤16) (OR=2.03; P<0.01), and of FSD (OR=9.73; P=0.04). Conclusions: Neurological disability, depression and DO are significantly predictive of SD in MS patients, irrespective of gender. An EDSS≥4.5 may significantly predict the presence of SD.
机译：简介：性功能障碍（SD）在多发性硬化症（MS）患者中普遍存在，并影响生活质量。此外，下尿路功能障碍（LUTD）在MS患者中很常见。目的：本研究旨在评估MS和LUTD患者的SD，神经功能障碍，抑郁，焦虑和尿动力学改变之间的关系。方法：从2011年1月至2013年9月，根据国际节制学会的标准，连续135例处于缓解期且LUTD的MS患者接受了首次尿动力学检查。使用汉密尔顿抑郁量表（HAM-D）和汉密尔顿焦虑量表（HAM-A）评估抑郁和焦虑，使用扩展残疾状况量表（EDSS）评估神经功能障碍，并使用女性性功能指数调查SD （FSFI）或国际勃起功能指数（IIEF-15）。主要结果指标：进行多因素logistic回归分析，以识别预测女性性功能障碍（FSD）（FSFI <26.55），男性SD（IIEF-15 <60）或中度勃起功能障碍（IIEF-EF≤16）的变量），并调整了混杂因素后。结果：EDSS≥4.5的受试者的IIEF-15总和所有子域（均P <0.01），总FSFI，FSFI刺激，FSFI润滑和FSFI高潮（均P <0.05）较低。我们发现IIEF-15与具有EDSS的相对子域（所有P <0.01）和FSFI与具有EDSS的相对子域（所有P <0.01），HAM-D（所有P <0.01）和HAM-A（所有P ＜0.01）。连续EDSS（赔率[OR] = 1.54; P = 0.03）和分类EDSS（≥4.5）（OR = 6.0; P = 0.03），HAM-D（OR = 4.74; P = 0.03）和HAM-A（ OR = 4.10; P = 0.02）与FSD显着相关（FSFI <26.55）。逼尿肌过度活动（DO）是中度重度ED（IIEF-EF≤16）（OR = 2.03; P <0.01）和FSD（OR = 9.73; P = 0.04）的独立预测因子。结论：无论性别，神经系统残疾，抑郁和DO均可显着预测MS患者的SD。 EDSS≥4.5可能会显着预测SD的存在。

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