Introduction
Infertility has been associated with anxiety, stress, and sexual problems in both men and women.
Aim
To assess quality of life, sexual health, and depression in the female partner of infertile couples.
Methods
Couples presenting for the evaluation of infertility at two tertiary care medical centers were invited to participate in a survey study.
Main Outcome Measures
Female partners completed the Female Sexual Function Index (FSFI) and a modified Self-Esteem and Relationship (SEAR) Questionnaire. Male partners completed the SEAR and the International Index of Erectile Function (IIEF). Both partners completed the Center for Epidemiological Studies Depression Scale (CES-D) for depression and the Short Form-36 (SF-36) for general quality of life. Demographic, fertility, and comorbidity information was recorded.
Results
One hundred and twenty-one couples constitute the study population. Mean female and male age was 32 ± 5 and 35 ± 7 years, respectively. Most (92%) couples were married. Mean duration of relationship and marriage were 6.4 ± 3.9 and 3.8 ± 3.2 years, respectively. Mean duration of attempted conception was 24 ± 24 months. On CES-D, 19% of women had moderate and 13% had severe depression. Women reported significantly worse SF-36 Mental Health subscale scores (mean = 47.8, P < 0.05) compared with normative values. The mean total FSFI score was 28 ± 7 (maximum score of 36), with 26% of the women scoring below 26.55, an established cut-off for high risk of female sexual dysfunction. FSFI scores had a modest positive correlation with male IIEF scores (r = 0.37, P < 0.01), and there was a trend toward a negative correlation with female CES-D scores (r = −0.16, P < 0.06). These relationships were maintained on multivariate analysis.
Conclusion
Depression and sexual dysfunction are prevalent in female partners of infertile couples. Female sexual function is positively correlated with male partner sexual function in this population.
Depression, erectile dysfunction and sexual relationship problems are prevalent among male partners of infertile couples. Partner sexual function is a significant predictor of male partner sexual function. Relationship duration and female partner assessment of relationship health are predictive of men's assessment of their relationship status.
Aim
Peyronie’s disease (PD) may be treated in a medical or surgical fashion. Factors involved in the decision of which treatment to choose include duration of disease and magnitude of penile deformity. Curvature can be measured using at-home photography (AHP), vacuum erection device (VED), or intracavernosal injection (ICI). This study was undertaken to determine the concordance between the three methods of deformity assessment. Patients were also questioned regarding the presence of erectile dysfunction (ED) based on self-report and the International Index of Erectile Function.
Materials and Methods
A total of 68 men presented to their urologist after taking penile photographs from three angles during maximal erectile rigidity. In the office, a VED was used to induce erection, and a goniometer was utilized to measure degree of curvature. ICI with trimix was then used to induce artificial erection, which was measured with a goniometer as well.
Results
There was a statistically significant difference in self-report curvature magnitude compared with measured ICI-assisted curvature. Curvature profiles included dorsal plaques in 50 patients (73.5%), ventral plaques in 10 (15%), and lateral in eight (11%). Using ICI, the mean curvature measured was 42 degrees. Mean degree of curvature using VED was 33 degrees, while that of photography was 34 degrees. Photographic measurements differed most from ICI in men with concurrent ED (P <0.01), while vacuum device measurements were most inaccurate in men with curvatures of >60 degrees.
Conclusion
Our results show that the degree of curvature measured using vacuum-assisted device and AHP is underestimated as compared with the gold standard ICI. We therefore recommend that ICI be used to most accurately determine degree of deformity. If ICI is not available, it is imperative that the same manner of measurement be used between all patients in a study group, as well as during serial evaluation in a trial.
Androgen deprivation seems to exert a deleterious effect on erectile function in men undergoing radiation therapy for prostate cancer. This was observed in men treated with conformal external beam and brachytherapy at short-term, medium term and long-term followup.
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