Assessment of sexual dysfunction in patients with perianal Crohn's disease

Abstract

Aim Over the past 10 years, several studies have focused on sexuality in patients with Crohn's disease. Very few of them specifically focused on perianal disease (PD). This study aimed to compare the prevalence of sexual dysfunction (SD) in Crohn's disease patients with active PD versus controls without active PD. Method Patients from 14 French centres with active PD, defined by the presence of symptomatic ulceration, fistula or stenosis, were arbitrarily included. They were compared with controls from the existing SEXIA cohort. Men completed the International Index of Erectile Function (IIEF) and women the Female Sexual Function Index (FSFI). The primary end‐point was SD defined by FSFI < 26.55 in women and IIEF < 42.9 in men. Results Ninety‐seven patients (64 women, 33 men) and 238 controls (131 women, 107 men) were included. SD was found in 66% of the female patients versus 50% of the controls (P = 0.04). In the male population, SD was found in 30% of the cases versus 16% of the controls (P = 0.06). Erectile dysfunction affected 46% of the male patients and 43% of the controls (P = 0.8). On multivariate analysis, the predictive factor most strongly associated with SD in women was severely active anal PD defined by a perineal disease activity index > 4 [OR = 13.05 (2.32–73.44)]. Conclusion Women with active PD had an increased prevalence of SD compared with controls without active PD. In the male population, the study was unable to determine whether there was a difference as it was underpowered.

Sexual and reproductive health for women who live with inflammatory bowel disease:

“…This literature review highlights the multifaceted sexual di culties women who live with IBD have, such as painful intercourse, vaginismus, lower sexual satisfaction and desire and di culty with orgasm [13,[18][19][20][21][22][23]. The literature also highlights that there is a bidirectional relationship between depression and sexual dysfunction [16,17] which has been described in the broader literature by Velten and Milani [37].…”

“…Boudiaf et al [19] explored sexual dysfunction speci cally for those who had a diagnosis of perianal CD and found that of the 64 French women who participated in their study, 66% had sexual dysfunction. Rivière et al [22] reported that of the 192 French women with IBD in their study 53.6% had sexual dysfunction scores and similarly, a Spanish study found that almost half of their participants had sexual dysfunction [21].…”

Sexual Function After Surgical Treatment for Benign Anorectal Disorders

“…During the literature review, we also identified that psychiatric disorders could be a contributing factor in understanding the relationship between perianal fistula disease and erectile dysfunction. Depression has been shown to be the most frequently reported predictive factor for sexual function impairment in perianal diseases ( Boudiaf et al, 2021 ). Moreover, mood disorders, including depression, are more common in benign anorectal diseases and are considered significant risk factors for sexual function impairment ( Akkoca et al, 2023 ).…”

Managing complex perianal disease after anti-TNF failure: Where to go next?

“…pCD is associated with poor quality of life and a high level of disability. Poor work productivity, sleep disturbance, and sexual dysfunction are frequently reported by these patients, leading to substantial morbidity ( Vollebregt et al., 2018 ; Vester-Andersen et al., 2015 ; Boudiaf et al., 2021 ). Furthermore, pCD is associated with more aggressive CD phenotypes and a greater likelihood of anal canal carcinoma, intestinal resection, and definitive stoma (see Fig.…”