Sexual functions in ankylosing spondylitis

Abstract

Ankylosing spondylitis (AS) is a chronic inflammatory disorder of the axial skeleton. In recent years, several authors reported an increased prevalence of sexual dysfunction among AS patients. We aimed to find out, whether the prevalence of erectile dysfunction among AS patients is different from age-matched healthy controls. Thirty-seven male patients with AS who were diagnosed according to the modified New York criteria and 67 normal healthy controls (NHC) were included in this study. Clinical characteristics of patients including age, disease duration and morning stiffness were noted. Disease activity was evaluated by using Bath AS disease activity index (BASDAI), functional statement was evaluated by using Bath AS functional index, and scores of spinal measurements were done by using Bath AS metrology index. Erectile function is evaluated using the International Index of Erectile Function (IIEF) scoring system. Health-related quality of life was assessed by short form 36. The mean age of the patients and controls were 42.8 + 10.8 and 43.6 + 5.9 years (P = 0.666). The prevalence of erectile dysfunction in AS patients and NHC were 35.1 and 26.9%, respectively (P = 0.335). There was no statistically significant difference between IIEF domain scores of AS patients and NHC except for the sexual desire domain (P = 0.014). Duration of morning stiffness and BASDAI was negatively correlated with sexual desire and overall satisfaction; however, they have no negative impact on erectile function, orgasmic function and intercourse satisfaction domains of IIEF. In this report, we showed that only the sexual desire domain of IIEF was significantly lower in AS patients. The prevalence of erectile dysfunction among AS patients is similar to NHC, which is a finding contrary to previous reports. AS patients do not suffer from erectile dysfunction, they rather have problems of satisfaction from the intercourse.

Assessment of Sexual Functions in Male Patients with Ankylosing Spondylitis Compared with Healthy Controls

“…Three of these studies concluded that sexual function was significantly affected by AS. [9,13,14] In our study, we used the IIEF scale, and our results were in line with the study done by Bal et al [12] We found no significant difference in sexual functions between the male patients with AS and the healthy controls, but the sexual drive domain of the IIEF was slightly lower in those with AS. However, this difference was not at a significant level.…”

“…The IIEF scoring scale was used in two previous studies. [9,12] Pırıldar et al [9] reported that all domains of the IIEF, except for sexual drive, were significantly lower in male patients with AS than in the healthy control group, and Bal et al [12] could not find any significant differences in terms of the IIEF, except for the sexual drive domain. Three of these studies concluded that sexual function was significantly affected by AS.…”

“…[27] To our knowledge, there have been four studies that investigated the sexual functions of male patients with AS with a validated scoring scale in the literature. [9,[12][13][14] Different validated scales [the IIEF, the Golombok Rust Inventory of Sexual Satisfaction (GRISS), and the [26] and has become the reference standard for assessing ED. [27] This scale is designed specifically for the assessment of sexual function in clinical research or practice.…”

“…[3,10,11] Only a few studies exist that have utilized validated questionnaires. [9,[12][13][14] However, each of these studies used a different validated scale, and the differences in their methods led to the controversial results. Therefore, further studies are necessary to clarify this issue.…”

Sexual function in male patients with ankylosing spondylitis

“…11 Pirildar et al compared AS male patients' erectile functions with healthy controls and found significantly higher frequency of ED in AS patients, in which the duration of morning stiffness was found to be the only clinical feature related to ED. 6 Bal et al 29 found significant difference only in sexual desire domain of International Index of Erectile Function scoring system, duration of morning stiffness and BASDAI was negatively correlated with sexual desire and overall satisfaction. Dincer et al 8 also reported significantly lower sexual drive, problem assessment and low overall satisfaction scores in AS patients compared with healthy controls.…”