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Yenişehir S, Karakaya İÇ, Özbey G. Sexual Function of Women with and without Pregnancy-Related Pelvic Girdle Pain and its Relationship with Physical Activity, Kinesiophobia and Body Image: A Cross-Sectional Comparative Study. Reprod Sci 2024; 31:3122-3131. [PMID: 38981994 PMCID: PMC11438718 DOI: 10.1007/s43032-024-01644-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 07/01/2024] [Indexed: 07/11/2024]
Abstract
The aim of this study was to compare the sexual function of women with and without pregnancy-related PGP, and to investigate its relationship with physical activity (PA), kinesiophobia, and body image (BI). Demographic characteristics, sexual function (Pregnancy Sexual Response Inventory), PA (Pregnancy Physical Activity Questionnaire), kinesiophobia (Tampa Kinesiophobia Scale), and BI (Body Image in Pregnancy Scale) of 125 pregnant women were recorded. In the PGP group (n = 46), visual analogue scales were used to assess the pain intensity during resting and sexual activity, and Pelvic Girdle Questionnaire was used to evaluate the activity limitation. Although total sexual function and BI scores of the groups were similar (p > 0.05), dyspareunia during pregnancy and level of kinesiophobia were higher, and energy expenditure during moderate-intensity PA was lower in pregnant women with PGP (p < 0.05). The PGP group had moderate activity limitation and reported increased PGP intensity during sexual activities (p < 0.001). PA level was significantly correlated with sexual desire (r = 0.180), and overall sexual function was correlated with kinesiophobia (r = -0.344) and BI (r = -0.199) during pregnancy (p < 0.05). These findings suggest that pregnant women with PGP are more vulnerable to sexual dysfunctions, and there is a need to develop biopsychosocial framework-oriented management strategies which aim to improve PA level and to eliminate psychological factors such as kinesiophobia and negative BI.Clinical Trial Registration: NCT05990361.
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Affiliation(s)
- Semiha Yenişehir
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muş Alparslan University, 49100, Muş, Turkey.
| | - İlkim Çıtak Karakaya
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Muğla Sıtkı Koçman University, 48000, Muğla, Turkey
| | - Gürkan Özbey
- Department of Obstetrics and Gynecology, Private Anadolu Hospital, Elazığ, Turkey
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Danazumi MS, Adamu IA, Usman MH, Yakasai AM. Manual therapy plus sexual advice compared with manual therapy or exercise therapy alone for lumbar radiculopathy: a randomized controlled trial. J Osteopath Med 2024:jom-2023-0075. [PMID: 39257326 DOI: 10.1515/jom-2023-0075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 06/06/2024] [Indexed: 09/12/2024]
Abstract
CONTEXT The biopsychosocial approach to managing low back pain (LBP) has the potential to improve the quality of care for patients. However, LBP trials that have utilized the biopsychosocial approach to treatment have largely neglected sexual activity, which is an important social component of individuals with LBP. OBJECTIVES The objectives of the study are to determine the effects of manual therapy plus sexual advice (MT+SA) compared with manual therapy (MT) or exercise therapy (ET) alone in the management of individuals with lumbar disc herniation with radiculopathy (DHR) and to determine the best sexual positions for these individuals. METHODS This was a single-blind randomized controlled trial. Fifty-four participants diagnosed as having chronic DHR (>3 months) were randomly allocated into three groups with 18 participants each in the MT+SA, MT and ET groups. The participants in the MT+SA group received manual therapy (including Dowling's progressive inhibition of neuromuscular structures and Mulligan's spinal mobilization with leg movement) plus sexual advice, those in the MT group received manual therapy only and those in the ET group received exercise therapy only. Each group received treatment for 12 weeks and then followed up for additional 40 weeks. The primary outcomes were pain, activity limitation, sexual disability and kinesiophobia at 12 weeks post-randomization. RESULTS The MT+SA group improved significantly better than the MT or ET group in all outcomes (except for nerve function), and at all timelines (6, 12, 26, and 52 weeks post-randomization). These improvements were also clinically meaningful for back pain, leg pain, medication intake, and functional mobility at 6 and 12 weeks post-randomization and for sexual disability, activity limitation, pain catastrophizing, and kinesiophobia at 6, 12, 26, and 52 weeks post-randomization (p<0.05). On the other hand, many preferred sexual positions for individuals with DHR emerged, with "side-lying" being the most practiced sexual position and "standing" being the least practiced sexual position by females. While "lying supine" was the most practiced sexual position and "sitting on a chair" was the least practiced sexual position by males. CONCLUSIONS This study found that individuals with DHR demonstrated better improvements in all outcomes when treated with MT+SA than when treated with MT or ET alone. These improvements were also clinically meaningful for sexual disability, activity limitation, pain catastrophizing, and kinesiophobia at long-term follow-up. There is also no one-size-fits-all to sexual positioning for individuals with DHR.
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Affiliation(s)
- Musa Sani Danazumi
- Discipline of Physiotherapy, School of Allied Health, Human Services and Sport, College of Sciences, Health and Engineering, La Trobe University, Bundoora, Victoria, Australia
| | - Isa Abubakar Adamu
- Department of Physiotherapy, Federal Medical Centre, Nguru, Yobe State, Nigeria
| | | | - Abdulsalam Mohammed Yakasai
- Medical Rehabilitation Therapists (Registration) Board of Nigeria, North-West Zonal Office, Kano State, Nigeria
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Goudman L, van Schaik D, Jager T, Moens M, Scheerlinck T. Discussing sexual health with patients eligible for spine surgery: An online survey in spine surgeon and pain physicians. BRAIN & SPINE 2024; 4:102776. [PMID: 38465281 PMCID: PMC10924173 DOI: 10.1016/j.bas.2024.102776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 02/03/2024] [Accepted: 02/19/2024] [Indexed: 03/12/2024]
Abstract
Introduction Spinal pain syndromes have a severe impact on the patient's sex life, contributing to a decrease in sexual function and sexual satisfaction. Despite the importance of sexual health on mental and physical wellbeing, sexual health is rarely discussed during consultations. Research question The aim of this study is to explore to what extent influencing factors can alter the discussion about sexual health during consultations. More specifically, we will evaluate the influence of healthcare profession, sex of the patient and the surgical approach that is proposed. Material and methods An online survey was sent to neurosurgeons, pain physicians and orthopedists in Belgium and The Netherlands in April 2019. Participants were asked about; counseling routine, knowledge, and opinion on sexual health. Answers were scored on a 5-point Likert scale. Independence between the response levels and type of surgery as well as profession were tested. Results In total, 350 respondents were approached of whom 57 completed the survey. The majority of respondents (61.4%) indicated that they rarely or never discussed sexual disturbances. Profession and type of surgery had an influence on discussing erectile dysfunction, retrograde ejaculation, and alterations in orgasms. Thirty-five percent of healthcare providers considered it the patient's responsibility to bring up the subject of sexual health. Discussion and conclusion Sexual health is rarely addressed by healthcare providers during spinal care. Profession as well as type of surgery seems to play a role on whether sexual health is discussed during consultations.
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Affiliation(s)
- Lisa Goudman
- STIMULUS Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Research Foundation—Flanders (FWO), 1090, Brussels, Belgium
| | - David van Schaik
- Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Tjeerd Jager
- Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Maarten Moens
- STIMULUS Research Group, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Department of Neurosurgery, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
- Center for Neurosciences (C4N), Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Pain in Motion (PAIN) Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium
- Department of Radiology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
| | - Thierry Scheerlinck
- Department of Orthopaedics and Traumatology, Universitair Ziekenhuis Brussel, Laarbeeklaan 101, 1090, Brussels, Belgium
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Vanti C, Ferrari S, Chiodini M, Olivoni C, Bortolami A, Pillastrini P. Sexual Disability in Low Back Pain: Diagnostic and Therapeutic Framework for Physical Therapists. Healthcare (Basel) 2023; 12:80. [PMID: 38200986 PMCID: PMC10778778 DOI: 10.3390/healthcare12010080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/18/2023] [Accepted: 12/26/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND The literature shows a relationship between sexual activity and low back pain (LBP). The aim of this work is to provide a theoretical framework and practical proposal for the management of sexual disability in individuals with LBP. METHODS Based on a literature review, a team of specialized physical therapists developed a pattern for the management of LBP-related sexual disability. RESULTS A patient reporting LBP-related sexual disability may be included in one of four clinical decision-making pathways corresponding to one of the following: #1 standard physical therapy (PT); #2 psychologically informed physical therapy (PIPT); #3 PIPT with referral; or #4 immediate referral. Standard PT concerns the management of LBP-related sexual disability in the absence of psychosocial or pathological issues. It includes strategies for pain modulation, stiffness management, motor control, stabilization, functional training, pacing activities comprising education, and stay-active advice. PIPT refers to patients with yellow flags or concerns about their relationship with partners; this treatment is oriented towards a specific psychological approach. "PIPT with referral" and "Immediate referral" pathways concern patients needing to be referred to specialists in other fields due to relationship problems or conditions requiring medical management or pelvic floor or sexual rehabilitation. CONCLUSIONS The proposed framework can help clinicians properly manage patients with LBP-related sexual disability.
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Affiliation(s)
- Carla Vanti
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, Via Massarenti 9, 40138 Bologna, Italy; (C.V.); (P.P.)
| | | | - Marco Chiodini
- Poliambulatorio Medico Associato, Via Monsignor Bertazzoni, 1, 46027 San Benedetto Po, Italy;
| | - Cesare Olivoni
- Studio Associato Fisioterapico Gallinucci Olivoni, Piazzale Marconi, 3/4, 48025 Riolo Terme, Italy;
| | | | - Paolo Pillastrini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater University of Bologna, Via Massarenti 9, 40138 Bologna, Italy; (C.V.); (P.P.)
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Via Pelagio Palagi 9, 40138 Bologna, Italy
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Somma F, Negro A, Tortora M, Gemini L, Pace G, Fasano F, Piscitelli V, Sicignano C, Prudente M, Falco AD, Villa A, Lugarà M, Pezzullo G, D'Agostino V, Gatta G. Sex life and low back pain: The impact of intradiscal ozone therapy in patients with herniated lumbar disc. Interv Neuroradiol 2023:15910199231183108. [PMID: 37321647 DOI: 10.1177/15910199231183108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023] Open
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVES To assess the improvement of sexual impairment after percutaneous intradiscal ozone therapy in patients complaining of low back pain (LBP) due to lumbar disc herniation. METHODS Between January 2018 and June 2021, 157 consecutive imaging-guided percutaneous intradiscal ozone therapies were performed on 122 patients with LBP and/or sciatic pain due to lumbar disc herniation. Oswestry Disability Index (ODI) was administered before the treatment and at 1-month and 3-month follow-ups and the ODI Section 8 (ODI-8/sex life) values were retrospectively reviewed to evaluate the improvement of sexual impairment and disability. RESULTS Mean age of patients was 54.63 ± 12.40. Technical success was achieved in all cases (157/157). Clinical success was registered in 61.97% (88/142) of patients at 1-month follow-up and in 82.69% (116/142) at 3-month follow-up. The mean ODI-8/sex life was 3.73 ± 1.29 before the procedure, 1.71 ± 1.37 at 1-month follow up and 0.44 ± 0.63 at 3-month follow-up. Compared to older patients, subjects under 50 years showed a significantly slower recovery of sexual impairment (p = 0.003). The treated levels were L3-L4, L4-L5, and L5-S1 in 4, 116, and 37 patients, respectively. Patients with L3-L4 disc herniation showed less sexual disability at presentation, with a significantly faster improvement of sexual life (p = 0.03). CONCLUSIONS Percutaneous intradiscal ozone therapy is highly effective in reducing sexual impairment due to lumbar disc herniation, and the improvement is faster in older patients and in the case of L3-L4 disc involvement.
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Affiliation(s)
- Francesco Somma
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Alberto Negro
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Mario Tortora
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Napoli, Italia
| | - Laura Gemini
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Napoli, Italia
| | - Gianvito Pace
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Fabrizio Fasano
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Valeria Piscitelli
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Carmine Sicignano
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Mariaevelina Prudente
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Arturo De Falco
- Neurology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Alessandro Villa
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Marina Lugarà
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Giovanna Pezzullo
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Vincenzo D'Agostino
- Neuroradiology Unit Ospedale del Mare, ASL NA1 Centro, Via Enrico Russo, Napoli, Italia
| | - Gianluca Gatta
- Department of Precision Medicine, University of Campania "L. Vanvitelli", Caserta, Italia
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Moscicki P, Bachmann GA. Characterization of Female Sexual Dysfunction Associated with Spinal Pathology and Surgery. Sex Med Rev 2022; 10:493-498. [PMID: 37051949 DOI: 10.1016/j.sxmr.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 01/07/2022] [Accepted: 01/13/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Studies demonstrate the connection between adverse sexual function and medical conditions such as diabetes and heart disease. However, in the areas of spinal and spinal cord pathologies that require surgical interventions, there are scant data. OBJECTIVES We undertook a narrative review to synthesize what is known on the topic, raise awareness, and call for action. METHODS PubMed and Google Scholar identified case reports and primary studies evaluating female sexual dysfunction associated with spinal pathology as well as surgical intervention success were reviewed to contextualize and characterize female sexual dysfunction. RESULTS Available case reports and primary studies suggest that female sexual dysfunction can result from traumatic spinal etiologies, malignant tumors, and benign tumors with and without bony involvement. Although identified as a key preoperative predictor in maintenance or improvement of neurologic status, sexuality is rarely addressed in the neurosurgical care plan. In spinal stenosis and degenerative spine disease, over half of patients report pain with sexual activity. Importantly, while pain can hinder sexual activity in females, there are other sexual issues, including desire and subjective arousal, lubrication, orgasm, and satisfaction that are usually not explored. Studies show the impact of spinal pathologies on frequency of sexual intercourse, hypoesthesia, anorgasmia, and depression. Surgical intervention of spinal pathologies has been cited to improve back pain however other types of sexual dysfunction usually fails to improve after surgical intervention. CONCLUSIONS The lack of high-quality research with adequate numbers of female participants that appropriately characterizes the nuances of female sexual dysfunction across various spinal pathologies, with post-surgical intervention analysis and consideration of surgical approach, necessitates consideration for future study. A pre-op and post-op sexual history in all woman undergoing spinal surgery should be a standard of care. Moscicki P, Bachmann GA. Characterization of Female Sexual Dysfunction Associated with Spinal Pathology and Surgery. Sex Med Rev 2021;XX:XXX-XXX.
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Affiliation(s)
- Patricia Moscicki
- Rutgers Robert Wood Johnson Medical School, Women's Health Institute, New Brunswick, NJ, USA
| | - Gloria A Bachmann
- Rutgers Robert Wood Johnson Medical School, Women's Health Institute, New Brunswick, NJ, USA.
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Katz H, Newton-John TRO, Shires A. Sexual Difficulties in the Population with Musculoskeletal Chronic Pain: A Systematic Review. PAIN MEDICINE 2021; 22:1982-1992. [PMID: 33576430 DOI: 10.1093/pm/pnaa451] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To review the current literature on the nature and prevalence of sexual difficulties in the population with chronic musculoskeletal pain, as well as to identify the biopsychosocial factors that maintain these difficulties. DESIGN Systematic review. METHODS Studies were found by using multiple electronic databases and examining reference lists. After application of inclusion and exclusion criteria, 10 studies were eligible for review. Data were extracted and characteristics were described for outcomes of interest (i.e., sexual dysfunction, pain condition, pain intensity, psychosocial factors, gender differences). Cochrane Risk of Bias was assessed for all included studies. RESULTS Ten studies (2,941 participants) were included in the review. Musculoskeletal conditions included low back pain and fibromyalgia. All studies examining sexual functioning found evidence of sexual difficulty among patients with chronic pain. Three studies demonstrated that sexual dysfunction was significantly greater in patients than in healthy matched controls. Nine studies found that greater pain levels significantly correlated with greater sexual dysfunction. Eight studies noted an increased prevalence of sexual difficulties in those with comorbid psychological problems. Heterogeneity between studies was identified, particularly with regard to gender outcomes. The risk-of-bias assessment also highlighted limitations in approximately half of studies. CONCLUSIONS This review reiterates the importance of investigating sexual functioning in the chronic musculoskeletal pain population, given the high prevalence of chronic musculoskeletal pain across all age bands. Given methodological limitations, future research should develop measures that sensitively cater to the various needs of patients with chronic pain. By modifying assessment to include biopsychosocial concerns, practitioners can tailor treatment to address transdiagnostic factors that maintain sexual dysfunction.
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Affiliation(s)
- Haydee Katz
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
| | | | - Alice Shires
- Graduate School of Health, University of Technology Sydney, Sydney, Australia
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Vanti C, Ferrari S, Guccione AA, Pillastrini P. Lumbar spondylolisthesis: STATE of the art on assessment and conservative treatment. Arch Physiother 2021; 11:19. [PMID: 34372944 PMCID: PMC8351422 DOI: 10.1186/s40945-021-00113-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 07/21/2021] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION There is weak relationship between the presence of lumbar spondylolisthesis [SPL] and low back pain that is not always associated with instability, either at the involved lumbar segment or at different spinal levels. Therefore patients with lumbar symptomatic SPL can be divided into stable and unstable, based on the level of mobility during flexion and extension movements as general classifications for diagnostic and therapeutic purposes. Different opinions persist about best treatment (conservative vs. surgical) and among conservative treatments, on the type, dosage, and progression of physical therapy procedures. PURPOSE AND IMPORTANCE TO PRACTICE The aim of this Masterclass is to provide clinicians evidence-based indications for assessment and conservative treatment of SPL, taking into consideration some subgroups related to specific clinical presentations. CLINICAL IMPLICATIONS This Masterclass addresses the different phases of the assessment of a patient with SPL, including history, imaging, physical exam, and questionnaires on disability and cognitive-behavioral components. Regarding conservative treatment, self- management approaches and graded supervised training, including therapeutic relationships, information and education, are explained. Primary therapeutic procedures for pain control, recovery of the function and the mobility through therapeutic exercise, passive mobilization and antalgic techniques are suggested. Moreover, some guidance is provided on conservative treatment in specific clinical presentations (lumbar SPL with radiating pain and/or lumbar stenosis, SPL complicated by other factors, and SPL in adolescents) and the number/duration of sessions. FUTURE RESEARCH PRIORITIES Some steps to improve the diagnostic-therapeutic approach in SPL are to identify the best cluster of clinical tests, define different lumbar SPL subgroups, and investigate the effects of treatments based on that classification, similarly to the approach already proposed for non-specific LBP.
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Affiliation(s)
- Carla Vanti
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
| | - Silvano Ferrari
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
| | - Andrew A. Guccione
- Department of Rehabilitation Science, College of Health and Human Services, George Mason University, Fairfax, VA 22030 USA
| | - Paolo Pillastrini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
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Xiao P, Liu M, Cui L, Ding S, Xie J, Cheng AS. Sexual dysfunction and activity avoidance in female kidney transplant patients. Clin Transplant 2021; 35:e14363. [PMID: 33998698 DOI: 10.1111/ctr.14363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 04/27/2021] [Accepted: 05/10/2021] [Indexed: 02/05/2023]
Abstract
Sexual dysfunction is common after kidney transplantation and has an adverse effect on patients' quality of life. This paper aims to evaluate the female sexual function, activity avoidance, and kidney function among a convenience sample of patients who had a kidney transplant. A cross-sectional study was conducted that included 250 patients had undergone a kidney transplant procedure >3 months ago, from multiple transplant centers and answered a self-reported sociodemographic questionnaire, the female version of the Arizona Sexual Experience Scale, and the Tampa Scale for Kinesiophobia-13. A correlation was found between sexual function and activity avoidance (r = .361, p < .001, n = 250) as well as between activity avoidance and kidney function (r = .198, p = .012, n = 250). Less education, having no child, post-transplant time for <36 months, and smoking (active and passive) were risk factors for female sexual dysfunction after kidney transplantation. The results suggest that physicians that the importance of recognize the relationship between fear of sexual activity and sexual function and that they should provide patients with more education and guidance on post-transplant sexual behaviors.
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Affiliation(s)
- Panpan Xiao
- Xiangya Nursing School, Central South University, Changsha, China
| | - Min Liu
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Lina Cui
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Siqing Ding
- The Third Xiangya Hospital, Central South University, Changsha, China.,Clinical Nursing Safety Management Research Center, Central South University, Changsha, China
| | - Jianfei Xie
- The Third Xiangya Hospital, Central South University, Changsha, China
| | - Andy Sk Cheng
- Department of Rehabilitation Sciences, the Hong Kong Polytechnic University, Kowloon, Hong Kong
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Ferrari S, Vanti C, Giagio S, Anesi M, Youssef S, Bortolami A, Cedraschi C, Pillastrini P. Low back pain and sexual disability from the patient's perspective: a qualitative study. Disabil Rehabil 2020; 44:2011-2019. [PMID: 32931339 DOI: 10.1080/09638288.2020.1817161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE The aim of this qualitative study is to investigate, from patient's perspective, the aspects of the relationship between low back pain and sexual life on physical, psychological and social aspects of individual's life. In addition, this study aims to explore patients' opinions on the role of health care providers in addressing and treating low back pain-related sexual problems. MATERIALS AND METHODS Semi-structured interviews were conducted with 26 outpatients referred to physical therapy for subacute or chronic non-specific low back pain; the questions investigated the presence of sexual disability and aspects related to patient's behaviour. Two independent physical therapists, supervised by a third expert physical therapist and a clinical psychologist proficient in qualitative methodology, performed thematic content analysis to identify categories and themes. RESULTS Patients with low back pain consider sexual disability severely limiting and correlated to pain. This study emphasized the perception of invalidity, the importance of the relationship with the partner, the emotions and gender roles in the couple, and the relevance for health care providers to take part in the clinical management. The physical therapist is believed to be a qualified figure to address this issue and specific suggestions on sexual activity could be useful. CONCLUSION Sexual disability in patients with subacute or chronic LBP acquires an important and individual meaning that can be investigated within the therapeutic context, especially by physical therapists.Implications for RehabilitationSexual disability related to low back pain is considered an important and meaningful topic from the patient's perspective.This reflects the importance of the emotional relationship with the partner.Within the therapeutic context, it is important to provide information to help manage pain during sexual activity.The physical therapist is seen to be a qualified figure to address this issue.
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Affiliation(s)
- Silvano Ferrari
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Carla Vanti
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Silvia Giagio
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Margherita Anesi
- Department of Rehabilitation Medicine, Provincial Healthcare Unit (APSS), Trento, Italy
| | - Saad Youssef
- Department of Medicine and Health Sciences Vincenzo Tiberio, University of Molise, Campobasso, Italy
| | - Arianna Bortolami
- Physiotherapy and Rehabilitation of Pelvic Floor Dysfunction, Studio Pelvic Floor, Padua, Italy
| | - Christine Cedraschi
- Department of Geriatrics and Readaptation (DRG), Service of Internal Medicine and Rehabilitation, and Multidisciplinary Pain Centre, Department of Acute Medicine (DMA), University of Geneva and University Hospitals of Geneva, Geneva, Switzerland
| | - Paolo Pillastrini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Bologna, Italy
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