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Tjahjodjati T, Steven S. Better renal replacement therapy to improve sexual function in female patients with end-stage renal disease: A cross-sectional study. Curr Urol 2023. [DOI: 10.1097/cu9.0000000000000195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
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2
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Yazıcı R, Yeksan M. Sexual dysfunction in female and male patients undergoing chronic ambulatory peritoneal dialysis. Int J Artif Organs 2023; 46:74-80. [PMID: 36585754 DOI: 10.1177/03913988221145505] [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: 01/01/2023]
Abstract
BACKGROUND To prolong survival and to provide a better quality of life (QoL) are two aims at the forefront in the care of peritoneal dialysis (PD) patients. In this study we aimed to determine frequency of sexual dysfunction (SD) and influencing factors in PD patients. METHODS Of the 201 patients, 114 under 65 years and on chronic ambulatory PD for at least 3 months were enrolled. Forty-nine females and 65 males completed the study. Survey forms were applied using face-to-face interview method. Female Sexual Function Index (FSFI) was used to assess SD in women; International Index for Erectile Function (IIEF) was used to assess erectile dysfunction (ED) in men. All patients completed SF-36 and Beck Depression Inventory (BDI) forms. RESULTS While SD was evident in 89.8% of female patients (FSFI score:10.4 ± 9.7), ED was present in 87.7% of males (IIEF score:13.8 ± 7.9). Depression rates were 65.3% and 49.2% in female and male patients, respectively. BDI scores were 21.6 ± 10.4 and 17.1 ± 9.5; physical component scores, 52.6 ± 20.4 and 55.2 ± 20.2; mental component scores, 45.2 ± 19.8 and 49.9 ± 22, in female and male patients, respectively. FSFI was correlated with age (β = -0.53 p < 0.001) and BDI score (β = -0.23 p = 0.04), (R2 = 0.64). ED showed correlation with age (β = -0.36 p < 0.001), BDI score (β = -0.57 p < 0.001), and hemoglobin level (β = 0.26 p = 0.003), (R2 = 0.74). CONCLUSION SD, often overlooked and not discussed by both patients and physicians, is encountered relatively frequently among PD patients. Left not discussed and untreated SD may adversely affect QoL.
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Affiliation(s)
- Raziye Yazıcı
- Department of Internal Medicine, Division of Nephrology, Konya Beyhekim Training and Research Hospital, Konya, Turkey
| | - Mehdi Yeksan
- Department of Internal Medicine, Division of Nephrology, Meram School of Medicine, Konya, Turkey
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Obaid ZM, Amer AW, Zaky MS, Elhenawy RM, Megahed AEM, Hanafy NS, Elsaie ML. Prevalence of female sexual dysfunction among diabetic females: a cross sectional case controlled study. Postgrad Med 2022; 134:680-685. [PMID: 35838136 DOI: 10.1080/00325481.2022.2102842] [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: 10/17/2022]
Abstract
BACKGROUND Sexual relationships, sexual functions are all parts of the female sexual identity and which influence physiological, psychological and reproductive functions of women. AIM OF THE WORK The study aimed to identify prevalence of Female Sexual Dysfunction (FSD) in women affected by type 1 and type 2 Diabetes Mellitus (DM) and to evaluate the impact of diabetes on female sexuality. PATIENT AND METHODS This cross-sectional study was carried out on 400 married females who were interviewed to answer Female Sexual Function Index (FSFI) questionnaire and were divided into two groups: the first group included 300 diabetes patients (134 patients with type 1 DM and 166 patients with type 2 DM), while the second included 100 women not diagnosed with diabetes who served as controls. RESULTS Considering female sexual dysfunction (score < 26.55), there was statistically significant increase of patients with female sexual dysfunction (FSD) in Type1 DM (50.7%) when compared to type 2 DM patients (28.9%) or control group (10.0%).. Conclusion FSD is a significant health problem in premenopausal women complaining of DM. Females with type 1 DM were more affected than females with type 2 DM, who in turn were more affected than healthy controls. Long duration of the disease was the main risk factor for developing FSD.
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Affiliation(s)
- Zakaria M Obaid
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Ahmed W Amer
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Mohamed S Zaky
- Department of Dermatology, Venereology and Andrology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Raghda M Elhenawy
- Department of Dermatology, Damietta dermatology and leprosy hospital, Egypt
| | - Alaa Eldin M Megahed
- Department of Obstetrics and Gynaecology, Damietta Faculty of Medicine, Al-Azhar University, Egypt
| | - Noha S Hanafy
- Department of Dermatology, Medical Research and Clinical Studies Institute; National Research Centre, Egypt
| | - Mohamed L Elsaie
- Department of Dermatology, Medical Research and Clinical Studies Institute; National Research Centre, Egypt
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Zahran MH, Elwasif SM, Khan I, Fakhreldin I, Elkasaby GE, El-Hefnawy AS, Osman Y, Ali-El-Dein B. The effect of renal transplantation on female sexual function: An age-matched pair analysis. Urology 2022; 165:164-169. [PMID: 35101547 DOI: 10.1016/j.urology.2022.01.029] [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: 11/24/2021] [Revised: 01/09/2022] [Accepted: 01/17/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To evaluate female sexual function (FSF) after renal transplantation (RT) and compare it to an age-matched normal females (control). MATERIAL AND METHODS The study included 100 sexually active RT women in child-bearing period. Sexual function was evaluated with Female Sexual Function Index (FSFI). We compared the mean scores of all domains of FSFI to an age-matched sexually active normal women. Also, we compared the current FSFI to the pre-transplant status in 54 married women before RT. Factors affecting the FSF after RT were assessed. RESULTS In comparison to control group, RT had statistically significant lower sexual desire (p <0.001) with no significant differences as regard arousal, lubrication, orgasm, satisfaction, pain and total FSFI score (P>0.05). Among RT, 83 % had normal sexual function and 83.7% of the control had normal sexual function (p=0.8). After RT, the FSFI score increased significantly from 20.7±5.4 to 27.8±3.1 (P<0.001) and 85.2% had normal sexual function compared to 22.2% before RT (P<0.001) with statistically significant improvement in all domains (p<0.001) except for pain score (p=0.8). Female circumcision was the only identified factor associated with FSD (P=0.02). CONCLUSION Successful RT significantly improves female sexual function of ESRD patients. The sexual function after RT is comparable to healthy control except for lower sexual desire.
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Affiliation(s)
- Mohamed H Zahran
- Urology department, Urology and nephrology center, Mansoura University, Egypt.
| | - Salwa M Elwasif
- Nephrology department, Urology and nephrology center, Mansoura University, Egypt.
| | - Imran Khan
- Urology department, Urology and nephrology center, Mansoura University, Egypt.
| | - Islam Fakhreldin
- Urology department, Urology and nephrology center, Mansoura University, Egypt.
| | - Ghalia E Elkasaby
- Nursing department, Urology and nephrology center, Mansoura University, Egypt.
| | - Ahmed S El-Hefnawy
- Urology department, Urology and nephrology center, Mansoura University, Egypt.
| | - Yasser Osman
- Urology department, Urology and nephrology center, Mansoura University, Egypt.
| | - Bedeir Ali-El-Dein
- Urology department, Urology and nephrology center, Mansoura University, Egypt.
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5
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Sexual Dysfunction Among Patients With Chronic Kidney Disease. Semin Nephrol 2022; 41:534-549. [PMID: 34973698 DOI: 10.1016/j.semnephrol.2021.10.006] [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: 11/22/2022]
Abstract
Sexual dysfunction (SD) in patients with chronic kidney disease is common and negatively impacts quality of life. SD is often under-appreciated because of overall low awareness. Diagnosis of SD is subjective, and manifestations can be different among men and women. Causes of SD are multifactorial, including psychological disorders, hormonal imbalances, vascular disorders, neurological disorders, and medication side effects. Non-specific approaches to improving sexual function include addressing underlying psychological disorders, promoting lifestyle modifications, optimizing dialysis care, and facilitating successful kidney transplantation, whereas treatment with phosphodiesterase type 5 inhibitor, hormone replacement, and mechanical devices can be offered to patients with specific indications.
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6
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Bayram R, Yıldız H, Karaca Sivrikaya S. Evaluation of Sexual Dysfunction in Patients Undergoing Hemodialysis Treatment. SEXUALITY AND DISABILITY 2021. [DOI: 10.1007/s11195-021-09710-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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7
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Pyrgidis N, Mykoniatis I, Tishukov M, Sokolakis I, Nigdelis MP, Sountoulides P, Hatzichristodoulou G, Hatzichristou D. Sexual Dysfunction in Women With End-Stage Renal Disease: A Systematic Review and Meta-Analysis. J Sex Med 2021; 18:936-945. [PMID: 33903042 DOI: 10.1016/j.jsxm.2021.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/07/2021] [Accepted: 02/18/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND In women with end-stage renal disease (ESRD), female sexual dysfunction (SD) remains underestimated. AIM To explore the prevalence, correlates, diagnostic approach and treatment modalities of sexual symptoms in females with ESRD. METHODS We performed a systematic review and meta-analysis to estimate both the prevalence of SD and the pooled Female Sexual Function Index (FSFI) scores in ESRD females. Similarly, for studies reporting the FSFI score before and after renal transplantation (RT), we estimated the effect of RT on sexual function. Further assessment of heterogeneity was conducted via subgroup and sensitivity analyses, cumulative meta-analysis and univariate meta-regression of important correlates. Records were identified through searching PubMed, Cochrane Library and Scopus databases as well as sources of grey literature until November 2020 (PROSPERO ID: CRD42020215178). OUTCOMES We included 47 studies with 61 patient group entries and 3490 ESRD female individuals (median age: 45.2 years, ΙQR: 40.4-50.6). RESULTS The SD prevalence in all females with ESRD was 74% (95%CI: 67%-80%, I2 = 92%) and the FSFI total score 16.1 points (95%CI: 14.3-17.8, I2 = 98%). The female SD prevalence was 63% (95%CI: 43%-81%, I2 = 92%) in renal transplant recipients, 80% (95%CI: 72%-87%, I2 = 91%) in hemodialysis patients and 67% (95%CI: 46%-84%, I2 = 90%) in peritoneal dialysis patients. The total FSFI score improved by 7.5 points (95%CI: 3.9-11.1, I2 = 92%) after RT. Older age and menopause were associated with higher SD prevalence. CLINICAL TRANSLATION Female SD is highly prevalent in all ESRD women, but renal transplant recipients reported improved sexual function. STRENGTHS & LIMITATIONS We provide the first study about SD in females and assessed the role of RT on sexual function. Contrary, none of the included studies evaluated the concomitant presence of distress with SD. The levels of heterogeneity were substantially high for all outcomes and we could not adjust for further correlates, which might have affected our measures. CONCLUSIONS Sexual symptoms negatively affect the quality of life and warrants appropriate clinical attention, as they are an underdetermined and undertreated clinical entity in females with ESRD. Studies on treatment modalities of female SD in patients with ESRD are mandatory, as currently no relevant studies or clinical recommendations exist. Pyrgidis N, Mykoniatis I, Tishukov M, et al. Sexual Dysfunction in Women With End-Stage Renal Disease: A Systematic Review and Meta-Analysis. Sex Med Rev 2021;18:936-945.
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Affiliation(s)
- Nikolaos Pyrgidis
- Urology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece; Department of Urology, 'Martha-Maria' Hospital Nuremberg, Nuremberg, Germany.
| | - Ioannis Mykoniatis
- Urology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maksim Tishukov
- Urology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ioannis Sokolakis
- Department of Urology, 'Martha-Maria' Hospital Nuremberg, Nuremberg, Germany
| | - Meletios P Nigdelis
- Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Petros Sountoulides
- Urology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Dimitrios Hatzichristou
- Urology Department, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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El Monem MMA, Salim HM. Nursing guidelines to improve sexual function and quality of life among women undergoing hemodialysis. CENTRAL EUROPEAN JOURNAL OF NURSING AND MIDWIFERY 2020. [DOI: 10.15452/cejnm.2020.11.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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9
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Ali S, Dave NN. Sexual Dysfunction in Women With Kidney Disease. Adv Chronic Kidney Dis 2020; 27:506-515. [PMID: 33328067 DOI: 10.1053/j.ackd.2020.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/02/2020] [Accepted: 07/15/2020] [Indexed: 12/23/2022]
Abstract
Sexual health is inversely associated with estimated glomerular filtration rate and is associated with adverse cardiovascular outcomes, depression, poor self-image, and impaired quality of life. Many women with chronic kidney disease (CKD) and ESKD experience symptoms of sexual dysfunction which is underrecognized secondary to a variety of factors including physicians' discomfort in discussing sexual health, patients' reluctance to bring up sexual health, difficulty in the assessment of sexual health in comparison to men, and the overall lack of well-conducted clinical studies in women. The pathophysiology is not fully understood but likely involves changes in sex hormones throughout the hypothalamic-pituitary-ovarian axis. Proper evaluation of this axis is necessary as treatment is tailored to these findings and can improve outcomes. A comprehensive assessment of sexual dysfunction inclusive of women with varying gender identification and sexual orientation, partnered with recognition and treatment of contributing factors as well as identifying the underlying cause, is paramount. With the lack of studies, particularly in women with CKD, treatment options, in some cases, can be considered unchartered territory. In this article, we will review available evidence on the pathophysiology, clinical manifestations, and treatment for sexual dysfunction in women with CKD and ESKD.
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10
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Mok MM, Liu CK, Lam MF, Kwan LPY, Chan GC, Ma MK, Yap DY, Chiu F, Choy CB, Tang SC, Chan TM. A Longitudinal Study on the Prevalence and Risk Factors for Depression and Anxiety, Quality of Life, and Clinical Outcomes in Incident Peritoneal Dialysis Patients. Perit Dial Int 2019; 39:74-82. [DOI: 10.3747/pdi.2017.00168] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Accepted: 04/30/2018] [Indexed: 11/15/2022] Open
Abstract
Background Starting dialysis is an important life event. The prevalence and evolution of psychological symptoms at commencement of long-term dialysis is unclear. We examined the prevalence of and risk factors for depression and anxiety, and the quality of life (QOL) of incident peritoneal dialysis (PD) patients, and also the change of these parameters in the first year of PD in relation to clinical outcomes under the PD-first policy. Methods All patients commencing long-term PD from March 2011 to April 2015 were asked to complete the Hospital Anxiety and Depression Scale (HADS), World Health Organization Quality of Life-BREF and the Kidney Disease Quality of Life Instrument Short Form questionnaire. Patient demographics and the incidence of hospitalization, peritonitis, exit-site infection, and all-cause mortality were studied. The HADS was repeated after 9 – 12 months. Results A high depression score was present in 39.6% of 191 patients at commencement of PD and was more common in diabetes patients (odds ratio [OR] 2.03, 95% confidence interval [CI] 1.09 – 3.81). A high anxiety score was present in 23.6%, and the risk factors included younger age (OR 0.96 per year, 95% CI 0.94 – 0.99) and diabetes (OR 2.59, 95% CI 1.20 – 5.57). Both high depression and anxiety scores were associated with an inferior QOL, overall and across most QOL domains. Depression and anxiety symptoms did not change in the first year of PD and were not associated with short-term clinical outcomes. Conclusions High depression and anxiety scores were prevalent in incident PD patients where PD-first policy is adopted and were associated with inferior QOL. There was no improvement after 1 year of PD. The impact of strategic interventions targeting patient groups at risk such as those with diabetes or of younger age warrants further investigation.
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Affiliation(s)
- Maggie M.Y. Mok
- Division of Nephrology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Carmen K.M. Liu
- Department of Clinical Psychology, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Man Fai Lam
- Division of Nephrology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Lorraine P. Y. Kwan
- Division of Nephrology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Gary C.W. Chan
- Division of Nephrology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Maggie K.M. Ma
- Division of Nephrology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Desmond Y.H. Yap
- Division of Nephrology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Francis Chiu
- Division of Nephrology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Cindy B.Y. Choy
- Division of Nephrology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Sydney C.W. Tang
- Division of Nephrology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
| | - Tak Mao Chan
- Division of Nephrology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong
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11
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Jalón Monzón A, Álvarez Múgica M, Gorostidi Pérez M, Escaf Barmadah S. [Sexual disorders in the renal patient]. Semergen 2018; 45:63-72. [PMID: 30482490 DOI: 10.1016/j.semerg.2018.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 09/04/2018] [Accepted: 09/08/2018] [Indexed: 01/23/2023]
Abstract
Quality of Life Related to Health is currently considered one of the primary therapeutic objectives in renal failure patients who need substitution treatment as life prolonging therapy. Sexual health is a basic right that positively affects the quality of life. Although a significant percentage of chronic patients have some type of sexual dysfunction, this is not openly discussed, making it important for doctors to address these issues in the clinic. A review is presented on the pathophysiology of sexual dysfunctions in both male and female chronic renal patients. The effects of dialysis and transplantation on sexual function will be addressed, as well as presenting the main sexual dysfunctions and their treatment.
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Affiliation(s)
- A Jalón Monzón
- Unidad de Gestión Clínica de Urología, Hospital Universitario Central de Asturias (HUCA), Oviedo, Asturias, España.
| | - M Álvarez Múgica
- Servicio de Urología, Hospital Valle del Nalón, Langreo, Asturias, España
| | - M Gorostidi Pérez
- Unidad de Gestión Clínica de Nefrología, HUCA, Oviedo, Asturias, España
| | - S Escaf Barmadah
- Unidad de Gestión Clínica de Urología, HUCA, Oviedo, Asturias, España
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Keskin G, Babacan Gümüş A, Taşdemir Yiğitoğlu G. Sexual dysfunctions and related variables with sexual function in patients who undergo dialysis for chronic renal failure. J Clin Nurs 2018; 28:257-269. [PMID: 29968304 DOI: 10.1111/jocn.14602] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 06/25/2018] [Accepted: 06/25/2018] [Indexed: 01/14/2023]
Abstract
AIMS AND OBJECTIVES To evaluate personality characteristics and psychological symptoms believed to have an effect on the sexual functions and performances of patients undergoing dialysis treatment. BACKGROUND Chronic renal failure is a life-threatening condition which can often have a poor prognosis. The loss of vital kidney function and other complications can affect almost all age groups. DESIGN A quantitative descriptive study. METHODS The study sample included 225 patients selected randomly from patients who have undergone dialysis treatment for at least 3 months at a dialysis centre in a university hospital. In this study, the Golombok Rust Inventory of Sexual Satisfaction (GRISS), the Eysenck Personality Inventory (EPI) and the Brief Symptom Inventory (BSI) were used. RESULTS In the correlation test, made to investigate the relation between the patients' sexual satisfaction and their personalities, a significant positive relation was found between the communication subscale of the GRISS and the Lie dimension of the EPI, and a significant negative relation was found between the Communication subscale of the GRISS and the Lie dimension of the EPI, and between the Vaginismus and Orgasm subscales of the GRISS and the Extroversion dimension of the EPI. CONCLUSION Results showed that sexual problems, in the areas of nonsensuality, anorgasmia, avoidance and communication, are associated with extroversion and psychological symptoms. RELEVANCE TO CLINICAL PRACTICE Sexual health and the psychological well-being of patients with renal failure is an important issue that should be considered in nursing practice. Nurses should take the psychological problems of patients and their relations with partners into account and consider these problems in a holistic manner within the framework of nursing practice. They would then be able to play an effective role in intervening at an early stage and would be better equipped to help and control the psychological and sexual problems that some patients may experience.
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Affiliation(s)
- Gülseren Keskin
- Atatürk Health Care Vocational School, Ege University, İzmir, Turkey
| | - Aysun Babacan Gümüş
- Nursing Department, Health High School, Çanakkale Onsekiz Mart University, Çanakkale, Turkey
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Basson R, Gilks T. Women's sexual dysfunction associated with psychiatric disorders and their treatment. WOMEN'S HEALTH (LONDON, ENGLAND) 2018; 14:1745506518762664. [PMID: 29649948 PMCID: PMC5900810 DOI: 10.1177/1745506518762664] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 12/08/2017] [Accepted: 01/28/2018] [Indexed: 12/13/2022]
Abstract
Impairment of mental health is the most important risk factor for female sexual dysfunction. Women living with psychiatric illness, despite their frequent sexual difficulties, consider sexuality to be an important aspect of their quality of life. Antidepressant and antipsychotic medication, the neurobiology and symptoms of the illness, past trauma, difficulties in establishing relationships and stigmatization can all contribute to sexual dysfunction. Low sexual desire is strongly linked to depression. Lack of subjective arousal and pleasure are linked to trait anxiety: the sensations of physical sexual arousal may lead to fear rather than to pleasure. The most common type of sexual pain is 10 times more common in women with previous diagnoses of anxiety disorder. Clinicians often do not routinely inquire about their patients' sexual concerns, particularly in the context of psychotic illness but careful assessment, diagnosis and explanation of their situation is necessary and in keeping with patients' wishes. Evidence-based pharmacological and non-pharmacological interventions are available but poorly researched in the context of psychotic illness.
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Affiliation(s)
| | - Thea Gilks
- The University of British Columbia, Vancouver, BC, Canada
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14
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Sexual dysfunction as a determinant of cardiovascular outcome in patients undergoing chronic hemodialysis. Int J Impot Res 2017; 30:14-20. [DOI: 10.1038/s41443-017-0001-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 07/19/2017] [Accepted: 08/25/2017] [Indexed: 01/08/2023]
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15
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Effects of Renal Transplantation on Female Sexual Dysfunction: Comparative Study With Hemodialysis and a Control Group. Transplant Proc 2017; 49:2099-2104. [DOI: 10.1016/j.transproceed.2017.07.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 06/21/2017] [Accepted: 07/30/2017] [Indexed: 11/21/2022]
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16
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Saglimbene V, Natale P, Palmer S, Scardapane M, Craig JC, Ruospo M, Gargano L, Lucisano G, Török M, Celia E, Gelfman R, Bednarek-Skublewska A, Dulawa J, Stroumza P, Leal M, Del Castillo D, Murgo AM, Schon S, Wollheim C, Hegbrant J, Strippoli GFM. The prevalence and correlates of low sexual functioning in women on hemodialysis: A multinational, cross-sectional study. PLoS One 2017; 12:e0179511. [PMID: 28632793 PMCID: PMC5478101 DOI: 10.1371/journal.pone.0179511] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/30/2017] [Indexed: 11/23/2022] Open
Abstract
Sexual dysfunction may affect 80% of women in hemodialysis. However the specific patterns and clinical correlates of sexual functioning remain poorly described. The aim of this study was to assess prevalence and correlates of the individual domains of sexual functioning in women treated with hemodialysis. We recruited, into this multinational cross-sectional study, women treated with long-term hemodialysis (Collaborative Working Group on Depression and Sexual dysfunction in Hemodialysis study). Self-reported domains of sexual functioning were assessed by the Female Sexual Function Index, which is routinely administered within the network of dialysis patients followed by the working group. Lower scores represented lower sexual functioning. Socio-demographic and clinical correlates of each domain of sexual functioning were identified by stepwise multivariable linear regression. Sensitivity analyses were restricted to women who reported being sexually active. We found that of 1309 enrolled women, 659 (50.3%) provided complete responses to FSFI survey questions and 232 (35%) reported being sexually active. Overall, most respondents reported either no sexual activity or low sexual functioning in all measured domains (orgasm 75.1%; arousal 64.0%; lubrication 63.3%; pain 60.7%; satisfaction 60.1%; sexual desire 58.0%). Respondents who were waitlisted for a kidney transplant reported scores with higher sexual functioning, while older respondents reported scores with lower functioning. The presence of depression was associated with worse lubrication and pain scores [mean difference for depressed versus non-depressed women (95% CI) -0.42 (-0.73 to -0.11), -0.53 (-0.89 to -0.16), respectively] while women who had experienced a previous cardiovascular event reported higher pain scores [-0.77 (-1.40- to -0.13)]. In conclusion, women in hemodialysis reported scores consistent with marked low sexual functioning across a range of domains; the low functioning appeared to be associated with comorbidity.
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Affiliation(s)
- Valeria Saglimbene
- Medical Scientific Office, Diaverum, Lund, Sweden
- Sydney School of Public Health, University of Sydney, Sydney, Australia
| | | | - Suetonia Palmer
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Marco Scardapane
- Centre for Outcomes, Research and clinical Epidemiology, Pescara, Italy
| | - Jonathan C. Craig
- Sydney School of Public Health, University of Sydney, Sydney, Australia
| | - Marinella Ruospo
- Medical Scientific Office, Diaverum, Lund, Sweden
- Division of Nephrology and Transplantation, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
| | | | - Giuseppe Lucisano
- Centre for Outcomes, Research and clinical Epidemiology, Pescara, Italy
| | | | | | | | | | - Jan Dulawa
- Medical Scientific Office, Diaverum, Lund, Sweden
- SHS, Medical University of Silesia, Katowice, Poland
| | | | - Miguel Leal
- Medical Scientific Office, Diaverum, Lund, Sweden
| | | | | | | | | | - Jörgen Hegbrant
- Medical Scientific Office, Diaverum, Lund, Sweden
- Diaverum Academy, Bari, Italy
| | - Giovanni F. M. Strippoli
- Medical Scientific Office, Diaverum, Lund, Sweden
- Sydney School of Public Health, University of Sydney, Sydney, Australia
- Diaverum Academy, Bari, Italy
- Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
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Abstract
Sexual dysfunction is a common finding in both men and women with chronic kidney failure. Common disturbances include erectile dysfunction in men, menstrual abnormalities in women, and decreased libido and fertility in both sexes. These abnormalities are primarily organic in nature and are related to uremia as well as the other comorbid conditions that frequently occur in the chronic kidney failure patient. Fatigue and psycho social factors related to the presence of a chronic disease are also contributory factors. Disturbances in the hypothalamic-pituitary-gonadal axis can be detected prior to the need for dialysis but continue to worsen once dialytic therapy is initiated. Impaired gonadal function is prominent in uremic men while the disturbances in the hypothalamic-pituitary axis are more subtle. By contrast, central disturbances are more prominent in uremic women. Therapy is initially directed towards optimizing the delivery of dialysis, correcting anemia with recombinant erythropoietin, and controlling the degree of secondary hyperparathyroidism with vitamin D. For many practicing nephrologists sildenafil has become the first line therapy in the treatment of impotence. In the hypogonadal man whose only complaint is decreased libido, testosterone may be of benefit. Regular gynecologic follow up is required in uremic women to guard against potential complications of unopposed estrogen effect. Uremic women should be advised against pregnancy while on dialysis. Successful transplantation is the most effective means of restoring normal sexual function in both men and women with chronic kidney failure.
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Affiliation(s)
- Biff F Palmer
- Department of Medicine, Division of Nephrology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA.
| | - Deborah J Clegg
- Biomedical Research Department, Diabetes and Obesity Research Division, Cedars-Sinai Medical Center, California, LA, USA
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Cho MK, Shin G. Gender-based experiences on the survival of chronic renal failure patients under hemodialysis for more than 20 years. Appl Nurs Res 2016; 32:262-268. [DOI: 10.1016/j.apnr.2016.08.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 08/20/2016] [Accepted: 08/20/2016] [Indexed: 11/16/2022]
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Thomas HN, Thurston RC. A biopsychosocial approach to women's sexual function and dysfunction at midlife: A narrative review. Maturitas 2016; 87:49-60. [PMID: 27013288 PMCID: PMC4808247 DOI: 10.1016/j.maturitas.2016.02.009] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 02/15/2016] [Indexed: 01/21/2023]
Abstract
A satisfying sex life is an important component of overall well-being, but sexual dysfunction is common, especially in midlife women. The aim of this review is (a) to define sexual function and dysfunction, (b) to present theoretical models of female sexual response, (c) to examine longitudinal studies of how sexual function changes during midlife, and (d) to review treatment options. Four types of female sexual dysfunction are currently recognized: Female Orgasmic Disorder, Female Sexual Interest/Arousal Disorder, Genito-Pelvic Pain/Penetration Disorder, and Substance/Medication-Induced Sexual Dysfunction. However, optimal sexual function transcends the simple absence of dysfunction. A biopsychosocial approach that simultaneously considers physical, psychological, sociocultural, and interpersonal factors is necessary to guide research and clinical care regarding women's sexual function. Most longitudinal studies reveal an association between advancing menopause status and worsening sexual function. Psychosocial variables, such as availability of a partner, relationship quality, and psychological functioning, also play an integral role. Future directions for research should include deepening our understanding of how sexual function changes with aging and developing safe and effective approaches to optimizing women's sexual function with aging. Overall, holistic, biopsychosocial approaches to women's sexual function are necessary to fully understand and treat this key component of midlife women's well-being.
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Affiliation(s)
- Holly N Thomas
- University of Pittsburgh, Department of Medicine, United States.
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A depressão nos doentes hemodialisados: o papel da satisfação corporal e da sexualidade. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.rpsp.2016.02.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Hedayati SS, Daniel DM, Cohen S, Comstock B, Cukor D, Diaz-Linhart Y, Dember LM, Dubovsky A, Greene T, Grote N, Heagerty P, Katon W, Kimmel PL, Kutner N, Linke L, Quinn D, Rue T, Trivedi MH, Unruh M, Weisbord S, Young BA, Mehrotra R. Rationale and design of A Trial of Sertraline vs. Cognitive Behavioral Therapy for End-stage Renal Disease Patients with Depression (ASCEND). Contemp Clin Trials 2015; 47:1-11. [PMID: 26621218 DOI: 10.1016/j.cct.2015.11.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 11/21/2015] [Accepted: 11/23/2015] [Indexed: 11/18/2022]
Abstract
Major Depressive Disorder (MDD) is highly prevalent in patients with End Stage Renal Disease (ESRD) treated with maintenance hemodialysis (HD). Despite the high prevalence and robust data demonstrating an independent association between depression and poor clinical and patient-reported outcomes, MDD is under-treated when identified in such patients. This may in part be due to the paucity of evidence confirming the safety and efficacy of treatments for depression in this population. It is also unclear whether HD patients are interested in receiving treatment for depression. ASCEND (Clinical Trials Identifier Number NCT02358343), A Trial of Sertraline vs. Cognitive Behavioral Therapy (CBT) for End-stage Renal Disease Patients with Depression, was designed as a multi-center, 12-week, open-label, randomized, controlled trial of prevalent HD patients with comorbid MDD or dysthymia. It will compare (1) a single Engagement Interview vs. a control visit for the probability of initiating treatment for comorbid depression in up to 400 patients; and (2) individual chair-side CBT vs. flexible-dose treatment with a selective serotonin reuptake inhibitor, sertraline, for improvement of depressive symptoms in 180 of the up to 400 patients. The evolution of depressive symptoms will also be examined in a prospective longitudinal cohort of 90 HD patients who choose not to be treated for depression. We discuss the rationale and design of ASCEND, the first large-scale randomized controlled trial evaluating efficacy of non-pharmacologic vs. pharmacologic treatment of depression in HD patients for patient-centered outcomes.
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Affiliation(s)
- S Susan Hedayati
- Renal Section, VA North Texas Health Care System, United States; Division of Nephrology, University of Texas Southwestern Medical Center, United States.
| | - Divya M Daniel
- Kidney Research Institute, University of Washington, United States
| | - Scott Cohen
- Division of Nephrology, George Washington University, United States
| | - Bryan Comstock
- School of Public Health, University of Washington, United States
| | - Daniel Cukor
- Department of Psychiatry, SUNY Downstate Medical Center, United States
| | | | - Laura M Dember
- Division of Nephrology, University of Pennsylvania, United States
| | - Amelia Dubovsky
- Department of Psychiatry, University of Washington, United States
| | | | - Nancy Grote
- School of Social Work, University of Washington, United States
| | - Patrick Heagerty
- School of Public Health, University of Washington, United States
| | - Wayne Katon
- Department of Psychiatry, University of Washington, United States
| | - Paul L Kimmel
- National Institute of Diabetes, Digestive and Kidney Diseases, National Institutes of Health, United States
| | | | - Lori Linke
- Kidney Research Institute, University of Washington, United States
| | - Davin Quinn
- Department of Psychiatry, University of New Mexico, United States
| | - Tessa Rue
- School of Public Health, University of Washington, United States
| | - Madhukar H Trivedi
- Department of Psychiatry, University of Texas Southwestern Medical Center, United States
| | - Mark Unruh
- Division of Nephrology, University of New Mexico, United States
| | - Steven Weisbord
- Division of Nephrology, VA Pittsburgh Healthcare System and University of Pittsburgh School of Medicine, United States
| | - Bessie A Young
- Kidney Research Institute, University of Washington, United States
| | - Rajnish Mehrotra
- Kidney Research Institute, University of Washington, United States
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Sabanciogullari S, Taşkın Yılmaz F, Güngör Fİ, Söylemez S, Benli RB. Sexual Function in Patients with Chronic Renal Failure on Hemodialysis and Its Effects on Patients’ Perception of Health and Life Satisfaction. SEXUALITY AND DISABILITY 2015. [DOI: 10.1007/s11195-015-9398-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Muehrer RJ, Lanuza DM, Brown RL, Djamali A. Sexual concerns among kidney transplant recipients. Clin Transplant 2014; 28:1294-302. [DOI: 10.1111/ctr.12454] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2014] [Indexed: 01/23/2023]
Affiliation(s)
- Rebecca J. Muehrer
- School of Nursing; University of Wisconsin-Madison; Madison WI USA
- Section of Nephrology; Department of Medicine; School of Medicine and Public Health; University of Wisconsin-Madison; Madison WI USA
| | | | - Roger L. Brown
- School of Nursing; University of Wisconsin-Madison; Madison WI USA
| | - Arjang Djamali
- Section of Nephrology; Department of Medicine; School of Medicine and Public Health; University of Wisconsin-Madison; Madison WI USA
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Altunoglu A, Yavuz D, Canoz MB, Yavuz R, Karakaş LA, Bayraktar N, Colak T, Sezer S, Ozdemir FN, Haberal M. Relationship Between Inflammation and Sex Hormone Profile in Female Patients Receiving Different Types of Renal Replacement Therapy. Transplant Proc 2014; 46:1585-90. [DOI: 10.1016/j.transproceed.2014.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 04/01/2014] [Indexed: 01/23/2023]
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Association between the hemodialysis adequacy and sexual dysfunction in chronic renal failure: a preliminary study. BMC Urol 2014; 14:4. [PMID: 24401120 PMCID: PMC3925321 DOI: 10.1186/1471-2490-14-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 01/03/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The core question of the study was whether adequately achieved HD affected the sexual dysfunction in women on hemodialysis (HD) with chronic renal failure (CRF). METHODS Thirty-seven female patients on HD, including 18 women with adequate HD and 19 women with non-adequate HD, and 36 healthy controls were included in this study. Demographic and clinical variables, including the sexual hormones estradiol and testosterone, were recorded. Sexual function was assessed according to the Female Sexual Function Index (FSFI) and results were compared between groups. Adequate HD was defined as an average urea clearance of over 1.3 (Kt/V) over three consecutive months. RESULTS All domains of the FSFI questionnaire, with the exception of satisfaction, were higher in the control group than in the HD group. In comparing the adequate and non-adequate HD groups, there was no difference in any of the six domains of the FSDI questionnaire. Among the clinical variables, the number of menopausal women was higher in the HD group than in the control group (P = 0.023). Estradiol and testosterone levels were higher in the control group than in the HD group (P = 0.003, 0.027, respectively). The number of menopausal women and estradiol and testosterone levels showed no differences between the adequate and non-adequate HD groups. Correlation analysis between Kt/V and FSFI showed no significant relationship, but estrogen did show a significant relationship with FSFI (correlation coefficient = 0.399, P = 0.001). CONCLUSIONS HD adequacy alone does not have a significant impact on sexual dysfunction. Other treatments options should be considered to treat sexual dysfunction in women with CRF.
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Sexual dysfunction is more than twice as frequent in Danish female predialysis patients compared to age- and gender-matched healthy controls. Int Urol Nephrol 2013; 46:979-84. [DOI: 10.1007/s11255-013-0566-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2013] [Accepted: 09/07/2013] [Indexed: 01/23/2023]
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Weisbord SD. Sexual Dysfunction and Quality of Life in Patients on Maintenance Dialysis. Semin Dial 2013; 26:278-80. [DOI: 10.1111/sdi.12068] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Assessing and improving the health-related quality of life of patients with ESRD. Nat Rev Nephrol 2012; 8:718-24. [DOI: 10.1038/nrneph.2012.238] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Oyekçin DG, Gülpek D, Sahin EM, Mete L. Depression, anxiety, body image, sexual functioning, and dyadic adjustment associated with dialysis type in chronic renal failure. Int J Psychiatry Med 2012; 43:227-41. [PMID: 22978081 DOI: 10.2190/pm.43.3.c] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Depression is the most widely studied complication in dialysis patients. In patients with chronic renal failure, changes in body image are considered to be associated with invasive treatment interventions. In addition, sexual problems are common in dialysis patients. In this study, hemodialysis and peritoneal dialysis patients are investigated for depression, anxiety, body image, sexual satisfaction, and dyadic adjustment. METHODS Hemodialysis patients (n = 36), peritoneal dialysis patients (n = 54), and healthy controls (n = 30) were included in the study. All the subjects were assessed with Structured Clinical Interview for DSM-IV, Body Image Scale, Beck Depression Inventory, Beck Anxiety Scale, Golombok-Rust Inventory for Sexual Satisfaction, and Dyadic Adjustment Scale. RESULTS Depression (20.64 +/- 15.20) and anxiety levels (14.72 +/- 12.36) were significantly higher in hemodialysis group compared to peritoneal dialysis (13.54 +/- 12.51; 12.74 +/- 11.21) and control groups (7.17 +/- 5.58; 9.86 +/- 9.19). In peritoneal dialysis group, as depression and anxiety levels increased, body image was disturbed and sexual satisfaction decreased. In peritoneal dialysis group, body image (86.98 +/- 23.63) was better than hemodialysis group (101.58 +/- 26.51) and was not different from the control group (83.67 +/- 22.11). In hemodialysis group, as depression and anxiety levels increased, body image was disturbed. In both groups, long-term dialysis disturbed body image. CONCLUSION Patients should be informed about the impacts of dialysis. Clinicians may wish to monitor dialysis-users for anxiety, depression, dyadic adjustment, and body image difficulties at follow-up appointments. Interventions that target intimate partner interventions, appearance-related beliefs, and anxiety depression may be of benefit to this population.
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Kurdoglu Z, Usul Soyoral Y, Tasdemir M, Kurdoglu M. Evaluation of the relationship between endogenous gonadotropins and female sexual function and psychological status in predialysis and hemodialysis patients. Gynecol Endocrinol 2012; 28:336-9. [PMID: 21824048 DOI: 10.3109/09513590.2011.593672] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To evaluate sexual function and psychological state and the factors affecting female sexual dysfunction in predialysis and hemodialysis patients. DESIGN AND METHODS Forty-seven women with chronic renal failure including 22 predialysis patients, 25 hemodialysis patients, and 30 healthy controls were included in this study. Demographic and clinical variables of the patients were recorded. The sexual functions and psychological states of the patients, assessed by the Arizona Sexual Experiences Scale (ASEX) and Beck Depression Inventory (BDI), respectively, were compared between the groups. RESULTS Total ASEX scores, ability to reach orgasm, and BDI scores were significantly higher in predialysis and hemodialysis patients than controls, reflecting sexual dysfunction. The patients in the predialysis group were 6 and 3.8 times more likely to develop depressive symptoms compared to the controls and hemodialysis patients, respectively. The predialysis patients who showed depressive symptoms were 24 times more likely to develop sexual dysfunction compared to those without depression. Serum FSH and LH levels were also positively correlated with arousal and erection/lubrication scores in the predialysis patients with depressive symptoms. CONCLUSION Female predialysis rather than dialysis patients might be more likely to develop depression. Those patients with depressive symptoms may also be at greater risk of developing sexual dysfunction in which increased gonadotropin levels and age may also be contributing factors. Therefore, psychiatric and gynecologic consultations may be beneficial.
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MESH Headings
- Adult
- Female
- Follicle Stimulating Hormone/blood
- Humans
- Kidney Failure, Chronic/blood
- Kidney Failure, Chronic/complications
- Kidney Failure, Chronic/psychology
- Kidney Failure, Chronic/therapy
- Luteinizing Hormone/blood
- Mental Health
- Middle Aged
- Quality of Life
- Renal Dialysis/psychology
- Sexual Dysfunction, Physiological/blood
- Sexual Dysfunction, Physiological/complications
- Sexual Dysfunction, Physiological/psychology
- Sexual Dysfunctions, Psychological/blood
- Sexual Dysfunctions, Psychological/complications
- Sexual Dysfunctions, Psychological/psychology
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Affiliation(s)
- Zehra Kurdoglu
- Department of Obstetrics and Gynecology, Yuzuncu Yil University, Van, Turkey
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Determining the Correlation Between Sexual Satisfaction and Loneliness Levels in Patients with Hemodialysis in a Muslim Community. SEXUALITY AND DISABILITY 2011. [DOI: 10.1007/s11195-011-9252-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Yang Y, Zhou Y, Lu M, An Y, Li R, Chen Y, Lu DR, Jin L, Zhou WP, Qian J, Wang HY. Association between fibroblast growth factor receptor 4 polymorphisms and risk of hepatocellular carcinoma. Mol Carcinog 2011; 51:515-21. [PMID: 21656577 DOI: 10.1002/mc.20805] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2011] [Revised: 05/04/2011] [Accepted: 05/04/2011] [Indexed: 12/11/2022]
Abstract
Human fibroblast growth factor receptor 4 (FGFR4) polymorphisms have recently been shown to be associated with tumor progression of various types of cancer, including cancer of the breast, colon, and prostate and sarcoma. However, their association with hepatocellular carcinoma (HCC) is unknown. We evaluated the association of FGFR4 polymorphisms with risk of HCC in a study population with HCC and with/without hepatitis B virus (HBV) infection in East China. We genotyped four FGFR4 SNPs (rs351855, rs641101, rs376618, and rs31777) in 1,451 Chinese subjects, including 711 patients with HCC, 368 controls with HBV infection and 372 controls without HBV infection, using the TaqMan genotyping assay. Unconditional logistic regression analysis was performed to evaluate associations of genotypes of each SNP with HCC risk. For the rs351855 (Arg388) locus, we observed a reduced HCC risk associated with the T variant genotypes, particularly for those whose tumors with gross portal vein tumor thrombosis (gross PVTT) (OR = 0.66; 95% confidence interval, 95% CI = 0.46-0.95 for CT + TT). Such a protective effect was also observed for those with liver cirrhosis (OR = 0.42; 95% CI = 0.20-0.88 for CT + TT). Clearly the T allele was associated with these conditions. Our findings suggest that genetic polymorphism in FGFR4 may be a marker for risk of HCC with liver cirrhosis and gross PVTT in Chinese populations.
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Affiliation(s)
- Yuan Yang
- Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, PR China
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Vecchio M, Navaneethan SD, Johnson DW, Lucisano G, Graziano G, Saglimbene V, Ruospo M, Querques M, Jannini EA, Strippoli GF. Interventions for treating sexual dysfunction in patients with chronic kidney disease. Cochrane Database Syst Rev 2010:CD007747. [PMID: 21154382 DOI: 10.1002/14651858.cd007747.pub2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND Sexual dysfunction is very common in patients with chronic kidney disease (CKD), but it is still significantly understudied. Treatment options exist but concerns have been raised relating to their efficacy and safety in CKD. OBJECTIVES We assessed the benefits and harms of existing interventions for treatment of sexual dysfunction in patients with CKD. SEARCH STRATEGY In October 2010 we searched the Cochrane Renal Group's specialised register, CENTRAL (The Cochrane Library, issue 10), MEDLINE (from 1966) and EMBASE (from 1980). SELECTION CRITERIA Randomised controlled trials (RCTs) and quasi-RCTs of any pharmacological and non-pharmacological interventions used to treat sexual dysfunction in male and female CKD patients (predialysis, dialysis and kidney transplant) were included. DATA COLLECTION AND ANALYSIS Two authors independently selected eligible studies, extracted data and assessed study quality. Disagreements were resolved in consultation with an arbitrator. Treatment effects were summarised as risk ratios (RR), mean differences (MD) or standardised mean difference (SMD) with 95% confidence intervals (CI) using a random-effects model. MAIN RESULTS Fifteen studies (8 parallel, 7 crossover; 352 patients) were included. Only one study enrolled women. Studies evaluated the effects of phosphodiesterase-5 inhibitors (PDE5i), zinc, vitamin E, vitamin D or bromocriptine compared to placebo. PDE5i significantly increased the overall International Index of Erectile Function-5 (IIEF-5) score (2 studies, 101 patients, MD 10.65, 95% CI 5.34 to 15.96), all its individual domains and the complete 15-item IIEF tool (1 study, 41 patients, MD 2.64, 95% CI 1.32 to 3.96). End of treatment testosterone levels were not significantly increased by addition of zinc to dialysate (2 studies, 22 patients, MD 0.21 ng/mL, 95% CI -2.14 to 2.55) but oral zinc improved end of treatment testosterone levels (1 study, 20 patients, SMD 1.62, 95% CI 0.58 to 2.66). There was no difference in plasma luteinizing and follicle-stimulating hormone levels at the end of the study period with zinc therapy. Only sparse data were available for vitamin E, bromocriptine and dihydroxycholecalciferol in CKD patients and there were no studies of intracavernous injections, transurethral injections, mechanical devices or psychosexual therapies in people with CKD. AUTHORS' CONCLUSIONS PDE5i and zinc are promising interventions for treating sexual dysfunction in men with CKD. Evidence supporting their routine use in CKD patients is limited. There is an unmet need for studying interventions for both male and female sexual dysfunction in CKD, considering the significant disease burden.
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Affiliation(s)
- Mariacristina Vecchio
- Clinical Pharmacology and Epidemiology, Mario Negri Sud Consortium, Via Nazionale 8/A, Santa Maria Imbaro, Chieti, Italy, 66030
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Noohi S, Azar M, Behzadi AH, Barbati ME, Haghshenas A, Amoozgar B, Karami M. COMPARISON OF SEXUAL FUNCTION IN FEMALES RECEIVING HAEMODIALYSIS AND AFTER RENAL TRANSPLANTATION. J Ren Care 2010; 36:212-7. [DOI: 10.1111/j.1755-6686.2010.00198.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Basson R. Sexual Function of Women with Chronic Illness and Cancer. WOMENS HEALTH 2010; 6:407-29. [PMID: 20426607 DOI: 10.2217/whe.10.23] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Addressing the sexual sequelae of chronic disease and its treatment is now accepted as a fundamental part of healthcare. Most of the sexual effects of chronic disease are negative, and ongoing illness continues to modulate a woman's sexual self-image, energy and interest in sexual activity, as well as her ability to respond to sexual stimuli with pleasurable sensations, excitement, orgasm and freedom from pain with genital stimulation or intercourse. Nevertheless, for many women with chronic illness, sexuality remains extremely important despite the commonly associated fatigue and acquired sexual dysfunctions; sexual resilience can be substantial. Following recovery from cancer surgery, chemotherapy and radiation, prognosis can be excellent and a return to full health can often be expected, and yet, there may have been devastating changes to sexual function owing to the cancer treatment. Women with metastatic disease may still treasure sexual intimacy. Assessment and management of sexual dysfunction is therefore necessary in all women with chronic illness or past or present cancer.
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Affiliation(s)
- Rosemary Basson
- Department of Psychiatry, University of British Columbia, Vancouver Hospital, 855 West 12th Ave., Vancouver, BC V5Z 1M9, Canada, Tel.: +1 604 875 8254, Fax: +1 604 875 8249,
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Muller KR, Prosser R, Bampton P, Mountifield R, Andrews JM. Female gender and surgery impair relationships, body image, and sexuality in inflammatory bowel disease: patient perceptions. Inflamm Bowel Dis 2010; 16:657-63. [PMID: 19714755 DOI: 10.1002/ibd.21090] [Citation(s) in RCA: 118] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND There is a paucity of literature on the impact of inflammatory bowel disease (IBD) on relationships, body image, and sexual function from a patient perspective. This study sought to describe patients' perceptions of these issues. METHODS In all, 347 patients, age 18-50 years, from a hospital-based IBD database were surveyed by post. Quantitative and qualitative data were obtained on demographics, relationships, quality of life (QoL), body image, and sexual function. Comparisons were made by diagnosis, gender, and operative status. Univariate and multivariable analyses and logistic regressions were performed; P < 0.05 was regarded as significant. RESULTS The response rate was 62.5%. Overall, 88.5% reported impaired QoL; 50.2% a negative effect on relationship status; and 66.8% impaired body image (females 74.8% versus males 51.4%, P = 0.0007; operated 81.4% versus nonoperated 51.3%, P = 0.0003). A greater proportion of women reported decreased frequency of sexual activity, as did operated subjects (female 66.3% versus male 40.5%, P < 0.0001; operated 68.5% versus nonoperated 50.4%, P = 0.0113). Women and operated subjects also more often reported decreased libido (female 67.1% versus male 41.9% P = 0.0005; operated 67.4% versus nonoperated 52.6%, P = 0.035). 9.7% omitted medication because of perceived negative effect(s) on sexual function. Logistic regression revealed that female gender negatively affected body image, libido, and sexual activity, while limited resection surgery negatively affected body image (all P < 0.005). CONCLUSIONS A large proportion of patients perceive IBD to negatively affect many aspects of sexuality. Females and operated subjects more frequently perceived these negative effects. These findings are important in overall clinical care of patients with IBD and should be addressed.
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Affiliation(s)
- Kate R Muller
- Southern Adelaide IBD Service, Flinders Medical Centre, Bedford Park, South Australia.
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Yencilek F, Attar R, Erol B, Narin R, Aydın H, Karateke A, Sarıca K. Factors affecting sexual function in premenopausal age women with type 2 diabetes: a comprehensive study. Fertil Steril 2010; 94:1840-3. [PMID: 20074725 DOI: 10.1016/j.fertnstert.2009.10.060] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2009] [Revised: 08/13/2009] [Accepted: 10/28/2009] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To compare the factors affecting sexual function in premenopausal women with type 2 diabetes using the female sexual function index (FSFI). DESIGN Cross-sectional study. SETTING Premenopausal women with type 2 diabetes and healthy volunteers in an academic research environment. PATIENT(S) Sixty-two type 2 diabetic women were compared with 50 controls. The FSFI scores of the patients were compared according to age, duration of diabetes, marriage, socioeconomic status, parity, menstruation regularity, body mass index (BMI), and smoking. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) Female sexual function index scores. RESULT(S) The mean FSFI score in diabetics was lower than in controls. Menstrual irregularity and duration of diabetes affected female sexual function unlike age, BMI, socioeconomic status, duration of marriage, or parity. Regularly menstruating women had higher FSFI scores (27.1 ± 6.7) than irregularly menstruating women (20.7 ± 7.4). Type 2 diabetics were divided into three groups according to duration of diabetes. The women having diabetes longer than 10 years had the worse sexual function. Also, smoking affected inversely female sexual well being. CONCLUSION(S) Menstrual disturbance, smoking, and longer duration of diabetes (more than 10 years) impair FSFI scores in premenopausal women with type 2 diabetes.
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Affiliation(s)
- Faruk Yencilek
- Department of Urology, Yeditepe University Medical Faculty, Istanbul, Turkey.
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Filocamo MT, Zanazzi M, Li Marzi V, Lombardi G, Del Popolo G, Mancini G, Salvadori M, Nicita G. Sexual Dysfunction in Women During Dialysis and after Renal Transplantation. J Sex Med 2009; 6:3125-31. [DOI: 10.1111/j.1743-6109.2009.01400.x] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Health related quality of life and the CKD patient: challenges for the nephrology community. Kidney Int 2009; 76:946-52. [DOI: 10.1038/ki.2009.307] [Citation(s) in RCA: 138] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Arslan SY, Ege E. Sexual Experiences of Women Exposed to Hemodialysis Treatment. SEXUALITY AND DISABILITY 2009. [DOI: 10.1007/s11195-009-9132-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Seethala S, Hess R, Bossola M, Unruh ML, Weisbord SD. Sexual function in women receiving maintenance dialysis. Hemodial Int 2009; 14:55-60. [PMID: 19758295 DOI: 10.1111/j.1542-4758.2009.00404.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
While substantial attention has been paid to the issue of sexual dysfunction in men on chronic dialysis, less is known about this problem in women with end-stage renal disease. We sought to assess sexual dysfunction in women on chronic dialysis and determine whether patients discuss this problem with their providers and receive treatment. We prospectively enrolled women receiving chronic hemodialysis or peritoneal dialysis in Pittsburgh, PA. We asked patients to complete the 19-item Female Sexual Function Index (FSFI) to assess sexual function and a 5-item survey that assessed whether patients had discussed sexual dysfunction with their providers and/or received treatment for this problem in the past. We enrolled 66 patients; 59 (89%) on hemodialysis and 7 (11%) on peritoneal dialysis. All patients completed the FSFI, of whom 53 (80%) had FSFI scores <26.55, consistent with the presence of sexual dysfunction. Of 37 patients who were married or residing with a significant other, 27 (73%) had sexual dysfunction. Among 24 participants who reported having been sexually active over the previous 4 weeks, 11 (46%) had sexual dysfunction. Only 21% of patients with sexual dysfunction had discussed this problem with their gynecologist, renal or primary provider, and 3 (6%) reported having received treatment. Sexual dysfunction is common in women on dialysis, even among patients who are married or residing with a significant other and those who are sexually active. However, few women discuss this issue with their providers or receive treatment.
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Affiliation(s)
- Srikanth Seethala
- Department of Medicine, University of Pittsburgh Medical Center, Mercy Hospital, Pittsburgh, Pennsylvania 15240, USA
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Yazici R, Altintepe L, Guney I, Yeksan M, Atalay H, Turk S, Tonbul HZ, Selcuk NY. Female Sexual Dysfunction in Peritoneal Dialysis and Hemodialysis Patients. Ren Fail 2009; 31:360-4. [DOI: 10.1080/08860220902883012] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Esposito K, Ciotola M, Maiorino MI, Giugliano F, Autorino R, De Sio M, Cozzolino D, Saccomanno F, Giugliano D. Hyperlipidemia and Sexual Function in Premenopausal Women. J Sex Med 2009; 6:1696-1703. [DOI: 10.1111/j.1743-6109.2009.01284.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Lew-Starowicz M, Gellert R. The Sexuality and Quality of Life of Hemodialyzed Patients—ASED Multicenter Study. J Sex Med 2009; 6:1062-1071. [DOI: 10.1111/j.1743-6109.2008.01040.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Assessment of female sexual function and quality of life in predialysis, peritoneal dialysis, hemodialysis, and renal transplant patients. Int Urol Nephrol 2008; 41:473-81. [DOI: 10.1007/s11255-008-9475-z] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2008] [Accepted: 09/08/2008] [Indexed: 11/26/2022]
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Yeh SCJ, Huang CH, Chou HC, Wan TTH. Gender Differences in Stress and Coping among Elderly Patients on Hemodialysis. SEX ROLES 2008. [DOI: 10.1007/s11199-008-9515-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kettaş E, Çayan F, Akbay E, Kıykım A, Çayan S. Sexual Dysfunction and Associated Risk Factors in Women with End-Stage Renal Disease. J Sex Med 2008; 5:872-877. [DOI: 10.1111/j.1743-6109.2007.00664.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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