阴茎部分切除对患者性功能的影响及其与焦虑、抑郁的相关性分析

目的 研究阴茎部分切除对阴茎癌患者性功能的影响,并分析其与患者焦虑、抑郁的相关性.方法 调查行阴茎部分切除手术的46例阴茎癌患者手术前以及手术后6个月时的国际勃起功能指数调查问卷(IIEF-15)评分、焦虑和抑郁自评量表(SAS/SDS)评分,分析其相关性.结果 术后6个月,患者的IIEF-15各项评分以及总分均低于手术前,SAS和SDS评分均高于手术前,差异均具有统计学意义(P＜0.05);术后患者的IIEF-15各项分数以及总分均与SAS、SDS呈现显著的负相关关系(P＜0.001).结论 阴茎部分切除手术导致患者的性功能下降,加重患者抑郁、焦虑的不良状态,两者呈现显著相关性.     

How different cystoscopy methods influence patient sexual satisfaction,anxiety, and depression levels: a randomized prospective trial

Purpose

Bladder cancer (BC) is one of the most common cancers worldwide. BC diagnosis and surveillance is based on cystoscopy (CS). CS impact on patient’s depression, anxiety, and sexual satisfaction (SS) is not sufficiently studied. There are no data on patient’s comfort with flexible or rigid CS.

Methods

We prospectively evaluated pain perception (PP), depression, anxiety, and SS of 100 male patients who previously underwent at least one rigid CS in our department as surveillance after TURB procedure due to non-muscle-invasive BC and were scheduled for the next CS examination. The patients were randomized for flexible or rigid CS. Before CS, patients described their recalled rigid CS-related pain by NRS and fulfilled HADS and SS questionnaires. After CS, PP was re-evaluated immediately and HADS and SS within 7–10 days following the CS.

Results

The baseline scores include 5.2 ± 2.6 points for rigid CS recalled pain, 7.2 ± 3.0 points for HADS anxiety, 5.8 ± 3.5 for depression, and 27.8 ± 5.1 for SS. The flexible CS-related pain was approximately three times lower than the recalled pain level and also than the current rigid CS related (p < 0.001). Mean SS score was two points lowered after rigid CS (p < 0.001). One point decrease in anxiety level was observed after flexible CS (p < 0.001). Multivariate analysis supported the hypothesis of patients benefiting from flexible CS in terms of pain perception, anxiety symptoms, and SS.

Conclusions

Our study demonstrates the superiority of flexible CS in terms of pain alleviation, and shifts in SS and anxiety levels.

     

Marital status, indicators of sexual activity and prostatic cancer.

STUDY OBJECTIVE--To analyse the relationship between marital status, indicators of sexual activity, history of urological and venereal diseases, and the risk of prostatic cancer. DESIGN--Case-control study. SETTING--A network of cooperating hospitals from northern Italy. PARTICIPANTS--A total of 271 patients with histologically confirmed prostatic cancer and 685 controls in hospital because of acute, non-neoplastic, non-genital or urological conditions. MEASUREMENTS AND MAIN RESULTS--Relative risks (RR) and the corresponding 95% confidence intervals (CI) derived from multiple logistic regression equations, including terms for age, area of residence, and education were determined. The risk of prostatic cancer was lower in never married than in married men (RR = 0.6), but not significantly so. Cases reported a significantly higher number of marriages than control subjects, and the RR was 3.2 (95% CI = 1.2, 8.9) for two or more marriages compared with never married men. Prostatic cancer patients also reported being significantly older at the time of their first marriage: compared with men who first married under age 25 years, the RR was 1.6 for marriage at age 25 to 29, and 1.8 for age 30 or more. With regard to urological or venereal diseases, only cystitis and nephrolithiasis were more frequently reported by cases, although there was no tendency for the risk to increase with the number of cystitis episodes and the RR decreased for longer periods since the first episode. CONCLUSIONS--Although these results do not show a totally cohesive picture, they confirm that some aspects of sexual lifestyle are associated with prostatic cancer in Italy.     

Marital sexual enjoyment and frustration of professional men

The psychological maturity, interpersonal, and marital attributes associated with the sexual pleasure and frustration of 59 married professional men, who had also been studied as adolescents, were examined by means of 10–12 hr of psychological tests, questionnaires, and interviews. The men's wives, closest friends, and colleagues also completed questionnaires about them. Masters and Johnson's hypothesis was confirmed that sexual pleasure is enhanced in psychologically mature and healthy men whose interpersonal relations are mature, whose relations with their spouses are marked by mutuality in fulfillment of each other's needs, and whose marriages are happy and satisfying. Increasing sexual frustration was associated, although not so consistently, with psychological unhealthiness, interpersonal immaturity, inadequate marital communication, and marital unhappiness. Degree of adult sexual pleasure and frustration was not reliably predicted by adolescent personality traits.This research was supported by the Spencer Foundation, W. Clement and Jessie Stone Foundation, and the National Institute of Mental Health, No. 11227.     

Cognitive distraction and women's sexual functioning

Past research on the role of cognitive distraction in sexual dysfunction typically has focused on males and has been conducted in the laboratory using artificial stimuli. In the current study, young adult women (N = 74) with coital experience completed questionnaires regarding cognitive distraction and their sexuality. Those women who reported greater cognitive distraction during sexual activity with a partner also reported relatively lower sexual esteem, less sexual satisfaction, less consistent orgasms, and higher incidence of pretending orgasm even after the women's general affect, sexual desire, general self-focus, general sexual attitudes, and body dissatisfaction were statistically controlled. Results are discussed with regard to directions for future research and implications for sex therapy.     

The relationship among back injury,pain and sexual functioning

Retrospective, self-reported frequencies of pre- and post-injury sexual intercourse were compared in four back injury diagnostic groups. Comparisons were made among groups, and the relation of self-reported pain was compared to the frequency of self-reported sexual intercourse. One hundred subjects were interviewed and their medical records reviewed two years, on average, post-injury. All subjects reported a reduction in sexual frequency post-injury. The surgery group was found to experience a greater reduction in sexual frequency than non-surgery back injured patients. In addition, all subjects reported experiencing some level of pain, and the degree of reported pain was significantly correlated with reduced frequency of sexual intercourse. However, this relationship was considered clinically insignificant. The implications of these findings for individuals with chronic back pain are discussed.Private Practice, Columbia, South Carolina.     

Gender, sexual dysfunctions, and the Journal of Sex & Marital Therapy.

The purpose of this study is to examine male and female sexual dysfunctions present in the Journal of Sex & Marital Therapy. The Journal of Sex Research, the Journal of Sex Education and Therapy, and the Archives of Sexual Behavior also are briefly discussed. The types of dysfunctions investigated include female orgasmic disorder, female sexual arousal disorder, male erectile disorder, and premature ejaculation. The results indicate that the focus has shifted to male sexual dysfunctions. Specifically, there is greater attention paid to erectile dysfunction. The implications of these findings are discussed.     

Radiotherapy for prostate cancer and sexual functioning

The incidence of erectile dysfunction after radiotherapy for prostate cancer is high. A multifactorial aetiology has to be considered, taking into account pretreatment erectile function. Patients need to be informed about effective treatments such as sildenafil and intracavernosal injections.     

产后母亲情绪与婴儿气质的关系

目的研究母亲在产后3个月内的抑郁、焦虑情绪对婴儿气质的影响。方法选取590名产妇,在产后3d、42d和3个月时以医院用抑郁/焦虑量表和爱丁堡产后抑郁量表进行评价,在3个月时由母亲填写婴儿气质量表评价婴儿的气质情况。结果产后3个月内有抑郁、焦虑情绪母亲的婴儿,其气质为中间偏难养型、难养型和启动缓慢型的比例较母亲无抑郁、焦虑情绪的婴儿有明显增高。母亲的抑郁、焦虑情绪对婴儿气质因子中的活动水平、趋避性、适应性、反应强度、情绪本质及注意分散度的变化有影响。婴儿气质类型为中间偏难养型、难养型和启动缓慢型的母亲中有抑郁焦虑情绪的母亲的比例也较高。结论产后母亲的抑郁、焦虑情绪对早期婴儿的气质发育有影响。     

牙周炎与抑郁、焦虑情绪及生活方式的相关性研究

目的 探讨牙周炎与抑郁、焦虑情绪及生活习惯的相关性.方法 从某医院体检人群中选取单纯牙周炎175例(轻、中、重度牙周炎分别为70例、58例和47例)和健康对照组200例为研究对象,以自填式问卷方式调查研究对象的一般情况、心理因素(抑郁和焦虑症状评定量表)及生活方式等内容.结果 轻、中、重度牙周炎组抑郁、焦虑情绪评分及检出率均高于健康组,且差异有统计学意义(均有P ＜0.05);多因素非条件Logistic回归分析结果显示,牙周炎危险因素有抑郁情绪(OR=4.090,95％ CI:1.901 ～8.800)、焦虑情绪(OR =3.311,95％ CI:1.586 ～6.912)、糖尿病(OR=2.543,95％CI:1.387 ～4.665)、高血压(OR=2.505,95％ CI:1.353 ～4.638)、吸烟(OR=2.262,95％ CI:1.622～3.154)、不良口腔习惯(OR=1.838,95％ CI:1.081 ～3.127)和饮酒(OR=1.705,95％ CI:1.225 ～2.374),保护因素有刷牙时间≥3 min(OR =0.318,95％ CI:0.186 ～0.544)、定期牙周检查(OR=0.374,95％ CI:0.203 ～0.689)、使用牙线(OR=0.450,95％ CI:0.262 ～0.772)、积极心理应对方式(OR=0.492,95％ CI:0.288 ～0.840)和饮用绿茶(OR=0.674,95％ CI:0.470～0.966).结论 改善牙周炎患者的不良情绪,控制血糖、血压,养成良好的口腔卫生习惯及生活方式,戒除不良行为等,可降低牙周炎的患病率.     

Marital status disparities in maternal smoking during pregnancy, breastfeeding and maternal depression

One of the dramatic recent changes in family life in Western nations has been the rise in non-marital childbearing. Much of this increase is attributable to the growth in cohabitation. But in some countries, notably the UK (and the USA) this is much less the case with significant proportions of children being born to parents who are not living together. This study uses data from the Millennium Cohort Study, a British birth cohort established in 2001, to examine whether the closeness of the tie between parents, as assessed by their partnership status at birth, is related to smoking during pregnancy, breastfeeding and maternal depression. Four sets of parents are distinguished representing a hierarchy of bonding or connectedness: married and cohabiting parents, and two groups of solo mothers, those closely involved with the father at the time of the birth and those not in a relationship. Smoking in pregnancy, breastfeeding and maternal depression tests for trend, adjusted for socio-demographic factors, showed that there was a statistically increased risk of adverse health and health behaviours by degree of parental connectedness. There were also consistent and statistically significant differences between married and non-married mothers. Particularly noteworthy was the finding that cohabiting mothers have greater risk of adverse outcomes than married women. Among the non-married set, there were also differences in risk of adverse outcomes. For smoking in pregnancy, the key difference for continuing to smoke throughout the pregnancy lay between mothers involved with partners and those lacking an intimate relationship. For breastfeeding, stronger parental bonds were associated with initiation of breastfeeding, with a clear difference between cohabiting mothers compared to solo mothers. There was also an increased risk of maternal depression with looser parental bonding, and among non-married groups this increased risk was most noticeable among cohabiting mothers when compared with solo mothers.