Böbrek Nakli Yapılan Kadın Hastalarda Cinsel işlev Bozukluğu’nun Arizona Cinsel Yaşantılar Ölçeği ile Değerlendirilmesi

Abstract

Bu çalışma böbrek nakli (KTx) yapılan kadınlarda Arizona Sexual Experiences Scale (ASEX) ile cinsel işlev bozukluğu sıklığı (SD), SD alt başlıklarını araştırmayı ve KTx öncesi ve sonrası SD sıklığını karşılaştırmayı amaçlamıştır. Çalışmaya 70 KTx yapılan kadın hasta dahil edildi. Hastaların karakteristik özellikleri, kronik hastalıkları, kullandıkları ilaçlar elektronik kayıtlardan elde edildi. SD değerlendirilmesi için ASEX kullanıldı. Hastalarımızın median yaş değeri 39 (23-66) yıldı. Hastalarımızın %11.4’inde diabetes mellitus (DM) tanısı vardı. Hastaların %97’si prednisolon tedavisi alıyordu. İmmünsupresif tedavi alan hastaların %58.6’i mikofenolik asit, %20’si mikofenolat mofetil, %18.6’sı azathioprin, %57.1’i takrolimus, %34.3’ü siklosporin, %2.9’u sirolimus, %4.3’ü everolimus tedavisi alıyordu. ASEX ile değerlendirilen SD oranı, %24.3 olarak saptandı. Hastalarımızın güncel ve önceki döneme ait ASEX alt grup skorları karşılaştırıldığında, alt grup skorları ve toplam skorlar arasında anlamlı fark bulunamadı. Hastalarımızda SD oranının KTx sonrası %27.4’den %24.3’e düştüğü gözlemlendi. Çalışmamızda böbrek nakli sonrası cinsel işlev bozukluğunda hafif, anlamlı olmayan bir azalma görüldü. Sonuç olarak böbrek nakli böbrek replasman tedavisi hastalarında SD insidansını azaltabilir ve hastanın iyilik halini arttırabilir.

Keywords

• ASEX
• Böbrek nakli
• Cinsel işlev bozukluğu

Assessment of Sexual Dysfunction in Female Kidney Transplant Patients Using the Arizona Sexual Experiences Scale

Abstract

This study aimed to investigate the prevalence of sexual dysfunction (SD) and its subcategories using the Arizona Sexual Experiences Scale (ASEX) in women undergoing kidney transplantation (KTx) and to compare the prevalence of SD before and after KTx. This study included 70 female KTx patients. Patient characteristics, chronic diseases, and medications were obtained from electronic records. ASEX was used to assess SD. The median age of our patients was 39 (23-66) years. Diabetes mellitus was diagnosed in 11.4% of our patients. In total, 97% of patients were receiving prednisolone therapy. Among patients receiving immunosuppressive therapy, 58.6% were receiving mycophenolic acid, 20% mycophenolate mofetil, 18.6% azathioprine, 57.1% tacrolimus, 34.3% cyclosporine, 2.9% sirolimus, and 4.3% everolimus. The SD rate as assessed by the ASEX was 24.3%. No significant difference was found between the current and previous ASEX subgroup and total scores when the scores of our patients were compared. We observed a decrease in the SD rate of 27.4% to 24.3% after KTx in our patients. In our study, sexual dysfunction showed a slight, non-significant decrease following kidney transplantation. In conclusion, kidney transplantation may reduce the incidence of SD and improve patient well-being among renal replacement therapy patients.

Keywords

• ASEX
• Kidney transplantation
• Sexual dysfunction

References

1. 1. Dalpiaz O, Kerschbaumer A, Mitterberger M, et al. Female sexual dysfunction: a new urogynaecological research field. BJU Int 2008;101(6):717-21.
2. 2. İncesu C. Cinsel islevler ve cinsel işlev bozuklukları. Klinik Psikiyatri 2004;3:3-13.
3. 3. Lewis RW, Fugl-Meyer KS, Corona G, et al. Definitions/epidemiology/risk factors for sexual dysfunction. J Sex Med 2010;7:1598–607.
4. 4. Registry of the Nephrology, Dialysis and Transplantation in Turkey report, 2003.
5. 5. Burgos FJ, Pascual J, Gomez V, et al. Effect of kidney transplantation and cyclosporine treatment on male sexual performance and hormone profile: a prospective study. Transplant Proc 1997;29:227-8.
6. 6. Finkelstein SH, Finkelstein FO. Evaluation of sexual dysfunction in dialysis patients. In: Nissenson AR, Fine RN, editors. Dialysis Therapy. 3rd ed. Philadelphia: Hanley and Belfus; 2002. 368-73.
7. 7. Michaelides N, Humke W. Erfahrungen bei der gynäkologischen Betrteuung von Patientinnen mit chronischer Niereninsuffizienz. Nieren-und Hochdruckkrankheiten 1993;22:187-92.
8. 8. Schaefer RM, Kokot F, Wernze H, Geiger H, Heidland A. Improved sexual function in hemodialysis patients on recombinant erythropoietin: A possible role for prolactin. Clin Nephrol 1989;31:1-5.

9. 9. Fearing MO. Case management of anemic patient. Epoetin alfa: Focus on sexual dysfunction. ANNA J 1992;19:570-1.
10. 10. Imagawa A, Kawanishi Y, Numata A. Is eryhropoetin effective for impotance in dialysis patients. Nephron 1990;54:95-6.
11. 11. Lawrence IG, Price DE, Howlett TA, et al. Erytropoetin and Sexual dysfunction. Nephrol Dial Transplant 1997;12:741-7.
12. 12. Zarifian A. Case study of anemic patient: Epoetin anfa-focus on sexual function. ANNA J 1994;21:368-71.
13. 13. Diemont WL, Vruggink PA, Meuleman EJ, et al. Sexual dysfunction after renal replacement therapy. Am J Kidney Dis 2000;35:845-51.
14. 14. Aslan E, Beji NK, Gungor I, Kadioglu A, Dikencik BK. Prevalence and Risk Factors for Low Sexual Function in Women: A Study of 1009 Women in an Outpatient Clinic of a University Hospital in İstanbul. J Sex Med 2008;5:2044-52.
15. 15. Cayan S, Akbay E, Bozlu M, Canpolat B, Acar D, Ulusoy E. The Prevalance of Female Dysfunction and Potential Risk Factors That May Impair Sexual Function in Turkish Women. Urol Int 2004;72:52-7.
16. 16. Amidu N, Owiredu WK, Woode E, et al. Incidence of sexual dysfunction: a prospective survey in Ghanaian females. Reprod Biol Endocrinol 2010;8:106-11.
17. 17.Lew-Starowicz M, Gellert R. The sexuality and quality of lifeof hemodialyzed patients--ASED multicenter study. J Sex Med2009;6:1062-71.
18. 18.Pontiroli AE, Cortelazzi D, Morabito A. Female sexualdysfunction and diabetes: a systematic review and meta-analysis. J Sex Med 2013;10:1044-51.
19. 19.Basok EK, Atsu N, Rifaioglu MM, et al. Assessment of femalesexual function and quality of life in predialysis, peritonealdialysis, hemodialysis, and renal transplant patients. Int UrolNephrol 2009;41:473-81.
20. 20.Kurdoglu Z, Usul Soyoral Y, Tasdemir M, et al. Evaluation ofthe relationship between endogenous gonadotropins and femalesexual function and psychological status in predialysis andhemodialysis patients. Gynecol Endocrinol 2012 ;28:336-9.
21. 21.Strippoli GF1; Collaborative Depression and SexualDysfunction (CDS) in Hemodialysis Working Group, VecchioM, et al. Sexual dysfunction in women with ESRD requiringhemodialysis. Clin J Am Soc Nephrol 2012;7:974-81.
22. 22.Koca TG, Koca N, Ersoy A. The comparison of the relationship between sociocultural-economic features and sexualdysfunction frequency in sexually active premenopausal femalepatients on renal replacement therapy. J Sex Med 2012;9:3171-9.
23. 23.McGahuey CA, Gelenberg AJ, Laukes CA, et al. The ArizonaSexual Experience Scale: Validity and reliability, in NewResearch Program and Abstracts, 150th Annual Meeting of theAmerican Psychiatric Association. Washington, DC, APA,1997:116.
24. 24.Soykan A. The reliability and validity of Arizona SexualExperiences Scale in Turkish ESRD patients undergoinghemodialysis. Int J Impot Res 2004;16:531–4
25. 25.Ali, S., & Dave, N. N. (2020). Sexual dysfunction in womenwith kidney disease. Advances in Chronic KidneyDisease, 27(6), 506-515.
26. 26.Filocamo, M. T., Zanazzi, M., Li Marzi, V., Lombardi, G., DelPopolo, G., Mancini, G., ... & Nicita, G. (2009). Sexualdysfunction in women during dialysis and after renaltransplantation. The journal of sexual medicine, 6(11), 3125-3131.
27. 27.Wang, G. C., Zheng, J. H., Xu, L. G., Min, Z. L., Zhu, Y. H.,Qi, J., & Duan, Q. L. (2010). Measurements of serum pituitary‐gonadal hormones and investigation of sexual and reproductivefunctions in kidney transplant recipients. International journalof nephrology, 2010(1), 612126.
28. 28.Vranješ, I. M., Školka, I., Jakab, J., Krajina, I., Krajina, V.,Šantić, A., & Zibar, L. (2022). Sexual function in hemodialysisand post-renal transplant women in a relationship: a cross-sectional study. International Urology and Nephrology, 54(8), 2037-2046.
29. 29.Pyrgidis, N., Mykoniatis, I., Tishukov, M., Sokolakis, I.,Nigdelis, M. P., Sountoulides, P., ... & Hatzichristou, D. (2021). Sexual dysfunction in women with end-stage renal disease: asystematic review and meta-analysis. The journal of sexualmedicine, 18(5), 936-945.
30. 30.Rosen R, Brown C, Heiman J, et al. The Female SexualFunction Index (FSFI): a multidimensional self-reportinstrument for the assessment of female sexual function. J SexMarital Ther 2000;26:191-208.
31. 31.Kurtulus, F. O., Salman, M. Y., Fazlioglu, A., & Fazlioglu, B.(2017, November). Effects of renal transplantation on femalesexual dysfunction: comparative study with hemodialysis and acontrol group. In Transplantation proceedings (Vol. 49, No. 9,pp. 2099-2104). Elsevier.
32. 32.Pertuz, W., Castaneda, D. A., Rincon, O., & Lozano, E. (2014,November). Sexual dysfunction in patients with chronic renaldisease: does it improve with renal transplantation?.In Transplantation proceedings (Vol. 46, No. 9, pp. 3021-3026). Elsevier.
33. 33.Einollahi, B., Tavallaii, S. A., Bahaeloo-Horeh, S., Omranifard,V., Salehi-Rad, S., & Khoddami-Vishteh, H. R. (2009). Marital relationship and its correlates in kidney recipients. Psychology, health & medicine, 14(2), 162-169.
34. 34.Kenawy, A. S., Gheith, O., Al-Otaibi, T., Othman, N., AboAtya, H., Al-Otaibi, M., & Nagy, M. S. (2019). Medicationcompliance and lifestyle adherence in renal transplantrecipients in Kuwait. Patient preference and adherence, 1477-1486.
35. 35.Mota, R. L., Fonseca, R., Santos, J. C., Covita, A. M., Marques, N., Matias, P., ... & Cardoso, J. (2019). Sexual dysfunction andsatisfaction in kidney transplant patients. The journal of sexualmedicine, 16(7), 1018-1028.
36. 36.Xiao, P., Liu, M., Cui, L., Ding, S., Xie, J., & Cheng, A. S.(2021). Sexual dysfunction and activity avoidance in femalekidney transplant patients. Clinical Transplantation, 35(8), e14363.
37. 37.Laguerre, M., Bouvier, N., Guleryuz, K., Doerfler, A., Parienti,J.J., Ait Said, K., & Tillou, X. (2021). Sexual DysfunctionImprovement after Kidney Transplantation: A ProspectiveStudy in Men and Women. International Journal of SexualHealth, 33(1), 1-8.