Background: Inflammatory Bowel Disease (IBD) can change patients' quality of life (QoL) and sexuality. The objectives were to evaluate the prevalence of sexual dysfunction and identify clinical and psychological factors associated with erectile dysfunction (ED) in men with IBD.
Methods: An observational study with 43 IBD outpatients and 48 controls was conducted. The Crohn's Disease Activity Index (CDAI) was used to assess the clinical activity of Crohn's Disease (CD) patients. Mayo score was used to assess the clinical activity of Ulcerative Colitis (UC) patients. The Inflammatory Bowel Disease Questionnaire (IBDQ) was used to measure QoL. The hospital anxiety and depression scale (HADS) was used to measure anxiety and depression. Erectile dysfunction was assessed with the International Index of Erectile Function (IIFE). Statistical analysis: descriptive statistics, Chi-square test (χ2), Pearson correlation test and logistical regression. This study was approved by the Research Ethics Committee (CAAE: 27545914.2.0000.5411).
Results: We evaluated 25 CD patients and 18 UC patients. The mean age was 38.8y (±13.5) for patients and 37.6y (±9.9) for controls. Regarding CD patients, 28% presented with activity disease, 64% perianal disease; among UC patients, 17% presented activity disease. 33% patients anxiety and 11% depression. ED was found in 27.9% of patients and 12.5% of controls (p=0.11). The presence of ED in the IBD group was associated with weight loss (p=0.0593), fatigue (p=0.0277), weakness (p=0.0445), perianal disease (p=0.0078) and satisfaction with sex life (p<0.0001). Depression (OR: 1.501; 95% CI: 1.106–2.037, p=0.0091) (R=−0.32180; p=0.0354) and low self-esteem (OR: 0.817; 95% CI: 0.709–0.942, p=0.0053) (R=0.43244; p=0.0038) were associated with increased risk of ED. Patients with a better QoL (OR: 0.981; 95% CI: 0.963–0.999, p=0.0379) had a decreased risk of ED, which was nor associated with the diagnosis of the disease (p=0.67) neither with the presence of disease activity.
Conclusions: Erectile dysfunction was a common finding in our study. Factors associated with ED were disease symptoms as weight loss, fatigue, weakness and presence of perianal disease. Psychological factors as depression and low self-esteem were associated with increased risk of ED.