Double-J Stentlerin Erkek Cinsel Fonksiyonu Üzerine Etkisi

Year 2023, , 263 - 269, 30.06.2023

Mehmet Emin Şirin , Mustafa Karaaslan , Erkan Ölçücüoğlu , Muhammed Emin Polat , Mehmet Yılmaz

https://doi.org/10.18663/tjcl.1288517

Abstract

Amaç: Bu çalışmamızla URS/RIRS sonrası çok sık kullanılan double-J stentler’in (DJS) erektil fonksiyon üzerine etkisini araştırarak literatüre katkıda bulunmayı amaçladık.
Gereç ve Yöntemler: Bu retrospektif çalışmada, üreter ve/veya böbrek taşı nedeniyle yapılan URS/RIRS sonrası DJS uygulanan erkek hastalar yer almaktadır. Hastaların stentli iken ve stent çıkarıldıktan sonraki İİEF-5 skor değişimi ile demografik verileri, alfa blokör kullanımı, cerrahi türü, IPSS, İİEF-5, VAS skoru ve stent takılı kalma süresi univariate analiz ile değerlendirildi. p<0.05 istatistiksel olarak anlamlı kabul edildi.
Bulgular: Dahil edilme kriterlerine uyan 75 erkek hasta istatistiksel analize dahil edildi. Alfa blokörlerden silodosin kullanan hasta grubunda İİEF-5 skor değişimi istatistiksel anlamlı yüksek saptandı (7,16 ± 7,34, p: 0,03). VKİ<25kg/m2 olan hasta grubunda, VKİ≥25 kg/m2 olan hasta grubuna göre istatistiksel anlamlı yüksek İİEF-5 skor değişimi gözlendi(p:0,04). Yaş ile İİEF-5 skor değişimi arasında <40 yaş olanlarda İİEF-5 skor değişimi ≥40 yaş olan hastalara göre istatistiksel anlamlı yüksek saptandı(p:0,006). İİEF-5 skor değişimi ile IPSS ve stent takılı kalma süresi arasında korelasyon saptanmazken(p>0,05) VAS skoru ile istatistiksel anlamlı pozitif korelasyon saptandı (r: 0,306 ve p:0,01). Stentli İİEF-5 skoru ile stent çıkarılmasından 4 hafta sonraki İİEF-5 skoru arasında istatistiksel anlamlı değişim gözlendi (15,72±6,49 ve 20,63±4,81, sırasıyla) (p<0,001).
Sonuç: DJS, erkek cinsel sağlığını geçici de olsa olumsuz etkilemektedir. Özellikle de genç, sağlıklı ve cinsel aktif popülasyonda bu etki daha belirgin olarak ön plana çıkmaktadır. DJS’nin erkek cinsel sağlığı üzerine etkilerinin daha net ortaya konulabilmesi için randomize prospektif ve daha fazla sayıda hasta ile yapılan, ayrıca hastaların ek hastalıklarıyla birlikte hormonal durumlarının da değerlendirildiği çalışmalara gereksinim olduğuna inanmaktayız.
Anahtar Kelimeler: double-j stent; iief-5; erkek cinselliği

Keywords

double-j stent, iief-5, erkek cinselliği

The Effect of Double-J Stents on Male Sexual Function

Abstract

ABSTRACT
Aim: In this study, we aimed to contribute to the literature by investigating the effect of double-j stent (DJS), which is frequently used after URS/RIRS, on erectile function.
Material and Methods: This retrospective study included male patients who underwent DJS after URS/RIRS for ureteral and/or renal stones. Demographic data, alpha-blocker use, type of surgery, IPSS, IIEF-5, VAS score, and the duration of stenting were evaluated by univariate analysis. p<0.05 was considered statistically significant.
Results: 75 male patients who met the inclusion criteria were included in the statistical analysis. The change in IIEF-5 score was found to be statistically significantly higher in the silodosin group among the alpha-blockers (7.16 ± 7.34, p: 0.03). A statistically significant higher IIEF-5 score change was observed in the patient group with BMI<25 kg/m2 compared to the patient group with BMI≥25 kg/m2 (p: 0.04). Between age and IIEF-5 score change, IIEF-5 score change was statistically significantly higher in patients aged <40 years than in patients aged ≥40 years (p:0.006). There was no correlation between IIEF-5 score change and IPSS and duration of stent implantation (p>0.05), while a statistically significant positive correlation was found with VAS score (r: 0.306 and p:0.01). A statistically significant change was observed between IIEF-5 score with stent and IIEF-5 score 4 weeks after stent removal (15.72±6.49 and 20.63±4.81, respectively) (p<0.001).
Conclusion: DJS has a negative, albeit temporary, effect on male sexual health. This effect is particularly pronounced in the young, healthy and sexually active population. We believe that randomized prospective studies with larger numbers of patients and evaluation of patient comorbidities and hormonal status are needed to clarify the impact of DJS on male sexual health.
Keywords: double-j stent; iief-5; male sexuality

Keywords

double-j stent, iief-5, male sexuality

References

• 1. Ambani, S.N. and K.R. Ghani, Stones in 2015: Changes in stone management - suspending belief for evidence. Nat Rev Urol, 2016. 13(2): p. 71-2.
• 2. Akinci, M., T. Esen, and S. Tellaloğlu, Urinary stone disease in Turkey: an updated epidemiological study. Eur Urol, 1991. 20(3): p. 200-3.
• 3. Muslumanoglu, A.Y., et al., Updated epidemiologic study of urolithiasis in Turkey. I: Changing characteristics of urolithiasis. Urol Res, 2011. 39(4): p. 309-14.
• 4. Ilie, V.G. and V.I. Ilie, Ureteric Stent Use - Part of the Solution and Part of the Problem. Curr Urol, 2018. 11(3): p. 126- 130.
• 5. Leibovici, D., et al., Ureteral stents: morbidity and impact on quality of life. Isr Med Assoc J, 2005. 7(8): p. 491-4.
• 6. Calabrò, R.S., et al., Neuroanatomy and function of human sexual behavior: A neglected or unknown issue? Brain Behav, 2019. 9(12): p. e01389.
• 7. Balthazart, J., Sex differences in partner preferences in humans and animals. Philos Trans R Soc Lond B Biol Sci, 2016. 371(1688): p. 20150118.
• 8. Masters, W. and V. Johnson, Human sexual response, Boston (Little, Brown and Company) 1966. 1966.
• 9. Lima, T.F.N., et al., Prevalence of post-prostatectomy erectile dysfunction and a review of the recommended therapeutic modalities. Int J Impot Res, 2021. 33(4): p. 401-409.
• 10. Mota, R.L., et al., Sexual Dysfunction and Satisfaction in Kidney Transplant Patients. J Sex Med, 2019. 16(7): p. 1018-1028.
• 11. Sun, V., et al., Sexual Function and Health-Related Quality of Life in Long-Term Rectal Cancer Survivors. J Sex Med, 2016. 13(7): p. 1071-9.
• 12. Eryildirim, B., et al., Evaluation of sexual function in patients submitted to ureteroscopic procedures. Int Braz J Urol, 2015. 41(4): p. 791-5.
• 13. Mosharafa, A., et al., Effect of endourological procedures on erectile function: a prospective cohort study. Int Urol Nephrol, 2016. 48(7): p. 1055-9.
• 14. van Kollenburg, R.A.A., D.M. de Bruin, and H. Wijkstra, Validation of the Electronic Version of the International Index of Erectile Function (IIEF-5 and IIEF-15): A Crossover Study. J Med Internet Res, 2019. 21(7): p. e13490.
• 15. TURUNÇ, T., et al., Uluslararası cinsel işlev indeksinin 5 soruluk versiyonunun (IIEF-5) Türkçe geçerlilik çalışmasının değerlendirilmesi. Türk Üroloji Dergisi/Turkish Journal of Urology, 2007. 33(1): p. 45-49.
• 16. Bozlu, M., et al., Effect of administration mode (patient vs physician) and patient's educational level on the Turkish version of the International Prostate Symptom Score. International journal of urology, 2002. 9(8): p. 417-421.
• 17. Consultation, W., Obesity: preventing and managing the global epidemic. World Health Organization technical report series, 2000. 894: p. 1-253.
• 18. Anderson, R.M., Positive sexuality and its impact on overall well-being. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz, 2013. 56(2): p. 208-14.
• 19. Diamond, L.M. and D.M. Huebner, Is good sex good for you? Rethinking sexuality and health. Social and Personality Psychology Compass, 2012. 6(1): p. 54-69.
• 20. Aggarwal, S.P., et al., A Randomized Controlled Trial to Compare the Safety and Efficacy of Tadalafil and Tamsulosin in Relieving Double J Stent Related Symptoms. Adv Urol, 2015. 2015: p. 592175.
• 21. Arora, A., et al., Sexual dysfunction in Indian men undergoing Double J ureteral stenting following ureteroscopy-A prospective analysis. Andrologia, 2020. 52(10): p. e13790.
• 22. Giannarini, G., et al., Re: Indwelling ureteral stents and sexual health: a prospective, multivariate analysis. M. C. Sighinolfi, S. Micali, S. De Stefani, A. Mofferdin, M. Grande, M. Giacometti, N. Ferrari, M. Rivalta and G. Bianchi. J Urol 2007; 178: 229-231. J Urol, 2008. 180(3): p. 1188-9; author reply 1189-90.
• 23. Bolat, M.S., et al., Ureterorenoscopy with stenting and its effect on male sexual function: A controlled randomised prospective study. Andrologia, 2017. 49(9).
• 24. Sighinolfi, M.C., et al., Indwelling ureteral stents and sexual health: a prospective, multivariate analysis. J Urol, 2007. 178(1): p. 229-31.
• 25. Giuliano, F. and S. Droupy, [Erectile dysfunction]. Prog Urol, 2013. 23(9): p. 629-37.