General Erectile Kugwira Ntchito pakati pa Achinyamata, Amuna Ogonana Amuna Omwe Amachita Ndiponso Sakunena Mavuto Ogwirizanitsa Kondomu (CAEP) (2015)

NDEMANGA: Onani kusanthula uku kwa kafukufukuyu

Stephanie A. Sanders PhD 1,2,3 , Brandon J. Hill PhD 1,4 , Erick Janssen PhD 1,5 , Cynthia A. Graham PhD 1,2,6,* , Richard A. Crosby PhD 1,2,7 , Robin R. Milhausen PhD 1,2,8 ndi William L. Yarber HSD 1,2,3,9

Nkhani yoyamba yofalitsidwa pa intaneti: 17 AUG 2015

CHITANI: 10.1111 / jsm.12964

Kafukufuku amene adalembedwa mu bukhuli adathandizidwa ndi Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) a National Institutes of Health pansi pa Award Number R21 HD 060447, E. Janssen ndi SA Sanders (PIs). Zomwe zili ndizo udindo wa olemba ndipo sizikuimira mawonedwe ovomerezeka a National Institutes of Health.

Kudalirika

Introduction

Mavuto okhudzana ndi erection (CAEP) ndi chinthu chosagwirizana ndi kugwiritsidwa ntchito kondomu ya amuna kapena osakwanira. Njira zogwiritsira ntchito za CAEP sizidziwika, ndipo kaya amuna omwe amafotokoza mavutowa amakhalanso ndi vuto la erectile m'mikhalidwe yomwe makondomu sagwiritsidwa ntchito sanaphunzirepo.

cholinga

Cholinga cha phunziroli chinali kufufuza, pogwiritsa ntchito kondomu pogwiritsira ntchito achinyamata, amuna amodzi (omwe ali ndi zaka 18-24), ngakhale amuna omwe amafotokoza kuti CAEP ndi ovuta (i) kukhala ndi mavuto okhwimitsa osagwiritsa ntchito makondomu ndi (ii) ) kukwaniritsa zoyenera za erectile kulephera.

Njira

Amuna onse a 479 omwe adatumizidwa pa intaneti adamaliza International Index of Erectile Function (IIEF-5) ndikuyankha mafunso okhudza mavuto okonzekera erection pamene akugwiritsa ntchito komanso osagwiritsira ntchito kondomu m'masiku otsiriza a 90. Chiwerengero cha anthu, chidziwitso cha kugonana, ndi zosiyana siyana zaumoyo zinkafufuzidwa monga correlates.

Zotsatira Zazikulu

Kudziwika kwafupipafupi kosavuta kutayika panthawi yogwiritsira ntchito kondomu kapena penile-m'mimba kugonana (PVI) m'masiku akale a 90 ndi IIEF-5.

Results

Amunawa, 38.4% adasankhidwa mu gulu la CAEP, 13.8% ali ndi CAEP panthawi yogwiritsira ntchito kondomu, 15.7% monga CAEP pa PVI, ndi 32.2% ali ndi CAEP panthawi ya kugwiritsa ntchito kondomu komanso PVI. Amuna amalembera mtundu uliwonse wa CAEP anali ochepa kwambiri kusiyana ndi amuna omwe sanena kuti CAEP iyeneranso kulongosola zovuta zokhudzana ndi kugonana pamene sagwiritse ntchito makondomu. Amuna omwe anafotokoza CAEP pa PVI pokhapokha panthawi yonseyi komanso PVI anapeza zochepa kwambiri pa IIEF-5 kuposa amuna opanda CAEP.

Kutsiliza

Zomwe anapeza zikusonyeza kuti amuna omwe amafotokoza za CAEP amakhalanso ndi mavuto ambiri. Madokotala ayenera kufufuza ngati amuna ogwiritsira ntchito makondomu amapezekanso ndi CAEP ndipo ngati n'koyenera, ayang'anire mankhwala othandizira kugonana kapena kupereka maphunziro a luso la kondomu.

Introduction

Kuchuluka kwa vuto la erectile dysfunction (ED) kumasiyana malinga ndi kafukufuku, kutengera gawo la tanthauzo ndi njira zomwe zagwiritsidwa ntchito [1-3] . Chimodzi mwa zinthu zomwe zimadziwika bwino za mavuto a erectile ndi zaka. Ngakhale kufalikira kwa ED kuli kwakukulu kwambiri pakati pa amuna okalamba [4] , mavuto a erectile amanenedwanso ndi anyamata. Kafukufuku wina wa epidemiologic adawonetsa kuti pafupifupi 2% ya amuna osakwana zaka 40-50 adadandaula za mavuto a erectile pafupipafupi (EPs) [2] . Kafukufuku waposachedwapa m'maiko asanu aku Europe adanenanso kuti 5% ya amuna azaka zapakati pa 18 ndi 29 adakumana ndi ED m'miyezi 6 yapitayi [5] . Komabe, chiwerengero cha anyamata omwe amakumana ndi mavuto a erectile nthawi zina ndi chachikulu kwambiri, kuyambira 16% mwa amuna aku US osakwana zaka 40 [6] mpaka 30% mwa amuna aku Switzerland azaka 18-25 [7].

Kukumana ndi mavuto okhudzana ndi kugonana nthawi zina kumasonyeza kuti zinthu zomwe zimayambitsa vuto la kugonana nthawi zina zingayambitse vuto lalikulu. Kugwiritsa ntchito makondomu a amuna kungakhale chitsanzo chimodzi cha vuto lomwe limapangitsa amuna ena kukhala ndi vuto la kugonana. Mu kafukufuku wa ophunzira azachipatala aku Brazil (zaka zapakati: zaka 21.2), 13.3% adapezeka kuti ali ndi ED, pogwiritsa ntchito simplified International Index of Erectile Function (IIEF-5) [8] . Anyamata achinyamata mu kafukufukuyu omwe adagwiritsa ntchito makondomu anali ndi mwayi wowirikiza kawiri wa kunena za mavuto okhudzana ndi kugonana. Mu chitsanzo cha anyamata achichepere omwe adapezeka kuchipatala cha matenda opatsirana pogonana (STI) [9] , 37.1% ya amuna adanenanso za mavuto okhudzana ndi kugonana okhudzana ndi kondomu (CAEP) nthawi imodzi. Kafukufuku angapo, okhudza amuna ogonana amuna kapena akazi okhaokha komanso amuna kapena akazi okhaokha, tsopano alemba kuti CAEP ikhoza kukhala yofala [10] . Ngakhale njira zomwe zimayambitsa CAEP sizikumveka bwino, mu kafukufuku waposachedwa wa psychophysiologic wa machitidwe okhudzana ndi kugonana, amuna omwe ali ndi CAEP amafunikira nthawi yochulukirapo komanso/kapena kukakamizidwa kwambiri kuti ayambe kugonana kuposa amuna omwe alibe CAEP [11] . Komabe, n'zochititsa chidwi kuti mayankho a erectile anali otsika mu gulu la CAEP pokhapokha mphindi yoyamba yokhudzana ndi chilakolako chogonana, popanda kusiyana kwakukulu pambuyo pake.

Mavuto okhudzana ndi kugonana chifukwa cha kondomu angakhale chinthu chosaganiziridwa bwino chokhudzana ndi kugwiritsa ntchito kondomu molakwika, chifukwa amuna omwe amanena kuti CAEP ndi omwe ali ndi vuto lalikulu logwiritsa ntchito kondomu, kuphatikizapo kutsetsereka kwa kondomu [12] , kugwiritsa ntchito kondomu mochedwa (kuigwiritsa ntchito mochedwa komanso kuchotsa msanga) [9,13] , komanso kugwiritsa ntchito kondomu mosagwirizana [14,15] . Mu kafukufuku wina waposachedwa wokhudza amuna 1,875, malingaliro okhudza "ubwino" wa kugonana (kuphatikizapo kulimba, kutalika kwa mbolo, ndi kuzungulira, komanso kuvutika kusunga kugonana) adalumikizidwa ndi mwayi waukulu wogwiritsa ntchito kondomu molakwika [13] . Amuna akhoza kukhala ndi mwayi waukulu wokumana ndi CAEP ngati alibe chidaliro chogwiritsa ntchito kondomu moyenera, ngati akukumana ndi mavuto ndi momwe kondomu imagwirizanirana kapena momwe imamvekera, komanso ngati agonana ndi anthu ambiri [9].

Zolinga

Funso limodzi limene sikunayambe kufufuzidwa ndiloti amuna omwe amanena kuti CAEP ali ndi vuto lalikulu la Erectile m'zochitika za kugonana kumene makondomu sagwiritsidwe ntchito. Cholinga cha phunziroli chinali kufufuza, pogwiritsa ntchito kondomu pogwiritsira ntchito achinyamata, amuna amodzi (omwe ali ndi zaka 18-24), kaya iwo omwe amafotokoza za CAEP (panthawi yomwe amagwiritsidwa ntchito pa kondomu, penile-vaginal sex [PVI], kapena muzochitika zonsezi) ndizovuta: (i) kukhala ndi EPs pamene sagwiritse ntchito makondomu; ndi (ii) zolemba mosiyana pa IIEF. Cholinga chathu sichinali kuyesa kuchuluka kwa zovuta za erectile koma kuzindikira zilembo za CAEP muzitsanzo za achinyamata, kugwiritsa ntchito kondomu.

Njira

ophunzira

Anthu omwe adatenga nawo mbali anali anyamata, amuna ogonana amuna kapena akazi okhaokha omwe adalembedwa ntchito kudzera m'ma listserv a ku yunivesite (monga magulu a ophunzira aku yunivesite ndi mndandanda wa madipatimenti) ndi ma newsletter apakompyuta omwe adafalitsidwa pa Facebook. Chilolezo chinapezeka kuchokera kwa oyang'anira listserv ndipo malangizo otsatsa a Facebook adatsatiridwa. Tinayesa amuna omwe ali ndi CAEP mopitirira muyeso ndi ma newsletter omwe adafunsa kuti: "Kodi makondomu amasokoneza kugonana kwanu?" ndi "Kodi makondomu amasokoneza chilakolako chanu?" Zofunikira zovomerezeka zikuphatikizapo kukhala ndi intaneti, kukhala ndi zaka zapakati pa 18 ndi 24, kudzizindikiritsa ngati mwamuna kapena mkazi, kugwiritsa ntchito kondomu ya PVI m'masiku 90 apitawa, komanso kuthekera kuwerenga Chingerezi. Kuphatikiza apo, amuna adachotsedwa ngati adakhala pachibwenzi chogonana (chokhala ndi mwamuna m'modzi) kwa mwezi umodzi kapena kuposerapo, chifukwa kugwiritsa ntchito kondomu kwapezeka kuti kwatha mkati mwa mwezi woyamba waubwenzi [16] . Amuna omwe adanena za CAEP adayesa mopitirira muyeso. Tinafunsa omwe adayankha funso linalake kumapeto kwa kafukufukuyu ngati adatenga mafunso mozama komanso ngati chidziwitso chawo chiyenera kugwiritsidwa ntchito; 1.2% yokha idayankha kuti sanatenge kafukufukuyu mozama ndipo tidachotsa deta yawo.

Chitsanzo chomaliza chinali anyamata 479. Chilolezo chodziwitsidwa chinaperekedwa kuchokera kwa onse omwe atenga nawo mbali ndipo University of Institutional Review Board inavomereza njira zonse zowerengera.

Njira

Zotsatira Zoyamba

EPs Popanda Kugwiritsa Ntchito Makondomu

Mafunso awiri adayesa ma EP pomwe amuna sanali kugwiritsa ntchito kondomu. Ophunzira adafunsidwa kuti "Ganizirani za nthawi yomwe mudali ogonana ndi mbolo m'masiku 90 apitawa ndipo simunagwiritse ntchito kondomu." Izi zidatsatiridwa ndi mafunso awiri, "Munataya kangati kapena kuyamba kutaya erection musanalowemo (musanayike mbolo yanu kumaliseche)?" ndipo "Ndi kangati munataya kapena kuyamba kutaya chidwi chanu mukamagonana (musanamalize)?" Njira zowayankhira zinali izi: "konse," "nthawi zina," "osachepera theka la nthawi," "nthawi zambiri," "nthawi zonse," komanso "sindingayankhe chifukwa ndimagwiritsa ntchito kondomu nthawi zonse." Mitundu iwiriyi imadziwika kuti EPs isanalowe (EP-Before) ndi EPs nthawi ya PVI (EP-PVI), motsatana. Pazosintha zilizonse, amuna amatchulidwa kuti "Inde" ngati amayankha kangapo kapena kangapo ndipo "Ayi" ngati sanayankhe konse.

IIEF-5 [17]

IIEF-5 ndi mtundu wachidule wa IIEF ya zinthu 15, yomwe imagwiritsidwa ntchito ngati chida chachidule chowunikira ED. Chiwerengero chachidule chinapangidwa pa chinthu chilichonse mwa zisanu ndipo chinagwiritsidwa ntchito powunika. Kutengera ndi zigoli izi, amuna adagawidwa m'magulu ngati opanda ED (22-25), ED yofatsa (17-21), ED yofatsa mpaka yapakati (12-16), ED yocheperako (8-11), kapena ED yoopsa (5-7), motsatira njira zomwe Rosen ndi anzake adapereka [17].

Mitundu Yabwino Yophatikizapo Ogwira Ntchito

CAEPs

Zili ziwiri za CAEP zilizonse zomwe zimayesedwa ndi zinthu imodzi. Choyamba, abambo anafunsidwa kuti, "Ndi nthawi zingati m'masiku akale a 90 omwe munataya kapena kuyamba kutaya makonzedwe anu pomwe mukuika kondomu musanayambe kugonana?" Njira zina zowonjezera ndizi: "Nthawi zina," " Nthawi, "" nthawi zambiri, "ndi" nthawi zonse. "Kenaka, amuna anafunsidwa kuti," Kodi mumataya nthawi zingati m'masiku akale a 90 kapena mumayamba kutaya makondomu pamene mukuvala kondomu pa nthawi yogonana? " : "Nthawi zonse," "nthawi yosachepera," "nthawi yambiri," ndi "nthawi zonse." Zinthu ziwirizi zimatchedwa CAEP-Application (CAEP pa kondomu) ndi CAEP-PVI ( CAEP mukamagwiritsa ntchito kondomu ku PVI), motero. Kwa anthu osiyanasiyana, anthu amawaika ngati "Inde" ngati atayankha nthawi ndi nthawi kapena "Ayi" ngati sakuyankha. Magulu anayi adapangidwa pogwiritsa ntchito mitundu iwiri: Palibe CAEP, CAEP-Application yekha, CAEP-PVI yekha, ndi CAEP-Onse awiri.

Zitsanzo Zolemba ndi Zowona Zogwirizana

Kuphatikiza pa ndondomeko zovomerezeka ndi zochotsedweratu zomwe tazitchula kale, zitsanzo zofotokozera zotsatirazi ndi zotsatira zotsatizana za zotsatira zinayesedwa: mtundu, masipanishi / chikhalidwe cha Latino, maphunziro, chipembedzo, ndalama, kukula kwa mzinda, mdulidwe, mbiri ya moyo wa matenda opatsirana pogonana, kaya Wophunzirayo adaikapo munthu wina mwadzidzidzi, komanso ngati adaphunzitsidwa kugwiritsa ntchito kondomu ya amuna. Matenda a masiku ano (matenda a shuga, khunyu, kupweteka / nkhawa, multiple sclerosis, muscular dystrophy, kuthamanga kwa magazi, mtima wamtima, zina) ndi kugwiritsa ntchito mankhwala (chifukwa cha kuchepa kwa matenda / matenda osokoneza bongo [ADHD / ADD], shuga, mtima , kupanikizika, nkhawa, mahomoni, zina) zinafunsidwa komanso ngati wophunzirayo adalandira chithandizo cha kugonana m'miyezi yapitayi ya 12. Pogwiritsira ntchito tsiku la kukumbukira tsiku la 90, zotsatirazi zidayesedwa: ngati wophunzirayo adakhalapo pulogalamu yosintha khalidwe la kondomu kapena kusintha khalidwe la kugonana, kugwiritsa ntchito njira zina zothandizira, ngakhale kuti akuyesera kupatsa mnzake mnzakeyo ( s), komanso kangati anagwiritsa ntchito phosphodiesterase mtundu wa 5 inhibitors (PDE-5i) pa nthawi yogonana pamene anali komanso sakugwiritsa ntchito kondomu.

Kusanthula Deta

Mayesero a Chi-squared adagwiritsidwa ntchito kuti adziwe mayanjano pakati pa magulu a CAEP (No CAEP, CAEP-Application yekha, CAEP-PVI yekha, ndi CAEP-Onse) komanso mayankho a mafunso awiriwa potsutsa kondomu, Gawo la IIEF-5 (palibe ED kupyola ED kwambiri), ndi zina zosiyana. Popeza kuti yaing'ono mpaka zero idawonetsera maulendo m'maselo ena akuphwanya malingaliro a kufufuza kwa chi-squared, tinapanga 4 × 2 (osayesana ndi zochitika zonse za EP panthaŵi ya malipoti). Pambuyo pake, kufananitsa kwapadera kunkachitidwa pogwiritsa ntchito mayesero a 2 × 2 chi-squared.

Kusanthula kwa kusiyana kunagwiritsidwa ntchito poyerekeza IIEF-5 ndi zigoli zina zopitilira m'magulu osiyanasiyana ndi mayeso a Scheffé omwe amagwiritsidwa ntchito poyerekeza pambuyo pa hoc. Kufunika kunapezeka pa P < 0.05. Kusanthula kunachitika pogwiritsa ntchito SPSS Version 21 (IBM SPSS statistics for Windows, version 21.0; IBM Corp., Armonk, NY, USA).

Results

Zaka zowonjezera zinali zaka 20.43 (kutsika kwapadera = 1.63). Ambiri amadziwika ngati oyera (80.1%), 6.8% monga Asia, 4.7% monga African American / wakuda, ndi otsala monga mafuko ena. Chikhalidwe cha ku Puerto Rico / Latino chinanenedwa ndi 4.2% ya amuna. Ambiri (66.5%) amasonyeza maphunziro awo apamwamba monga sukulu ya koleji / sayansi, 3.8% digiri yapamwamba, 29.4% sekondale, ndipo 0.4% sanamalize sukulu ya sekondale. Oposa hafu (54.7%) adasonyeza kuti ndalama zawo zapadera ndizochepa kapena osachepera ndipo 53.0% anakulira mumzinda wapakati mpaka waukulu. Ambiri adadulidwa (87.3%), anali asanapezepo ndi matenda opatsirana pogonana (97.3%), ndipo adaphunzitsidwa kugwiritsa ntchito kondomu ya amuna (63.0%). Kuperekera mwadzidzidzi kunanenedwa ndi 9.2%.

Amuna a 479, 184 (38.4%) adasankhidwa kukhala No-CAEP, 66 (13.8%) monga CAEP-Application yekha, 75 (15.7%) monga CAEP-PVI okha, ndi 154 (32.2%) monga CAEP-Onse awiri. Palibe kusiyana kwa magulu omwe anapezeka chifukwa cha msinkhu, mtundu, chikhalidwe cha ku Spain / Latino, maphunziro, chipembedzo, ndalama, kukula kwa mudzi, kumadzulo, mbiri ya moyo wa matenda opatsirana pogonana, kaya atapatsidwa chidziwitso kwa munthu wina, komanso ngati adaphunzitsidwa kugwiritsa ntchito kondomu ya amuna.

Popeza pali mavuto azaumoyo ochepa komanso kugwiritsa ntchito mankhwala, deta yochokera kwa amuna onse omwe adanena za CAEP iliyonse idaphatikizidwa (gulu lililonse la CAEP) ndikuyerekeza ndi ya amuna omwe adanena kuti alibe CAEP. Kusiyana kwa magulu komwe kudapezeka kunali kwa kuvutika maganizo/nkhawa, pomwe 12.9% ya amuna omwe ali mgulu la CAEP adanena izi poyerekeza ndi 4.9% ya amuna omwe ali mgulu la No-CAEP (χ 2 = 8.14, madigiri a ufulu [df] 1, P = 0.004). Komabe, panalibe kusiyana kwa magulu omwe adanenanso za kugwiritsa ntchito mankhwala pochiza kuvutika maganizo (3.2%) kapena nkhawa (2.9%). Kusiyana kwa magulu komwe kunanenedwa za kugwiritsa ntchito mankhwala kunali kwa mankhwala a ADHD/ADD, pomwe 3.3% ya gulu la No-CAEP ndi 8.9% ya gulu lililonse la CAEP adanenanso za kugwiritsa ntchito mankhwalawa (χ 2 = 5.62, df 1, P = 0.018). Anthu ochepera 1% adanena kuti ali ndi matenda a shuga (0.8%), khunyu (0.8%), multiple sclerosis (0.2%), muscular dystrophy (0.2%), matenda a mtima (0.9%); anthu ochepa omwe adagwiritsa ntchito mankhwala a shuga (0.8%), mankhwala a mtima (0.4%), ndi mankhwala a mahomoni (0.9%). Anthu ambiri omwe adatenga nawo mbali adawonetsa kuthamanga kwa magazi (2.1%), mavuto ena azachipatala (1.7%), ndi chithandizo cha mavuto okhudzana ndi kugonana m'miyezi 12 yapitayi (1.5%).

M'masiku 90 apitawa, anthu ochepa okha omwe adatenga nawo mbali adalowa nawo mapulogalamu osintha kugwiritsa ntchito makondomu (1.7%) kapena machitidwe ogonana (1.3%) ndipo ochepa adagwiritsa ntchito PDE-5i pogonana ndi (1.9%) kapena opanda makondomu (1.9%). Palibe amene anayesa kutenga pakati ndi mnzawo. Amuna opitilira theka adawonetsa kuti amadalira makondomu a amuna poletsa kubereka (54.9%) ndi/kapena kuti adagwiritsa ntchito makondomu a amuna ndi mitundu ina yoletsa kubereka (59.1%) nthawi zina m'masiku 90 apitawa. Palibe kusiyana kwa magulu komwe kudapezeka pa chilichonse mwa izi. Amuna ambiri m'gulu lililonse la CAEP (17.3%) kuposa gulu la No-CAEP (9.8%) adanenanso kuti adalira njira ina yoletsa kubereka kupatula makondomu nthawi zina m'masiku 90 apitawa (χ 2 = 5.18, df 1, P = 0.023).

Chiwerengero chapakati cha nthawi zomwe amuna adagwiritsa ntchito makondomu m'masiku 90 chinali 10.8 (standard deviation = 14.3) ndipo izi sizinasiyane kwambiri m'magulu anayi. Komabe, kugwiritsa ntchito makondomu nthawi zonse kunali kotsika kwambiri kwa CAEP-Gulu lonse (73.4%) poyerekeza ndi gulu la No-CAEP (82.4%) (F(3,471) = 3.44, P = 0.017), pomwe magulu ena anali apakatikati ndipo sanali osiyana kwambiri (CAEP-Application Only 82.1%; CAEP-PVI Only 77.7%).

EPs Popanda Kugwiritsa Ntchito Makondomu

Pafupifupi gawo limodzi mwa magawo anayi a zitsanzo (23.0%) linasonyeza kuti sakanatha kuyankha mafunso awa chifukwa nthawi zonse ankagwiritsa ntchito makondomu. Gome 1 likuwonetsa kusanthula kwa amuna otsalawo. Popeza amuna ochepa adawonetsa zochitika pafupipafupi za ma EP pamene makondomu sanagwiritsidwe ntchito, kusanthula kwa chi-squared kunayerekeza magulu anayi a CAEP pa kuchuluka kwa magawo omwe adagawidwa ngati "Inde" motsutsana ndi "Ayi" a EP-Before ndi EP-PVI. Magulu a CAEP adasiyana kwambiri pa EP-Before variable (χ 2 = 40.14, df 3, P < .001). Chiwerengero cha amuna omwe adanena kuti adachita EP nthawi zina asanalowe mu No-CAEP, CAEP-Application yokha, CAEP-PVI yokha, ndi CAEP-Magulu onse awiri, anali 9.9, 35.7, 23.6, ndi 43.0, motsatana. Mu kusanthula kwa post-hoc, gulu la No-CAEP linali ndi amuna ochepa omwe adanena kuti adachita EP asanalowe mu kondomu poyerekeza ndi magulu ena. Gome 1 likuwonetsa zotsatira za kufananiza konse kwa post-hoc.

Tebulo 1. Pafupipafupi mavuto a erection mukamagwiritsa ntchito kondomu poyerekeza m'magulu onse a CAEP

Mavuto okhwimitsa osagwiritsa ntchito kondomu

magulu

Palibe-CAEP ( n = 142)

CAEP-Kugwiritsa ntchito kokha ( n = 42)

CAEP-PVI yokha ( n = 55)

CAEP-Zonse ( n = 128)
  1. *P <0.001
  2. Zolemba zapamwamba zimasonyeza zotsatira za kufananitsa kwapambuyo pogwiritsa ntchito P  <0.05 njira. Magulu omwe amagawana kalata siosiyana kwambiri. Omwe sagawana kalata ndi osiyana kwambiri.
  3. CAEP = vuto logwirizana ndi kondomu; PVI = penile-kugonana kugonana.
Asanalowemo        
Palibe (%) 90.1a 64.3b, c 75.4b 57.0 c
Nthaŵi zina (%) 4.9 28.6 16.4 30.5
Pasanathe theka la nthawi (%) 3.5 7.1 5.5 8.6
Nthawi zambiri (%) 1.4 0 1.8 3.9
Nthawi zonse (%) 0 0 0 0
PVI        
Palibe (%) 95.1a 85.7b 43.6 c 54.6 c
Nthaŵi zina (%) 3.5 11.9 40.0 33.1
Pasanathe theka la nthawi (%) 1.4 2.4 12.7 7.7
Nthawi zambiri (%) 0 0 1.8 4.6
Nthawi zonse (%) 0 0 1.8 0

Magulu a CAEP nawonso anali osiyana kwambiri pa EP-PVI (χ 2 = 8 3.00, df 3, P < .001). Chiwerengero cha omwe adatenga nawo mbali omwe adanena kuti adachita EP nthawi zina panthawi ya PVI chinali 4.9, 14.3, 56.4, ndi 45.4 pa No-CAEP, CAEP-Application yokha, CAEP-PVI yokha, ndi CAEP-Magulu onsewa, motsatana. Mu kusanthula kwa post-hoc, amuna ochepa kwambiri mu gulu la No-CAEP adanena kuti adachita EP panthawi ya PVI pomwe sanagwiritse ntchito kondomu poyerekeza ndi magulu ena onse. CAEP-PVI Yokha ndi CAEP-Magulu onsewa anali ndi kuchuluka kwakukulu ndipo sanali osiyana kwambiri. Chiwerengero cha amuna mu gulu la CAEP-Application Only omwe adachita EP nthawi zina panthawi ya PVI chinali chapakati komanso chosiyana kwambiri ndi magulu ena onse.

IIEF-5

Alpha ya Cronbach ya IIEF-5 ya chitsanzo ichi inali 0.76. Monga momwe zasonyezedwera mu Table 2 , zigoli za IIEF-5 zinali zosiyana kwambiri m'magulu a CAEP ( F (3,475) = 15.40, P < .001). Zigoli zapakati pa magulu onse zinali zoposa 21 (m'magulu osakhudzana ndi matenda) [17] . Gulu la No-CAEP linali ndi zigoli zapamwamba kwambiri (23.92) (kusonyeza kuti kugonana kwabwino kumagwirira ntchito), zosiyana kwambiri ndi CAEP-PVI yokha (22.93) ndi CAEP-magulu onse (22.12), koma osati kuchokera ku CAEP-Application yokha (23.20). Zigoli zapakati pa gulu la CAEP-Awiriwa sizinali zosiyana kwambiri ndi za gulu la CAEP-PVI yokha, koma zinali zosiyana kwambiri ndi magulu ena awiriwa. Zigoli zapakati pa magulu a CAEP-Application yokha ndi CAEP-PVI yokha sizinali zosiyana kwambiri.

Gulu 2. Maphunziro a IIEF-5 ndi magulu a ED ndi magulu a CAEP

 

Palibe-CAEP ( n = 184)

CAEP-Kugwiritsa ntchito kokha ( n = 66)

CAEP-PVI yokha ( n = 75)

CAEP-Zonse ( n = 154)
  1. *P <0.001
  2. Zolemba zapamwamba zimasonyeza zotsatira za kufananitsa kwapambuyo pogwiritsa ntchito P  <0.05 njira. Magulu omwe amagawana kalata siosiyana kwambiri. Omwe sagawana kalata ndi osiyana kwambiri.
  3. CAEP = vuto logwirizana ndi kondomu; ED = kutaya kwa erectile; IIEF-5, International Index of Erectile Function; PVI = penile-kugonana kugonana; SD = kusemphana.
Ndemanga (SD) IIEF-5* 23.92 (2.24)a 23.20 (2.51)a, b 22.93 (2.56)b, c 22.12 (2.54)c
Mndandanda wa Zachiwiri za IIEF-5*        
Palibe ED (%) 91.3a 81.8b 77.3b, c 68.2 c
Osavuta ED (%) 7.1 15.2 20.0 28.6
Wowonongeka ED (%) 0.5 3.0 1.3 3.2
Momwemo ED (%) 1.1 0 1.3 0
Oposa (%) 0 0 0 0

Pogwiritsa ntchito zigoli za IIEF-5, amuna adagawidwa kuyambira pa ED yopanda ED kupita ku ED yovuta pogwiritsa ntchito njira zomwe Rosen et al. [17] (onani Gome 2 ). Chifukwa chakuti amuna ochepa adagawidwa kukhala ED yofatsa mpaka yapakati kapena kupitirira apo, tidaphatikiza amuna ndi ED iliyonse kukhala gulu limodzi. Poyerekeza magulu anayi a CAEP pa kuchuluka komwe kudagawidwa ngati palibe ED poyerekeza ndi ED iliyonse, panali mgwirizano wofunikira (χ 2 = 28.98, df 3, P < .001). Chiwerengero cha omwe adagawidwa ngati ED iliyonse chinali 8.7, 18.2, 22.7, ndi 31.8 pa No-CAEP, CAEP-Application yokha, CAEP-PVI yokha, ndi CAEP-Magulu onse awiri, motsatana. Zolemba zazikulu za Gome 2 zikuwonetsa zotsatira za kusanthula kwa post-hoc komwe kukuwonetsa kuti gulu la No-CAEP lidaphatikizapo amuna ochepa kwambiri omwe ali ndi ED iliyonse kuposa magulu ena.

Kukambirana

Mu chitsanzo cha achinyamata, kugonana kwa amuna kapena akazi okhaokha, kugwiritsa ntchito kondomu, kugwiritsa ntchito kondomu, ma CAEP adagwirizanitsidwa ndi anthu ambiri, komabe makamaka magawo (ofatsa) a mavuto a erectile. Amuna amalembera mtundu uliwonse wa CAEP (panthawi yogwiritsira ntchito kapena / kapena PVI) anali ochepa kwambiri kuposa gulu la No-CAEP kuti lifotokozenso mavuto okhwima asanalowe mkati ndi kugonana popanda kugwiritsira ntchito kondomu. Amuna omwe anena za CAEP pa PVI pokhapokha panthawi yonseyi komanso PVI anapeza zochepa kwambiri pa IIEF-5 kusiyana ndi amuna omwe sanena za CAEP. Magulu onse omwe amapereka CAEP anali ochepa kwambiri kuti akhale owerengeka monga ED ochepa kapena ochepa kuposa gulu la No-CAEP. Komabe, ngakhale mu CAEP-Gulu lonseli, lomwe linali ndi malipiro apamwamba a IIEF-5-ED, ambiri (68.2%) a amuna sanakumane ndi njira zachipatala zokhala ndi ED.

Pali zifukwa zosiyanasiyana zomwe zingayambitse izi. Choyamba, sizingakhale zodabwitsa ngati amuna omwe ali ndi ED nawonso ali ndi EP akamagwiritsa ntchito makondomu. Chachiwiri, ngakhale kuti ndi zongopeka, ndizotheka kuti amuna omwe amayamba kutaya mphamvu yogonana akamagwiritsa ntchito makondomu angadandaule kuti akumva mphamvu yogonana nthawi zambiri ndipo motero amakhala pachiwopsezo chachikulu chokumana ndi ED yochuluka [18] . Izi zikugwirizana ndi kafukufuku wina wosonyeza kufunika kwa zinthu zamaganizo ndi zamaganizo monga nkhawa ndi kusokonezeka pazifukwa zomwe zimayambitsa komanso kusunga ED [19].

Amuna omwe adanena kuti agwiritsa ntchito mankhwala a ADHD anali ndi mwayi waukulu wonena za CAEP. Kafukufuku wakale adanenanso kuti achinyamata omwe ali ndi ADHD ali ndi khalidwe loopsa logonana [20] ndipo amuna omwe amagwiritsa ntchito mankhwala a ADHD nthawi zina amanena kuti ali ndi vuto la kugonana chifukwa cha zotsatirapo za mankhwalawa [21].

sitingathe

Kuchuluka kwa zomwe tapeza kungakhale kochepa. Chitsanzocho chinali chochepa mwa kapangidwe kake kwa amuna achichepere, amuna ogonana amuna kapena akazi okhaokha, omwe amagwiritsa ntchito makondomu omwe sali pachibwenzi cha nthawi yayitali, omwe amalankhula Chingerezi, komanso omwe anali ndi intaneti. Chifukwa chake, zomwe zapezekazi sizingafanane ndi amuna ena kupatula izi. Chifukwa chathu chochotsera amuna omwe anali pachibwenzi chogonana kwa mwezi umodzi kapena kuposerapo chinali chakuti kafukufuku wasonyeza kuti amuna omwe ali mgulu la zaka 18-24 amanena kuti kugwiritsa ntchito makondomu ndi amuna okhazikika sikuchepa poyerekeza ndi amuna okwatirana mwachizolowezi [22] . Amuna omwe ali mgulu la zaka 18-24 nawonso ali pachiwopsezo chachikulu chotenga matenda opatsirana pogonana ndi kachilombo ka HIV [23] , ngakhale kuti kugwiritsa ntchito makondomu kuli ndi kuchuluka kwakukulu [24].

Popeza kugwiritsa ntchito kondomu kunali muyezo woyenera, amuna omwe kale adagwiritsa ntchito makondomu koma adasiya kugwiritsa ntchito, mwina chifukwa cha CAEP kapena mavuto ena, sanayimidwe mu chitsanzo chathu. Choletsa china ndichakuti ngakhale tidagwiritsa ntchito chida chovomerezeka kuti tiwone kuopsa kwa mavuto okhudzana ndi kugonana, sitinayang'ane nkhawa ya munthu payekha chifukwa cha vutoli; njira zodziwira matenda a kugonana amuna zimafuna kukhalapo kwa nkhawa yayikulu yokhudzana ndi zizindikiro [25] . Komabe, cholinga chathu mu kafukufukuyu sichinali kunena za kuchuluka kwa matenda okhudzana ndi kugonana, koma kudziwa ngati amuna omwe amanena za CAEP amanenanso kuti adakumana ndi EP pamene sakugwiritsa ntchito makondomu komanso ngati zigoli za IIEF zimasiyana ndi amuna omwe sananene za CAEP.

Zomwe tapeza zikusonyeza kuti mwa amuna omwe adanena za CAEP mu chitsanzo chathu, pafupifupi 18–32% adakwaniritsa zofunikira za IIEF za ED yocheperako mpaka yapakati (kutengera ngati adanena za CAEP panthawi yogwiritsa ntchito makondomu okha, panthawi ya PVI, kapena panthawi yonse yogwiritsa ntchito komanso PVI). Ngakhale kuti ambiri mwa omwe adatenga nawo mbali adagawidwa m'gulu la "ED yocheperako", komabe pali zotsatira zomveka bwino zachipatala za zomwe zapezekazi. Ma EP agwirizanitsidwa ndi kugwiritsa ntchito kondomu kosakhazikika komanso kosakwanira, [9] komwe kumalumikizidwa ndi chiopsezo chotenga matenda opatsirana pogonana/kachirombo ka HIV; motero, kukonza zomwe amuna akumana nazo pogwiritsa ntchito kondomu ndikofunikira. Gulu la amunali lingapindule ndi njira yachidule yochepetsera mavuto awo okhudzana ndi kugonana. Ngakhale kuti mankhwala a ED nthawi zambiri amakhala njira "yoyamba" kwa amuna omwe ali ndi mavuto okhudzana ndi kugonana, maphunziro am'mbuyomu adawonetsa kuti PDE-5i sikuti imangogonjetsa CAEP [26] . Kuphatikiza apo, kugwiritsa ntchito PDE-5i kungakhale chifukwa choopsa chosweka kwa kondomu [27].

Poganizira zomwe zapezeka kuti amuna omwe ali ndi CAEP angafunike nthawi yochulukirapo kuti ayambe kudzuka kuposa amuna omwe sananene za CAEP, Janssen ndi anzake [11] adalimbikitsa kuti amuna omwe ali ndi CAEP alimbikitsidwe kutenga nthawi yokwanira kuti ayambe kudzuka ndikuwonetsetsa kuti akupeza chilimbikitso chokwanira, makamaka akamagwiritsa ntchito makondomu. Kafukufuku waposachedwa wa njira yodziwongolera yochokera kunyumba yolimbikitsa kugwiritsa ntchito makondomu pakati pa anyamata (yomwe imafuna thandizo lochepa la dokotala) yanena kuti pali chidaliro chowonjezeka pa luso la amuna logwiritsa ntchito makondomu, kudzigwira bwino ntchito pogwiritsa ntchito makondomu, komanso kumasuka kwa makondomu komanso kuchepa kwa kusweka ndi ma EP pambuyo polowererapo [28,29] . Palinso kufunika kwa malangizo abwino ogwiritsira ntchito makondomu moyenera. Oposa gawo limodzi mwa magawo atatu (37%) a amuna omwe amagwiritsa ntchito makondomu sanaphunzitsidwepo momwe angagwiritsire ntchito kondomu moyenera. Madokotala ayenera kuwunika ngati amuna omwe amagwiritsa ntchito makondomu amakumana ndi CAEP ndipo ngati kuli koyenera, apereke malangizo kwa amuna kuti akalandire chithandizo cha kugonana kapena kupereka maphunziro a luso la makondomu [28,29].

Kutsiliza

Zomwe anapeza zikusonyeza kuti amuna omwe amafotokoza za CAEP amakhalanso ndi mavuto ambiri. Ngakhale kuti ma EPs sangakwaniritse zofunikira zachipatala kwa ED, odwala ayenera kufufuza ngati amuna ogwiritsira ntchito kondomu amatha kupeza CAEP ndipo ngati n'koyenera, amatchula mankhwala opatsirana pogonana kapena amapereka maphunziro a luso la kondomu.

Kusamvana kwa Zofuna: Wolemba (olemba) sananene kuti palibe kusamvana kwa zokonda.

Ndondomeko ya Wolemba

Category 1

  • (a) Mimba ndi KulengedwaStephanie Sanders; Chiwonetsero; Brandon Hill
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  • (a) Kusindikiza ChigamuloStephanie Sanders; Cynthia Graham; Bill Yarber; Rick Crosby; Robin Milhausen
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  • (a) Kuvomerezedwa Kwachidule kwa Nkhani YomalizidwaStephanie Sanders; Cynthia Graham; Bill Yarber; Rick Crosby; Robin Milhausen; Chiwonetsero; Brandon Hill

Zothandizira

1 Mitchell KR, Mercer CH, Ploubidis GB, Jones KG, J J, Field J, Copas AJ, Tanton C, Erens B, Sonnenberg P, Clifton S, Macdowall W, Phelps A, Johnson AM, Wellings K. Zogonana ku Britain : Zotsatira kuchokera kufukufuku wachitatu wa zokhudzana ndi kugonana ndi moyo (Natsal-3). Lancet 2013; 382: 1817-1829.