I-Erectile jikelele esebenzayo phakathi kwabaselula, abafazi be-Heterosexual Who Do and Do not Report Problems Associated Problems (CAEP) (2015)

IMIBUZO: Jonga olu hlalutyo lophononongo

UStephanie A. Sanders PhD1,2,3, uBrandon J. Hill PhD1,4, Erick Janssen PhD1,5, Cynthia A. Graham PhD1,2,6, *, uRichard A. Crosby PhD1,2,7, URobin R. Milhausen PhD1,2,8 kunye noWilliam L. Yarber HSD1,2,3,9

Inqaku lipapashwe okokuqala kwi-intanethi: 17 AUG 2015

INGXELO: 10.1111 / jsm.12964

Uphando oluchazwe kule mpapasho luxhaswe yi-Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) yamaZiko ezeMpilo eSizwe phantsi kwe-Award Number R21 HD 060447, E. Janssen kunye ne-SA Sanders (PIs). Umxholo kuphela uxanduva lwababhali kwaye akufuneki ukumela iimbono ezisemthethweni zamaZiko ezeMpilo eSizwe.

Abstract

intshayelelo

Iingxaki zokumitha ezinxusene nekhondom (CAEP) yimeko engacingelwayo enxulumene nokungangqinelani okanye ukungapheleli kokusetyenziswa kwekhondom yamadoda. Iindlela ezisisiseko ze-CAEP aziqondwa, kwaye nokuba ngaba amadoda achaza obu bunzima nabo banokufumana iingxaki zokuqhafaza kwiimeko apho iikhondom zingasetyenziswanga akukhange kufundwe.

injongo

Injongo yophononongo yayikukuphanda, kwisampulu yamadoda aselula asebenzisa ikhondom, amadoda aselula, athandana nesini esahlukileyo (abudala buphakathi kwe-18–24 yeminyaka), ukuba ngaba amadoda axela i-CAEP kunokwenzeka ukuba (i) abe nengxaki yokuchama xa engasebenzisi iikhondom kwaye (ii) ) ukuhlangabezana nemilinganiselo yokungasebenzi kakuhle kwe-erectile.

tindlela

Inani elipheleleyo lamadoda angama-479 aqeshwe kwi-intanethi agqibe i-International Index ye-Erectile Function (IIEF-5) kwaye aphendule imibuzo malunga neengxaki zokuqhafaza ezifunyenwe xa usebenzisa kwaye ungasebenzisi iikhondom kwiintsuku ze-90 zokugqibela. Ubume boluntu, amava ngokwesondo, kunye nokuguquguquka kwesimo sempilo kuphandwe njengezinto ezinxibeleleneyo.

Iziphumo eziPhambili

Ukuzixela ngokuphindaphindiweyo ukulahleka kokumiswa ngexesha lokusetyenziswa kwekhondom okanye ngexesha lokwabelana ngesondo kwe-penile-vaginal (PVI) kwiintsuku ezingama-90 ezidlulileyo kunye namanqaku e-IEF-5.

iziphumo

Kumadoda, i-38.4% yahlelwa kwiqela elingekho le-CAEP, i-13.8% njenge-CAPP ngexesha lokufakwa kwekhondom, i-15.7% njenge-CAEP ngexesha le-PVI, kunye ne-32.2% njenge-CAEP ngexesha lokufakwa kwekhondom kunye ne-PVI. Amadoda anika ingxelo ngalo naluphi na uhlobo lwe-CAEP athandeka kakhulu kunamadoda axela ukuba akukho CAEP nawo axele ubunzima bokuma ngexesha lokwabelana ngesondo xa engasebenzisi iikhondom. Amadoda anike ingxelo ye-CAEP ngexesha le-PVI kuphela okanye ngexesha zombini isicelo kunye ne-PVI yafumana amanqaku aphantsi kakhulu kwi-IEF-5 kunamadoda angenayo i-CAEP.

isiphelo

Iziphumo zophando zibonisa ukuba amadoda anika ingxelo ye-CAEP anokuba nengxaki yokuchama ngokubanzi. Oogqirha kufuneka bavavanye ukuba ngaba amadoda asebenzisa iikhondom anamava e-CAEP kwaye apho kufanelekileyo, abhekisele kunyango lwengqondo okanye abonelele ngezakhono zekhondom.

intshayelelo

Ukuxhaphaka okuqikelelweyo kwe-erectile dysfunction (ED) kuyahluka kwizifundo, kuxhomekeke kwinxalenye kwinkcazo kunye neendlela ezisetyenzisiweyo. [1-3]. Esinye sezona ziqikelelo ezihambelanayo zeengxaki ze-erectile bubudala. Nangona ukuxhaphaka kwe-ED kuphezulu kakhulu phakathi kwamadoda amadala [4], iingxaki ze-erectile zixelwa ngamadoda amancinci ngokunjalo. Olunye uphando lwe-epidemiologic luqikelele ukuba malunga ne-2% yamadoda angaphantsi kweminyaka engama-40-50 ubudala akhalaza ngeengxaki zokumiswa rhoqo (EPs) [2]. Uphononongo lwakutsha nje kumazwe amahlanu aseYurophu luxele ukuba i-5% yamadoda aphakathi kwe-18 kunye ne-29 yeminyaka ubudala anamava e-ED kwiinyanga ezi-6 ezidlulileyo. [5]. Umlinganiselo wamadoda amancinci afumana ubunzima be-erectile ngamaxesha athile, nangona kunjalo, aphezulu kakhulu, ukusuka kwi-16% kwisampuli yamadoda ase-US phantsi kweminyaka eyi-40. [6] ukuya kwi-30% kwisampuli yaseSwitzerland yamadoda aneminyaka eyi-18-25 iminyaka [7].

Amava aqhelekileyo eengxaki ze-erectile ngamanye amaxesha abonisa ukuba iimeko zemeko zingadlala indima ebalulekileyo ye-etiologic. Ukusetyenziswa kweekhondom zamadoda kusenokuba ngumzekelo omnye wemeko ebeka amanye amadoda ukuba abe nobunzima bokukhula. Kuphononongo lwabafundi bezonyango baseBrazil (iminyaka yobudala: iminyaka eyi-21.2), i-13.3% yafumanisa ukuba ine-ED, isebenzisa i-Index ye-International Index ye-Erectile Function (IIEF-5) eyenziwe lula. [8]. Abafana abancinci kolu phononongo abasebenzise iikhondom banethuba eliphindwe kabini lokuxela iingxaki ze-erectile. Kwisampulu yolosuleleko lwamakhwenkwe aselula (STI) abazimase ikliniki [9], i-37.1% yamadoda ibike iingxaki ezihambelana nekhondom (CAEP) ubuncinane kwisihlandlo esinye. Izifundo ezininzi, ezibandakanya amadoda angamafanasini kunye namadoda athandana nesini esahlukileyo, ngoku zibhale ukuba i-CAEP inokuba yinto eqhelekileyo. [10]. Nangona iindlela eziphantsi kwe-CAEP zisaqondwa kakuhle, kuphononongo lwamva nje lwe-psychophysiologic yeepateni zokuvuswa ngokwesondo, amadoda ane-CAEP adinga ixesha elingakumbi kunye / okanye uvuselelo olunamandla ngakumbi ukuze avuswe kunamadoda angenayo i-CAEP. [11]. Kuyaphawuleka, nangona kunjalo, ukuba iimpendulo ze-erectile zaziphantsi kwiqela le-CAEP kuphela ngomzuzu wokuqala wokuvezwa kwe-stimuli yesondo, kungekho nantlukwano ebalulekileyo emva koko.

Ubunzima be-erectile obunxulumene nekhondom bunokuba yinto engaphantsi kwento enxulumene nokusetyenziswa okungafezekiyo, kuba amadoda achaza i-CAEP kunokwenzeka ukuba achaze uluhlu lwezinye iimpazamo zokusetyenziswa kweekhondom kunye neengxaki, kubandakanywa i-condom slippage. [12], ukusetyenziswa kwekhondom engaphelelanga (ukufakwa kade kunye nokususwa kwangoko) [9,13], kunye nokusetyenziswa kwekhondom ngokungaguqukiyo [14,15]. Kolunye uphononongo olulindelekileyo lwakutsha nje olubandakanya amadoda ali-1,875, iimbono zokumiswa “komgangatho” (kubandakanywa uqikelelo lokuqina, ubude belungu lobudoda, kunye nomjikelezo, kunye nobunzima bokugcina imiqhamo) zayanyaniswa nokuba nokwenzeka kokusetyenziswa kwekhondom engaphelelanga. [13]. Amadoda anokuba nethuba lokufumana i-CAEP ukuba akazithembanga ekusebenziseni iikhondom ngokuchanekileyo, ukuba abanengxaki malunga nendlela iikhondom ezilingana ngayo okanye eziziva ngayo, kunye nokuba ababelana ngesondo namaqabane amaninzi. [9].

Iinjongo

Omnye umbuzo, okwangoku, ongekaphandwa ngowokuba ngaba amadoda anika ingxelo ye-CAEP kunokwenzeka ukuba abe nobunzima bokuqhankqalaza kwiimeko zesondo apho iikhondom zingasetyenziswa. Ngokunjalo, injongo yolu phononongo yayikukuphanda, kwisampulu yamadoda aselula, athandana nesini esahlukileyo (abaneminyaka eyi-18-24), ukuba ngaba abo baxela i-CAEP (mhlawumbi ngexesha lokusetyenziswa kwekhondom, ngexesha lokwabelana ngesondo lobufazi [PVI], okanye kuzo zombini iimeko) kunokwenzeka ukuba: (i) babe neeEPs xa bengasebenzisi iikhondom; kunye (ii) namanqaku ahlukileyo kwi-IEF. Injongo yethu yayingekuko ukuqikelela ukuxhaphaka kobunzima be-erectile kodwa ukuchonga i-correlates ye-CAEP kwisampulu engabonakaliyo yamadoda amancinci, asebenzisa ikhondom.

tindlela

nxaxheba

Abathathi-nxaxheba yayingamadoda aselula, athandana nesini esahlukileyo athe agaywa kusetyenziswa uluhlu lweedyunivesithi (umzekelo, amaqela abafundi baseyunivesithi kunye noluhlu lwamasebe) kunye neeflaya zombane ezisasazwa kuFacebook. Imvume ifunyenwe kubaphathi be-listserv kunye nezikhokelo zentengiso ye-Facebook zalandelwa. Sigqithise amadoda ane-CAEP ngeeflaya ekujoliswe kuzo ezibuza: "Ingaba iikhondom ziyaphazamisana nokufakwa kwakho?" kunye "Ingaba iikhondom ziyaphazamisana nokuvuka kwakho?" Iikhrayitheriya zokufaneleka zibandakanya ukufikelela kwi-Intanethi, ukuba phakathi kwe-18 kunye ne-24 yeminyaka ubudala, ukuzibona njengomntu onesini esahlukileyo, ukusebenzisa ikhondom ye-PVI kwiintsuku ezingama-90 ezidlulileyo, kunye nokukwazi ukufunda isiNgesi. Ukongeza, amadoda ebekhutshelwa ngaphandle ukuba ebekubudlelwane obubodwa (monogamous) kwinyanga enye okanye ngaphezulu, njengoko ukusetyenziswa kwekhondom kuye kwafunyaniswa ukuba kwehla kwinyanga yokuqala yobudlelwane. [16]. Amadoda anika ingxelo ye-CAEP athathwe ngokugqithisileyo. Sibuze abaphenduli umbuzo othile ekupheleni kophando malunga nokuba ngaba bathathe i-questionnaire nzulu kunye nokuba ulwazi lwabo lufanele lusetyenziswe; kuphela i-1.2% iphendule ukuba ayizange iyithathele ingqalelo uphando kwaye asiyibandakanyi idatha yabo.

Isampulu yokugqibela yayiquka abafana abangama-479. Imvume ebhaliweyo enolwazi ifunyenwe kubo bonke abathathi-nxaxheba kwaye iBhodi yokuHlola iziko yeyunivesithi yavuma zonke iinkqubo zokufunda.

Amanyathelo

Amanyathelo eSiphumo aPhambili

Ii-EPs Xa Ungasebenzisi Iikhondom

Imibuzo emibini ivavanywe ii-EPs xa amadoda engasebenzisi iikhondom. Abathathi-nxaxheba bacelwa ukuba "Cinga ngamaxesha apho wawulalana ngelungu lobudoda-kwilungu lobufazi KWIINTSUKU EZIDLULILEYO ezingama-90 kwaye UNGAYIsebenzisi ikhondom." Oku kwalandelwa yimibuzo emibini, “Kukangaphi uphulukene okanye uqalise ukuphulukana nokomelela ngaphambi kokuba ungene (phambi kokubeka incanca yakho kwilungu lobufazi)?” kwaye "Kukangaphi uphulukene okanye uqale ukuphulukana nokuchama ngelixa usabelana ngesondo (phambi kokuba wenziwe)?" Iimpendulo ezizezinye zezi: “azange,” “ngamathuba athile,” “ngaphantsi kwesiqingatha sexesha,” “amaxesha amaninzi,” “rhoqo,” kwaye “andikwazi ukuphendula kuba bendisoloko ndisebenzisa ikhondom.” Ezi zintlu ezimbini zibizwa ngokuba yi-EPs ngaphambi kokungena (EP-Before) kunye ne-EP ngexesha le-PVI (EP-PVI), ngokulandelanayo. Kuluhlu ngalunye, amadoda ayehlelwa njengo-“Ewe” ukuba ayephendula ngamaxesha athile okanye rhoqo yaye “Hayi” ukuba akazange aphendule.

IIEF-5 [17]

I-IEF-5 yinguqulelo emfutshane ye-15-into ye-IEF, esetyenziswa njengesixhobo esifutshane sokuxilonga ukuvavanya i-ED. Amanqaku ashwankathelayo enziwe kwinto nganye kwezi zintlanu kwaye asetyenziselwa uhlalutyo. Ngokusekelwe kula manqaku, amadoda aye ahlelwa njengabangenayo i-ED (22-25), i-ED emnene (17-21), i-ED ephakathi ukuya kwimodareyitha (12-16), i-ED ephakathi (8-11), okanye i-ED enzima (5 –7), ngokulandela imigaqo ecetyiswe nguRosen kunye noogxa bakhe [17].

Iiguquguquko zamaqela abathathi-nxaxheba abaphambili

IiCAPS

Iindlela ezimbini ze-CAEP nganye zavavanywa ngento enye. Okokuqala, amadoda abuzwa, “Kukangaphi kwezi ntsuku zingama-90 zidlulileyo uphulukene okanye uqale ukuchacha xa ufaka ikhondom phambi kokwabelana ngesondo ngelungu lobufazi?” Iimpendulo ezizezinye zezi: “awuzange,” “ngamaxesha athile,” “ngaphantsi kwesiqingatha sexesha,” “amaxesha amaninzi,” yaye “rhoqo.” Emva koko, amadoda abuzwa, “Kukangaphi kwezi ntsuku zingama-90 zidlulileyo uphulukene okanye uqale ukuchacha xa unxibe ikhondom ngexesha lokwabelana ngesondo ngelungu lobufazi?” Iimpendulo ezizezinye zezi: “awuzange,” “ngamaxesha athile,” “ngaphantsi kwesiqingatha sexesha,” “amaxesha amaninzi,” yaye “rhoqo.” Ezi ziguquko zimbini zibizwa ngokuba yi-CAEP-Application (CAEP ngexesha lokufakwa kwekhondom) kunye ne-CAEP-PVI (CAEP xa usebenzisa ikhondom kwi-PVI), ngokulandelelanayo. Kuluhlu ngalunye, amadoda ayehlelwa njengo-“Ewe” ukuba ayephendula ngamaxesha athile okanye rhoqo yaye “Hayi” ukuba akazange aphendule. Amaqela amane adalwe kusetyenziswa ezi ziguquko zimbini: Akukho-CAEP, i-CAEP-Application kuphela, i-CAEP-PVI kuphela, kunye ne-CAEP-Zombini.

Iinkcazo zeSampuli kunye neziNxulumano ezinokubakho

Ukongeza kwimilinganiselo yokufaneleka kunye nokukhutshwa okuchazwe ngaphambili, i-descriptor variables yesampula elandelayo kunye nokulungelelaniswa kweziphumo zihlolwe: uhlanga, i-Hispanic / Latino ethnicity, imfundo, inkolo, ingeniso, ubukhulu bedolophu, isimo sokwaluka, imbali yobomi be-STI, nokuba Umthathi-nxaxheba wakhe wammithisa engenzeki ngabom, nokuba wakha wafundiswa ukusebenzisa ikhondom yamadoda. Iingxaki zempilo zangoku (isifo seswekile, isifo sokuwa, ukudakumba / ukuxhalaba, ukuqina kwemithambo, i-muscular dystrophy, uxinzelelo lwegazi oluphezulu, imeko yentliziyo, nezinye) kunye nokusetyenziswa kwamayeza (ukwenzela ingqalelo ukusilela kwengxaki yokungakhathali / ukusilela ingqalelo [ADHD/ADD], isifo seswekile, intliziyo , ukudakumba, ukuxhalaba, i-hormonal, enye) nazo zavavanywa kunye nokuba ngaba umthathi-nxaxheba uye waphathwa ngengxaki yesondo kwiinyanga ze-12 zangaphambili. Ukusebenzisa ixesha lokukhumbula iintsuku ezingama-90, oku kuguquguqukayo kulandelayo kulinganiswe: nokuba ngaba umthathi-nxaxheba wayekwinkqubo yokutshintsha indlela yokuziphatha yokusetyenziswa kwekhondom okanye omnye ukuguqula indlela yokuziphatha ngokwesondo, ukusebenzisa ezinye iindlela zokuthintela ukukhulelwa, nokuba ebezama ukumitha iqabane lakhe ( s), kunye nokuba wayesebenzise kaninzi kangakanani i-phosphodiesterase type 5 inhibitors (PDE-5i) ngexesha lokwabelana ngesondo xa wayesebenzisa ikhondom.

Uhlalutyo lweenkcukacha

Iimvavanyo ze-Chi-squared zisetyenziselwa ukufumanisa ubudlelwane phakathi kokuhlelwa kweqela le-CAEP (No-CAEP, i-CAEP-Application kuphela, i-CAEP-PVI kuphela, kunye ne-CAEP-Zombini) kunye neempendulo kwimibuzo emibini malunga nokulungiswa xa ungasebenzisi ikhondom, Iindidi ze-IEF-5 (akukho ED ukuya kwi-ED enzima), kunye nezinye iinguqu zecategorical. Ngenxa yokuba incinci ukuya kwi-zero ibone i-frequencies kwezinye iiseli iphule ingqikelelo yohlalutyo lwe-chi-squared, senze i-4 × 2 (ayizange ihlangabezane nawaphi na amava e-EPs ngexesha lokunika ingxelo). Ukulandela oku, ukuthelekiswa kwe-post-hoc kuqhutywe ngokusebenzisa i-2 × i-2 ye-chi-squared tests.

Uhlalutyo lokungafani lusetyenziselwe ukuthelekisa i-IEF-5 kunye namanye amanqaku aqhubekayo kumaqela kunye novavanyo lwe-Scheffé olusetyenziselwa ukuthelekisa emva kwe-hoc. Ukubaluleka kwasekwa kwi P < 0.05. Uhlalutyo lwenziwa kusetyenziswa i-SPSS Version 21 (izibalo ze-IBM SPSS zeWindows, inguqulo 21.0; IBM Corp., Armonk, NY, USA).

iziphumo

Umyinge weminyaka yobudala yayiyi-20.43 iminyaka (i-standard standard = 1.63). Uninzi luchongwe njengabamhlophe (80.1%), i-6.8% njengama-Asia, i-4.7% njengama-Afrika aseMelika/abantsundu, kunye nentsalela njengamanye amaqela eentlanga. I-Hispanic / Latino uhlanga lwabikwa yi-4.2% yamadoda. Uninzi (66.5%) lubonise elona nqanaba liphezulu lemfundo njengezikolo zasekholejini/zobugcisa, i-3.8% yesidanga semfundo ephakamileyo, i-29.4% yamabanga aphakamileyo, yaza i-0.4% ayizange iyigqibe imfundo yamabanga aphakamileyo. Ngaphezulu nje kwesiqingatha (54.7%) babonise ukuba inqanaba lemivuzo yabo likudidi oluphakathi okanye ngaphantsi kwaye i-53.0% ikhule kwizixeko eziphakathi ukuya ezikhulu. Uninzi lwabo balukile (87.3%), abazange bafunyanwe bene-STI (97.3%), kwaye bafundiswe ukusebenzisa ikhondom yamadoda (63.0%). Ukukhulelwa okungenziwanga ngabom kunikwe ingxelo nge-9.2%.

Kumadoda angama-479, i-184 (38.4%) yachazwa njenge-No-CAEP, i-66 (13.8%) njenge-CAEP-Application kuphela, i-75 (15.7%) njenge-CAEP-PVI kuphela, kunye ne-154 (32.2%) njenge-CAEP-Zombini. Akukho yantlukwano yeqela efunyenweyo yobudala, ubuhlanga, ubuhlanga beSpanishi / isiLatino, imfundo, inkolo, umvuzo, ubungakanani bedolophu yasekhaya, imeko yolwaluko, imbali yobomi be-STI, nokuba wakhe wakhulelwa umntu engenzelwanga ngabom, nokuba wakha wafundiswa ukusebenzisa ikhondom yamadoda.

Ukunikezelwa kokuphindaphindiweyo kweengxaki zempilo zangoku kunye nokusetyenziswa kweyeza, idatha evela kuwo onke amadoda anika ingxelo nayiphi na i-CAEP yadityaniswa (naliphi na iqela le-CAEP) kwaye xa kuthelekiswa nalawo avela kumadoda abika i-CAEP. Ukwahlukana kweqela kuphela okufunyenweyo kwakungenxa yokudakumba / ukuxhalaba, kunye ne-12.9% yamadoda kwiqela le-CAEP elibika oku xa kuthelekiswa ne-4.9% yamadoda kwiqela le-No-CAEP (χ2 = 8.14, iqondo lenkululeko [df] 1, P  = 0.004). Nangona kunjalo, akukho ntlukwano yeqela ekusetyenzisweni kweyeza elixeliweyo lokudakumba (3.2%) okanye ukuxhalaba (2.9%). Umahluko weqela kuphela ekusetyenzisweni kwamayeza yayiyeye-ADHD/ADD, ene-3.3% yeqela le-No-CAEP kunye ne-8.9% yalo naliphi na iqela le-CAEP elixela ukusetyenziswa kwala mayeza (χ2 = 5.62, df 1, P = 0.018). Ngaphantsi kwe-1% ibike isifo sikashukela (i-0.8%), i-epilepsy (0.8%), i-multiple sclerosis (0.2%), i-muscular dystrophy (0.2%), imeko yentliziyo (0.9%); umlinganiselo ophantsi ofanayo osetyenzisiweyo amayeza esifo seswekile (0.8%), amayeza entliziyo (0.4%), kunye namayeza ehomoni (0.9%). Abathathi-nxaxheba abancinci babonise uxinzelelo lwegazi oluphezulu (2.1%), ezinye iingxaki zonyango (1.7%), kunye nokunyangwa kweengxaki zesondo kwiinyanga ezili-12 ezidlulileyo (1.5%).

Kwiintsuku ze-90 ezidlulileyo, abambalwa abathathi-nxaxheba bebekho kwiinkqubo zokutshintsha ukusetyenziswa kwekhondom (1.7%) okanye ukuziphatha ngokwesondo (1.3%) kwaye bambalwa basebenzise i-PDE-5i ngesondo kunye (1.9%) okanye ngaphandle kweekhondom (1.9%). . Akukho namnye owayezama ukumithisa iqabane. Ngaphezu kwesiqingatha samadoda abonise ukuba athembele kwiikhondom zamadoda ekulawuleni inzala (54.9%) kunye / okanye ukuba asebenzise iikhondom zamadoda kunye nezinye iindlela zokulawula ukuzala (59.1%) ubuncinane ngexesha elithile kwiintsuku ezingama-90 ezidlulileyo. Akukho mahluko wamaqela afunyenweyo kuyo nayiphi na kwezi ziguquguqukayo. Ngokuphawulekayo amadoda amaninzi kulo naliphi na iqela le-CAEP (17.3%) kuneqela le-No-CAEP (9.8%) lichaze ukuba lithembele kuhlobo lolawulo lokubeleka ngaphandle kweekhondom ubuncinane kwizihlandlo ezithile kwiintsuku ezingama-90 ezidlulileyo (χ2 = 5.18, df 1, P = 0.023).

Inani eliqhelekileyo lamaxesha amadoda asebenzisa iikhondom kwisithuba seentsuku ezingama-90 zokukhumbula laliyi-10.8 (inxaso eqhelekileyo = 14.3) kwaye oku akuzange kwahluke kakhulu kumaqela amane. Ukuhambelana kokusetyenziswa kwekhondom, nangona kunjalo, kwakuphantsi kakhulu kwi-CAEP-Bobabini iqela (73.4%) xa kuthelekiswa neqela le-No-CAEP (82.4%) (F (3,471) = 3.44, P = 0.017), kunye namanye amaqela aphakathi kwaye awahluke kakhulu omnye komnye (i-CAEP-Application Kuphela i-82.1%; i-CAEP-PVI Kuphela i-77.7%).

Ii-EPs Xa Ungasebenzisi Iikhondom

Malunga nekota enye yesampula (23.0%) ibonise ukuba abanakuyiphendula le mibuzo kuba bebesoloko besebenzisa iikhondom. Itheyibhile 1 inikezela ngohlalutyo lwamadoda aseleyo. Ngenxa yokuba amadoda ambalwa abonise amava aqhelekileyo e-EPs xa iikhondom zingasetyenziswanga, uhlalutyo lwe-chi-squared luthelekisa amaqela amane e-CAEP kwiipesenti ezichazwe ngokuthi "Ewe" vs. "Hayi" ye-EP-Before kunye ne-EP-PVI. Amaqela e-CAEP ahluke kakhulu kwi-EP-Ngaphambi kokuguquguquka (χ2 = 40.14, df 3, P  <.001). Ipesenti yamadoda abika ubuncinci be-EP ngaphambi kokungena kwi-No-CAEP, i-CAEP-Application kuphela, i-CAEP-PVI kuphela, kunye ne-CAEP-Bobabini amaqela, ayeyi-9.9, 35.7, 23.6, kunye ne-43.0, ngokulandelanayo. Kuhlalutyo lwe-post-hoc, iqela le-No-CAEP lalinamadoda ambalwa kakhulu abika ii-EPs ngaphambi kokungena xa lingasebenzisi ikhondom xa kuthelekiswa namanye amaqela. Itheyibhile 1 ibonisa iziphumo zalo lonke uthelekiso lwasemva kwe-hoc.

Itheyibhile 1. Ukuphindaphinda kweengxaki zokumiswa xa ungasebenzisi iikhondom xa kuthelekiswa nawo onke amaqela e-CAEP

Iingxaki zokuchama xa ungasebenzisi ikhondom

amaqela

Akukho-CAEP (n = 142 XNUMX)

CAEP-Isicelo kuphela (n = 42 XNUMX)

CAEP-PVI kuphela (n = 55 XNUMX)

CAEP-Zombini (n = 128 XNUMX)

  1. *P <0.001
  2. Iisuperscripts zibonisa iziphumo zokuthelekisa emva kwe-hoc kusetyenziswa P  < 0.05 iikhrayitheriya. Amaqela abelana ngeleta awohlukanga kakhulu. Abo bangabelani ngeleta bahluke kakhulu.
  3. CAEP = ingxaki yokwakhiwa kwekhondom; PVI = Ukwabelana ngesondo kwilungu lobufazi.
Ngaphambi kokungena    
Ungaze (%)90.1a64.3b,c75.4b57.0 c
Ngamanye amaxesha (%)4.928.616.430.5
Ngaphantsi kwesiqingatha sexesha (%)3.57.15.58.6
Ngamaxesha amaninzi (%)1.401.83.9
Ngalo lonke ixesha (%)0000
Ngexesha le-PVI    
Ungaze (%)95.1a85.7b43.6 c54.6 c
Ngamanye amaxesha (%)3.511.940.033.1
Ngaphantsi kwesiqingatha sexesha (%)1.42.412.77.7
Ngamaxesha amaninzi (%)001.84.6
Ngalo lonke ixesha (%)001.80

Amaqela e-CAEP nawo ahluke kakhulu kwi-EP-PVI (χ2 = 8 3.00, df 3, P  <.001). Ipesenti yabathathi-nxaxheba ababika ubuncinci be-EP ngexesha le-PVI babeyi-4.9, 14.3, 56.4, kunye ne-45.4 ye-No-CAEP, i-CAEP-Application kuphela, i-CAEP-PVI kuphela, kunye ne-CAEP-Omabini amaqela, ngokulandelanayo. Kuhlalutyo lwe-post-hoc, amadoda ambalwa kakhulu kwiqela le-No-CAEP abike ukuba ane-EP ngexesha le-PVI xa engasebenzisi ikhondom xa kuthelekiswa nawo onke amanye amaqela. I-CAEP-PVI Kuphela kunye ne-CAEP-Omabini amaqela aneepesenti eziphezulu kwaye ayengahlukanga kakhulu kwelinye. Ipesenti yamadoda kwi-CAEP-Application Iqela kuphela eline-EP yamathuba athile ngexesha le-PVI yayiphakathi kwaye yahluke kakhulu kuwo onke amanye amaqela.

IIEF-5

I-alpha kaCronbach ye-IEF-5 yale sampuli yayingu-0.76. Njengoko kubonisiwe kwiThebhile 2, amanqaku e-IEF-5 ahluke kakhulu kumaqela e-CAPP (F(3,475) = 15.40, P <.001). Amanqaku aphakathi kwawo onke amaqela ayengaphezulu kwama-21 (kuluhlu lwe-nonclinical) [17]. Iqela le-No-CAEP lalinamanqaku aphezulu (23.92) (ebonisa ukusebenza okungcono kwe-erectile), ihluke kakhulu kwi-CAEP-PVI kuphela (22.93) kunye ne-CAEP-Bobabini amaqela (22.12), kodwa kungekhona kwi-CAEP-Application kuphela (23.20) . Amanqaku aphakathi kwe-CAEP-Bobabini iqela lalingafani kakhulu neqela le-CAEP-PVI kuphela, kodwa lalihluke kakhulu kwamanye amaqela amabini. Amanqaku aphakathi kwe-CAEP-Application kuphela kunye namaqela e-CAEP-PVI kuphela nawo awahlukanga kakhulu.

Uluhlu 2. Amanqaku e-IEF-5 kunye nokuhlelwa kwe-ED ngamaqela e-CAEP

 

Akukho-CAEP (n = 184 XNUMX)

CAEP-Isicelo kuphela (n = 66 XNUMX)

CAEP-PVI kuphela (n = 75 XNUMX)

CAEP-Zombini (n = 154 XNUMX)

  1. *P <0.001
  2. Iisuperscripts zibonisa iziphumo zokuthelekisa emva kwe-hoc kusetyenziswa P  < 0.05 iikhrayitheriya. Amaqela abelana ngeleta awohlukanga kakhulu. Abo bangabelani ngeleta bahluke kakhulu.
  3. CAEP = ingxaki yokwakhiwa kwekhondom; ED = ukungasebenzi kakuhle kwe-erectile; IIEF-5, Isalathiso samazwe ngamazwe se-Erectile Function; I-PVI = ukwabelana ngesondo-kwilungu lobufazi; SD = ukutenxa okusemgangathweni.
Ithetha (SD) IIEF-5 amanqaku*23.92 (2.24)a23.20 (2.51), b22.93 (2.56)b,c22.12 (2.54)c
Ukuhlelwa kwe-IEF-5 Amanqaku*    
Akukho ED (%)91.3a81.8b77.3b,c68.2 c
I-ED ephakathi (%)7.115.220.028.6
Iphakathi ukuya phakathi kwe-ED (%)0.53.01.33.2
I-ED ephakathi (%)1.101.30
Eqatha (%)0000

Ukusebenzisa amanqaku e-IEF-5, amadoda aye ahlelwa ukusuka kwi-ED ukuya kwi-ED enzima esebenzisa imigaqo echazwe nguRosen et al. [17] (jonga kwiTheyibhile 2). Ngenxa yokuba amadoda ambalwa ahlelwa njenge-ED ephakathi ukuya kwi-moderate okanye ngaphezulu, sadibanisa amadoda kunye nayo nayiphi na i-ED kwiqela elinye. Ukuthelekisa amaqela amane e-CAEP kwiipesenti ezichazwe njenge-ED ngokuchasene nayo nayiphi na i-ED, bekukho umbutho obalulekileyo (χ2 = 28.98, df 3, P <.001). Ipesenti yabathathi-nxaxheba abahlelwa njengayo nayiphi na i-ED yayiyi-8.7, 18.2, 22.7, kunye ne-31.8 ye-No-CAEP, i-CAEP-Application kuphela, i-CAEP-PVI kuphela, kunye ne-CAEP-Omabini amaqela, ngokulandelelanayo. Itheyibhile 2 imibhalo ephezulu ibonisa iziphumo zohlalutyo lwe-post-hoc olubonisa ukuba iqela le-No-CAEP libandakanya amadoda ambalwa kakhulu kunye nayiphi na i-ED kunamanye amaqela.

ingxoxo

Kule sampuli yamadoda aselula, athandana nesini esingafaniyo, asebenzisa ikhondom, ii-CAEPs zadityaniswa namanqanaba abanzi, kodwa uninzi lwamanqanaba angaphantsi (obuncinci) obunzima be-erectile. Amadoda anika ingxelo ngalo naluphi na uhlobo lwe-CAEP (ngexesha lokufaka isicelo kunye/okanye ngexesha le-PVI) ayenokwenzeka kakhulu kuneqela le-No-CAEP ukuba anike ingxelo ngobunzima bokumiswa phambi kokungena kunye nangexesha lokwabelana ngesondo xa engasebenzisi ikhondom. Amadoda anike ingxelo ye-CAEP ngexesha le-PVI kuphela okanye ngexesha lesicelo zombini kunye ne-PVI yafumana amanqaku aphantsi kakhulu kwi-IEF-5 kunamadoda abika i-CAEP. Onke amaqela anika ingxelo ye-CAEP abonakele kakhulu ukuba ahlelwe njengane-ED ephakathi ukuya kwephakathi kuneqela le-No-CAEP. Nangona kunjalo, nakwi-CAEP-Bobabini iqela, elinamazinga aphezulu e-IEF-5-echongiwe ED, uninzi (68.2%) lwamadoda aluzange luhlangabezane neendlela zeklinikhi zokuba ne-ED.

Kukho uluhlu lweengcaciso ezinokubakho kwezi ziphumo. Okokuqala, akuyi kumangalisa ukuba amadoda ane-ED nawo ane-EPs xa esebenzisa iikhondom. Okwesibini, ngelixa kuqikelelwa, kunokwenzeka ukuba amadoda aqala ukufumana ilahleko yokuchama xa esebenzisa iikhondom anokuba nexhala malunga nokufumana ii-erections ngokubanzi kwaye ke abe sesichengeni sokufumana iED ngokubanzi. [18]. Oku kuya kuhambelana nolunye uphando olubonisa ukubaluleka kwezinto zengqondo kunye neemvakalelo ezifana nokukhathazeka kunye nokuphazamiseka kwi-etiology kunye nokugcinwa kwe-ED. [19].

Amadoda achaze ukusetyenziswa kwamayeza e-ADHD ayenokwenzeka kakhulu ukuba axele i-CAEP. Izifundo zangaphambili zichaze amazinga aphezulu okuziphatha ngokwesondo okuyingozi phakathi kwabantu abadala abancinci abane-ADHD [20] kunye namadoda asebenzisa amayeza e-ADHD ngamanye amaxesha achaza iingxaki ze-erectile njengempembelelo yeyeza [21].

Imida

Ukudityaniswa ngokubanzi kweziphumo zethu kunokunqongophala. Isampulu yayinqunyelwe kuyilo lwabantu abadala abancinci, abathandana nesini esahlukileyo, abasebenzisa iikhondom ngoku abangekho kubudlelwane bexesha elide obubodwa, abathetha isiNgesi, kwaye banokufikelela kwi-Intanethi. Ke ngoko, iziphumo zinokuthi zingabikho ngokubanzi kumadoda angaphandle kwezi ndlela zokufaneleka. Isizathu sethu sokungabandakanyi amadoda abenobudlelwane obubodwa ngokwesondo kangangenyanga enye okanye ngaphezulu yayikukuba uphando lubonise ukuba amadoda akwiqela leminyaka eli-18 ukuya kwengama-24 anika ingxelo yokusetyenziswa kweekhondom okusezantsi kakhulu kumaqabane asele ekhona kunakwiqabane eliqhelekileyo. [22]. Amadoda akwiqela leminyaka eli-18–24 nawo asemngciphekweni omkhulu wosulelo lwe-STI kunye ne-HIV [23], nangona izinga eliphezulu lokusetyenziswa kwekhondom [24].

Ngenxa yokuba ukusetyenziswa kwekhondom yayingumlinganiselo wokufaneleka, amadoda awayekhe asebenzisa iikhondom ngaphambili kodwa ayeka ukuzisebenzisa, mhlawumbi ngenxa ye-CAEP okanye ezinye iingxaki, ayengamelwanga kwisampulu yethu. Ukukhawulela okongeziweyo kukuba ngelixa sisebenzise isixhobo esiqinisekisiweyo sokuvavanya ubunzima beengxaki ze-erectile, asizange sihlole uxinzelelo lomntu malunga nengxaki; indlela yokuxilongwa kwe-erectile disorder yamadoda ifuna ubukho boxinzelelo olubalulekileyo lweklinikhi malunga neempawu [25]. Injongo yethu kolu phononongo yayingekho, nangona kunjalo, ukubika amazinga okuxhaphaka kwe-erectile disorder, kodwa ukuseka ukuba amadoda abika i-CAEP aphinde achaze ukuba afumana ii-EPs xa engasebenzisi iikhondom kunye nokuba amanqaku e-IEF ahluke kumadoda angabiki ingxelo ye-CAEP.

Iziphumo zethu zibonisa ukuba kumadoda anika ingxelo ye-CAEP kwisampuli yethu, malunga ne-18-32% idibene ne-IEF ye-ED ye-mild ukuya kwimodareyitha (kuxhomekeke ekubeni babike i-CAEP ngexesha lokusetyenziswa kweekhondom kuphela, ngexesha le-PVI, okanye ngexesha lokufaka isicelo kunye ne-PVI). Nangona uninzi lwaba bathathi-nxaxheba bahlelwa kudidi lwe-ED "elula", nangona kunjalo kukho iziphumo ezicacileyo zekliniki zezi ziphumo. Ii-EPs ziye zanxulunyaniswa nokungaguquguquki kunye nokungaphelelanga kokusetyenziswa kwekhondom, [9] nto leyo eyayanyaniswa nomngcipheko wokufumana i-STI/HIV; ngoko ke, ukuphuculwa kwamava amadoda okusetyenziswa kwekhondom kubalulekile. Eli qela lamadoda linokuthi lizuze kuhlobo oluthile lokungenelela kokuziphatha okufutshane ukunciphisa ubunzima babo be-erectile. Nangona unyango lwe-pharmacological lwe-ED luhlala luyindlela "yokuqala" kumadoda anobunzima bokuzala, izifundo zangaphambili zicebise ukuba i-PDE-5i ayiyiyoyisi i-CAEP. [26]. Ngaphaya koko, ukusetyenziswa kwe-PDE-5i kunokuba ngumngcipheko wokuqhawuka kwekhondom [27].

Ngenxa yoko kufunyanisiweyo ukuba amadoda ane-CAEP anokufuna ixesha elingakumbi lokuvuka kunamadoda angayixeliyo i-CAEP, uJanssen kunye noogxa bakhe. [11] wenze isindululo sokuba amadoda ane-CAEP kufuneka akhuthazwe ukuba athathe ixesha elaneleyo lokuvuka kwaye aqinisekise ukuba afumana uvuselelo olwaneleyo, ngakumbi xa esebenzisa iikhondom. Uphononongo lwakutsha nje lolingo longenelelo ngoncedo lwasekhaya olukhokelwayo lokukhuthaza ukusetyenziswa kwekhondom kubafana abatsha (olufuna kuphela igalelo lonyango elingephi) luchaze ukuzithemba okukhulayo kumandla amadoda okusebenzisa iikhondom, ukukwazi ukusebenzisa ikhondom, kunye nokukhululeka kwekhondom ngokunjalo ukunciphisa ukuphuka kunye ne-EPs emva kokungenelela [28,29]. Kukwakho nesidingo somyalelo ongcono wokusetyenziswa kwekhondom ngokuchanekileyo. Ngaphezu kwesinye kwisithathu (37%) sesampulu yangoku yamadoda asebenzisa ikhondom zange afundiswe indlela yokusebenzisa ikhondom ngokuchanekileyo. Oogqirha kufuneka bavavanye ukuba ngaba amadoda asebenzisa iikhondom anamava e-CAEP kwaye apho kufanelekileyo, athumele abantu kunyango lwengqondo okanye babonelele ngezakhono zekhondom. [28,29].

isiphelo

Iziphumo zophando zibonisa ukuba amadoda anika ingxelo ye-CAEP anokuba nengxaki yokuchama ngokubanzi. Nangona ii-EPs zingenako ukuhlangabezana neekhrayitheriya zeklinikhi ze-ED, oogqirha kufuneka bahlole ukuba ngaba amadoda asebenzisa iikhondom bafumana i-CAEP kwaye apho kufanelekileyo, babhekiselele kunyango lwe-psychosexual okanye banike imfundo yezakhono zekhondom.

Ukugqubana kwemidla: Umbhali (ababhali) baxela akukho kungqubana komdla.

Inkcazo yoBungqina

Udidi 1

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  • (a) Ukuqulunqwa kweSiqenduUStephanie Sanders; UCynthia Graham; uBill Yarber; uRick Crosby; URobin Milhausen
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Udidi 3

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Ucaphulo

1 Mitchell KR, Mercer CH, Ploubidis GB, Jones KG, Datta J, Field J, Copas AJ, Tanton C, Erens B, Sonnenberg P, Clifton S, Macdowall W, Phelps A, Johnson AM, Wellings K. Umsebenzi wezesondo eBrithani. : Iziphumo ezivela kuPhando lweSizwe lwesithathu lweZimo zeSexual and Lifestyles (Natsal-3). ILancet 2013;382:1817-1829.