Ubuninzi be-erectile dysfunction: ukuphononongwa ngokuchanekileyo kwezifundo-based based (2002)

Int J Impot Res. 2002 Dec;14(6):422-32.

Prins J¹, I-Blanker MH, Bohnen AM, Thomas S, Bosch JL.

Abstract

Uphononongo olucwangcisiweyo lwenziwe malunga nokuxhaphaka kwe-erectile dysfunction (ED) kubantu bonke. Izifundo zafunyanwa eziye zachaza amazinga okuxhaphaka kwe-ED kubantu ngokubanzi. Kusetyenziswa uludwe lwekhrayitheriya ephuhliswe ngokukodwa, umgangatho we-methodological wezi zifundo wavavanywa kwaye idatha kumazinga okuxhaphaka kwacatshulwa. Sichonge izifundo ze-23 ezivela eYurophu (15), eU.SA (5), e-Asia (2) nase-Australia (1). Kuluhlu lwethu lwe-criteria yezinto ze-12, umgangatho we-methodological uvela kwi-5 ukuya kwi-12. Ukuxhaphaka kwe-ED ukusuka kwi-2% kumadoda angaphantsi kwe-40 y ukuya kwi-86% kumadoda 80 y nangaphezulu. Ukuthelekisa phakathi kwedatha yokuxhaphaka kuthintelwa ngumahluko omkhulu weendlela phakathi kwezifundo, ngakumbi kusetyenziso lwemibuzo eyahlukeneyo kunye neenkcazo ezahlukeneyo ze-ED. Sigxininisa ukubaluleka kokubonelela ngalo lonke ulwazi oluyimfuneko xa kunikwa ingxelo ngokuxhaphaka kwe-ED. Ngaphezu koko, izifundo zamazwe ngamazwe kufuneka zenziwe ukuseka ukuxhaphaka kokwenyani kwe-ED kumazwe ngamazwe.

PMID: 12494273

DOI: 10.1038/sj.ijir.3900905

intshayelelo

Uphando lwe-Epidemiological malunga ne-erectile dysfunction (ED) lukhula ngokukhawuleza kwaye izifundo malunga nokuxhaphaka kwe-ED kubemi ngokubanzi zisanda kupapashwa. Emva koko, uphononongo oluninzi olungacwangciswanga luye lwashwankathela ukhetho olusuka kwezi zifundo.^1,2,3,4,5 Nangona uninzi lwezi phononongo lugqibe kwelokuba ukuxhaphaka kwe-ED kwahluka phakathi kwezifundo, ukutolika kolu phononongo kuthintelwa ziingxaki ezininzi. Okokuqala, iindlela ezisetyenziselwa ukukhethwa kwamanqaku azivezwanga kuyo nayiphi na iphononongo, okwesibini, akukho nkcazo eyenziweyo malunga nokuqinisekiswa kwezifundo ezihlukeneyo, kwaye okwesithathu, ingqalelo encinci inikezelwa kwiinkcazo ze-ED ezisetyenzisiweyo. Ezi ntsilelo ziyahambelana nezo zifunyenwe kuphononongo lwe-epidemiological kwezinye izivuno zophando.⁶ Ukucacisa ukuxhaphaka kwe-ED kubantu ngokubanzi, uphando olucwangcisiweyo lophononongo lwenziwe apho ingqalelo ekhethekileyo ihlawulwe kumgangatho we-methodological kunye nexabiso lezifundo zomntu ngamnye. Ngenxa yale njongo, uluhlu lweenqobo zovavanyo lokuqinisekisa ubungakanani bezifundo zaphuhliswa.

Impahla nenkqubo

Isicwangciso soPhando

NgoDisemba 2001, uphando lwenziwa ukusuka kwi-1966 ukuya kuDisemba 2001 kwi-database ye-Medline kunye ne-Psychinfo kusetyenziswa amagama angundoqo alandelayo: [ukungabi namandla OKANYE ukungasebenzi kakuhle kwe-erectile OKANYE ukukhubazeka ngokwesondo] KUNYE [abemi ngokubanzi OKANYE-based based OR labantu-based OR epidemiology]. Zonke izinto zikhangelwe kusetyenziswa 'Zonke iindawo'. Ukukhangela uncwadi kwakulinganiselwe kwiilwimi zesiNgesi nesiDatshi.

Izihloko kunye nezicatshulwa zamanqaku apapashiweyo achongiweyo ahlaziywa ngokuzimeleyo (nguJP kunye ne-MHB) ukumisela ukufaneleka kwamanqaku. Ucaphulo ngalunye lwahlelwa 'njengokuquka', 'ukungaqinisekanga' okanye 'ukukhutshelwa ngaphandle'. Kwimeko yokungavumelani phakathi kwababuyekezi babini, imvumelwano yafikelelwa ukusombulula ukungavumelani. Emva koku, izicatshulwa ezikhutshiweyo azizange ziphinde ziqwalaselwe. Uluhlu lweereferensi lwamanqaku afakiweyo luhlolwe ukuchonga izifundo ezongezelelweyo ezingafumanekiyo kwi-Medline okanye kwi-database ye-psych-info.

Ukukhethwa kwezifundo

Izifundo ezibandakanyiweyo zavavanywa ngokweenkcukacha (nguJP kunye ne-MHB) ukwenza ukhetho lokugqibela lwezifundo zophononongo. Ukufaneleka yayizizifundo kunye noyilo lwesifundo esinqamlezileyo okanye izifundo zeqela ezibandakanya amadoda athathwe kuluntu ngokubanzi kwaye anike ingxelo yedatha yentsusa kumazinga okuxhaphaka kwe-erectile dysfunction. Amaphepha aqulathe izicatshulwa kuphela aye ashiywa.

Indlela yokuvavanya umgangatho

Kwisigwebo somgangatho wemethodological imiba emibini yokunyaniseka ibalulekile: ukunyaniseka kwangaphandle kunxulumene nokusebenziseka kweziphumo zophando kwabanye abantu, ngelixa ukunyaniseka kwangaphakathi kuthetha umlinganiselo ochanekileyo ngaphandle kwempazamo engacwangciswanga. Njengoko kungekho luluhlu lwemigaqo yovavanyo lomgangatho wezifundo zokuxhaphaka lukhona, uluhlu lwayilwa (bona 1 Table), ebandakanya izinto ezintandathu ezisemthethweni zangaphakathi, izinto ezintandathu ezisemthethweni zangaphandle kunye nezinto ezintathu kulwazi. Imiba yokugqibela ayiqukwanga kuvavanyo lomgangatho wemethodological kodwa inika isalathiso sokunikwa kweengxelo. Zonke izinto zafumana amanqaku ezintle okanye ezimbi ngokuzimeleyo (nguJP kunye ne-MHB) kwaye ukubaluleka kwazo akuzange kulinganiswe. Ngenxa yezizathu ezinokwenzeka, uvavanyo lomgangatho aluzange lwenziwe phantsi kweemeko ezigqunyiweyo. Kwimeko yokungavisisani, kwafikelelwa kwimvumelwano.

Uluhlu loku-1: Iikhrayitheriya zovavanyo lomgangatho wendlela yezifundo zokuxhaphaka

Itafile yesayizi epheleleyo

Inkcazo yedata

Ukusebenzisa iifom ezisemgangathweni, ababuyekezi ababini (JP kunye ne-MHB) bakhuphe ngokuzimeleyo ulwazi kunye nedatha kwizifundo zomntu ngamnye. Xa kungekho okanye ulwazi olwaneleyo lunikezelwe kwinqaku, siphendle i-database ye-Medline kwamanye amaphepha kwisifundo esifanayo ukuze sifumane ulwazi olongezelelweyo, usebenzisa amagama ababhali okanye amaqela athile okufunda. Ngenxa yezizathu ezinokwenzeka, akukho malinge enziweyo ukuqhagamshelana ngokuthe ngqo nababhali bamaphepha apapashiweyo.

Ukuthelekiswa kwezifundo

Indlela yokusebenza yezifundo zomntu ngamnye yathelekiswa ukumisela ukuba uthelekiso lwamazinga axeliweyo okuxhaphaka luya kufaneleka kwaye lube nentsingiselo.

iziphumo

Ukukhethwa kwezifundo

Uphando oluphambili luvelise izicatshulwa ze-581, apho i-63 yakhethwa ukuba ihlaziywe ngokupheleleyo, kubandakanywa neengcaphuno ze-11 ezingaqinisekanga apho kungekho nto ikhoyo. Itshekhi yoluhlu lweereferensi lwala maphepha luvelise izicatshulwa ezongezelelweyo ezingama-39, apho ezingama-30 zakhethwa ukuba zihlolwe ngokupheleleyo. Ke ngoko, izicatshulwa ezingama-93 ziye zaphononongwa ukuze zifaneleke. Kula maphepha, amaphepha angama-47 aye ashiywa ngenxa yezi zizathu zilandelayo: ukungabikho kwedatha yokuqala (n=25, apho i-13 ibingamanqaku ophononongo), abantu abafundayo abangaveli kubantu ngokubanzi (n=8), iphepha liqulathe abstract kuphela (n=2), iphepha lingenalwazi nge-ED (n=8), akukho lwazi olongezelelweyo (n=1), ayifumaneki (n=3). Amaphepha alishumi avela kwi-Massachusetts Male Aging Study (MMAS); kwezi, amaphepha amane asetyenziswa ukufumana lonke ulwazi oluyimfuneko; abanye abathandathu ababonelelanga ngolwazi olongezelelweyo olufanelekileyo kolu hlaziyo. Elinye inqaku lifunyenwe ngolwazi olongezelelweyo malunga nezifundo ezikhethiweyo. Ekugqibeleni, idatha evela kumaphepha e-40 inike ulwazi kwizifundo ze-23.^{7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46} Zimbini kuphela kwezi zifundo ezakhethwayo ngokujonga izintlu zeereferensi.

Indlela yokuvavanya umgangatho

2 Table ibonisa iziphumo zovavanyo lomgangatho. Ngokomyinge, izinto ze-4.5 (uluhlu lwe-1-6) ekuqinisekiseni kwangaphandle zafumana amanqaku afanelekileyo, njengoko i-4.3 (uluhlu lwe-2-6) lusemthethweni lwangaphakathi. Izifundo ezimbini kuphela ezifumene amanqaku afanelekileyo kuzo zonke iikhrayitheriya zokuqinisekiswa kwe-12;^40,41,45 nangona kunjalo, xa kuqwalaselwa umbuzo omnye kwi-ED, zombini ezi zifundo zokugqibela zafumana amanqaku angalunganga kwizinto ezimbini (h kwaye i) yokunyaniseka kwangaphakathi.

Itheyibhile 2: Unyaka opapashwe kunye novavanyo lomgangatho wezifundo ezikhethiweyo

Itafile yesayizi epheleleyo

Inkcazo yabemi abakhethiweyo bofundo

Inkcazo yamanani abantu ababandakanyiweyo kwizifundo ezikhethiweyo inikwe 3 Table. Kwizifundo ze-11, iindlela zokufaneleka azizange zichazwe. Akukho lwazi kubantu abangaphenduliyo olufumanekayo kwizifundo ze-11, ngelixa kwizifundo ezintlanu ulwazi oluthile lufunyenwe (isampuli) kwabo bangaphenduliyo; Ezinye izifundo ezisixhenxe zithelekisa iimpawu zabathathi-nxaxheba kugcino-lwazi lwangaphandle, irejista yesiseko yabemi okanye iimpawu zabathathi-nxaxheba abasisiseko. Kwesinye isifundo, ngenxa yendlela yesampulu (i-stratified kwi-continence state), inani labantu bophononongo alikwazanga ukwenziwa ngokubanzi kuluntu apho abathathi-nxaxheba bakhethwa khona.⁷

Uluhlu 3: Inkcazo yamanani abantu kwizifundo ezikhethiweyo

Itafile yesayizi epheleleyo

Ukuqokelelwa kwedatha kwizifundo ezikhethiweyo

4 Table dwelisa iindlela ezisetyenziselwa ukufumana idatha malunga nomsebenzi we-erectile kunye neenkcazo ezisetyenziselwa i-ED. Kwizifundo ze-17 ii-questionnaire ezizilawulayo zisetyenzisiwe, izifundo ezintandathu zasebenzisa udliwano-ndlebe, kwaye kwizifundo ezintlanu iindlela ezisetyenzisiweyo azizange zichazwe.

Itheyibhile 4: Indlela esetyenziselwa ukufumana ulwazi malunga nokungasebenzi kakuhle kwe-erectile, inkcazo kunye namazinga okuxhaphaka

Itafile yesayizi epheleleyo

Uluhlu lwemibuzo olwahlukeneyo lwasetyenziselwa ukuhlola i-ED kubemi. Ezi khweshine ziqulathe nokuba ngumbuzo omnye kwi-ED,^{7,8,9,14,15,16,17,18,19,20,22,23,24,29,30,31,32,33,34,35,40,41,42,43,44,45} okanye uthotho lwemibuzo nge-ED ekuthathwe kuyo isimbuku samanqaku.^39,40,41,45

Kwizifundo ezimbini, iindlela ezimbini zisetyenziselwe ukumisela i-ED, oko kukuthi, umbuzo omnye kwi-ED kunye ne-questionnaire enkulu.^40,41,45 Kwi-MMAS, uphononongo lolungelelwaniso lusetyenziselwe ukufumanisa ukungabi namandla ukusuka kwiimpendulo ukuya kwimibuzo engachanekanga ngomsebenzi wesondo.¹⁰ Kwiingxelo zokuqala ze-ED, isampulu yeklinikhi yomchamo yasetyenziselwa le njongo ('indlela yonyango'),¹⁰ ngelixa kwiingxelo zamva kwidatha yobude, isampulu yophononongo ngokwayo yasetyenziswa ('indlela ye-MMAS').¹² Ezi ndlela zimbini zibangele amazinga ahlukeneyo okuxhaphaka.¹²

Inkcazo yokungasebenzi kakuhle kwe-erectile

Akukho nkcazo ye-ED echazwe kwingxelo enye, ngelixa izifundo ezine zichaza 'ukungabi namandla', kunye nezifundo ezintathu zichaza 'ubunzima be-erectile', 'i-erectile disability' okanye 'iingxaki zokumisa'. Kwizifundo ezili-16 ezishiyekileyo inkcazo ye-ED yanikwa (bona 4 Table).

Ukuxhaphaka kokungasebenzi kakuhle kwe-erectile

Amazinga okuxhaphaka ahluka kakhulu (4 Table). Zonke izifundo zibonise ukonyuka komgca wokuxhaphaka kunye nobudala obudala. Kwizifundo ezibini akukho kuxhaphaka kweminyaka ethile kunikezelweyo.^8,9,26 Amazinga okuxhaphaka kwamadoda angaphantsi kweminyaka engama-40 ubudala (axelwe kwizifundo ezithandathu) asuka malunga ne-2 ukuya kwi-9%. Izinga lokuxhaphaka kwamadoda amadala kune-70 y (exelwe kwizifundo ze-13) ukusuka kwi-10 ukuya kwi-71%, kanti kumadoda amadala kune-80 y (exelwe kwizifundo ezithathu) ukuxhaphaka ukusuka kwi-18 ukuya kwi-86%.

Ukuthelekisa ngokuthe ngqo ukuxhaphaka kwakunokwenzeka kwizibini ezimbini kuphela zezifundo. Ukuxhaphaka okuxeliweyo kwiSifundo seNqila yase-Olmsted (OCS)^14,15,16 kunye nophando lwaseJapan³² zaziphantse zifane kwaye zibonise ukwanda okukhulu kwimiba emva kweminyaka eyi-70. Ukuxhaphaka okuxeliweyo eLeicestershire (UK)²³ bebephezulu kakhulu kumaqela abantu abadala (60–69 kunye 70–79 y) kunabo baseKrimpen aan den IJssel (eNetherlands);^43,44 kolu thelekiso, kwisifundo saseDatshi zonke iindidi zobunzima be-ED zadityaniswa, kuba isifundo sase-UK asizange sinikeze ulwazi kwiindidi zobunzima be-ED ezahlukeneyo.

ingxoxo

Olu luphononongo lokuqala olucwangcisiweyo loncwadi olugxile ekuxhaphakeni kwe-erectile dysfunction kubantu bonke. Ngaphambili, idatha ekhoyo kule ntsimi ye-epidemiological ekhula ngokukhawuleza yokukhangela kwakhona yayishwankathelwa ngokungahambi kakuhle,^{1,2,3,4,5,47,48,49,50,51,52,53,54} okanye ngaphandle kokugxila kubemi ngokubanzi.⁵⁵ Ngokukodwa, akukho lwazi malunga nokukhethwa kwezifundo ezibandakanyiweyo ezinikezelweyo,^{1,2,3,4,5,47,48,49,50,51,52,53,54} kwaye ukuqinisekiswa kwezifundo ezibandakanyiweyo akuzange kuxoxwe ngababhali.^{1,2,3,4,5,47,48,49,50,51,52,53,54,55} Kuphononongo lwangoku, ushwankathelo loncwadi olukhoyo lunikezelwa kwaye uvavanyo lomgangatho wezifundo zomntu ngamnye lunikezelwa, ngokwezikhokelo ezicetywayo zokunika ingxelo yokuphononongwa okucwangcisiweyo.^56,57

Ukukhethwa kwezifundo kunye nokutsalwa kwedatha

Izifundo ezimbini kuphela ezifunyenwe ngoluhlu lwereferensi, ebonisa ukuba isicwangciso sokuqala sokukhangela sanele. Izifundo ezichazwe kwiincwadi azizange zibandakanywe kuphononongo lwangoku. Sagqiba ekubeni singaqhagamshelani nababhali bezifundo ezikhethiweyo njengoko oku kungazisa ucalucalulo; ababhali bezifundo zamva nje kunokuba lula ukunxibelelana, kwaye ulwazi lunokufumaneka lula kunezifundo zakudala. Ngokubanzi, sikholelwa ukuba ulwazi kufuneka lufumaneke lula ukuze lusetyenziswe ngabafundi bamanqaku.

Indlela yokuvavanya umgangatho

Njengoko kungekho luluhlu lweendlela zokuvavanya umgangatho wezifundo ezixhaphakileyo ezikhoyo, siphuhlise uluhlu olunjalo olusekwe kwingqwalasela yethiyori kunye nengqiqo eqhelekileyo (1 Table), engasetyenziselwa ukuphononongwa okucwangcisiweyo kokuxhaphaka kwezinye iimeko kubemi bonke.

Umahluko owenziwe phakathi kokusemthethweni kunye nokungasebenziyo ngokusekelwe kumanqaku ewonke, kunye nokusetyenziswa kwamanqaku okusikwayo akunangqiqo. Kufuneka kuqatshelwe, nangona kunjalo, ukuba ezinye zezifundo ezikhethiweyo zinenani eliphezulu lamanqaku angalunganga (2 Table). Ngokwayo, isifundo sinokusebenza, kodwa ukuba ingxelo ayichanekanga, ukuthelekisana nezinye izifundo kunye nokusetyenziswa kwayo kuhlaziyo olucwangcisiweyo kuya kuthintelwa.

Ngaphandle kovavanyo lulonke lomgangatho, amagqabantshintshi anokwenziwa kwiikhrayitheriya zokuthembeka ezahlukileyo, ezinjengokumelwa kwabantu bophononongo (into d kuvavanyo lomgangatho). Kwizifundo ze-11, izinga lokuphendula lalingaphantsi kwe-70% kwaye idatha enganeleyo yayifumaneka ngokumeleli kwabantu. Kwizimbini zezi zifundo, izinga lokuphendula eliphantsi lingachazwa ngumgudu ophezulu ofunekayo kubathathi-nxaxheba okanye ukufakwa kwemilinganiselo eyongezelelweyo.^23,31,32 Okumangalisayo kukuba, kwizifundo ezithandathu, akukho lwazi lunikezelweyo ngexesha lokufunda.

Iinkcazo ze-ED kunye noluhlu lwemibuzo

Nangona ababhali abahlukeneyo bebhekisa kwinkcazo yemvumelwano ye-ED-'ukungakwazi ukufikelela kunye nokugcina i-erection eyaneleyo yokwenza umsebenzi wesondo owanelisayo'⁵⁸-kwiingxelo zabo, babini kuphela abayisebenzisayo kuqikelelo lwamazinga okuxhaphaka.^36,37,38 Uyilo lwekhweshine lunokuba nefuthe kumazinga okuxhaphaka okufunyenwe kulo; umzekelo, i-ED-rating scale kwi-Cologne ED Questionnaire iqulethe imibuzo emihlanu ehambelana ngokusondeleyo;³⁹ amanqaku aqinisekileyo kumbuzo omnye aphantse athethe ngokuzenzekelayo amanqaku avumayo komnye umbuzo. Ngaphezu koko, umlinganiselo we-ED-rating wawuquka umbuzo malunga nokukwazi ukufikelela kwi-orgasm;³⁹ olu lwakhiwo lunokubangela ukuqikelelwa okubalulekileyo kokuxhaphaka kwe-ED.

Ukusetyenziswa kwesampulu yeklinikhi ye-urological kuphononongo lokulinganisa kwi-MMAS kuye kwakhokelela ekugqithiseni ubuninzi be-ED, echazwe kwiphepha elilandelayo kolu phononongo.¹² Kwinxalenye yobude be-MMAS, umbuzo omnye kwi-ED wongezwa kwi-questionnaire, okubangele ukuxhaphaka okuphantsi, ngakumbi kwabo baphakathi ukuya kwi-impotence enzima.^12,13

Kwizifundo ze-14, umbuzo omnye wasetyenziselwa ukufumana ulwazi malunga nomsebenzi we-erectile; nangona kunjalo, akukho namnye kule mibuzo owaqinisekiswa ngokusesikweni. Kutshanje, izifundo ezimbini zibonise ukuba umbuzo omnye kwi-ED unokusetyenziswa kuphando lwe-epidemiological, kodwa ukuqulunqwa ngokuchanekileyo kombuzo onjalo akuzange kuxoxwe.^13,45 Nangona kunjalo, sicinga ukuba, xa ichazwe ngokufanelekileyo, imibuzo enye esetyenziswa kwezinye izifundo inika ulwazi olufanelekileyo.

Ukuthelekiswa kwamazinga okuxhaphaka

Uphononongo lwangoku lubonisa ukuba ukuxhaphaka okuxeliweyo kwe-ED kwahluka kakhulu kwaye kukho umahluko omkhulu phakathi kwezifundo. Ke ngoko, akucaci ukuba oku kuxhaphaka kwahluka kubonisa umahluko wokwenyani phakathi kwamazwe okanye umahluko wendlela yokusebenza. Ngokombono wethu, iinguqu ezinkulu zemethodological, ngakumbi iinkcazo ezahlukeneyo ezisetyenzisiweyo, zithintela uthelekiso oluthe ngqo lwamazinga okuxhaphaka okuxelwe kwizifundo ezininzi. Zimbalwa izifundo ezinokuthelekiswa ngokufanelekileyo.

Umzekelo, uyilo olufanayo lwe-OCS kunye nophononongo lwaseJapan luyakuvumela ukuba uthelekiso lwenziwe.^{14,15,16,31,32} Kwiingxelo ze-OCS,^14,15,16 nangona kunjalo, akukho mazinga achanekileyo okuxhaphaka kwe-ED anikezelwayo, ngaphandle kokusabalalisa okuqokelelweyo kweempendulo kwimibuzo ethile, kwingxelo edibeneyo yezifundo zombini.³² Sifumene ukuxhaphaka kule ngxelo yokugqibela: ukuba i-44% (109 ngaphandle kwe-245) yala madoda ibike ukuba 'erections akukho xesha'³² Okumangalisayo kukuba, oku kuxhaphaka akuhambelani nengxelo yangaphambili evela kolu phononongo apho ababhali bathi 'ipesenti yezifundo ezikwaziyo ukuba ne-erections encinci okanye akukho nalinye ixesha lenyuka ... ukuya ngaphezu kwekota yamadoda aneminyaka eyi-70 okanye ngaphezulu'¹⁴

Izifundo ezivela eLeicestershire (UK) naseKrimpen aan den IJssel (eNetherlands) zisebenzise ingcaciso efanayo kunye noluhlu lwemibuzo (I-International Continence Society isini sendoda iphepha lemibuzo).^23,44 Ukwahluka kwiiprofayili zengozi kunye nemibono eyahlukileyo yengxaki ingaba negalelo kwizinto ezingafaniyo kwingxelo yobuninzi be-ED phakathi kwamadoda aneminyaka eyi-60 nangaphezulu; uphando olongezelelweyo luyafuneka ukucacisa lo mahluko.

Ngaphambili, kwaye kwagqitywa ukuba ukuxhaphaka okusezantsi kakhulu eSpain (xa kuthelekiswa neenkcukacha zeMMAS) kunokubalelwa kumahluko kwimbono ye-ED kwiinkcubeko ezahlukeneyo.⁴⁵ Ngokoluvo lwethu, nangona kunjalo, lo mahluko usenokuba ubangelwa ngumahluko kwimibuzo ebisetyenzisiwe (bona 3 Table).

Izigqibo ezininzi zinokuthathwa kolu hlaziyo olucwangcisiweyo loncwadi malunga nokuxhaphaka kwe-erectile dysfunction kubantu bonke. Okokuqala, ulwazi kwiingxelo ezininzi alwanelanga ukubonelela ngedatha echanekileyo kumazinga okuxhaphaka kwaye ngoko ke ayinakwenziwa ngokubanzi okanye isetyenziswe ukwenza izigqibo ngokuthelekiswa nezinye izifundo. Okwesibini, iindlela ezisetyenziselwa ukufumana ulwazi malunga nomsebenzi we-erectile ziyahluka kakhulu. Umahluko kwiinkcazo (ephuma kwiimibuzo ezahlukeneyo) ngowona mqobo uphambili ekuthelekiseni ukuxhaphaka okuxeliweyo. Okwesithathu, kwezo zifundo zifanayo, idatha ethile malunga nobudala obuthile kunye nobunzima obuthile be-ED bunqongophele, njengoko lulwazi malunga nokungahambi kakuhle kwaba bantu bophononongo.

Xa sinikela ingxelo malunga nokuxhaphaka kwe-ED, sigxininisa ukubaluleka kokuchaza lonke ulwazi olufanelekileyo ekutolikeni kwedatha. Uphononongo lwexesha elizayo kufuneka lujolise ekucaciseni ukuba ngaba iyantlukwano echaziweyo kwi-prevalence kungenxa yomahluko wemethodological kuphela, okanye ingabalelwa kwinkcubeko okanye ezinye izinto. Izifundo ezinkulu zeqela lamazwe ngamazwe zibonakala zineyona ndlela ifanelekileyo yokujongana nale mibuzo, kodwa ukuhlalutya kwakhona idatha eluhlaza evela kwizifundo ezikhoyo zokuxhaphaka, njengoko kuchazwe kolu hlaziyo, kunokufaneleka.

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Khuphela izikhombisi

Imibulelo

Ababhali babulela uNksk Arianne Verhagen ngezimvo zakhe zendlela kunye neengcebiso malunga nombhalo-ngqangi.

Ulwazi loMbhali

Unxibelelwano

1. ISebe leMisebenzi Jikelele, iYunivesithi yase-Erasmus eRotterdam, eNetherlands
   • J Prins
   • , MH Blanker
   • , AM Bohnen
   •  kunye noS Thomas
2. Isebe leUrology, kwisibhedlele saseYunivesithi iRotterdam, eNetherlands
   • J Prins
   •  kunye ne-JLHR Bosch

Umbhali ohambelanayo

Imbalelwano kwi MH Blanker.

Amalungelo kunye neemvume

Ukufumana imvume yokusebenzisa kwakhona umxholo kweli nqaku ndwendwela RightsLink.

Malunga neli nqaku

Imbali yopapasho

I funyenwe

12 Februwari 2002

Hlaziywa

06 Juni 2002

ipapashwe

13 Disemba 2002

DOI

https://doi.org/10.1038/sj.ijir.3900905

Yabelana ngale nqaku