I-General Erectile isebenze phakathi kwabancane, amadoda angama-Heterosexual enza futhi angawakhulumi izinkinga zokuhlanganiswa ezihambisana nekhondomu (i-CAEP) (i-2015)

IZIMPENDULO: Bona lokhu kuhlaziywa kwesifundo

UStephanie A. Sanders PhD1,2,3, UBrandon J. Hill PhD1,4, I-Erick Janssen PhD1,5, UCynthia A. Graham PhDI-1,2,6, *, URichard A. Crosby PhD1,2,7, URobin R. Milhausen PhD1,2,8 noWilliam L. Yarber HSD1,2,3,9

Isihloko sokuqala eshicilelwe ku-Intanethi: 17 AUG 2015

INGXENYE: 10.1111 / jsm.12964

Ucwaningo olubikwe kule ncwadi lwalusekelwa yi-Eunice Kennedy Shriver National Institute of Health Child and Human Development (NICHD) weNational Institutes of Health ngaphansi kweNombolo Ye-Award R21 HD 060447, E. Janssen no-SA Sanders (PIs). Okuqukethwe kuphela umthwalo wabalobi futhi akumele imele imibono esemthethweni yamaNational Institutes of Health.

abstract

Isingeniso

Izinkinga zokulungiswa kwekhondomu (CAEP) ziyisici esingacatshangelwe esihlobene nokusetshenziswa okungahambisani noma okungaphelele ukusetshenziswa kwekhondomu yabesilisa. Izindlela ezisemqoka ze-CAEP aziqondakali, nokuthi ngabe amadoda abika lezi zinkinga kungenzeka nokuthi abhekana nezinkinga ezibhekene ne-erectile ezimweni lapho amakhondomu engasetshenziswanga afundwanga.

Aim

Inhloso yalolu cwaningo kwakuwukuphenya, ngesampula yekhondomu-besebenzisa abasha, abesilisa abesilisa nabesifazane (abaneminyaka eyi-18-24 ubudala), kungakhathaliseki ukuthi abantu ababika i-CAEP banamathuba okuba (i) babe nezinkinga zokulungisa uma bengasebenzisi amakhondomu kanye (ii) ) ukuhlangabezana nezilinganiso ze-erectile ukungasebenzi.

izindlela

Ingqikithi yamadoda e-479 aqashwe ku-intanethi agcwalise i-International Index of Erectile Function (IIEF-5) futhi waphendula imibuzo mayelana nezinkinga zokulungiswa ezenzeka lapho usebenzisa futhi ungasebenzisi amakhondomu phakathi nezinsuku zokugcina ze-90. Ukubalwa komuntu, isipiliyoni socansi, neziguquko zesimo sezempilo zaphenywa njenge-correlates.

Izindlela Eziyinhloko Zomphumela

Ukuvama kokubikwa kokukhishwa kwesikhashana ngesikhathi sokusebenza kondomu noma ngesikhathi sokuziphatha kwe-penile-vaginal (PVI) ezinsukwini ze-90 ezedlule nezikolo ze-IIEF-5.

Imiphumela

Kula madoda, i-38.4% yahlukaniswa eqenjini le-CAEP, i-13.8% njenge-CAEP ngesikhathi sokusebenza kondomu, i-15.7% njenge-CAEP ngesikhathi se-PVI, ne-32.2% njenge-CAEP phakathi kokubili kokusebenza kwekhondomu kanye ne-PVI. Amadoda abika noma yiliphi uhlobo le-CAEP lalingamathuba amaningi kakhulu kunamadoda angabika uCCA ukuthi aphinde abike ubunzima bokuhlela ngesikhathi sokusebenza ngokocansi uma ungasebenzisi amakhondomu. Amadoda abika i-CAEP ngesikhathi se-PVI kuphela noma phakathi kokubili uhlelo lokusebenza no-PVI bahola kakhulu e-IIEF-5 kunamadoda angenawo i-CAEP.

Isiphetho

Okutholakisayo kusikisela ukuthi amadoda abika i-CAEP nawo angase aphinde ahlangabezane nobunzima obuningi bokukhiqiza. Abahlengikazi kufanele bahlole ukuthi amadoda abasebenzisa amakhondomu ahlangabezana ne-CAEP futhi uma kufanelekile, ubheke ukwelashwa kwengqondo noma ukuhlinzeka ngemfundo yamakhondomu.

Isingeniso

Ukuqhathaniswa kwe-erectile ukungasebenzi (ED) kuhlukahluka kuzo zonke izifundo, kuye ngokuthi yingxenye yencazelo nemigomo esetshenzisiwe [1-3]. Esinye sezibikezelo ezingaguquguquki ezinkingeni ze-erectile zingu-age. Nakuba ukusabalalisa kwe-ED kuphakeme kakhulu phakathi kwamadoda amadala [4], izinkinga ze-erectile zibikwa nezinsizwa. Ucwaningo olulodwa lwe-epidemiologic lucatshangisa ukuthi cishe ama-2% wamadoda amancane kuneminyaka yobudala ye-40-50 ekhononda ngezinkinga zokuvama ezivamile (EPs) [2]. Ucwaningo lwamuva kakhulu emazweni amahlanu aseYurophu lubike ukuthi i-5% yamadoda aneminyaka ephakathi kuka-18 no-29 ubudala abaneminyaka engu-ED ezinyangeni ezidlule ze-6 [5]. Inani lezinsizwa ezibhekana nobunzima bezikhathi ezithile ze-erectile, noma kunjalo, ziphakeme kakhulu, kusukela ku-16% kwisampula yamadoda ase-US ngaphansi kweminyaka engu-40 [6] ku-30% esampula yaseSwitzerland yamadoda aneminyaka engu-18-25 [7].

Okuhlangenwe nakho okuvamile ngokwengeziwe kwezinkinga ze-erectile kusikisela ukuthi izici zesimo zingase zidlale indima ebalulekile ye-etiologic. Ukusetshenziswa kwamakhondomoduna wesilisa kungaba yisibonelo esisodwa sesimo esenza abanye besilisa bahlangabezane nezinkinga zokuhlushwa. Ekuhlolisweni kwabafundi bezokwelapha zaseBrazil (iminyaka yobudala: iminyaka engu-21.2), i-13.3% yatholwa ukuthi ine-ED, isebenzisa i-International Index ye-Erectile Function elula (i-IIEF-5) [8]. Amadoda asetshenziswe kulolu cwaningo abasebenzisa amakhondomu aphindwe kabili ukubika izinkinga ze-erectile. Esikhathini sampula yezinsizwa ezincane ezithathelwana ngesandulela ngculaza (STI) [9], I-37.1% yabesilisa ibike izinkinga zokumiswa kwekhondomu (CAEP) okungenani ngesinye isikhathi. Ucwaningo oluthile, olubandakanya kokubili amadoda angqingili nabesilisa abesilisa nabesilisa, basuke baqopha ukuthi i-CAEP ingaba yinto evamile [10]. Nakuba izindlela ze-CAEP ezisezingeni eliphansi zingakacaciswanga kahle, ocwaningweni lwamuva lwe-psychophysiologic mayelana nemikhuba yokuvuthwa ngokocansi, amadoda ayenayo i-CAEP adinga isikhathi esiningi kanye / noma ukuvuselela okukhulu ukuvuswa kunamadoda ngaphandle kwe-CAEP [11]. Kodwa-ke, kuyaphawuleka ukuthi izimpendulo ze-erectile zaziphansi eqenjini le-CAEP kuphela eminithini yokuqala yokuchasisa ezenzweni zobulili, ngaphandle kokungafani okuphawulekayo ngemuva kwalokho.

Izinkinga ze-erectile ezihambisana nekhondomu zingase zibe yisici esingaphansi kokuphathelene nokusetshenziswa okungaphelele, ngoba amadoda abika i-CAEP angase abike amanani amaphutha okusebenzisa ikhondomu kanye nezinkinga, kufaka phakathi ukukhishwa kwekhondomu [12], ukusetshenziswa kokukhondomu okungaphelele (isicelo sekwephuzile kanye nokususwa kokuqala) [9,13], futhi ukusetshenziswa kokukhondomu okungavumelani [14,15]. Kwesinye isikhathi esanda kuhlola okubandakanya amadoda e-1,875, imibono yokulungiswa "ikhwalithi" (kufaka phakathi izilinganiso zokuqina, ubude be-penile, kanye nesigcawu, kanye nobunzima bokugcina izikhathi ezithile) zazihlotshaniswa nethuba elikhulu lokusetshenziswa kogondla okungaphelele [13]. Amadoda angase abe nakho ukuzwa i-CAEP uma bengenakho ukuzethemba ukusebenzisa amakhondomu ngendlela efanele, uma behlangabezana nezinkinga ngendlela amakhondomu afanelekile noma azizwa ngayo, futhi uma elala nozakwethu abaningi [9].

Izinhloso

Omunye umbuzo okwamanje, awuzange uphenywe ukuthi ngabe amadoda abika i-CAEP angase abone ubunzima be-erectile ezimweni zobulili lapho ikhondomu engasetshenziswanga khona. Ngakho-ke, inhloso yalolu cwaningo kwakuwukuphenya, ngesampula yekhondomu-besebenzisa abasha, abesilisa abangasithandani nabo (abaneminyaka engu-18-24), kungakhathaliseki ukuthi babika i-CAEP (noma ngabe yikuphi ngesikhathi sokusebenzisa ikhondomu, ngesikhathi se-penile-vaginal sex [PVI], noma kuzo zombili izimo) kungenzeka ukuthi: (i) abe nama-EP uma ungawasebenzisi amakhondomu; futhi (ii) amaphuzu ahlukene nge-IIEF. Inhloso yethu kwakungeyona ukulinganisela ubunzima be-erectile kodwa ukukhomba ukuxhuma kwe-CAEP esampula esingenasiceleni samantombazane amancane, abasebenzisa ikhondomu.

izindlela

Abahlanganyeli

Abahlanganyeli babesemusha, amadoda angabesilisa abangabesilisa ocansini abaqashiwe ngokusebenzisa izinyuvesi (isib., Amaqembu abafundi baseyunivesithi kanye nokuhlungwa kweminyango) kanye namafayili e-electronics asakazwa kwi-Facebook. Imvume itholakala kubaphathi abahlulekile kanye nemihlahlandlela yokukhangisa ye-Facebook yalandelwa. Siphindaphindile amadoda nge-CAEP ngamafolda ahlosiwe abuza: "Ingabe amakhondomu aphazamisa ukuphazamiseka kwakho?" Futhi "Ingabe amakhondomu aphazamisa ukuvusa kwakho?" Indlela yokufaneleka ihlanganisa ukufinyelela kwe-intanethi, phakathi kwe-18 ne-24 ubudala ubudala, ukuzikhomba njengobulili obuhlukile, esebenzisa ikhondomu ku-PVI ezinsukwini ze-90 ezedlule, nekhono lokufunda isiNgisi. Ukwengeza, amadoda akhishwe ngaphandle uma bebe nobuhlobo bobulili obuhlukile (ubuhlobo bomuntu oyedwa) owenziwe ngenyanga ye-1 noma ngaphezulu, njengoba ukusetshenziswa komkhondomu kutholakala ukuthi kunqamule ngenyanga yokuqala yobudlelwane [16]. Amadoda abika i-CAEP ayedluliwe. Sabuza abaphenduli ngombuzo othize ekupheleni kocwaningo mayelana nokuthi babetholile lemibuzo ngokubaluleka nokuthi ngabe ulwazi lwabo kufanele lusetshenziswe yini; kuphela i-1.2% yaphendula ukuthi ayizange ithathe ucwaningo ngokungathí sina futhi salukhipha idatha yabo.

Isampula lokugcina lalinezinsizwa ezingama-479. Imvume ebhaliwe enolwazi yatholakala kubo bonke ababambiqhaza futhi iBhodi Yezokubuyekezwa Kwesikhungo yunivesithi yavuma zonke izinqubo zokufunda.

Izindlela

Izindlela Zomphumela Oyinhloko

Ama-EPs Uma Ungasebenzisi Amakhondomu

Imibuzo emibili ihlolwe ama-EP lapho abesilisa bengasebenzisi amakhondomu. Ababambiqhaza babuzwa ukuthi “Cabanga ngezikhathi lapho wawukade uya ocansini lobulili besitho sangasese sowesilisa ngezinsuku ezidlule ezingama-90 futhi ungazange usebenzise ikhondomu.” Lokhu kwalandelwa imibuzo emibili, "Ulahlekelwe kangaki noma uqale ukulahlekelwa ukwakhiwa ngaphambi kokungena (ngaphambi kokufaka ipipi lakho esithweni sangasese)?" nokuthi "Ulahlekelwe kangaki noma uqale ukulahlekelwa ukwakheka kwakho ngenkathi uya ocansini (ngaphambi kokuba uqede)?" Izindlela zokuphendula bekungukuthi: “angikaze,” “ngezikhathi ezithile,” “ngaphansi kwengxenye yesikhathi,” “isikhathi esiningi,” “njalo,” futhi “angikwazi ukuphendula ngoba ngihlale ngisebenzisa ikhondomu.” Lezi zinguquko ezimbili zibizwa ngama-EP ngaphambi kokungena (EP-Before) nama-EP ngesikhathi se-PVI (EP-PVI), ngokulandelana. Kokuguquguqukayo ngakunye, amadoda ahlukaniswa njengo- “Yebo” uma ephendula ngezikhathi ezithile noma kaningi futhi ethi “Cha” uma engaphendulanga.

I-IIEF-5 [17]

I-IIEF-5 inguqulo efinyelelekile ye-15-item IIEF, esetshenziswe njengethuluzi lokuxilonga elifushane lokuhlola i-ED. Isiklomelo esifingqiwe sakhiwe ngayinye yalezi zinto ezinhlanu futhi sisetshenziselwa ukuhlaziywa. Ngokusekelwe kulezi ziqephu, amadoda ahlukaniswa njengo-ED (22-25), i-ED emfushane (17-21), i-ED emfushane (12-16), i-ED elinganisiwe (8-11), noma i-ED enzima (5 -7), ngokulandela indlela ephakanyiswa nguRosen kanye nozakwethu [17].

Izinhlobonhlobo zokubamba iqhaza eziyinhloko

Ama-CAEP

Izinhlobo ezimbili ze-CAEP zihlolwe yizinto ezilodwa. Okokuqala, amadoda abuzwa ukuthi, "Ziningi kangakanani ezinsukwini ze-90 ezedlule noma uqale ukulahlekelwa ukulungiswa kwakho ngenkathi ubeka ikhondomu ngaphambi kokulala ngokobulili?" Ezinye izimpendulo zazingezansi: "neze," "ngezikhathi ezithile," "ngaphansi kwesigamu Isikhathi, "" isikhathi esiningi, "futhi" ngaso sonke isikhathi. "Ngokulandelayo, amadoda abuzwa," Kangaki ulahlekelwa yizinsuku ze-90 ezinsukwini ezidlule noma uqala ukulahlekelwa ukulungiswa kwakho ngenkathi ugqoka ikhondomu ngesikhathi sokulala komzimba? "Ezinye izindlela zokuphendula : "Angalokothi," "ngezikhathi ezithile," "ngaphansi kwesigamu sesikhathi," "isikhathi esiningi," nokuthi "njalo." Lezi ziguquko ezimbili zibizwa ngokuthi yi-CAEP-Application (i-CAEP ngesikhathi sokusebenzisa ikhondomu) ne-CAEP-PVI ( I-CAEP uma usebenzisa ikhondomu ku-PVI), ngokulandelana. Ngokwehlukahluka ngalunye, amadoda ahlukaniswa ngokuthi "Yebo" uma ephendula ngezikhathi ezithile noma ngaphezulu futhi "Cha" uma bephendula bengakaze. Amaqembu amane adalwe esebenzisa lezi zinguquko ezimbili: Cha-CAEP, CAEP-Isicelo kuphela, i-CAEP-PVI kuphela, ne-CAEP-Bobabili.

Izimpendulo Zezibonelo Nezixhumanisi Ezingenzeka

Ngaphandle kwemigomo yokufaneleka nokukhishwa okuchazwe ekuqaleni, izilinganiso ezilandelayo zesampula yezibalo kanye nama-correlate angaphumelela wemiphumela zihlolwe: ubuhlanga, ubuhlanga be-Hispanic / Latino, imfundo, inkolo, inzuzo, ubukhulu bendawo yakubo, isimo sokusoka, umlando wokuphila we-STI, noma ngabe umhlanganyeli owake wafaka umuntu ngokungenhloso, nokuthi ngabe uke wafundiswa ukusebenzisa ikhondomu yesilisa. Izinkinga zempilo zamanje (isifo sikashukela, isithuthwane, ukucindezeleka / ukukhathazeka, i-multiple sclerosis, i-muscular dystrophy, ukucindezela kwegazi eliphezulu, isimo senhliziyo, enye) nokusebenzisa imithi (ukunakekelwa kokungabi nalutho ukukhathazeka ngokweqile / ukuhlukunyezwa kwengqondo [ADHD / ADD], isifo sikashukela, inhliziyo , ukucindezeleka, ukukhathazeka, i-hormonal, nezinye) nazo zihlolwe nokuthi ngabe umhlanganyeli uphethwe inkinga yocansi ezinyangeni zangaphambilini ze-12. Ukusebenzisa isikhathi sokukhumbula usuku lwe-90, lezi zinguquko ezilandelayo zilinganiselwe: ngabe ngabe umhlanganyeli ube esesimweni sokushintsha ukuziphatha kokusebenzisa ikhondomu noma ukushintsha ukuziphatha kocansi, ukusebenzisa ezinye izindlela zokuvimbela, noma ngabe uzama ukungenisa umlingani wakhe ( s), futhi kangakanani ukuthi wayesebenzise i-phosphodiesterase uhlobo lwe-5 inhibitors (i-PDE-5i) phakathi nomsebenzi wezocansi ngenkathi ekhona futhi engayisebenzisi ikhondomu.

Ukuhlaziya Data

Ukuhlolwa kwe-Chi-squared kusetshenziselwa ukunquma izinhlangano eziphakathi kweqembu le-CAEP (No-CAEP, CAEP-Application kuphela, i-CAEP-PVI kuphela, ne-CAEP-Bobabili) kanye nezimpendulo zemibuzo emibili mayelana nokukhipha lapho kungasebenzisi ikhondomu, Izigaba ze-IIEF-5 (akukho ED kuya kwi-ED eqinile), nezinye iziguquko zezinhlelo. Njengoba kunikezwe ukuthi ama-freelance amancane athile ama-frequencies kwamanye amaseli aphule ukucatshangelwa kokuhlaziywa kwe-chi-squared, senze i-4 × 2 (angalokothi sibhekane nanoma yikuphi okuhlangenwe nakho kwama-EP ngenkathi yokubika). Ukulandela lokhu, ukuqhathaniswa okuthunyelwe kuqhutshwa ngokusebenzisa ukuhlolwa kwe-2 × 2 chi-squared.

Ukuhlaziywa kokwehluka kusetshenziselwe ukuqhathanisa i-IIEF-5 nezinye izikolo eziqhubekayo emaqenjini ngokuhlolwa kukaScheffé okusetshenziselwa ukuqhathanisa kwe-post-hoc. Ukubaluleka kwasungulwa e P <0.05. Ukuhlaziywa kwenziwa kusetshenziswa i-SPSS Version 21 (izibalo ze-IBM SPSS zeWindows, inguqulo 21.0; IBM Corp., Armonk, NY, USA).

Imiphumela

Iminyaka yobudala yayingu-20.43 iminyaka (ukwehluka okujwayelekile = 1.63). Iningi likhonjiswe njengomhlophe (i-80.1%), i-6.8% njenge-Asia, i-4.7% njenge-Afrika yaseMelika / emnyama, kanti okusele njengamanye amaqembu obuhlanga. Ubuzwe be-Hispanic / Latino bubikwe ngu-4.2% wamadoda. Iningi (i-66.5%) libonise izinga eliphezulu lemfundo njengezikole lekolishi / lobuchwepheshe, i-3.8% degree ephakeme, isikole se-29.4% esikoleni esiphakeme, no-0.4% abangaqedanga esikoleni esiphakeme. Ngaphezulu kwengxenye eyodwa (i-54.7%) ikhombise ukuthi izinga labo lokuthola imali laliphansi noma liphansi futhi i-53.0% yakhula emadolobheni aphakathi kuya kwamakhulu. Iningi lasokile (87.3%), lingakaze litholwe ukuthi linesifo se-STI (97.3%), futhi sase sifundiswe ukuthi singasebenzisa kanjani ikhondomu yesilisa (63.0%). Ukungeniswa okungahlosiwe kwabikwa ngu-9.2%.

Kubantu bakwa-479, i-184 (38.4%) yahlukaniswa njenge-No-CAEP, i-66 (13.8%) njenge-CAEP-Isicelo kuphela, i-75 (15.7%) njenge-CAEP-PVI kuphela, ne-154 (32.2%) njenge-CAEP-Bobabili. Awukho umehluko weqembu owatholwa ngobudala, ubuhlanga, ubuhlanga be-Hispanic / Latino, imfundo, inkolo, inzuzo, ubukhulu bendawo yakubo, isimo sokusoka, umlando wokuphila we-STI, noma ngabe ubani owenziwe ngokungenhloso, nokuthi ngabe uke wafundiswa ukusebenzisa ikhondomu yabesilisa.

Njengoba kunikezwe imvamisa ephansi yezinkinga zempilo zamanje kanye nokusetshenziswa kwezidakamizwa, idatha evela kuwo wonke amadoda okubika noma yikuphi i-CAEP yahlanganiswa (noma yiliphi iqembu le-CAEP) futhi iqhathaniswa nalabo abavela emadodeni ababika nge-CAEP. Ukuhlukana kweqembu kuphela okutholakele kungukucindezeleka / ukukhathazeka, ne-12.9% yamadoda eqenjini le-CAEP elibika lokhu kuqhathaniswa ne-4.9% yamadoda eqenjini le-No-CAEP (χ2 = 8.14, amadigri enkululeko [df] 1, P  = 0.004). Kwakungekho, noma kunjalo, akukho mehluko weqembu ekusetshenzisweni kwemithi okubikiwe kwengcindezi (3.2%) noma ukukhathazeka (2.9%). Umehluko weqembu kuphela ekusetshenzisweni kwemithi wawungowemithi ye-ADHD / ADD, ne-3.3% yeqembu le-No-CAEP kanye ne-8.9% yanoma yiliphi iqembu le-CAEP elibika ukusetshenziswa kwale mithi (χ2 = 5.62, df 1, P = 0.018). Ngaphansi kuka-1% kubikwe isifo sikashukela (0.8%), isithuthwane (0.8%), multiple sclerosis (0.2%), muscular dystrophy (0.2%), isimo senhliziyo (0.9%); inani elifanayo eliphansi elisetshenzisiwe imithi yesifo sikashukela (0.8%), imithi yenhliziyo (0.4%), nemithi yehomoni (0.9%). Kancane kancane ababambiqhaza bakhombise umfutho wegazi ophakeme (2.1%), ezinye izinkinga zezokwelapha (1.7%), kanye nokwelashwa kwezinkinga zocansi ezinyangeni eziyi-12 ezedlule (1.5%).

Ezinsukwini ezidlule ze-90, abambalwa abahlanganyeli bebelokhu bezinhlelo zokushintsha ukusetshenziswa kwazo kwekhondomu (1.7%) noma ukuziphatha kocansi (1.3%) futhi bambalwa basebenzise i-PDE-5i emsebenzini wezocansi no-1.9% noma ngaphandle kwekhondomu (1.9%) . Akekho owayezama ukuthola umlingani okhulelwe. Abangaphezu kwesigamu samadoda babonise ukuthi bancike emakhondomu abesilisa ekulawuleni ukubeletha (54.9%) kanye / noma ukuthi basebenzisa amakhondomu abesilisa ngezinye izinhlobo zokulawulwa kokuzalwa (59.1%) okungenani isikhathi esithile ezinsukwini ezingu-90 ezedlule. Awekho ukuhlukana kweqembu okutholiwe nganoma iyiphi yalezi ziguquguquko. Amadoda amaningi kakhulu kunoma yiliphi iqembu le-CAEP (i-17.3%) kuneqenjini le-No-CAEP (i-9.8%) libike ukuthi lithembele kuhlobo lokulawulwa kokuzalwa ngaphandle kwamakhondomu okungenani ngezikhathi ezinsukwini ze-90 ezedlule (χ2 = 5.18, df 1, P = 0.023).

Inombolo eningi yezikhathi abesilisa abasebenzisa amakhondomu esikhathini sokukhumbula usuku lwe-90 yi-10.8 (ukuphambuka okujwayelekile = 14.3) futhi lokhu akufani neze kakhulu kuwo wonke amaqembu amane. Ukusetshenziswa kokukhondomu okungahambisani nanoma yikuphi okuphansi kakhulu kwe-CAEP-Iqembu elibili (73.4%) eliqhathaniswa neqembu le-No-CAEP (82.4%) (F (3,471) = 3.44, P = 0.017), namanye amaqembu aphakathi futhi angahlukile kakhulu komunye nomunye (I-CAEP-Isicelo Kuphela 82.1%; I-CAEP-PVI kuphela i-77.7%).

Ama-EPs Uma Ungasebenzisi Amakhondomu

Cishe ikota eyodwa yesampula (23.0%) iveze ukuthi abakwazi ukuphendula le mibuzo ngoba bebehlala basebenzisa amakhondomu. Ithebula 1 unikeza ukuhlaziywa kwamadoda asele. Ngenxa yokuthi amadoda ambalwa abonisa okuhlangenwe nakho okuvamile kwama-EP uma ama-condoms engasetshenziswanga, ukuhlaziywa kwe-chi-squared kuqhathanisa amaqembu amane we-CAEP ngamaphesenti ahlukaniswe ngokuthi "Yebo" ngokumelene ne- "Cha" ye-EP-Ngaphambi ne-EP-PVI. Amaqembu we-CAEP ahluke kakhulu kwi-EP-Ngaphambi kokuguquguquka (χ2 = 40.14, df 3, P  <.001). Amaphesenti wamadoda abika okungenani i-EP ngezikhathi ezithile ngaphambi kokungena ku-No-CAEP, CAEP-Application kuphela, i-CAEP-PVI kuphela, kanye ne-CAEP-Womabili amaqembu, kwakungu-9.9, 35.7, 23.6, no-43.0, ngokulandelana. Ekuhlaziyweni kwe-post-hoc, iqembu le-No-CAEP lalinamadoda ambalwa kakhulu abika ama-EP ngaphambi kokungena lapho engasebenzisi ikhondomu uma kuqhathaniswa namanye amaqembu. Ithebula 1 iveza imiphumela yazo zonke iziqhathaniso ezilandelayo.

Ithebula 1. Imvamisa yezinkinga zokwakhiwa lapho ungasebenzisi amakhondomu uma kuqhathaniswa namaqembu e-CAEP

Izinkinga zokulungisa uma ungasebenzisi ikhondomu

Amaqembu

Ayikho i-CAEP (n = 142)

I-CAEP-Isicelo kuphela (n = 42)

I-CAEP-PVI kuphela (n = 55)

I-CAEP-Bobabili (n = 128)

  1. *P <0.001
  2. Imibiko ephezulu ibonisa imiphumela yokuqhathaniswa kokulandela kokugcina P  <0.05 imibandela. Amaqembu abelana ngencwadi awahlukile kakhulu. Labo abangahlanganyeli incwadi bahluke kakhulu.
  3. I-CAEP = inkinga yokuhlanganiswa ekhondomu; I-PVI = ubulili be-penile-ubulili.
Ngaphambi kokungena    
Akukaze (%)90.1a64.3b, c75.4b57.0 c
Ngezinye izikhathi (%)4.928.616.430.5
Ngaphansi kwesigamu sesikhathi (%)3.57.15.58.6
Isikhathi esiningi (%)1.401.83.9
Njalo (%)0000
Ngesikhathi se-PVI    
Akukaze (%)95.1a85.7b43.6 c54.6 c
Ngezinye izikhathi (%)3.511.940.033.1
Ngaphansi kwesigamu sesikhathi (%)1.42.412.77.7
Isikhathi esiningi (%)001.84.6
Njalo (%)001.80

Amaqembu we-CAEP ahluke kakhulu nge-EP-PVI (χ2 = 8 3.00, df 3, P  <.001). Iphesenti labahlanganyeli ababika okungenani i-EP ngezikhathi ezithile phakathi ne-PVI kwakungu-4.9, 14.3, 56.4, no-45.4 we-No-CAEP, CAEP-Application kuphela, i-CAEP-PVI kuphela, kanye ne-CAEP-Womabili amaqembu, ngokulandelana. Ekuhlaziyweni kwe-post-hoc, ambalwa kakhulu amadoda eqenjini le-No-CAEP abike ukuthi anama-EPs ngesikhathi se-PVI lapho engasebenzisi ikhondomu uma kuqhathaniswa namanye amaqembu. I-CAEP-PVI Kuphela kanye ne-CAEP-Womabili la maqembu ayenamaphesenti aphezulu kakhulu futhi ayengahlukile kakhulu komunye nomunye. Iphesenti lamadoda eqenjini le-CAEP-Application Only eline-EP okungenani ngezikhathi ezithile phakathi ne-PVI laliphakathi futhi lihluke kakhulu kuwo wonke amanye amaqembu.

I-IIEF-5

I-alpha kaCronbach ye-IIEF-5 yalesi sampula yayingu-0.76. Njengoba kukhonjisiwe kuThebula 2, Izikolo ze-IIEF-5 zahluke kakhulu kunamaqembu we-CAEP (F(3,475) = 15.40, P <.001). Izilinganiso ezishiwoyo zawo wonke amaqembu zazingaphezulu kwama-21 (kubanga lokungekho emtholampilo) [17]. Iqembu le-No-CAEP linamaphuzu aphezulu kakhulu (i-23.92) (ebonisa ukusebenza okungcono kwe-erectile), ngokuhluke kakhulu ku-CAEP-PVI kuphela (22.93) ne-CAEP-Amaqembu womabili (i-22.12), kodwa hhayi ku-CAEP-Isicelo kuphela (i-23.20) . I-score eyinhloko ye-CAEP-Iqembu lazo zombili azifani neze kakhulu neqembu le-CAEP-PVI kuphela, kodwa lalihluke kakhulu kwamanye amaqembu amabili. Amanani amaningi we-CAEP-Application kuphela namaqembu we-CAEP-PVI-kuphela ayengafani kakhulu.

Ithebula 2. Izikolo ze-IIEF-5 nokuhlukaniswa kwe-ED ngamaqembu e-CAEP

 

Ayikho i-CAEP (n = 184)

I-CAEP-Isicelo kuphela (n = 66)

I-CAEP-PVI kuphela (n = 75)

I-CAEP-Bobabili (n = 154)

  1. *P <0.001
  2. Imibiko ephezulu ibonisa imiphumela yokuqhathaniswa kokulandela kokugcina P  <0.05 imibandela. Amaqembu abelana ngencwadi awahlukile kakhulu. Labo abangahlanganyeli incwadi bahluke kakhulu.
  3. I-CAEP = inkinga yokuhlanganiswa ekhondomu; ED = ukukhubazeka kwe-erectile; IIEF-5, International Index of Erectile Umsebenzi; I-PVI = ubulili bobulili obunama-penile-ubulili; I-SD = ukuphambuka okujwayelekile.
Isilinganiso (i-SD) se-IIEF-5 score*23.92 (2.24)a23.20 (2.51)a, b22.93 (2.56)b, c22.12 (2.54)c
Ukufakwa kwekhasi le-IIEF-5*    
Ayikho i-ED (%)91.3a81.8b77.3b, c68.2 c
I-ED efudumele (%)7.115.220.028.6
Kulula ukulinganisa i-ED (%)0.53.01.33.2
I-Moderate ED (%)1.101.30
Okukhulu (%)0000

Ngokusebenzisa izikolo ze-IIEF-5, amadoda ahlukaniswa kusukela ku-ED kuya ku-ED okukhulu usebenzisa izindlela ezibikwe nguRosen et al. [17] (bheka ithebula 2). Ngenxa yokuthi amadoda ambalwa kakhulu ahlukaniswa njengobumnene ukuze ahlolisise i-ED noma ngenhla, sihlangene namadoda nganoma iyiphi i-ED ibe iqembu elilodwa. Ukuqhathanisa amaqembu amane we-CAEP ngamaphesenti ahlukaniswa njenge-ED ngaphandle kokuphi na-ED, kwakukhona ubudlelwane obalulekile (χ2 = 28.98, df 3, P <.001). Amaphesenti wabahlanganyeli ahlukaniswe njenganoma iyiphi i-ED ayengu-8.7, 18.2, 22.7, no-31.8 we-No-CAEP, CAEP-Application kuphela, CAEP-PVI kuphela, kanye namaqembu e-CAEP-Womabili amaqembu, ngokulandelana. Ithebula 2 imibhalo ephezulu ibonisa imiphumela yokuhlaziywa okulandela ngemuva kokubonisa ukuthi iqembu le-No-CAEP libandakanya amadoda ambalwa kakhulu anama-ED kunamanye amaqembu.

Ingxoxo

Kulesi sampula sezinsizwa ezincane, abesilisa abesilisa nabesifazane, abasebenzisa ikhondomu, abasebenzisa ikhondomu, ama-CAEP ahlotshaniswa namazinga ajwayelekile, kodwa ikakhulukazi ama-subclinical (omnene) wezinkinga ze-erectile. Amadoda abika noma yiliphi uhlobo le-CAEP (ngesikhathi sokusebenza kanye / noma ngesikhathi se-PVI) ayengaphezulu kakhulu kuneqembu le-No-CAEP futhi libike nobunzima bokuhlela ngaphambi kokungena kanye nangesikhathi sokulala uma ungasebenzisi ikhondomu. Amadoda abika i-CAEP ngesikhathi se-PVI kuphela noma phakathi kokubili uhlelo lokusebenza kanye ne-PVI bahola kakhulu e-IIEF-5 kunamadoda angabika uCCA. Wonke amaqembu abika i-CAEP ayengaba amathuba amaningi okuhlukaniswa njengama-ED emnene kuya okulinganisako kuneqembu le-No-CAEP. Noma kunjalo, ngisho ne-CAEP-Iqembu elibili, elinamanani aphakeme kakhulu e-IIEF-5-ahlonzwe ED, iningi (68.2%) lamadoda alizange lihlangabezane nemigomo ye-clinical yokuba ne-ED.

Kukhona izincazelo eziningi ezikhona zalokho okutholakele. Okokuqala, ngeke kusimangaze uma amadoda ane-ED futhi enama-EP uma usebenzisa amakhondomu. Okwesibili, kuyilapho kuqhathaniswa, kungenzeka ukuthi amadoda okutholwa ukulahlekelwa ukulungiswa uma esebenzisa amakhondomu angase akhathazeke ngokubhekana nokudla okuningi ngokujwayelekile futhi ngaleyo ndlela abe engozini kakhulu yokubhekana no-ED jikelele [18]. Lokhu kuzohambisana nokunye ukucwaninga okuphakamisa ukubaluleka kwezici ezinengqondo nokukhathazeka njengokukhathazeka nokuphazamiseka ku-etiology nokugcinwa kwe-ED [19].

Amadoda abika ukuthi ukusetshenziswa kwemithi ye-ADHD kwakungcono kakhulu ukubika i-CAEP. Ucwaningo lwangaphambili lubike izinga eliphezulu lokuziphatha kocansi oluyingozi kubantu abasha abane-ADHD [20] futhi amadoda asebenzisa imithi ye-ADHD ngezinye izikhathi abika izinkinga ze-erectile njengemiphumela emibi yemithi [21].

Ukulinganiselwa

Ukujwayelekile kokuthola kwethu kunganciphisa. Isampula yayinqunyelwe umklamo kumuntu omdala osemusha, isandulela ngculaza, isandulela ngculazi-esebenzisa amadoda okwamanje engekho ebuhlotsheni obude bezocansi, owakhuluma isiNgisi, futhi abe nokufinyelela kwe-inthanethi. Ngakho-ke, lokho okutholakele kungase kungabonakali kubantu abangaphandle kwalezi zidingo zokufaneleka. Isizathu sethu sokungabandakanyi amadoda asebudlelwaneni bobulili obulodwa ngenyanga noma ngaphezulu kwaba ukuthi ucwaningo luye lwabonisa ukuthi amadoda e-18-24 yenkathi yobudala bonyaka abika ukusetshenziswa kakhudlwana okuphansi kakhulu nabalingani abasungulwe kunabalingani abangavamile [22]. Amadoda eqembu le-18-24 ayesengozini enkulu yokudluliswa kwe-STI kanye ne-HIV [23], naphezu kokusetshenziswa kwamakhondomu aphezulu [24].

Njengoba kunikezwe ukuthi ukusetshenziswa kwekhondomu kwakuyindlela yokufaneleka, abesilisa ababekade besebenzisa amakhondomu kodwa beyeka ukusebenzisa, mhlawumbe ngenxa ye-CAEP noma ezinye izinkinga, bebengamelwe kusampula lethu. Umkhawulo owengeziwe ukuthi ngenkathi sisebenzisa ithuluzi eliqinisekisiwe ukuhlola ubunzima bezinkinga ze-erectile, asizange sihlole ukukhathazeka komuntu ngenkinga; izindlela zokuxilongwa kwesifo se-erectile erectile kudinga ukuba khona kokucindezeleka okuphawulekayo emitholampilo mayelana nezimpawu [25]. Inhloso yethu kulolu cwaningo kwakungenjalo ukubika amanani okukhula kwesifo se-erectile, kodwa ukuveza ukuthi amadoda abika i-CAEP abuye abike nama-EP uma engasebenzisi amakondomu nokuthi ngabe izikolo ze-IIEF zihluke yini kubantu abangabika i-CAEP.

Okutholakele kwethu kusikisela ukuthi amadoda abika i-CAEP kusampula sethu, cishe i-18-32% ihlangabezana nezilinganiso ze-IIEF zokunciphisa i-ED (kuye ngokuthi ngabe babika i-CAEP ngesikhathi sokusebenzisa amakhondomu kuphela, ngesikhathi se-PVI, noma phakathi kokubili kokusebenza kanye ne-PVI). Nakuba iningi lalaba bahlanganyeli lihlelwa esigabeni "sobumnene" se-ED, kunemiphumela emtholampilo ecacile yalokhu okutholakele. Ama-EPs ahlotshaniswa nokusetshenziswa okungagculiseki futhi okuphelele okusetshenziselwa ikhondomu, [9] nazo ezihlotshaniswa nobungozi bokutholwa kwe-STI / HIV; ngakho-ke, ukwenza ngcono okuhlangenwe nakho kwamadoda ngokusetshenziswa kwamakhondomu kubalulekile. Leli qembu lamadoda lingazuza ngohlobo oluthile lokungenelela okufushane kokuziphatha ukunciphisa ubunzima babo be-erectile. Yize ukwelashwa kwemithi kwe-ED kuvame ukuba yindlela "yomugqa wokuqala" yamadoda anezinkinga ze-erectile, izifundo zangaphambilini ziphakamise ukuthi iPDE-5i ayinqobi i-CAEP [26]. Ngaphezu kwalokho, ukusetshenziswa kwe-PDE-5i kungase kube yingozi engozini yokwehlukanisa ikhondomu [27].

Ngenxa yokuthola ukuthi amadoda ane-CAEP angadinga isikhathi esengeziwe sokuvuswa kunamadoda angabika i-CAEP, i-Janssen kanye nosebenza nabo [11] Kunconywe ukuthi abesilisa abane-CAEP kufanele bakhuthazwe ukuthi bathathe isikhathi esanele sokuvuswa futhi baqinisekise ukuthi bathola ukukhuthazeka okwanele, ikakhulukazi uma besebenzisa amakhondomu. Ucwaningo lwakamuva lokungenelela olususelwa ekhaya olwenzelwe ukuthuthukisa ukusetshenziswa kwamakhondomu phakathi kwezinsizwa (ezidinga okokufaka okuncane komtholampilo) kubike ukuzethemba okukhulu ekukwazini kwamadoda ukusebenzisa amakhondomu, ukuzikhandla ekusebenziseni ikhondomu, nokunethezeka kwekhondomu kanye ukunciphisa ukwehlukana kanye nama-EP ngemuva kokungenelela [28,29]. Kukhona nesidingo semfundo engcono ekusebenziseni ikhondomu efanele. Ngaphezu kweyodwa kweyesithathu (37%) yesampula yamanje samakhondomu-abasebenzisa amadoda babengakaze bafundiswe indlela yokusebenzisa ikhondomu ngendlela efanele. Abahlengikazi kufanele bahlole ukuthi amadoda abasebenzisa amakhondomu ahlangabezana ne-CAEP futhi uma kufanelekile, enze ukuhanjiswa kwe-psychosexual therapy noma unikeze imfundo yamakhono ekhondomu [28,29].

Isiphetho

Okutholakisayo kusikisela ukuthi amadoda abika i-CAEP nawo angase aphinde ahlangabezane nobunzima obuningi bokukhiqiza. Nakuba ama-EP angase ahlangabezane nemigomo yemitholampilo ye-ED, odokotela kumele bahlole ukuthi amadoda abasebenzisa amakhondomu ahlangabezana ne-CAEP futhi uma kufanelekile, ubheke ukwelashwa kwengqondo noma ukuhlinzeka ngemfundo yamakhondomu.

Ukungqubuzana kwezintshisekelo: Umbhali (s) akhiphe ukungqubuzana kwezintshisekelo.

Isitatimende sobunikazi

Isigaba 1

  • (A) Ukuklama nokuklamaUStephanie Sanders; U-Erick Janssen; Brandon Hill
  • (B) Ukutholwa kwedathaUStephanie Sanders; U-Erick Janssen; Brandon Hill
  • (C) Ukuhlaziywa nokuchazwa kwedathaUStephanie Sanders; U-Erick Janssen

Isigaba 2

  • (A) Ukuhlelwa kwe-ArticleUStephanie Sanders; Cynthia Graham; UBill Yarber; URick Crosby; URobin Milhausen
  • (B) Ukuyibuyekeza Ngokuqukethwe KwengqondoUStephanie Sanders; Cynthia Graham; UBill Yarber; URick Crosby; URobin Milhausen; U-Erick Janssen; Brandon Hill

Isigaba 3

  • (A) Ukuvunyelwa kokugcina kwesiGungu esiqediweUStephanie Sanders; Cynthia Graham; UBill Yarber; URick Crosby; URobin Milhausen; U-Erick Janssen; Brandon Hill

Okubhekwayo

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 wobulili eBrithani : Ukuthola okuvela ku-National Survey yesimo sengqondo socansi kanye nokuphila (Natsal-3). I-Lancet 2013; 382: 1817-1829.