Chronic pelvic pain in men tied to severe sexual dysfunction

Men with urologic chronic pelvic pain syndrome (UCPPS) tend to suffer a more severe sexual dysfunction, including erectile (ED) and ejaculatory dysfunction, when compared to their healthy counterparts or patients with other chronic pain conditions, reveals a study.

UCPPS includes chronic prostatitis (CP) or chronic pelvic pain syndrome and interstitial cystitis (IS) or bladder pain syndrome (BPS).

A group of researchers conducted this study to compare sexual dysfunction among male patients with UCPPS, other chronic pain conditions (positive controls), and health controls without chronic pain. They also examined the association of comorbidities, psychological factors, and urologic factors with sexual dysfunction using multivariable logistic and linear regression.

Assessment of sexual dysfunction involved the use of the International Index of Erectile Function-Erectile Function Domain (IIEF-EF) and the Ejaculatory Function Scale (EFS). Male ED was defined as a composite IIEF-EF score <21, and a higher EFS score indicated worse sexual dysfunction. No threshold defining sexual dysfunction had been identified for the EFS.

The study included 191 men with UCPPS, 44 positive controls, and 182 healthy controls. Those with UCPPS experienced a higher degree of sexual dysfunction, such as lower mean IIEF-EF scores, greater ejaculatory dysfunction, and lower quality of sexual relationships, than did positive and healthy controls.

Univariable and multivariable analyses revealed that the association of depression, stress, pain, and diabetes mellitus with ED. Additionally, pain in the genitalia, urinary symptoms severity, depression, stress, and history of sexual trauma all correlated with ejaculatory dysfunction.

“A multidisciplinary approach that addresses the identified risk factors for sexual dysfunction may improve overall quality of life in males with UCPPS,” the researchers suggested.