Objective: To assess physical and psychological concerns related to sexuality, the prevalence rate of erectile dysfunction and their relationship to patients’ quality of life.
Design: Questionnaire based survey.
Setting: Tertiary care center.
Patients: Consecutive sample of 342 males with congenital heart disease (age: 18-69 years; median 23 years).
Main outcome measures: Besides various components concerning sexuality the International Index of Erectile Function, a generic health related quality of life instrument (SF-12) and a depression scale (ADS) were included.
Results: Men under the age of 40 engage less frequently in sexual relationships than their peers from the general population. Fears before or during sexual intercourse (10.0%), as well as physical symptoms, such as dyspnea (9.6%), feelings of arrhythmia (9.3%) or chest pain (5.9%) are common. 10.2% reached a score on the International Index of Erectile Function indicative of an erectile dysfunction. Men with erectile dysfunction scored significantly worse on the SF-12 mental (43.5 vs. 52.0, p<0.001) as well as on the physical sum scale (46.3 vs. 52.6, p=0.002) when compared to patients without erectile problems. Additionally, in the group of men without erectile dysfunction only 3.7% showed signs of depressive symptoms, whereas among men with erectile dysfunction this figure increased to 31.6% (p<0.001).
Conclusions: The issue of sexuality should be integrated in the regular consultations of these patients. The strong association between sexual health and subjective wellbeing emphasis the need of diagnosing and, if necessary, treating these problems.
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