Disfunção sexual masculina após transplantação renal : influência do tempo pós-transplantação renal e do impacto da imagem corporal na satisfação sexual pós-transplantação
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Data
2017
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Estima-se que 10% da população mundial sofra de insuficiência renal crónica (IRC). Esta
altera a qualidade de vida e a sobrevida dos doentes, sobretudo no período terminal da doença
pela necessidade de utilização de uma técnica de substituição da função renal. A
transplantação renal é a terapêutica que oferece uma qualidade de vida que mais se aproxima
da dos indivíduos sem IRC terminal.
A sexualidade é uma componente significativa da qualidade de vida global (QoL) e da
qualidade de vida associada à saúde (HRQoL), sendo no doente transplantado renal
influenciada por diversos factores biopsicossociais. A disfunção sexual é muito prevalente no
transplantado renal, apresentando uma etiologia multifactorial e exercendo um impacto
negativo sobre a satisfação sexual e sobre a QoL e a HRQoL. Nos transplantados, a
integração de um novo órgão no organismo implica um reajustamento da imagem corporal,
com a probabilidade de desencadear efeitos psicológicos negativos, bem como repercussões
na intimidade e na resposta sexual.
Este estudo teve como objectivo avaliar a função sexual masculina, a satisfação sexual e a
satisfação com a imagem corporal após transplantação, numa amostra de conveniência obtida
na Unidade de Transplantação Renal do Centro Hospitalar de Lisboa Ocidental. Foi realizado
um estudo transversal unicêntrico com recurso aos seguintes instrumentos: International
Index of Erectile Satisfaction, New Scale of Sexual Satisfaction, Brief Symtom Inventory e
Body Image Scale.
A taxa de resposta foi de 27.2% diagnosticando-se disfunção eréctil em 66.1% da amostra.
Identificou-se a presença de pelo menos um factor de risco para doença cardiovascular em
97.3% dos inquiridos e de 3 ou mais factores em 27.7%. Encontrou-se uma correlação entre o
funcionamento sexual e a satisfação sexual (r=.598; p<.01; n =112) e entre satisfação com a
imagem corporal e a função sexual (r =-.193; p<.05; n =112). O tempo decorrido após a
transplantação (<ou>36meses) não evidenciou diferença na função sexual e na satisfação
sexual ainda que a idade, o consumo de psicofármacos, a imagem corporal e a existência de
parceira/o sexual tenham moderado a variância entre esses grupos de transplantados. Estes resultados apontam para uma elevada taxa de disfunção sexual, nomeadamente de
disfunção eréctil, face à prevalência conhecida para a população geral. Verificou-se uma
relação entre a função sexual e a satisfação sexual. A imagem corporal mais satisfatória
associou-se a um melhor funcionamento sexual mas não a maior satisfação sexual reflectindo
provavelmente os mecanismos de ajustamento que a satisfação sexual tende a manter ao
longo da vida de um indivíduo. Permanece por determinar de modo longitudinal o efeito da
transplantação renal sobre a sexualidade e a imagem corporal.
Ten per cent of the worldwide population suffer from chronic kidney disease (CKD). This can impact survival and quality of life, namely in the terminal period of illness that implies the use of kidney function substitution. Kidney transplant is the technique that provides a quality of life (QoL) comparable with the one of an individual without terminal CKD. Sexuality is an important domain of the health-related quality of life (HRQoL) and of the global quality of QoL and is influenced by several biopsychossocial factors in the kidney transplant recipient. Sexual dysfunction is prevalent after kidney transplantation and its aetiology is presumed to be multifactorial. Sexual dysfunction exerts a negative impact on sexual satisfaction, HRQoL and global QoL. The integration of a new organ in the body can imply an adjustment of the body image perception, which eventually may have a negative influence on intimacy and sexual response. This study purposes to evaluate male sexual function, sexual satisfaction and body image in a convenience sample collected in the Department of Kidney Transplantation of the Centro Hospitalar de Lisboa Ocidental. This is a single centre cross-sectional study using the International Index of Erectile Satisfaction, the New Scale of Sexual Satisfaction, the Brief Symtom Inventory and the Body Image Scale. The response rate was 27.2% and erectile dysfunction was identified in 66.1% of the sample. Presence of at least one risk factor for cardiovascular disease was identified in 97.3% and 27.7% had 3 or more cardiovascular risk factors. A correlation was identified between sexual function and sexual satisfaction (r=.598; p<.01; n =112) and between body image satisfaction and sexual function (r =-.193; p<.05; n =112). The time after transplantation (< or >36meses) did not demonstrate a difference in sexual functioning or sexual satisfaction, although age, psycothropic drugs, body image perception and sexual partner availability accounts for the variations between the influences that time exerts in sexual function and satisfaction. These results showed high sexual dysfunction rates in the sample, namely erectile dysfunction, compared to those exhibited by the general population. A relation between sexual function and sexual satisfaction was established although it is not possible to evaluate if it was already evident before kidney transplant. The greater satisfaction with body image was associated with better sexual function but not with sexual satisfaction. This probably evidences the adjustment mechanisms developed to maintain sexual satisfaction throughout the life. Longitudinal evaluation is still required for the effects that kidney transplantation exerts in sexuality and the body image.
Ten per cent of the worldwide population suffer from chronic kidney disease (CKD). This can impact survival and quality of life, namely in the terminal period of illness that implies the use of kidney function substitution. Kidney transplant is the technique that provides a quality of life (QoL) comparable with the one of an individual without terminal CKD. Sexuality is an important domain of the health-related quality of life (HRQoL) and of the global quality of QoL and is influenced by several biopsychossocial factors in the kidney transplant recipient. Sexual dysfunction is prevalent after kidney transplantation and its aetiology is presumed to be multifactorial. Sexual dysfunction exerts a negative impact on sexual satisfaction, HRQoL and global QoL. The integration of a new organ in the body can imply an adjustment of the body image perception, which eventually may have a negative influence on intimacy and sexual response. This study purposes to evaluate male sexual function, sexual satisfaction and body image in a convenience sample collected in the Department of Kidney Transplantation of the Centro Hospitalar de Lisboa Ocidental. This is a single centre cross-sectional study using the International Index of Erectile Satisfaction, the New Scale of Sexual Satisfaction, the Brief Symtom Inventory and the Body Image Scale. The response rate was 27.2% and erectile dysfunction was identified in 66.1% of the sample. Presence of at least one risk factor for cardiovascular disease was identified in 97.3% and 27.7% had 3 or more cardiovascular risk factors. A correlation was identified between sexual function and sexual satisfaction (r=.598; p<.01; n =112) and between body image satisfaction and sexual function (r =-.193; p<.05; n =112). The time after transplantation (< or >36meses) did not demonstrate a difference in sexual functioning or sexual satisfaction, although age, psycothropic drugs, body image perception and sexual partner availability accounts for the variations between the influences that time exerts in sexual function and satisfaction. These results showed high sexual dysfunction rates in the sample, namely erectile dysfunction, compared to those exhibited by the general population. A relation between sexual function and sexual satisfaction was established although it is not possible to evaluate if it was already evident before kidney transplant. The greater satisfaction with body image was associated with better sexual function but not with sexual satisfaction. This probably evidences the adjustment mechanisms developed to maintain sexual satisfaction throughout the life. Longitudinal evaluation is still required for the effects that kidney transplantation exerts in sexuality and the body image.
Descrição
Orientação: Jorge Manuel dos Santos Cardoso
Palavras-chave
MESTRADO EM TRANSDISCIPLINAR DE SEXOLOGIA, SEXOLOGIA, DISFUNÇÕES SEXUAIS, INSUFICIÊNCIA RENAL, TRANSPLANTE RENAL, IMAGEM CORPORAL, SATISFAÇÃO SEXUAL, IIEF (ÍNDICE...), NSSS, BSI (INVENTÁRIO...), BIS (ESCALA...), TESTES PSICOLÓGICOS, SEXOLOGY, SEXUAL DYSFUNCTIONS, KIDNEY FAILURE, KIDNEY TRANSPLANT, BODY IMAGE, SEXUAL SATISFACTION, PSYCHOLOGICAL TESTS, DOENÇAS CRÓNICAS, CHRONIC DISEASES