MATERIALS AND METHODS: A Medline search was conducted according to the PRISMA statement for all English full-text articles published between 1980 and 2016 and assessing female sexual function post radical cystectomy and urinary diversion. Eligible studies were subjected to critical analysis and revision. The primary outcomes were the reporting methods for female sexual dysfunction (FSD), manifestations of FSD, and factors associated with FSD, postoperative recoverability of FSD, and awareness level regarding FSD.
RESULTS: From the resulting 117 articles, 11 studies were finally included in our systematic review, with a total of 361 women. Loss of sexual desire and orgasm disorders were the most frequently reported (49% and 39%). Dyspareunia and vaginal lubrication disorders were reported in 25% and 9.5%, respectively. The incidence of sexual dysfunction was 10% in 30 patients receiving genital- or nerve-sparing cystectomy vs. 59% receiving conventional cystectomy.
CONCLUSION: Although female sexual function is an important predictor of health-related quality of life post radical cystectomy and urinary diversion, the available literature is not enough to provide proper information for surgeons and patients.
Method: In this cross-sectional study, we recruited 420 women from nine primary care clinics in Kuantan, Pahang, Malaysia. All participants had given livebirths within six weeks to six months and had attended either a postnatal or a well-child clinic at a government primary care clinic. The assessment of female sexual dysfunction (FSD) was done using a validated Malay version of the female sexual function index (MVFSFI). Data were statistically analysed using appropriate methods.
Results: More than one-third (35.5%) of women had postpartum sexual dysfunction. The most common types were lubrication disorder 85.6% (n = 113), followed by loss of desire 69.7% (n = 92) and pain disorders 62.9% (n = 83). Satisfaction disorder 7.3% (n = 27), orgasmic disorder 9.7% (n = 56) and arousal disorder 11.0% (n = 41) were less common sexual problems. The independent associated factors for FSD were high education level (adjusted odd ratio = 1.717, 95% CI 1.036-2.844; p sexual dysfunction in Kuantan, Pahang, Malaysia. The most common type of sexual dysfunction was lubrication disorder. Efforts at increasing awareness in healthcare professionals should be made.
METHODS: Focus group interviews were conducted to determine the construct of the questionnaire. Content and face validity were assessed by a panel of experts. A pilot study was conducted to validate the Sexual Dysfunction in Asian Men with Diabetes (SAD-MEN) questionnaire in English and Malay. The International Index of Erectile Function-5 (IIEF-5) was used for comparison. Construct validity was assessed using exploratory factor analysis, reliability was determined using Cronbach's α (> 0.700), and test-retest reliability using Spearman's rank correlation coefficient.
RESULTS: The SAD-MEN questionnaire yielded moderate face and content validity, with high reliability as shown by Cronbach's α values of 0.949 for sexual performance and 0.775 for sexual desire for the English version. The Malay language questionnaire had a Cronbach's α value of 0.945 for sexual performance and 0.750 for sexual desire. Test-retest reliability using Spearman's test gave correlation coefficients of r = 0.853, P = 0.000 for the English language questionnaire and r = 0.908, P = 0.000 for the Malay language questionnaire.
CONCLUSION: The SAD-MEN questionnaire is a valid and reliable tool by which to assess sexual dysfunction in English- and Malay-speaking Malaysian and South East Asian men with diabetes.