Male Sexual Dysfunction : among male applicants of a family planning center for vasectomy B. Dilbaz, E.Caliskan, H. Cengiz, S. Gungor, S. Dilbaz and A. Haberal Ankara Etlik Maternity and Women’s Health Training & Research Hospital

Disorders of sexual function are common among men of all ages, ethnicities and cultural backgrounds. Sexual dysfunction diminishes the quality of life and can be an indication of serious medical problems,including diabetes mellitus, atherosclerosis, pituitary tumors, chronic renal or cardiac disease and depression. It may be a of marital discordance

Male sexual dysfunction evaluation begins with a sexual history and phsical examination.The history and physical examination have been reported to have a 95% sensitivity We used;Florida Sexual Health Questionnaire (FSHQ) Turkish version to evaluate the male sexual dysfunction among men who applied to the family planning center (FPC) for vasectomy

Florida Sexual Health Questionnaire FSHQ is described by Geisser et al (1991) It is a 20 item questionnarie developed as a brief,multidimensional self-report instrument for assessing the key dimensions of sexual function: desire, erectile dysfunction, ejaculation function, intercourse frequency, sexual development and satisfaction Its validity is tested among Turkish men by Oksuz & Malhan (2005)

VASECTOMY Vasectomy is a simple operation designed to make a man sterile. A total of about 50 million men have had a vasectomy Most series report pregnancy rates of less then 1 percent. The patients express anxiety about their sexual lives after vasectomy

VASECTOMY Permanent birth control Allows sexual spontaneity Requires no daily attention Does not affect pleasure Not messy Less complicated than female sterilizationfemale sterilization IN OUR STUDY;We aimed to evaluate male sexual dysfunction before vasectomy

Material & Methods The study was carried out between September - December Forty-nine men who applied to FPC for a non-scalpel vasectomy & accepted to fill in the questionnarie were taken as the study group We used the FSHQ Turkish version to evaluate male sexual dysfunction A FSHQ score of ≤ 95 was considered as male sexual dysfunction(MSD) and the prevelance of sexual dysfunction is detected

RESULTS The median age of the patient group (N:49) was 39.4± % of the patients prefered withdrawal method. Median FSHQ score was found to be 82.7±6. All the patients had a score below 95. There was no statistically significant relationship between the risk factors (education, income, smoking, contraceptive method, age) and MSD (p>0.005 for all variables)

Six domains are analyzed: Desire20.4 % Intercourse 32.7% Sexual development73.4% Satisfaction89.7% Ejaculation95.9% Erectile dysfunction100%

Characteristics of the patient group Male Age(year) 39.47±5.6 (30-57) Female Age(year) 35.95±4.6 (27-44) Male Age at Marriage 22.79±4.0 (14-34) Female Age at Marriage Age 20.08±3.3 (13-29) Duration of Marriage 15.51±4.5 (5-23) Gravidity 4.23±1.8 (2-10) Male Sexual Dysfunction Score 82.75±6.4 (64-92)

Educational status of men & their partners

Economical status of the patients

Sexual concerns are common among patients; however, there is evidence to suggest that these concerns are not appropriately investigated by clinicians The prevalence of MSD was reported to be 43.3% in Turkish men. MSD was higher for men with smoking, lower education, and chronic medical diseases (Oksuz & Malhan, 2005)

In a study 80 % of the couples reported that their marital and sexual relations were happy and satisfying, 40 % of the men reported erectile or ejeculatory dysfunction. A good sexual history should be taken in order to understand the physical and psychological well being There may be embarressment in discussing sexual issues, and differences in culture, socioeconomic level, age, race and gender. Lack of privacy or fear of lack of confidentially may prevent the patient from sharing sexual concerns

As there are concerns of men who applied for a vasectomy about its effects on sexual life various studies have been carried out showing no adverse outcome. In our study group,we analyzed the sexual functions before vasectomy and all of the patients had sexual dysfunction problems. The patients must be evaluated thoroughly before vasectomy

Sexual dysfunction has long been a hidden problem due to various restrictions such as culture, religion or social factors The findings of the presented study highlight the importance of encouraging male applicants speaking out their problems about their sexual health that constitutes a major part of reproductive health