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14 October 2008
Sexual dysfunction can persist after major trauma
by George Atkinson

In one of the first studies to examine sexual dysfunction in trauma patients, researchers have found that sexual dysfunction can remain prevalent long after physical injuries from major trauma have been treated and resolved. Specifically, nearly a third of patients who had sustained moderate to severe trauma reported some degree of sexual dysfunction, and most characterized the dysfunction as severe, a year after a traumatic event.

Presented at the 2008 Clinical Congress of the American College of Surgeons, the study included patients who were treated in hospitals from 14 states across the country. Surgeons at the University of Washington (UW) decided to conduct the study after hearing complaints about sexual dysfunction from young trauma patients. The surgeons did not expect to find that sexual dysfunction was so widespread among trauma patients, however.

"The prevalence of sexual dysfunction in this study was more common than we expected it to be. Overall, the sexual dysfunction rate in this study is about double what it is in studies of healthy patients. And, for patients under the age of 50 years, the rate is about triple. In fact, we found that a moderate to severe traumatic injury imparts a risk of sexual dysfunction above and beyond the risk that may be imparted by known risk factors for sexual dysfunction, such as increasing age, diabetes, and lower socioeconomic status," said Mathew D. Sorensen, a urologist at UW.

Interestingly, the risk of sexual dysfunction in the study was found to be independent of the type of injury. "Unlike other studies that have shown an increased risk of sexual dysfunction after specific injuries involving parts of the body that are involved in sexual function, such as the pelvis and spine or genitalia, it appears from our study that just the general occurrence of a traumatic event may result in sexual dysfunction," Dr. Sorensen noted.

The risk also was not related to gender. Most of the patients in the study (68 percent) were male. The prevalence of sexual dysfunction was similar for both sexes, with 21 percent of men and 23 percent of women reporting severe or complete sexual dysfunction.

The researchers are not sure why sexual dysfunction may be a persistent problem for trauma patients. However, Dr. Sorensen suspects that it may be related to psychological effects of trauma and its aftermath. "Patients surviving major trauma often have long-standing limitations. It's been shown in previous studies that many of these patients have pain and many develop depression. All of these factors have been associated with sexual dysfunction. So it's possible that just by being involved in a major traumatic event, a patient may recover and be discharged from the hospital but still have physical, mental, or emotional limitations a year later. That may be part of the reason why patients have sexual dysfunction," he explained.

Findings from this study should serve as a wake-up call for physicians who treat trauma patients, Dr. Sorensen said. "If patients recognized that sexual dysfunction happens to many men and women who have had major trauma, then they may feel less of a taboo about bringing up the topic," he concluded.

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Source: American College of Surgeons

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