ABSTRACT
To identify the sexual problems, to assess their prevalence and to determine the various factors involved in their occurrence in patients on hemodialysis for at least 6 months. Fifty hemodialysis patients consulting in the dialysis unit of the nephrology department of the University Hospital Hedi Chaker of Sfax [Tunisia], during the period from 1 June to 30 August 2012, were included in this study, The Hospital Anxiety and Depression Scale [HADS] was used to evaluate anxiety and depression. The patients' quality of life was assessed by Kidney Disease Quality of Life [KDQoL]. Patients' mean age was 51.2 years. The average of hemodialysis period was 6,73 years. After the beginning of hemodialysis, 26% of patients were sexually inactive and 62% reported a decrease of their sexual activity. The prevalence of sexual dysfunction was 86.48%. Mean age of 55 years or greater was significantly correlated with risk of sexual disorders. These disorders were also positively correlated with personal medical history, some nephropathy data, a hemodialysis period greater than or equal to 1 year, depression, anxiety and impaired quality of life. The prevalence of sexual dysfunction in hemodialysis patients is high and many factors were involved in their occurrence. A collaborative effort between nephrologists, psychiatrists and sexologists before dialysis, seems to be essential
ABSTRACT
To investigate the impact of pregnancy and the post partum period on the female sexuality and the coupledom, and to evaluate the quality of information and dialogue about this subject. A prospective descriptive and analytical study included patients from the department of obstetrics and gynecology in the university hospital Hédi Chaker during July and August 2010. We choose randomly 80 Tunisian women, whatever the reasons for consultation. Data were obtained via questionnaires containing 45 questions about sexual behavior during the last pregnancy and the postpartum period, the influence on coupledom, and the quality of information and dialogue about this subject. Statistical analysis was conducted using SPSS for Windows version 17. Statistical significance was defined as a p value 5% using the X2 test. The average age was 31.64 [+/- 6] years. Before pregnancy, sexuality was qualified as "satisfactory" by nearly the half of the sample [48, 5%] against 78.8% by their partners. 18% of women thought it was not possible to have intercourse during pregnancy. This idea doesn't correlate with the education [p=0.151] neither the geographic origin [p=0.064]. 54.5% of women mentioned a decrease on their sexual interest and activity during pregnancy. The three main causes of this decline were: the physical symptoms [83%], the fear to harm the fetus [66.7%] and the women hypoactive sexual desire [33.4%]. After delivery, sexual interest and activity tends to be reduced in 64% of women. The resumption of normal sexual activity was about 4 months around the delivery [with variations between 1 month and 2 years]. Sexuality was considered as taboo by 81, 8% of women. The information on sexuality by health professionals was deemed insufficient by 78.8% of women. Sexuality remains a taboo for the most of woman. Their belief in the impossibility of intercourse during pregnancy doesn't correlate with education neither with origin. The period of pregnancy and the postpartum changes the sexual behavior, interferes with the quality of life and disturbs the coupledom. However information and the support of women in this period are still insufficient