[SS-132]

Oturum adı: ORAL SESSION 7 | Oturum salonu: SALON 4 | Oturum tarihi: 17 Ekim 2014 | Oturum saati: 14:30 - 17:00

Koroner Arter Hastalığı Olan Kadınlarda Cinsel Fonksiyonların Sorgulanması

Ahmet Şalvarcı1, Tevfik Fikret İlgenli2
1Konya Hospital, Üroloji Bölümü, Konya, Türkiye
2Konya Hospital, Kardioloji Bölümü, Konya, Türkiye

AMAÇ:
Toplum genelinde kadın cinsel işlev bozukluğu %40-45 gözlenmesine rağmen diyabetik, hipertansif, kalp damar hastalıklarında ve menopoz durumunda bu durum daha sık gözlenebilir.
YÖNTEM:
Korener kalp hastalığı önceden bilinen kadınlarda; anemnez, fizik muayene, eströdiol, testesteron, Arizona cinsel yaşantı ölçeği (ACYÖ), Glombok-Rust Sexual Satisfaction, Inventory (GRISS), Beck depresyon testis sorgulandı.
BULGULAR:
2013 yılında 45±4 yaşında 31 koroner kalp hastası kadın sorgulandı. Hastaların status performans ortalaması 2 ( günlük işlerini yapabilen, haftada en az bir kere ilişkisi var). Evlilik süreleri 21±3 y, çocuk sayısı 7±4 idi. Hastaların 17 sinde korener arter stent, 8 hastaya açık kalp cerrahisi uygulanılmıştı. Hastaların 11 de tip II diabet var idi. Tüm hastalarda düzenli menstürial siklus oldugu ögrenildi. Hastalardan 9 u kalp hastalıgından dolayı cinsel ilişkiyi risk olarak gördüklerini ifade ettiler. ACYÖ göre 20±6 hesaplanıldı. Kadınların 23 ünde cinsel isteksizlik, uyarılma hissinde azalma, vajinal kuruluk ve orgazm olamadıklarını ifade ettiler. GRISS sorgulamada 4±2 ve özellikle anorgazm ön planda, ilişki sıklığında azalma ve ilişki istemediklerini ifade ettiler. Total testesteron 4 hastada 3 ng/ml ( premonopozal 10-70 ng /ml normal). Testesteron seviyesi düşük olan hastalar tedavi edildi. Yine Beck depresyon sorgulamasında 6 hastada major depresif bulgular icin vediğer hastalara yönelik psikiyatr tedavi önerildi. Özellikle 23 hastadan 9 da belirgin cinsel aktivite sayısında ve cinsel ilişkinin risk düşüncesinde azalma olduğu takiplerde öğrenildi.
SONUÇ:
Koroner kalp hastası kadınlarda ileri derecede cinsel fonksiyon bozukluğu ve major depresyon tespit edilebilir. Hastalarda cinsel fonksiyonların sorgulanması, bilinçlendirilmesi ve multidisipliner yaklaşımlarla tedavisi gerekebilir.

Investigation of Sexual Functions of Women with Coronary Artery Disease

Ahmet Şalvarcı1, Tevfik Fikret İlgenli2
1Konya Hospital, Department of Urology, Konya, Turkey
2Konya Hospital, Department of Cardiology, Konya, Turkey

Objective
Although female sexual dysfunction is observed at a rate of 40-46% within the society in general, this may be observed more frequently in hypertensive and cardiovascular diseases and in menopause cases.
Methodology
Anamnesis, physical examination was conducted, estradiol, testosterone levels were checked and Arizona Sexual Experience Scale (ASES), Glombol-Rust Inventory of Sexual Satisfaction (GRISS) and Beck Depression Inventory were conducted in women known to have coronary heart disease previously.
Findings
In 2013, 31 women aged 45±4 years and with coronary heart disease were investigated. The patients’ average status performance was 2 (can perform daily chores, has sexual intercourse at least once a week). The duration of their marriages was 21±3 years and the number of children was 7±4. Coronary artery stenting was performed on 17 patients, while open heart surgery was conducted in 8 patients. 11 patients had type II diabetes. It was reported that all patients had regular menstrual cycle. 9 patients stated that they regarded sexual intercourse as a risk due their heart disease. ASES was measured as 20±6. 23 patients recorded that there was low libido, reduction in arousal sensation, reduction in arousal sensation, vaginal dryness and anorgasmia in 23 women. In the GRISS examination, their score was 4±2 and they reported that especially anorgasmia was prominent, there was a reduction in intercourse frequency and that they did not want to have an intercourse. Total testosterone was 3 ng/ml in 4 patients (normal premenopausal level is 10-70 ng/ml). Patients with low testosterone level were treated. Also, psychiatric treatment was recommended for 6 patients as well as other patients in the Beck Depression Inventory. It was revealed in the follow ups that there was an evident increase in the number of sexual intercourse and reduction in the thought that sexual intercourse constitutes a risk especially in 23 patients.
Conclusion
Advanced sexual dysfunction and major depression may be detected in women with coronary heart disease. The investigation and awareness raising on sexual functions and treatment with multidisciplinary approach may be required in patients.