Sexual function behavior in men with non-oncological chronic low back pain in a pain clinic of the city of Manizales, Colombia

Abstract

Objectives: Sexual life is a fundamental aspect of the quality of life of human beings and chronic pain can present as a pathology that significantly compromises quality of life. This study investigates the influence of chronic non-oncological low back pain, its treatment, sociodemographic aspects of these people and other pathologies that can impact sexual function. Methods: Cross-sectional descriptive study focused on the sexual behavior of men with chronic low back pain. The sample was obtained from consultants at the Instituto Caldense de Medicina del Dolor. They were administered a survey using the Visual Analogue Scale (VAS) which is widely used to better characterize the main components of pain and obtain the international index of erectile function-15 Chile. The data were obtained in a single interview and analyzed in IBM-SPSS. Results: Sample consisting of 40 non-oncological low back pain patients. Of these, the mean age was 52.9 years (SD 13.8), of which 80 % were from a low socioeconomic stratum, 85 % had a stable partner, 40 % did not complete high school studies and 20 % obtained a bachelor's degree. high school graduates, the others accessed some degree of higher education. The median duration of pain is 5 years (IQR 2.2-9.7), 92.5 % considered their pain moderate-severe (VAS); 50 % considered that they required professional sexological care, 72.5 % had another type of disease associated with chronic pain, namely (cardiovascular risk diseases 45 %, mental health diseases 32.5 %, among others). Most patients had multimodal treatment, among these 65 % of the population received treatment with opioid pharmacological therapy, 40 % anticonvulsants, 37.5 % antidepressants and the remaining 30% other medications. The prevalence of global dysfunction (libido disturbance, erectile dysfunction and orgasm disturbance) was 45 %, however, when considering each individual factor, there was a prevalence of erectile, orgasmic dysfunction and dissatisfaction with sexuality (DeOS) of 57.5 % and a decrease in libido of 47.5 %. Of the people in treatment with opioids, 65.4 % present DeOS and 46.2 % present low libido, of the users in treatment with anticonvulsants, 68.8 % present DeOS and 62.5 % have low libido, for those in treatment with antidepressants 66.7% present DeOS as well as low libido. Discussion: This study was conducted in patients with chronic non-cancer low back pain, in whom sexual dysfunction is greater than in the population without this condition; the older you are, the greater the prevalence of DeOS. On the other hand, the more intense the pain and for longer (5 years or more), the greater the prevalence of sexual dysfunction. Regarding the treatments used, the most common includes opioids, which can have a high prevalence of DeOS and low libido, likewise, the use of anticonvulsants and antidepressants could also cause high prevalences of global sexual dysfunction. These results point out the importance of investigating the sexual life of patients with chronic low back pain during their treatment, so it is considered pertinent to expand research into the sexuality of patients with painful conditions in greater depth; as well as the continuity of projects in this line of research, which would allow adequate knowledge, innovation and a truly comprehensive treatment for the patient, which guarantees a better quality of life.