Male Sexual Dysfunction and Ankylosing Spondylitis: a Systematic Review and Metaanalysis

Objective: No consensus has been reached on sexual dysfunction in men with ankylosing spondylitis (AS). Our study aimed to derive a more precise estimation of the sexual function and its clinical correlations in men with AS.

Methods: A metaanalysis was performed and the related literature were searched in PubMed, Elsevier Science Direct, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, and in reference lists of articles and systematic reviews. Score of the International Index of Erectile Function (IIEF) was used as the outcome measurement, and standardized mean differences (SMD) with 95% CI were calculated.

Results: Eleven studies were included, including 535 men with AS and 430 male controls. Each domain of the IIEF score (erectile function: SMD -0.52, 95% CI -0.68 - -0.37; orgasmic function: -0.72, -1.03 - -0.42; sexual drive: -0.40, -0.62 - -0.18; intercourse satisfaction: -0.86, -1.15 - -0.56; and overall satisfaction: -0.61, -0.91 - -0.32) were lower in men with AS than in controls. In the subgroup analysis, the results did not change except for the sexual drive in the Asians group (-0.15, -0.42-0.13). At metaregression, no study characteristics were significantly associated with effect size of the IIEF score.

Conclusion: Sexual function is impaired in male patients with AS and further studies are necessary to better understand risk factors for sexual dysfunction in this population.