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Effect of cigarette smoking on sexual functions,psychological factors,and disease activity in male patients with ankylosing spondylitis
Authors:?lknur Aykurt Karl?bel  Seyhan Dülger  Meliha Kasapo?lu Aksoy  Muhammet Güzelsoy  Ali R?za Türko?lu  Lale Altan
Institution:1. Department of Physical Medicine and Rehabilitation, University of Health Sciences Bursa Yüksek ?htisas Training and Research Hospital, Bursa, Turkey;2. karlibeli@hotmail.com;4. Department of Pulmonology, University of Health Sciences Bursa Yüksek ?htisas Training and Research Hospital, Bursa, Turkey;5. Department of Urology, University of Health Sciences Bursa Yüksek ?htisas Training and Research Hospital, Bursa, Turkey;6. Department of Physical Medicine and Rehabilitation, Uluda? University Medicine Faculty, Bursa, Turkey
Abstract:Objective: This study aims to investigate the effect of smoking on sexual functions in AS patients.

Patients and methods: A total of 67 male AS patients with a median age of 34 years (range: 18–57) reporting sexual activity at least for the past 4 weeks period were included. Patients were divided into smokers (Group 1, n?=?47) and non-smokers (Group 2, n?=?20). Fagerström test for nicotine dependence, smoking history, exhaled carbon monoxide test were recorded for smoking AS patients. Visual analogue scale (VAS), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Metrology Index (BASMI), Bath Ankylosing Spondylitis Functional Index (BASFI), Ankylosing Spondylitis Quality of Life (ASQoL), International Index of Erectile Function (IIEF), Beck Depression Inventory (BDI) were filled for both groups.

Results: There was no significant difference between smokers and non-smokers in all evaluation parameters. BASMI scores were significantly lower in the mild dependency subgroup as compared to those with moderate or severe dependency (p?=?.005 and p?=?.007, respectively). Total IIEF score and IIEF categories correlated significantly with BASDAI, BASFI, BASMI, ASQoL, pain, fatigue, and cumulative smoking. BDI showed an inverse correlation with the IIEF score and IIEF category (p?r?=?–0.520, p?r?=?–0.508, respectively).

Conclusions: Sexual function in AS patients is associated with the pain, fatigue, disease activity, functional status, quality of life, depression as well as the cumulative exposure to smoking, and that sexual functions tend to decline with increasing degree of cigarette dependency.
Keywords:Ankylosing spondylitis  erectile dysfunction  nicotine dependence  sexual dysfunction  smoking
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