男性和女性患者的感染、炎症和性功能

——第五屆國際性醫學諮詢會議 (ICSM 2024) 的建議

Infection, inflammation, and sexual function in male and female patients—recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024)

——《性醫學評論》2025年第13卷第3期——

Volume 13, Issue 3, 2025

【摘要】引言：男性和女性的性功能障礙是一個重要的臨床問題；感染和炎症可導致社會、醫學和心理問題，對全球的性健康和生殖健康產生深遠影響。目的：我們旨在識別由感染和炎症引起的男性和女性性功能障礙，並提出有效的干預措施，這些措施已於2024年6月在西班牙馬德里舉行的第五屆國際性醫學諮詢會議（ICSM）上得到評估。方法：我們在MEDLINE、Embase和Cochrane臨床對照試驗中心註冊庫（CENTRAL）中檢索已發表的同行評審期刊文章，並在ClinicalTrials.gov和世界衛生組織（WHO）國際臨床試驗註冊平台中檢索前瞻性試驗。本研究匯集了來自6個國家的10位專家在完成文獻綜述後達成的共識，並根據這些共識，列出了一系列強度等級的建議。本文件已提交給公開論壇進行同行評審和討論，並根據第五屆國際性傳播疾病大會（ICSM）主席的建議進行了修訂。結果：感染，尤其是性傳播感染 (STI)，無論性取向和性別如何，都會嚴重影響個人和伴侶的性健康和生殖健康。同樣，非傳染性慢性疾病 (NCD) 通過炎症這一常見致病機制，可直接損害性交、生育和享受性生活的能力。結論：本專家共識建議優先考慮早期發現、綜合治療方法和預防措施，以減輕感染和炎症對患者和伴侶性健康的影響。這些見解為改善患者預後和提高全球對感染、炎症和性功能障礙之間相互關聯性的認識奠定了基礎。

【關鍵詞】性功能障礙、慢性炎症、非傳染性慢性疾病感染、性傳播疾病 (STD)、慢性盆腔痛——新冠病毒病

[Abstract] Introduction: Sexual dysfunction in men and women is an important clinical issue; infection and inflammation can cause social, medical, and psychological problems that have a profound impact on sexual and reproductive health worldwide. Objectives: We set out to identify sexual dysfunctions in men and women that arise from infection and inflammation and propose meaningful interventions, as evaluated by the Fifth International Consultation on Sexual Medicine (ICSM) held in June 2024 in Madrid (Spain). Methods: We searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials (CENTRAL) for published peer-reviewed journal articles and ClinicalTrials.gov and the World Health Organization's (WHO’s) International Clinical Trials Registry Platform for prospective trials. This manuscript represents the opinions of 10 experts from 6 countries developed in a consensus process after completing the literature review, which produced a list of recommendations graded as weak or strong. This document was presented for peer review and debate in a public forum, and revisions were made based on the recommendations of chairpersons of the 5th ICSM. Results: Infections, and in particular sexually transmitted infections (STIs), dramatically affect the sexual and reproductive health of individuals and couples, irrespective of sexual orientation and gender. Similarly, non-communicable chronic diseases (NCDs), through the common pathogenetic mechanism of inflammation, can directly impair the ability to copulate, reproduce, and enjoy sexual life. Conclusions: This expert consensus recommends prioritizing early detection, comprehensive treatment approaches, and preventive measures to mitigate the effects of infection and inflammation on sexual health, both for the patient and the couple. These insights provide a foundation for improving patient outcomes and fostering global awareness of the interconnections between infection, inflammation, and sexual dysfunction.

[Key words] sexual dysfunction, chronic inflammation, NCD infection, STD, chronic pelvic pain—COVID-19

論文原文：Fernando Facio, Elena Colonnello, Laith Alzweri, et al (2025). Infection, inflammation, and sexual function in male and female patients—recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024). Sexual Medicine Reviews, Volume 13, Issue 3, Pages 301–317. July 2025.

https://doi.org/10.1093/sxmrev/qeaf021

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