Investigation of the effect of sexual dysfunction on marital satisfaction and divorce in multiple sclerosis cases

Introduction and Purpose: In our study, we determined the rates of sexual dysfunction (SD) and urinary dysfunction (UD) in patients with Multiple Sclerosis and examined the impact of these dysfunctions on the patients' depression, quality of life, marital life and causes of divorce. Materials and Methods: 198 cases with different MS subtypes who were followed up in Aydin Adnan Menderes University Department of Neurology Multiple Sclerosis Polyclinic were included in the study. In addition to the clinical and demographic data of the patients, the Expanded Disability Status Scale (EDSS), Beck Depression Inventory (BDI), Multiple Sclerosis Intimacy and Sexuality Questionnaire-19 (MSISQ- 19), Arizona Sexual Experiences Scale, International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), Short Form-36 (SF-36) and Modified Fatigue Impact Scale (MFIS), Marital Life Scale were applied and the reasons for divorce were questioned. The scales and questions used were made by the neurologist who performed the examination. Results: Of the cases included in the study, 133 were women (67.1%) and 65 were men (32.9%). According to the MSISQ-19 score, 117 (59.1%) of the cases had SD. 37 of them were men (31.6%) and 80 were women (68.4%). The frequency of SD was found to increase as age, disease duration, and disability rate increased. When regression analysis was performed, it was observed that the factors that increased the risk of SD were age (2.5 times) and increased EDSS (6.4 times). In the presence of SD, MFIS and Beck Depression Inventory scores were found to be higher, and SF-36 subgroup scores and Marital Life Scale scores were significantly lower. According to the ICIQ-SF score, UD was detected in 66 (33.3%) of the cases. Similar to SD, the frequency of UD in cases was found to increase as age, disease duration and disability rate increased. When regression analysis was performed, it was observed that the factors that increased the risk of UD were age (4.6 times) and increased EDSS (5.2 times). While the MFIS scores were higher and SF-36 sub-scores were lower in cases with SD, similar to SD, unlike SD, Marital Life Scale scores and Beck Depression Inventory results showed no difference. A moderate correlation was observed between UD and SD. The reasons for divorce were similar in all MS cases and in cases with SD alone, and when the reasons were listed, the reasons affecting more than half of them were severe disagreement, spouse's bad behavior, degrading behavior, cheating, abandonment and sexuality. Conclusion: SD and UD were more common in MS cases than in the normal population. Variables that increase the risk for SD and UD are age and increased EDSS. The presence of SD makes a difference in terms of depression, fatigue, lower quality of life, worse marital life and divorce. Unlike SD, UD does not affect marital life or depression. When the reasons for divorce are evaluated, the presence of SD does not produce a significant difference in the cases. Key words: Multiple Sclerosis, Sexual Dysfunction, Urinary Dysfunction, Divorce