Italian residents in urology sexual health: A multicentric study

Aim of the study: Several trials have dealt with residents well-being and burn-out, however, few data are available on residents Sexual Health. We aim to investigate Sexual Health among Italian residents in urology. Materials and methods: Between March and August 2018 Female Sexual Function Index (FSFI), Brief Index of Sexual Functioning Male (BISF-M), General Health Survey (SF-36) and Beck Depression Inventory Primary Care (BDI-PC) questionnaires were web-based administered to 299 residents from all of the 25 Italian Residency Programs. Data included: year of training (PGY), location, age, gender, sexual orientation, marital status, children, duty hours. Mean level differences in BDI-PC, FSFI and BISF-M levels for between-people variables such as sex (BDI-PC only), day/night shifts, and children were inspected via ANOVA; correlations between depression and sexual functioning were investigated as well. Results: The responding rate was 49%, 101 males (M), 50 females (F); 38 surveys were however incomplete, and the final sample consisted of 113 participants. They well represent the PGYs. Mean age was 30.4 (SD 2.2), 83% M and 86% F had a stable relationship, 33% of the residents were engaged to a colleague (35%M, 42%F), 6% had children (5%M, 6%F). 97% defined themselves heterosexual, 2% bisexual, 1% homosexual. Among females, 19% reported a FSFI total score below the critical value of 26, indicating a possible sexual dysfunction. In addition, 33% F and 11% M had a BMI-PC score >3, indicating a mild to severe depression level. Such percentages are higher than the quoted lifetime prevalence of depression in Italian general population (1.7% age group 15–44 years). 64% of the residents did night shifts, ANOVAs revealed a significant interaction effect ( p < 0.05, eta square=.06) between sex and night shifts on BDI-PC levels, with women with night shift work reaching a critical mean BDI-PC score of 4.21. Chi square analysis also demonstrated that women with night vs day-only shifts reported BDI scores in the critical range (p<0.06). Correlations further revealed that higher BDI scores were associated with lower FSFI Arousal scores (p<0.001), higher FSFI Dyspareunia scores ( p < 0.05) and lower FSFI total scores ( p < 0.05). No correlations were observed between BDI-PC and BISF-M or between sexual satisfaction and PGY, stable relationship and workload. Discussion: Residency is a stressful period during which residents work several hours, have tremendous responsibilities and personal relationship may be affected. The present results indicate that female residents suffer more than male from such an experience, probably because there is still no gender equality in the Italian surgical environment. These findings highlight the importance of introducing stress-management efforts and psychological supports in residency programs in order to improve sexual health and quality of life with probable positive effects on residents work.