Comparison of the simplified International Index of Erectile Function (IIEF-5) in patients of erectile dysfunction with different pathophysiologies

Zhengyan Tang, Dongjie Li, Xiaobo Zhang, Lu Yi, Xiangsheng Zhu, Xiangyang Zeng, Yuxin Tang, Zhengyan Tang, Dongjie Li, Xiaobo Zhang, Lu Yi, Xiangsheng Zhu, Xiangyang Zeng, Yuxin Tang

Abstract

Background: The simplified International Index of Erectile Function (IIEF-5) is a convenient, reliable and validated diagnostic tool for erectile dysfunction (ED). However, few studies focused on IIEF-5 in ED patients with different pathophysiological causes. ,We aim to compare the IIEF-5 score among ED patients with specific pathophysiologies in this study.

Methods: The IIEF-5 score of 3,327 ED patients (median age 39 years) was analyzed. The primary causes of ED were determined by comprehensive diagnostic procedures in the urology/andrology clinics in five training hospitals. Patients with uncertain pathophysiologic cause were excluded.

Results: 176 patients were excluded, 3151 patients with ED history between 0.5 year and 20 years, were enrolled. The causes of ED was classified as psychogenic (59.2%), vasoculogenic (21.3%), neurogenic (4.1%), anatomical/structural (2.8%), hormonal (7.1%) or drug-induced (5.5%). A significant difference was detected in the median IIEF-5 score between psychogenic ED and organic ED (15 (IQR 13, 17) versus 12 (IQR 9.5, 14.5), P < 0.001). There was no significant difference of IIEF-5 scores among the organic groups (P = 0.073), or between arteriogenic and venogenic groups (13 (IQR 10.5, 15.5) versus 13 (IQR 11-15), P = 0.912 (adjusted α = 0.017)). However, the median IIEF-5 score of those with a mixed vascular cause was the lowest among vasculogenic patients (11 (IQR 8.5-13.5), scores for the three groups: P = 0.003.).

Conclusions: The IIEF-5 scores of men with psychological ED are higher than those with organic causes, but there is no difference among patients with different organic pathophysiologies. Our data indicate that IIEF-5 is not a definitive diagnostic tool to discriminate the pathophysiological causes of ED.

Figures

Figure 1
Figure 1
The IIEF-5 scores of 3,151 patients with different pathophysiologic causes. Error bar: interquartile range. Kruskal-Wallis H test for all groups, all organic groups (except for psychogenic): P = 0.000, and P = 0.073, respectively.
Figure 2
Figure 2
Severity of ED increased with age. Spearman correlations for 3151 patients: rs = −0.198, P = 0.000.

References

    1. NIH Consensus Conference: Impotence. NIH consensus development panel on impotence. JAMA. 1993;270:83–90.
    1. Shamloul R, Ghanem H. Erectile dysfunction. Lancet. 2013;381:153–165.
    1. Corona G, Lee DM, Forti G, O’Connor DB, Maggi M, O’Neill TW, Pendleton N, Bartfai G, Boonen S, Casanueva FF, Finn JD, Giwercman A, Han TS, Huhtaniemi IT, Kula K, Lean ME, Punab M, Silman AJ, Vanderschueren D, Wu FC. EMAS Study Group. Age-related changes in general and sexual health in middle-aged and older men: results from the European Male Ageing Study (EMAS) J Sex Med. 2010;7:1362–1380.
    1. Ayta IA, McKinlay JB, Krane RJ. The likely worldwide increase in erectile dysfunction between 1995 and 2025 and some possible policy consequences. BJU Int. 1999;84:50–56.
    1. Padma-nathan H, Eardley I, Kloner RA, Laties AM, Montorsi F. A 4-year update on the safety of sildenafil citrate (Viagra) Urology. 2002;60:67–90.
    1. Son H, Park K, Kim SW, Paick JS. Reasons for discontinuation of sildenafil citrate after successful restoration of erectile function. Asian J Androl. 2004;6:117–120.
    1. Seftel AD. Challenges in oral therapy for erectile dysfunction. J Androl. 2002;23:729–736.
    1. Wespes E, Amar E, Hatzichristou D, Hatzimouratidis K, Montorsi F, Pryor J, Vardi Y. Guidelines on erectile cysfunction: European association of urology. 2005.
    1. Corona G, Mannucci E, Schulman C, Petrone L, Mansani R, Cilotti A, Balercia G, Chiarini V, Forti G, Maggi M. Psychobiologic correlates of the metabolic syndrome and associated sexual dysfunction. Eur Urol. 2006;50:595–604.
    1. Li D, Jiang X, Zhang X, Yi L, Zhu X, Zeng X, Guo X, Tang Y. Multicenter pathophysiologic investigation of erectile dysfunction in clinic outpatients in China. Urology. 2012;79:601–606.
    1. Hatzimouratidis K, Amar E, Eardley I, Giuliano F, Hatzichristou D, Montorsi F, Vardi Y, Wespes E. European Association of Urology. Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation. Eur Urol. 2010;57:804–814.
    1. Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology. 1997;49:822–830.
    1. Rhoden EL, Teloken C, Sogari PR, Vargas SC. The use of the simplified International Index of Erectile Function (IIEF-5) as a diagnostic tool to study the prevalence of erectile dysfunction. Int J Impot Res. 2002;14:245–250.
    1. Rosen RC, Althof SE, Giuliano F. Research instruments for the diagnosis and treatment of patients with erectile dysfunction. Urology. 2006;68:6–16.
    1. Deveci S, O’Brien K, Ahmed A, Parker M, Guhring P, Mulhall JP. Can the international index of erectile function distinguish between organic and psychogenic erectile function? BJU Int. 2008;102:354–356.
    1. Kassouf W, Carrier S. A comparison of the international index of erectile function and erectile dysfunction studies. BJU Int. 2003;91:667–669.
    1. Chen B, Lu YN, Han YF, Huang XY, Hu K, Wang YX, Huang YR. IIEF-5 cannot be used as a tool for differential diagnosis of vasculogenic erectile dysfunction. Zhonghua Nan Ke Xue. 2007;13:118–121.
    1. Blander DS, Sanchez-Ortiz RF, Broderick GA. Sex inventories: can questionnaires replace erectile dysfunction testing? Urology. 1999;54:719–723.
    1. Hatzichristou D, Hatzimouratidis K, Bekas M, Apostolidis A, Tzortzis V, Yannakoyorgos K. Diagnostic steps in the evaluation of patients with erectile dysfunction. J Urol. 2002;168:615–620.
    1. Akkus E, Kadioglu A, Esen A, Doran S, Ergen A, Anafarta K, Hattat H. Turkish Erectile Dysfunction Prevalence Study Group. Prevalence and correlates of erectile dysfunction in Turkey: a population-based study. Eur Urol. 2002;41:298–304.
    1. Tariq SH, Haleem U, Omran ML, Kaiser FE, Perry HM, Morley JE. Erectile dysfunction: etiology and treatment in young and old patients. Clin Geriatr Med. 2003;19:539–551.
    1. Corona G, Mannucci E, Mansani R, Petrone L, Bartolini M, Giommi R, Mancini M, Forti G, Maggi M. Aging and pathogenesis of erectile dysfunction. Int J Impot Res. 2004;16:395–402.
    1. Liu DF, Jiang H, Hong K, Zhao LM, Ma LL, Zhu JC. [Epidemiological changes of ED patients: investigations in 11 Chinese cities during the past 5 years] Zhonghua Nan Ke Xue. 2009;15:724–726.
    1. Jiang H, Bai Q, Hong K, Xu QQ, Zhu JC. [Study on the knowledge of and attitude to sexual dysfunction in aged men] Zhonghua Nan Ke Xue. 2005;11:752–754.
    1. Wong SY, Leung JC, Woo J. Sexual activity, erectile dysfunction and their correlates among 1,566 older Chinese men in Southern China. J Sex Med. 2009;6:74–80.
    1. Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA. 1999;281:537–544.
    1. Althof SE. Quality of life and erectile dysfunction. Urology. 2002;59:803–810.
    1. Lue TF. Erectile dysfunction. N Engl J Med. 2000;342:1802–1813.
    1. Dean RC, Lue TF. Physiology of penile erection and pathophysiology of erectile dysfunction. Urol Clin North Am. 2005;32:379–395.
    1. Corona G, Mannucci E, Lotti F, Boddi V, Jannini EA, Fisher AD, Monami M, Sforza A, Forti G, Maggi M. Impairment of couple relationship in male patients with sexual dysfunction is associated with overt hypogonadism. J Sex Med. 2009;6:2591–2600.
    1. Caskurlu T, Tasci AI, Resim S, Sahinkanat T, Ergenekon E. The etiology of erectile dysfunction and contributing factors in different age groups in Turkey. Int J Urol. 2004;11:525–529.
    1. Davis-Joseph B, Tiefer L, Melman A. Accuracy of the initial history and physical examination to establish the etiology of erectile dysfunction. Urology. 1995;45:498–502.
    1. Ponholzer A, Temml C, Mock K, Marszalek M, Obermayr R, Madersbacher S. Prevalence and risk factors for erectile dysfunction in 2869 men using a validated questionnaire. Eur Urol. 2005;47:80–86.
    1. Rosen RC, Cappelleri JC, Gendrano N. The International Index of Erectile Function (IIEF): a state-of-the-science review. Int J Impot Res. 2002;14:226–244.
    1. Melman A, Fogarty J, Hafron J. Can self-administered questionnaires supplant objective testing of erectile function? A comparison between the International Index Of Erectile Function and objective studies. Int J Impot Res. 2006;18:126–129.

Source: PubMed

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