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Agochukwu-Mmonu N, Radix A, Zhao L, Makarov D, Bluebond-Langner R, Fendrick AM, Castle E, Berry C. Patient reported outcomes in genital gender-affirming surgery: the time is now. J Patient Rep Outcomes 2022; 6:39. [PMID: 35467181 PMCID: PMC9038968 DOI: 10.1186/s41687-022-00446-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 04/02/2022] [Indexed: 11/16/2022] Open
Abstract
Transgender and non-binary (TGNB) individuals often experience gender dysphoria. TGNB individuals with gender dysphoria may undergo genital gender-affirming surgery including vaginoplasty, phalloplasty, or metoidioplasty so that their genitourinary anatomy is congruent with their experienced gender. Given decreasing social stigma and increasing coverage from private and public payers, there has been a rapid increase in genital gender-affirming surgery in the past few years. As the incidence of genital gender-affirming surgery increases, a concurrent increase in the development and utilization of patient reported outcome measurement tools is critical. To date, there is no systematic way to assess and measure patients' perspectives on their surgeries nor is there a validated measure to capture patient reported outcomes for TGNB individuals undergoing genital gender-affirming surgery. Without a systematic way to assess and measure patients' perspectives on their care, there may be fragmentation of care. This fragmentation may result in challenges to ensure patients' goals are at the forefront of shared- decision making. As we aim to increase access to surgical care for TGNB individuals, it is important to ensure this care is patient-centered and high-quality. The development of patient-reported outcomes for patients undergoing genital gender-affirming surgery is the first step in ensuring high quality patient-centered care. Herein, we discuss the critical need for development of validated patient reported outcome measures for transgender and non-binary patients undergoing genital reconstruction. We also propose a model of patient-engaged patient reported outcome measure development.
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Affiliation(s)
- Nnenaya Agochukwu-Mmonu
- Department of Urology, NYU School of Medicine, New York University, 221 East 41st Street, New York, NY, 10017, USA.
- Department of Population Health, NYU School of Medicine, New York, NY, USA.
| | - Asa Radix
- Department of Medicine, NYU School of Medicine, New York, NY, USA
- Callen-Lorde Community Health Center, New York, NY, USA
| | - Lee Zhao
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Danil Makarov
- Department of Urology, NYU School of Medicine, New York University, 221 East 41st Street, New York, NY, 10017, USA
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | | | - A Mark Fendrick
- Department of Medicine, University of Michigan, Ann Arbor, MI, USA
- Department of Public Policy, University of Michigan, Ann Arbor, MI, USA
| | - Elijah Castle
- Department of Urology, NYU School of Medicine, New York University, 221 East 41st Street, New York, NY, 10017, USA
- Department of Population Health, NYU School of Medicine, New York, NY, USA
| | - Carolyn Berry
- Department of Population Health, NYU School of Medicine, New York, NY, USA
- Department of Medicine, NYU School of Medicine, New York, NY, USA
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Said SZ, Nasser TA, Ayad M, Motawi AT. Evaluation of the sensitivity of different doses of vasoactive drugs in diagnosing erectile dysfunction in impotent patients: a prospective case-control study. Cent European J Urol 2021; 74:109-115. [PMID: 33976925 PMCID: PMC8097656 DOI: 10.5173/ceju.2021.00042.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 07/30/2020] [Accepted: 12/08/2020] [Indexed: 11/22/2022] Open
Abstract
Introduction Erectile dysfunction (ED) is one of the most common sexual disorders worldwide affecting about 30 million men in the United States, and an estimated 100 million men worldwide. Penile duplex doppler ultrasound (PDDU) is performed using an intracavernosal injection (ICI) of a vasoactive agent to demonstrate both arterial insufficiency and veno-occlusive dysfunction. This article aims to evaluate the sensitivity of different doses of different vasoactive agents used to diagnose ED in impotent patients. Material and methods This study recruited 90 subjects with ED and 100 healthy subjects as controls. All of the subjects were assessed using the International Index of Erectile Function score (IIEF-5) while degree of erection was assessed by the Erection Hardness Score (EHS). Two penile duplex tests were done for each candidate two weeks apart. Results None of the sample population achieved a normal clinical response (EHS >2) to 10 ug PGE1. In contrast, 60 controls (60%) had a normal response (EHS >2) to 10 ug PGE1. This difference in response between the sample and control populations to 10 ug PGE1 was of high statistical significance 11 (p <0.001). In contrast, 54 (60%) out of the 90 cases had normal clinical response (EHS >2) to 0.25cc Trimix (everywhere). Interestingly, 96 controls (96%) demonstrated normal response (EHS >2) to 0.25cc Trimix. This difference in response between the sample and control populations to 0.25 cc Trimix was also of high statistical significance (p <0.001). Conclusions Our study demonstrated a statistically significant association between the response to Trimix over PGE1 and peak systolic velocity (PSV) and end diastolic velocity (EDV). Thus, we conclude that 0.25 cc Trimix is more sensitive than 20 ug PGE1 in diagnosing ED for impotent patients and also provides a more potent response.
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Affiliation(s)
- Shady Zaki Said
- Department of Andrology, Sexual Medicine and STIs, Faculty of Medicine, Cairo University, Egypt
| | - Taha Abdel Nasser
- Department of Andrology, Sexual Medicine and STIs, Faculty of Medicine, Cairo University, Egypt
| | | | - Ahmad Tarek Motawi
- Department of Andrology, Sexual Medicine and STIs, Faculty of Medicine, Cairo University, Egypt
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Masuku NP, Unuofin JO, Lebelo SL. Promising role of medicinal plants in the regulation and management of male erectile dysfunction. Biomed Pharmacother 2020; 130:110555. [PMID: 32795922 DOI: 10.1016/j.biopha.2020.110555] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 07/03/2020] [Accepted: 07/25/2020] [Indexed: 12/31/2022] Open
Abstract
Male erectile dysfunction (ED) refers to incompetency to reaching and retaining adequate penile tumescence for sexual intercourse. Over 152 million men globally suffer from ED and by 2025, the number of affected individuals is anticipated to be around 322 million. Pharmacological and nonpharmacological therapies such as phosphodiesterase (PDE) inhibitors, alprostadil, penile prosthesis surgery, and hormonal replacement are available for management and recuperation of ED. Nevertheless, such therapies are reported to have adverse effects as well as life-threatening. Accordingly, diversity of medicinal plant species and bioactive active compounds are preferred as therapeutic options because they are natural, abundant, available, low-cost and cause fewer or no side effects. This current review will emphasise the aetiology, risk factors, mechanisms underlying the pathophysiology of ED, treatments of ED as well as their side effects. It also provides medicinal plants that are proven effective in vivo and in vitro for the mitigation and treatment of male ED. This knowledge could be used in the future in drug discovery for the development of more natural drugs with no side effects.
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Affiliation(s)
- Nelisiwe Prenate Masuku
- Department of Life and Consumer Sciences, University of South Africa, Cnr Christiaan de Wet and Pioneer Ave, Private Bag X6, Florida, 1710, South Africa
| | - Jeremiah Oshiomame Unuofin
- Department of Life and Consumer Sciences, University of South Africa, Cnr Christiaan de Wet and Pioneer Ave, Private Bag X6, Florida, 1710, South Africa.
| | - Sogolo Lucky Lebelo
- Department of Life and Consumer Sciences, University of South Africa, Cnr Christiaan de Wet and Pioneer Ave, Private Bag X6, Florida, 1710, South Africa
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Goldstein I, Giraldi A, Maculaitis MC, Li VW, Hartzell-Cushanick R, Hassan TA. Real-World Assessment of the Impact of Erectile Dysfunction on Sexual Planning Behavior and Health- and Treatment-Related Outcomes Among Men in 8 Countries. Sex Med 2020; 8:338-349. [PMID: 32605816 PMCID: PMC7471092 DOI: 10.1016/j.esxm.2020.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The effect of erectile dysfunction (ED) on sexual planning behaviors and outcomes in men taking phosphodiesterase type 5 inhibitors (PDE5Is) is not well studied. AIMS To assess sexual habits, behaviors, and treatment-related outcomes of PDE5I-treated men with ED. METHODS This cross-sectional observational study recruited men aged 30 to 70 years with mild-to-severe ED from 8 diverse countries (the United States, the United Kingdom, Italy, Russia, Turkey, Israel, China, and Japan) to complete an approximately 15-minute survey. Differences were evaluated using bivariate analyses, and data were summarized using descriptive statistics. MAIN OUTCOME MEASURES Self-reported data were collected for demographics, health characteristics, treatment, sexual habits, ED severity, ED-specific quality of life, and treatment satisfaction. RESULTS The survey was completed by 1,575 men. Mean frequency of sexual intercourse was 5.7 times/month. Overall, 87.1% of men always, often, or sometimes planned for sexual activity. Of those planning in advance, 32.8% and 40.6% agreed or strongly agreed that they plan for specific days of the week and times of day, respectively. Sexual planning habits were similar for patients taking short-acting vs long-acting PDE5Is. The most commonly cited reasons for planning sexual activity were needing time to take medication (48.4%), needing to make sure medication has taken effect (43.4%), convenient time for sexual activity (34.9%), and needing the partner's agreement (33.4%). Mean Self-Esteem and Relationship Questionnaire total score was 56.4. CONCLUSIONS The differences in ED burden and sexual planning behavior observed across countries were not influenced by the type of PDE5I being taken, suggesting that cultural differences are an important factor when considering types of ED treatment. These findings provide a better understanding of burden, sexual habits, planning behaviors, quality of life, and treatment-related outcomes among PDE5I-treated men with ED in 8 Western and non-Western countries and may aid healthcare providers in selecting optimal treatments. Goldstein I, Giraldi A, Maculaitis MC, Real-World Assessment of the Impact of Erectile Dysfunction on Sexual Planning Behavior and Health- and Treatment-Related Outcomes Among Men in 8 Countries. J Sex Med 2020;8:338-349.
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Affiliation(s)
| | - Annamaria Giraldi
- Sexological Clinic, Psychiatric Centre Copenhagen, Copenhagen, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Yafi FA, Huynh LM, Ahlering T, Rosen R. What Is a "Validated Questionnaire"? A Critical Review of Erectile Function Assessment. J Sex Med 2020; 17:849-860. [PMID: 32146130 DOI: 10.1016/j.jsxm.2020.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 11/25/2019] [Accepted: 02/05/2020] [Indexed: 01/23/2023]
Abstract
BACKGROUND In recent years, the assessment of erectile dysfunction (ED) has experienced a paradigm shift from objective, quantitative methods to subjective, qualitative patient-reported outcomes. Facilitated by this shift is the ongoing debate on questionnaire selection and need for standardization, particularly among sexual medicine specialists. AIM To review current literature on assessment of erectile function via patient-reported outcomes and discuss the context, advantages, and limitations of currently available questionnaires. METHODS A thorough literature search of erectile function questionnaires developed from 1990 through 2019 was carried out using 3 methods: a search of the MedLine databases; hand-search of peer-reviewed urologic, sexual medicine, and health policy journals; and expert review. The following keywords were used: [assessment of], [inventory], [questionnaire], or [validated measure]; in combination with: [sexual function] or [erectile function]. Measures were stratified into one of the following 3 groups: screening, outcome, or disease-specific. 3 screening measures (International Index of Erectile Function, the Male Sexual Health Questionnaire, and Brief Male Sexual Inventory); 5 outcome measures (Sexual Health Inventory for Men, Erection Hardness Score, Erectile Dysfunction Inventory for Treatment and Satisfaction, and Treatment Satisfaction Scale); and 3 categories of disease-specific measures (cancer, Peyronie's disease, and spinal cord injury) were included. OUTCOMES Strengths, limitations, and valid uses of each erectile function questionnaire. RESULTS There currently exists a wide variety of screening, outcome, and disease-specific measures for ED diagnosis, assessment, and treatment. Rigor of psychometric validation varies greatly across studies. However, depending on purpose of use, all abovementioned questionnaires have merit for use in clinical practice, are nonredundant, and can complement and supplement one another. CLINICAL IMPLICATIONS Before choosing a specific measure for ED diagnosis, assessment, or treatment, there must be careful consideration of the questionnaire's psychometric properties, context of validation, and its possible limitations. STRENGTHS & LIMITATIONS The patient reported outcome measures highlighted in this article complement and supplement one another, as each emphasizes a related yet distinct central theme. During selection for use in clinical practice and research studies, special attention needs to be paid to the context, strengths, and weaknesses of each measure. CONCLUSION When used conscientiously, patient-reported questionnaires can significantly optimize patient management. Yafi FA, Huynh LM, Ahlering T, et al. What Is a "Validated Questionnaire"? A Critical Review of Erectile Function Assessment. J Sex Med 2020;17:849-860.
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Affiliation(s)
- Faysal A Yafi
- Department of Urology, University of California, Irvine Health Orange, CA, USA.
| | - Linda My Huynh
- Department of Urology, University of California, Irvine Health Orange, CA, USA
| | - Thomas Ahlering
- Department of Urology, University of California, Irvine Health Orange, CA, USA
| | - Raymond Rosen
- HealthCore/New England Research Institutes, Watertown, MA, USA
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Olamoyegun MA, Ayodele AO, Yemi FE, Akinyele AT. Prevalence of Premature Ejaculation among Patients with Type 2 Diabetes in a Tertiary Health Institution: A Cross-Sectional Study. ACTA ACUST UNITED AC 2020. [DOI: 10.4236/jdm.2020.102008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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The intra-meatal application of alprostadil cream (Vitaros®) improves drug efficacy and patient’s satisfaction: results from a randomized, two-administration route, cross-over clinical trial. Int J Impot Res 2018; 31:119-125. [PMID: 30323234 DOI: 10.1038/s41443-018-0087-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/28/2018] [Accepted: 09/20/2018] [Indexed: 01/14/2023]
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The 2018 Revision to the Process of Care Model for Evaluation of Erectile Dysfunction. J Sex Med 2018; 15:1280-1292. [DOI: 10.1016/j.jsxm.2018.06.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 05/25/2018] [Accepted: 06/07/2018] [Indexed: 10/28/2022]
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Cappelleri JC, Tseng LJ, Stecher V, Goldstein I. Enriching the Interpretation of the Erectile Dysfunction Inventory of Treatment Satisfaction: Characterizing Success in Treatment Satisfaction. J Sex Med 2018; 15:732-740. [DOI: 10.1016/j.jsxm.2018.03.078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 03/19/2018] [Accepted: 03/23/2018] [Indexed: 10/17/2022]
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Cappelleri JC, Tseng LJ, Stecher VJ, Althof SE. Clinically important difference on the Erectile Dysfunction Inventory of Treatment Satisfaction questionnaire in patients with erectile dysfunction. Int J Clin Pract 2018; 72:e13073. [PMID: 29493846 DOI: 10.1111/ijcp.13073] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 01/29/2018] [Indexed: 11/29/2022] Open
Abstract
AIM To determine what constitutes a clinically important difference (CID) on the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), an 11-item validated questionnaire assessing treatment satisfaction used in clinical trials for patients with erectile dysfunction (ED). METHODS Erectile Dysfunction Inventory of Treatment Satisfaction data were evaluated from a double-blind, fixed-dose trial of 279 men aged 18-65 years with ED who were treated with sildenafil 50 or 100 mg or placebo. The primary anchor measure was the erectile function (EF) domain of the International Index of Erectile Function (IIEF), which has a 4-point minimal CID. The CID on the EDITS index score was determined using a regression analysis comparing EDITS and IIEF EF scores at the end of the 8-week treatment. A similar analysis was performed for EDITS and the Erection Hardness Score (EHS) instrument, a single-item questionnaire measuring hardness, which was used as a secondary anchor measure. RESULTS Erectile Dysfunction Inventory of Treatment Satisfaction and IIEF EF domain scores were highly correlated (Pearson correlation coefficient = 0.75). EDITS total scores across treatments at week 8 averaged (mean ± standard deviation [SD]) 67.5 ± 21.6 (range, 0-100; higher scores indicate greater treatment satisfaction); IIEF EF domain scores averaged 22.2 ± 6.9 (range, 1-30; higher scores indicate higher erectile functioning). The calculated CID for EDITS scores was 9.5 (95% CI, 8.5-10.4; 0.44 SD units), corresponding to a medium effect size. EDITS and EHS instrument scores also correlated highly (Pearson correlation coefficient = 0.64). Placebo-adjusted EDITS mean scores were more than twice the CID, at 23 (95% CI, 17-28) and 28 (95% CI, 23-33) for the 50- and 100-mg doses, respectively. CONCLUSION Approximately 10 points on the EDITS index score is considered a CID. Serving as a benchmark, this finding aids interpretation of the clinical relevance of a difference in mean EDITS index scores between treatments for patients with ED.
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Affiliation(s)
| | | | | | - Stanley E Althof
- Center for Marital and Sexual Health of South Florida, West Palm Beach, FL, USA
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12
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Kałka D, Domagała Z, Rusiecki L, Karpiński Ł, Gebala J, Kolęda P, Rusiecka M, Gworys B, Pilecki W. Heart rate recovery, cardiac rehabilitation and erectile dysfunction in males with ischaemic heart disease. Anatol J Cardiol 2015; 16:256-63. [PMID: 26642468 PMCID: PMC5368435 DOI: 10.5152/anatoljcardiol.2015.6122] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Objective: Heart rate recovery (HRR) is a recognised marker used in clinical practice for assessing the risk of sudden cardiac death. Physical exercise leads to an improvement in HRR and has a proven beneficial effect on erection quality (EQ) related to the activity of the autonomic nervous system in men with ischaemic heart disease (IHD). This paper evaluates the relationship between HRR and EQ in patients with IHD and erectile dysfunction (ED) who underwent cardiac rehabilitation. Methods: The main analysis was based on the Mann–Whitney U test, Wilcoxon signed-rank test, Spearman correlation coefficient, Pearson’s chi-square test, chi-square test, with the Yates correction and (if possible) parametric tests were used. This prospective, non-randomised intervention study included 124 men with IHD and ED [International Index of Erectile Function (IIEF-5) scores of ≤21]. Of these, 89 patients underwent a 6-month cardiac rehabilitation phase III programme, whereas 35 did not. The results of the participants’ total IIEF-5 scores and their HRR, demographic and clinical data were analysed. Results: The results of the 89 rehabilitated patients (mean age: 60.44±9.29 years) and 35 controls (mean age: 61.43±8.81 years) were analysed. In the rehabilitated patients, the mean baseline IIEF-5 score was 13.15±5.76 (95% CI: 11.93–14.36) and HRR was 16.49±7.68/min (95% CI: 14.88–18.11). After cardiac rehabilitation, the parameters of ED and HRR improved significantly and were significantly higher than those of the controls; the mean IIEF-5 score of the rehabilitated group increased to 15.36±6.51 (95% CI: 13.99–16.73), while HRR increased to 21.40±7.25/min (95% CI: 19.88–22.93). A significant correlation was found between ∆HRR and ∆EQ (r=0.409791) as a result of the 6-month cardiac training programme Conclusion: Cardiac rehabilitation assessed by HRR has a sizable effect on autonomic balance in patients with IHD and ED, which plays a significant role in the mechanism of erection improvement.
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Affiliation(s)
- Dariusz Kałka
- Cardiosexology Unit, Department of Pathophysiology, Wroclaw Medical University; ul. K. Marcinkowskiego 1; Wroclaw Poland; Centre for Men's Health in Wroclaw-Poland.
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Hoyos CM, Melehan KL, Phillips CL, Grunstein RR, Liu PY. To ED or not to ED – Is erectile dysfunction in obstructive sleep apnea related to endothelial dysfunction? Sleep Med Rev 2015; 20:5-14. [DOI: 10.1016/j.smrv.2014.03.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 03/07/2014] [Accepted: 03/10/2014] [Indexed: 01/23/2023]
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Reis AL, Reis LO, Saade RD, Santos CA, de Lima ML, Fregonesi A. Validation of Portuguese version of Quality of Erection Questionnaire (QEQ) and comparison to International Index of Erectile Function (IIEF) and RAND 36-Item Health Survey. Int Braz J Urol 2015; 41:155-67. [PMID: 25928522 PMCID: PMC4752069 DOI: 10.1590/s1677-5538.ibju.2015.01.21] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 09/16/2014] [Indexed: 12/22/2022] Open
Abstract
PURPOSE To validate the Quality of Erection Questionnaire (QEQ) considering Brazilian social-cultural aspects. MATERIALS AND METHODS To determine equivalence between the Portuguese and the English QEQ versions, the Portuguese version was back-translated by two professors who are native English speakers. After language equivalence had been determined, urologists considered the QEQ Portuguese version suitable. Men with self-reported erectile dysfunction (ED) and infertile men who had a stable sexual relationship for at least 6 months were invited to answer the QEQ, the International Index of Erectile Function (IIEF) and the RAND 36-Item Health Survey (RAND-36). The questionnaires were presented together and answered without help in a private room. Internal consistency (Cronbach's α), test-retest reliability (Spearman), convergent validity (Spearman correlation) coefficients and known-groups validity (the ability of the QEQ Portuguese version to differentiate erectile dysfunction severity groups) were assessed. RESULTS We recruited 197 men (167 ED patients and 30 non-ED patients), mean age of 53.3 and median of 55.5 years (23-82 years). The Portuguese version of the QEQ had high internal consistency (Cronbach α=0.93), high stability between test and retest (ICC 0.83, with IC 95%: 0.76-0.88, p<0.001) and Spearman correlation coefficient r=0.82 (p<0.001), which demonstrated the high correlation between the QEQ and IIEF results. The correlations between the QEQ and RAND-36 were significantly low in ED (r=0.20, p=0.01) and non-ED patients (r=0.37, p=0.04). CONCLUSION The QEQ Portuguese version presented good psychometric properties and high convergent validity in relation to IIEF. The low correlations between the QEQ and the RAND-36, as well as between the IIEF and the RAND-36 indicated IIEF and QEQ specificity, which may have resulted from the patients' psychological adaptations that minimized the impact of ED on Quality of Life (QoL) and reestablished the well-being feeling.
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Affiliation(s)
- Ana Luiza Reis
- Department of Surgery (Urology), Faculty of Medical Sciences, University of Campinas (Unicamp), Brazil
| | - Leonardo Oliveira Reis
- Department of Surgery (Urology), Faculty of Medical Sciences, University of Campinas (Unicamp), Brazil
- Medicine (Urology), Center for Life Sciences, Pontifical Catholic University of Campinas (PUC-Campinas), Brazil
| | - Ricardo Destro Saade
- Department of Surgery (Urology), Faculty of Medical Sciences, University of Campinas (Unicamp), Brazil
| | - Carlos Alberto Santos
- Department of Surgery (Urology), Faculty of Medical Sciences, University of Campinas (Unicamp), Brazil
| | - Marcelo Lopes de Lima
- Department of Surgery (Urology), Faculty of Medical Sciences, University of Campinas (Unicamp), Brazil
| | - Adriano Fregonesi
- Department of Surgery (Urology), Faculty of Medical Sciences, University of Campinas (Unicamp), Brazil
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Kimura M, Shimura S, Tai T, Kobayashi H, Baba S, Kano M, Nagao K. A web-based survey of erection hardness score and its relationship to aging, sexual behavior, confidence, and risk factors in Japan. Sex Med 2014; 1:76-86. [PMID: 25356291 PMCID: PMC4184501 DOI: 10.1002/sm2.15] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Introduction Erection hardness is an elemental component of men's sexual quality of life that can be easily measured by the Erection Hardness Score (EHS). However, there are few published data regarding EHS, and there is little understanding of its relationships to aging, men's sexual behavior, sexual confidence, and risk factors in Japan. Aim To assess EHS and how it correlates to aging, sexual behaviors, sexual self-confidence, and risk factors in a Japanese population database. Methods A web-based cross-sectional nationwide survey conducted between March and May 2009 in Japan. Main Outcome Measures EHS, lifestyle factors, comorbidities, general health, sexual confidence, frequency of sexual behaviors, and attitudes toward treatment of erectile dysfunction (ED). Results A total of 7,710 men with a mean age of 39.3 ± 13.0 years participated in this survey. In 6,528 participants who were not using phosphodiesterase type 5 inhibitors, 3,540 (54.2%) had EHS ≤ 3 and 1,196 (18.3%) had EHS ≤ 2. We found a significant age-dependent decrease in EHS, sexual confidence, and frequency of sexual activities. Sexual confidence was strongly associated with higher EHS but was also associated with older age groups, presence of offspring, awareness of better general health, and greater frequency of sexual activity. In age-adjusted multivariate logistic regression, risk factors for a lower EHS (defined as EHS ≤ 2) were heavy smoking, which was defined as more than two packs per day (odds ratio [OR], 1.7) or a history of metabolic syndrome (OR, 1.4), hypertension (OR, 1.2), and diabetes mellitus (OR, 1.4). Conclusions EHS correlates to various elements, such as aging, sexual behaviors, sexual confidence, and ED-related risk factors, and can be a valuable tool in clinical practice for monitoring and treating ED and thereby improving the quality of life for men and their sexual partners. Kimura M, Shimura S, Tai T, Kobayashi H, Baba S, Kano M, and Nagao K. A web-based survey of Erection Hardness Score and its relationship to aging, sexual behavior, confidence, and risk factors in Japan. Sex Med 2013;1:76–86.
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Affiliation(s)
- Masaki Kimura
- Department of Urology, School of Medicine, Toho University Tokyo, Japan
| | - Satoru Shimura
- Department of Urology, School of Medicine, Kitasato University Sagamihara, Japan
| | - Toshihiro Tai
- Department of Urology, School of Medicine, Toho University Tokyo, Japan
| | | | - Shiro Baba
- Department of Urology, School of Medicine, Kitasato University Sagamihara, Japan
| | | | - Koichi Nagao
- Department of Urology, School of Medicine, Toho University Tokyo, Japan
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Kalka D, Domagala ZA, Kowalewski P, Rusiecki L, Koleda P, Marciniak W, Dworak J, Adamus J, Wojcieszczyk J, Pyke E, Pilecki W. Effect of Endurance Cardiovascular Training Intensity on Erectile Dysfunction Severity in Men With Ischemic Heart Disease. Am J Mens Health 2014; 9:360-9. [PMID: 25077728 DOI: 10.1177/1557988314544156] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The protective effect of physical activity on arteries is not limited to coronary vessels, but extends to the whole arterial system, including arteries, in which endothelial dysfunction and atherosclerotic changes are one of the key factors affecting erectile dysfunction development. The objective of this study was to report whether the endurance training intensity and training-induced chronotropic response are linked with a change in erectile dysfunction intensity in men with ischemic heart disease. A total of 150 men treated for ischemic heart disease, who suffered from erectile dysfunction, were analyzed. The study group consisted of 115 patients who were subjected to a cardiac rehabilitation program. The control group consisted of 35 patients who were not subjected to any cardiac rehabilitation. An IIEF-5 (International Index of Erectile Function) questionnaire was used for determining erectile dysfunction before and after cardiac rehabilitation. Cardiac training intensity was objectified by parameters describing work of endurance training. The mean initial intensity of erectile dysfunction in the study group was 12.46 ± 6.01 (95% confidence interval [CI] = 11.35-13.57). Final erectile dysfunction intensity (EDI) assessed after the cardiac rehabilitation program in the study group was 14.35 ± 6.88 (95% CI = 13.08-15.62), and it was statistically significantly greater from initial EDI. Mean final training work was statistically significantly greater than mean initial training work. From among the parameters describing training work, none were related significantly to reduction of EDI. In conclusion, cardiac rehabilitation program-induced improvement in erection severity is not correlated with endurance training intensity. Chronotropic response during exercise may be used for initial assessment of change in cardiac rehabilitation program-induced erection severity.
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Affiliation(s)
- Dariusz Kalka
- Wroclaw Medical University, Wroclaw, Poland Centre of Men's Health, Wroclaw, Poland
| | | | | | | | | | | | - Jacek Dworak
- 105th Military Hospital, General Surgery and Urology Unit, Zagan, Poland
| | - Jerzy Adamus
- Wroclaw Medical University, Wroclaw, Poland Centre of Men's Health, Wroclaw, Poland Dietrich Bonhoeffer Klinikum, Neubrandenburg, Germany Magodent Medical Centre, Warsaw, Poland 105th Military Hospital, General Surgery and Urology Unit, Zagan, Poland University School of Physical Education, Wroclaw, Poland
| | | | - Edel Pyke
- Wroclaw Medical University, Wroclaw, Poland
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Zhang K, Xu B, Liu D, Wang X, Zhu J, Deng C, Jin J, Jiang H. Sildenafil improves erectile hardness in Chinese men with erectile dysfunction: a real-life study analyzed on age stratification. Urology 2014; 83:831-6. [PMID: 24680453 DOI: 10.1016/j.urology.2013.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 11/09/2013] [Accepted: 12/03/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate the clinical efficacy of sildenafil for the improvement of penile erection hardness in erectile dysfunction (ED) patients and to determine the relationship between this improvement in erection hardness and social and psychological functioning. MATERIALS AND METHODS From 2007 to 2008, a total of 4507 men diagnosed with ED were enrolled from 46 centers in China; 4039 of these patients were treated with sildenafil and asked to complete the Erectile Function domain of the International Index of Erectile Function, Erection Hardness Score, and Quality of Erection Questionnaire. The patients were divided into 5 groups on the basis of their age (group A: 20-30 years; group B: 31-40 years; group C: 41-50 years; group D: 51-60 years; and group E: >60 years). RESULTS A total of 3837 (95.0%) patients completed the entire study. After sildenafil treatment, the vast majority (96.3%) of the men were able to achieve grade 3-4 erection hardness. Patients with a better baseline erection hardness were more able to achieve grade 4 hardness after treatment (P <.001). Comparisons of the Erection Hardness Score improvement before and after treatment between the age-categorized groups also showed that the erection hardness improvement was much greater in men older than 50 years. CONCLUSION Sildenafil can help the vast majority of Chinese ED patients achieve grade 3-4 erection hardness. Grade 4 hardness can improve the patients' sexual life to a greater extent than grade 3 hardness. A marked improvement in erection hardness can be achieved in patients older than 50 years.
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Affiliation(s)
- Kai Zhang
- Department of Urology, Peking University First Hospital, Beijing, China
| | - Ben Xu
- Department of Urology, Peking University First Hospital, Beijing, China
| | - Defeng Liu
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Xiaofeng Wang
- Department of Urology, Peking University People's Hospital, Beijing, China
| | - Jichuan Zhu
- Department of Urology, Peking University People's Hospital, Beijing, China
| | - Chunhua Deng
- Department of Urology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jie Jin
- Department of Urology, Peking University First Hospital, Beijing, China
| | - Hui Jiang
- Department of Urology, Peking University Third Hospital, Beijing, China.
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Psychometric validation of the Confidence in Performing Sexual Intercourse Questionnaire and Difficulty in Performing Sexual Intercourse Questionnaire. Int J Impot Res 2013; 26:105-11. [PMID: 24335748 DOI: 10.1038/ijir.2013.45] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 10/03/2013] [Accepted: 11/06/2013] [Indexed: 11/08/2022]
Abstract
The objective of this study was to perform psychometric testing of two new patient-reported outcome instruments (PROs), the Confidence in Performing Sexual Intercourse Questionnaire (CPSIQ) and the Difficulty in Performing Sexual Intercourse Questionnaire (DPSIQ). The new PROs were administered at non-drug, run-in, baseline and end point in men with erectile dysfunction (ED) participating in a randomized clinical trial of ED treatment (Study 1, n=291) and two times within 2 weeks to men with ED participating in a web-based survey (Study 2, n=71). Psychometric tests included factor analysis, internal consistency and test-retest reliability, construct validity and responsiveness. Analysis of data from Study 1 participants (74% ≤65 years, 83% Caucasian and 75% with moderate ED) suggested one-factor solutions for both PROs with Cronbach's α >0.88. CPSIQ and DPSIQ total scores discriminated between ED severity groups showed worsening after a 4-week non-drug, run-in period, and showed improvement after 12 weeks of ED treatment (all, P<0.05). Intraclass correlation coefficients calculated for the CPSIQ and DPSIQ, using data from Study 2 participants (82% ≤65 years, 90% Caucasian and 66% with mild ED), were 0.56 and 0.83, respectively. The CPSIQ and DPSIQ show potential for augmenting existing treatment outcome measures used in the evaluation of ED treatment.
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Iacono F, Prezioso D, Ruffo A, Illiano E, Romeo G, Amato B. Tunical plication in the management of penile curvature due La Peyronie's disease. Our experience on 47 cases. BMC Surg 2012; 12 Suppl 1:S25. [PMID: 23173735 PMCID: PMC3499200 DOI: 10.1186/1471-2482-12-s1-s25] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Peyronie's disease is an acquired connective tissue disorder of the penile tunica albuginea with fibrosis and inflammation. The disease produces palpable plaques, penile curvature and pain during erections. Patients report negative effects in four major domains: physical appearance and self-image, sexual function and performance. These changes damage sexual life and compromise the quality of life. Our objective is to review the patient's sexual life after penile tunical plicature using the International Index of Erectile Function (IIEF) and the Sexual Encounter Profile (SEP) questionnaires. METHODS A total of 47 patients with Peyronie's disease (PD) were enrolled at our urology department and they underwent correction of penile deviation between February 2009 and March 2010. Mean patient age was 56 years and mean follow-up was 24 months. Patients with painless PD plaque with no progression in angulation for at least 12 months were chosen for surgery. They underwent a penile tunical plication.IIEF and SEP questionnaire were administered to all patients. RESULTS Of all treated patients, 94% were able to insert their penis in the partner's vagina (p<0.01; SEP question 2), compared with 62% preoperatively and 90% of them was satisfied overall with the sexual intercourse (p<0.01; SEP question 5) .Patients had a significantly higher endpoint and a greater change from baseline for the remaining SEP questions related to achievement of an erection, satisfaction of erection hardness (SEP questions 1 and 4; p < 0:001).We reported a significant improvement in the IIEF scores (from a baseline total score of 25.2 +/- 3.2 to a final score of 38.3 +/- 5.2; P<0.01). It resulted in significantly higher endpoint IIEF scores across all five IIEF domains: Erectile Function, Intercourse Satisfaction, Orgasmic Function, Sexual Desire and Overall Satisfaction. The main complaint was penile shortening (28 patients, 60%), feeling of the suture during flaccidity and tumescence (37 patients, 80%). CONCLUSION Patient quality of life improved after surgery thanks to the improvement of their sexual life. The complications are unimportant and few bother symptoms are reported. The significant improvement in erectile function was also supported by IIEF and SEP questionnaire data. Nowadays tunical plication is a safe, advantageous and useful technique to treat patients suffering of Peyronie's disease.
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Affiliation(s)
- Fabrizio Iacono
- Department of Urology, University “Federico II” of Naples, Via Pansini, 5 - 80131 – Naples, Italy
| | - Domenico Prezioso
- Department of Urology, University “Federico II” of Naples, Via Pansini, 5 - 80131 – Naples, Italy
| | - Antonio Ruffo
- Department of Urology, University “Federico II” of Naples, Via Pansini, 5 - 80131 – Naples, Italy
| | - Ester Illiano
- Department of Urology, University “Federico II” of Naples, Via Pansini, 5 - 80131 – Naples, Italy
| | - Giuseppe Romeo
- Department of Urology, University “Federico II” of Naples, Via Pansini, 5 - 80131 – Naples, Italy
| | - Bruno Amato
- Department of General, Geriatric, Oncologic Surgery and Advanced Technologies, University “Federico II” of Naples, Via Pansini, 5 - 80131 – Naples, Italy
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Perceptions and opinions of men and women on a man's sexual confidence and its relationship to ED: results of the European Sexual Confidence Survey. Int J Impot Res 2012; 24:234-41. [PMID: 22717763 DOI: 10.1038/ijir.2012.23] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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21
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Kimura M, Shimura S, Kobayashi H, Tai T, Chikano Y, Baba S, Kano M, Nagao K. Profiling Characteristics of Men Who Use Phosphodiesterase Type 5 Inhibitors Based on Obtaining Patterns: Data from the Nationwide Japanese Population. J Sex Med 2012; 9:1649-58. [DOI: 10.1111/j.1743-6109.2012.02728.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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22
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Araujo AB, Allen KR, Ni X, Rosen RC. Minimal Clinically Important Differences in the Vaginal Insertion and Successful Intercourse Items of the Sexual Encounter Profile. J Sex Med 2012; 9:169-79. [PMID: 21981744 DOI: 10.1111/j.1743-6109.2011.02506.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Andre B Araujo
- New England Research Institutes, Inc, Watertown, MA 02472, USA.
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Kingsberg SA, Althof SE. Satisfying Sexual Events as Outcome Measures in Clinical Trial of Female Sexual Dysfunction. J Sex Med 2011; 8:3262-70. [DOI: 10.1111/j.1743-6109.2011.02447.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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24
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Rosen RC, Allen KR, Ni X, Araujo AB. Minimal clinically important differences in the erectile function domain of the International Index of Erectile Function scale. Eur Urol 2011; 60:1010-6. [PMID: 21855209 DOI: 10.1016/j.eururo.2011.07.053] [Citation(s) in RCA: 294] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Accepted: 07/21/2011] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite widespread adoption of the six-item erectile function (EF) domain of the International Index of Erectile Function (IIEF) as a clinical trial end point, there are currently no objective data on what constitutes a minimal clinically important difference (MCID) in the EF domain. OBJECTIVE Estimate the MCID for the IIEF EF domain. DESIGN, SETTING, AND PARTICIPANTS Anchor-based MCIDs were estimated using data from 17 randomized, double-blind, placebo-controlled, parallel-group clinical trials of the phosphodiesterase type 5 inhibitor (PDE5-I) tadalafil for 3345 patients treated for 12 wk. MEASUREMENTS The anchor for the MCID is the minimal improvement measure calculated using change from baseline to 12 wk on IIEF question 7: "Over the past 4 weeks, when you attempted sexual intercourse how often was it satisfactory for you?" MCIDs were developed using analysis of variance (ANOVA)- and receiver operating characteristic (ROC)-based methods in a subset of studies (n=11) by comparing patients with and without minimal improvement (n=863). MCIDs were validated in the remaining six studies (n=377). RESULTS AND LIMITATIONS The ROC-based MCID for the EF domain was 4, with estimated sensitivity and specificity of 0.74 and 0.73, respectively. MCIDs varied significantly (p<0.0001) according to baseline ED severity (mild: 2; moderate: 5; severe: 7). MCIDs consistently distinguished between patients in the validation sample classified as no change or minimally improved overall and by geographic region, ED etiology, and age group. MCIDs did not differ by age group, geographic region, or ED etiology. Current analyses were based on 17 clinical trials of tadalafil. Results need to be replicated in studies using other PDE5-Is or in nonpharmacologic intervention studies. CONCLUSIONS The contextualization of treatment-related changes in terms of clinically relevant improvement is essential to understanding treatment efficacy, to interpreting results across studies, and to managing patients effectively. This analysis provides, for the first time, anchor-based estimates of MCIDs in the EF domain score of the IIEF.
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Affiliation(s)
- Raymond C Rosen
- New England Research Institutes, Inc., Watertown, MA 02472, USA.
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25
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Satisfaction with sex and erection hardness: results of the Asia-Pacific Sexual Health and Overall Wellness survey. Int J Impot Res 2011; 23:135-41. [DOI: 10.1038/ijir.2011.17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Gutiérrez Hernández PR. Nueva formulación bucodispersable de vardenafilo para el tratamiento de la disfunción eréctil. Rev Int Androl 2011. [DOI: 10.1016/s1698-031x(11)70005-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Schnetzler G, Banks I, Kirby M, Zou KH, Symonds T. Characteristics, behaviors, and attitudes of men bypassing the healthcare system when obtaining phosphodiesterase type 5 inhibitors. J Sex Med 2010; 7:1237-46. [PMID: 20136707 DOI: 10.1111/j.1743-6109.2009.01674.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Men may choose to bypass the healthcare system to obtain a phosphodiesterase type 5 inhibitor (PDE5i). AIM Evaluate the characteristics and purchasing patterns of men obtaining a PDE5i without prior healthcare professional (HCP) interaction. MAIN OUTCOME MEASURES Prior HCP interaction, defined as having a prescription for any PDE5i, having a PDE5i sample from a physician, or buying the PDE5i in a retail pharmacy; and erectile dysfunction (ED, the Massachusetts Male Aging Study single-item question) were assessed. A multivariate regression analysis determined predictive factors for PDE5i purchase without prior HCP interaction. Methods. A Web-based observational study was conducted in the United Kingdom, Germany, and Italy. RESULTS Of the 11,899 participants, 1,252 (10.5% [95% CI, 10.0-11.1%]) reported PDE5i use in the last 6 months. PDE5is were obtained without prior HCP interaction by 403 users (32.3% [95% CI, 29.6-34.8%]); 65.5% of them had ED. Overall prevalence of men using PDE5is without HCP interaction was 3.0% (95% CI, 2.6-3.5%), 4.1% (95% CI, 3.5-4.6%), and 2.8% (95% CI, 2.1-3.5%) for men aged 18-34, 35-50, and >50 years, respectively (P = 0.0045). Predictive factors for obtaining a PDE5i without prior HCP interaction were embarrassment to speak to a physician (P = 0.0009) and the perception that this would be the cheapest way to get the medicine (P = 0.03). CONCLUSIONS Based on these findings, it can be estimated that approximately 6 million men in Europe might currently bypass the healthcare system to obtain a PDE5i. In addition to the risks associated with use of PDE5is from uncontrolled sources, because most of these men have ED, they also miss the opportunity for important health information or medical follow-up. HCPs should actively address ED and offer treatment to discourage men from seeking uncontrolled sources of ED medicines.
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Chang HS, Park CH, Kim DK, Park JK, Hong SJ, Chung BH, Lee JG, Kim CS, Lee KS, Kim JC. Assessment of patient-reported outcome of patients with lower urinary tract symptoms suggestive of benign prostatic hyperplasia and treated with tamsulosin HCl in Korea. Urology 2009; 75:1156-61. [PMID: 19914692 DOI: 10.1016/j.urology.2009.09.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Revised: 09/04/2009] [Accepted: 09/05/2009] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate the effect of tamsulosin 0.2 mg once daily in treatment of patients with benign prostatic hyperplasia (BPH) using the new subjective assessment of patient-reported outcomes and the lower urinary tract symptoms (LUTS) outcome score (LOS). METHODS Of 370 patients from 9 urology outpatient clinics, 299 finished this study. Tamsulosin 0.2 mg once daily was administered orally in a nonblind design for a 12-week period. The primary endpoint of this study was to evaluate the effect of tamsulosin with new assessing parameters; the most bothersome symptoms, BPH K1-short form and LOS. The secondary endpoint was to evaluate the effect of tamsulosin with conventional parameters, International Prostate Symptom Score (IPSS), maximum flow rate (Q(max.)), and postvoiding residual urine volume. RESULTS A total of 189 (63.2%) of 299 patients responded that their most bothersome symptom had been improved at 12 weeks after study. All 9 items in BPH K1-short form showed statistically significant improvement (P <.05). Overall, 20 (6.7%) patients met criteria for cured, 246 (82.3%) for improved, and 33 (11.0%) for failed. Statistically significant improvements were observed in IPSS, Q(max.), and postvoiding residual urine volume (P <.05). CONCLUSIONS Tamsulosin 0.2 mg once daily may be an effective treatment, subjectively and objectively in patients with BPH. To evaluate the effect of the treatment in patients with BPH, it may be more effective to use the subjective quality of life questionnaire and the subjective-objective data integrated LOS than the currently used IPSS and Q(max.).
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Affiliation(s)
- Hyuk Soo Chang
- Department of Urology, Dongsan Hospital, Keimyung University School of Medicine, Daegu, Korea
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Clinically meaningful improvement on the quality of erection questionnaire in men with erectile dysfunction. Int J Impot Res 2009; 22:45-50. [DOI: 10.1038/ijir.2009.47] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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30
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Current World Literature. Curr Opin Obstet Gynecol 2009; 21:353-63. [DOI: 10.1097/gco.0b013e32832f731f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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31
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Current Opinion in Oncology. Current world literature. Curr Opin Oncol 2009; 21:386-92. [PMID: 19509503 DOI: 10.1097/cco.0b013e32832e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cappelleri JC, Bushmakin AG, Symonds T, Schnetzler G. Scoring Correspondence in Outcomes Related to Erectile Dysfunction Treatment on a 4-Point Scale (SCORE-4). J Sex Med 2009; 6:809-19. [DOI: 10.1111/j.1743-6109.2008.01155.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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