Sex inventories:: Can questionnaires replace erectile dysfunction testing?
Sex inventories:: Can questionnaires replace erectile dysfunction testing?
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DOI：
10.1016/s0090-4295(99)00223-x
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发表时间：
1999-10-01
期刊：
影响因子：
2.1
通讯作者：
Broderick, GA
中科院分区：
文献类型：
--
作者：
Blander, DS;S치nchez-Ortiz, RF;Broderick, GA
目标。制药业广泛使用“纸笔”性量表来对勃起功能障碍(ED)的严重程度进行分类，并作为药物治疗的疗效终点。国际勃起功能指数(IIEF)评估了男性性行为的几个领域：勃起、性高潮、欲望和满足感。我们将阴茎勃起功能的主观IIEF评分与前列腺素E-1(PGE(1))药理试验和彩色双功超声检查(阴茎血流研究[PBFS])确定的勃起功能障碍的严重程度和病因进行比较。来自IIEF的五个问题要求患者量化他的勃起能力，并与PBFS数据进行了比较。考官在考试过程中并不知道IIEF的分数。在注射PGE(1)、隐私和自我刺激后进行PBFSS；剂量为6 mg(50~59岁)或10 mg(60岁或以上)。PbFS诊断为动脉供血不足，收缩期峰值流速<25 cm/S，海绵状静脉闭塞症，>35 cm/S，阻力指数<0.9，混合性血管性勃起功能障碍，峰值流速25~35 cm/S，阻力指数<0.9。正常的血管诊断要求PSV大于35 cm/S，RI0.9或以上。在没有多普勒评估的情况下，勃起反应的视觉评分(不充分、适当或优良)也与IIEF和伟哥研究组标准(Q3+4)进行了比较。89名患者接受了完整的评估。8例(9%)血管正常(平均PSV40.9 cm/S，平均RI0.99)。AL34例(38%)，平均PSV 17.5，平均RI 0.74；混合性血管ED 33例(37%)，平均PSV 29.1，平均RI 0.80；CVOD 14例，平均PSV 45.9，平均RI 0.73。正常受试者的IIEF平均评分为13.3分，A1、混合性血管性ED和CVOD患者的平均IIEF评分分别为6.9、8.5和8.1。IIEF和Q3+4值在正常组和异常组之间差异有统计学意义(分别为P<；0.05和P<；0.025)，但在异常组之间IIEF和Q3+4得分差异无统计学意义。勃起功能的视觉评分分析显示，勃起功能不佳者与有效者之间IIEF评分差异有统计学意义(P<；0.05)。通过PBFS的循证测试，IIEF评分在ED的特定病因之间没有统计学上的区别。此外，使用前列腺素E(1)(10微克或更少)测试后结果正常的患者，勃起功能的自我评级令人惊讶地低(25分中有13分)。对于主要照顾者，IIEF可能有助于获取男性性史，但对于专家来说，性问卷评分不能区分血管性ED的各种病因，也不能预测药理学测试的结果。(C)1999，爱思唯尔科学公司。
Objectives. "Paper and pencil" sexual inventories are widely used by the pharmaceutical industry for categorizing the severity of erectile dysfunction (ED) and for efficacy end points of drug therapy. The International Index of Erectile Function (IIEF) evaluates several domains of male sexual behavior: erection, orgasm, desire, and satisfaction. We compared the subjective IIEF score for erectile function with the severity and etiology of ED as determined by pharmacologic testing with prostaglandin E-1 (PGE(1)) and color duplex Doppler ultrasound testing (penile blood flow study [PBFS]).Methods. Five questions from the IIEF that require the patient to quantify his erectile performance were compared with PBFS data. Examiners were unaware of IIEF scores during testing. PBFSs were performed after PGE(1) injection, privacy, and self-stimulation; dosing was 6 mu g (50 to 59 years) or 10 mu g (60 years or older). PBFS diagnoses were arterial insufficiency (AI) for peak systolic velocity (PSV) less than 25 cm/s; cavernous venous occlusive disease (CVOD) for PSV greater than 35 cm/s and resistive index (RI) less than 0.9; and mixed vascular erectile dysfunction for a PSV from 25 to 35 cm/s and RI less than 0.9. A normal vascular diagnosis required a PSV greater than 35 cm/s and an RI of 0.9 or greater. Visual ratings of the erectile responses without Doppler assessment (inadequate, adequate, or excellent) were also compared with the IIEF and Viagra Study Group criteria (Q3+4).Results. Eighty-nine patients underwent the complete evaluation. Eight patients (9%) were found to be normal vascularly (mean PSV 40.9 cm/s, mean RI 0.99). Thirty-four patients (38%) had Al (mean PSV 17.5, mean RI 0.74), 33 patients (37%) had mixed vascular ED (mean PSV 29.1, mean RI 0.80), and 14 patients (16%) had CVOD (mean PSV 45.9, mean RI 0.73). The mean IIEF score for the normal responders was 13.3; patients with Al, mixed vascular ED, and CVOD had mean IIEF scores of 6.9, 8.5, and 8.1, respectively. IIEF and Q3+4 values differed significantly between the normal and abnormal groups (P < 0.05 and P < 0.025, respectively), but no statistically significant differences in IIEF or Q3+4 scores were noted among the subgroups of abnormal responders. Analysis of the visual ratings of erections demonstrated that IIEF scores were significantly different between inadequate and excellent responders (P < 0.05).Conclusions. IIEF scores did not statistically differentiate among the specific etiologies of ED as determined by evidence-based testing with PBFS. Furthermore, patients with normal results after testing with PGE(1) (10 mu g or less) had surprisingly low self-ratings of erectile performance (13 of 25 points). For the primary caregiver, the IIEF may help in the taking of the male sexual history, but for the specialist, sexual inventory scores will not distinguish among the various etiologies of vascular ED and do not predict the results of pharmacologic testing. (C) 1999, Elsevier Science Inc.