Is erectile dysfunction a reliable proxy of general male health status? The case for the International Index of Erectile Function-erectile function domain - Abstract

Introduction: Erectile dysfunction (ED) has emerged progressively as a sentinel marker of cardiovascular disease (CVD).

The correlation between ED and the burden arising from multiple comorbid conditions has been incompletely analyzed.

Aim: Assess whether erectile function, defined with the International Index of Erectile Function-Erectile Function (IIEF-EF) domain score, is associated with health-significant comorbidities scored with the Charlson comorbidity index (CCI).

Methods: Clinical and hemodynamic variables of the last 140 consecutive patients who underwent penile color Doppler ultrasonography for new-onset ED were considered. Patients were assessed with a thorough medical and sexual history. Health-significant comorbidities were scored with the CCI.

Main Outcome Measure: Descriptive statistics and either linear or logistic regression models tested the association among IIEF-EF, hemodynamic parameters, and CCI, which was included in the model both as continuous and categorized variable (0 vs. ≥1).

Results: Complete data were available for 138 patients (98.6%) (mean age 46.6 years [standard deviation 13.0]; range 21-75 years). CCI was 0, 1, and ≥2 in 94 (68.1%), 23 (16.7%), and 21 (15.25%) patients, respectively. Of all, 35 patients (79.5%) did not have a CVD comorbidity. Mean IIEF-EF was 13.7 (9.3). ED severity was no ED, mild, mild to moderate, moderate, and severe in 12 (9.1%), 28 (20.2%), 12 (9.1%), 23 (16.2%), and 63 (45.5%) patients, respectively. At multivariable linear regression analysis, CCI significantly worsened with increased age (β = 0.33; P = 0.001) and decreased IIEF-EF values (β = -0.25; P = 0.01). At logistic regression analysis, age (odds ratio [OR]: 1.05; P = 0.004) and IIEF-EF (OR: 0.95; P = 0.04) emerged as significant predictors of categorized CCI.

Conclusions: Severity of ED, as objectively interpreted with IIEF-EF, accounts for a higher CCI, which may be considered a reliable proxy of a lower general male health status regardless of the etiology of ED.

Written by:
Salonia A, Castagna G, Saccà A, Ferrari M, Capitanio U, Castiglione F, Rocchini L, Briganti A, Rigatti P, Montorsi F.   Are you the author?
Department of Urology, University Vita-Salute San Raffaele, Milan, Italy.

Reference: J Sex Med. 2012 Oct;9(10):2708-15.
doi: 10.1111/j.1743-6109.2012.02869.x

PubMed Abstract
PMID: 22897643 Erectile Dysfunction Section