To address the severity of erectile dysfunction (ED) in consecutive sexually active men seeking a prostate health screening through a multivariable risk stratification including comorbidities and lower urinary tract symptoms (LUTS).
Four hundred and twenty five consecutive subjects with stable sexual relationship with normal testosterone levels were enrolled. The International Index of Erectile Function (IIEF-5) and the International Prostate Symptom Score (IPSS) questionnaires were collected and health-significant comorbidities were scored with the Charlson comorbidity index (CCI). All the independent predictors of ED were combined to form four different risk categories of ED: low (age⩽65 years and IPSS65 years, IPSS⩾8 or CCI⩾1), high (two of the following: age>65 years, IPSS⩾8 or CCI⩾1) and very high (age >65 years, IPSS⩾8 and CCI⩾1).
The prevalence of ED increased with increase of CCI (χ(2) likelihood ratio: 40.85, P=0.001). The median of the IIEF-5 significantly reduced with the increase of the CCI (P<0.001) and with the worsening of our risk group stratification (P<0.001). At univariate logistic regression analysis very high risk was significantly associated with of ED (odds ratio: 26.85, P<0.001). Very high-risk group predicted ED with 88% and 56% of specificity and sensitivity, respectively.
Combining these risk factors through our risk stratification may be usefulness in revealing an underling ED.
International Journal of Impotence Research advance online publication, 30 July 2015; doi:10.1038/ijir.2015.15.
Int J Impot Res. 2015 Jul 30. doi: 10.1038/ijir.2015.15. [Epub ahead of print]
Favilla V1, Russo GI1, Reale G1, Leone S1, Castelli T1, La Vignera S2, Condorelli RA2, Calogero AE2, Cimino S1, Morgia G1.
Department of Urology, University of Catania, Catania, Italy.
Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology, and Internal Medicine, University of Catania, Catania, Italy.