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Enhanced understanding of the relationship between erection and satisfaction in ED treatment: application of a longitudinal mediation model

International Journal of Impotence Research volume 26, pages 20–23 (2014)Cite this article

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Abstract

To apportion the direct effect and the indirect effect (through erections) that sildenafil (vs placebo) has on individual satisfaction and couple satisfaction over time, longitudinal mediation modeling was applied to outcomes on the Sexual Experience Questionnaire. The model included data from weeks 4 and 10 (double-blind phase) and week 16 (open-label phase) of a controlled study. Data from 167 patients with erectile dysfunction (ED) were available for analysis. Estimation of statistical significance was based on bootstrap simulations, which allowed inferences at and between time points. Percentages (and corresponding 95% confidence intervals) for direct and indirect effects of treatment were calculated using the model. For the individual satisfaction and couple satisfaction domains, direct treatment effects were negligible (not statistically significant) whereas indirect treatment effects via the erection domain represented >90% of the treatment effects (statistically significant). Week 4 vs week 10 percentages of direct and indirect effects were not statistically different, indicating that the mediation effects are longitudinally invariant. As there was no placebo arm in the open-label phase, mediation effects at week 16 were not estimable. In conclusion, erection has a crucial role as a mediator in restoring individual satisfaction and couple satisfaction in men with ED treated with sildenafil.

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Acknowledgements

This study was sponsored by Pfizer. Editorial support was provided by Deborah M Campoli-Richards, BSPharm, RPh, Janet Matsuura, PhD and Candace Lundin, DVM, MS, of Complete Healthcare Communications, and was funded by Pfizer.

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Authors and Affiliations

  1. Pfizer, Statistics, Groton, CT, USA

    A G Bushmakin & J C Cappelleri

  2. Market Access, Primary Care Business Unit, Pfizer Ltd, Surrey, Kent, UK

    T Symonds

  3. Pfizer, New York, NY, USA

    V J Stecher

Authors
  1. A G Bushmakin
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  2. J C Cappelleri
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  3. T Symonds
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  4. V J Stecher
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Correspondence to J C Cappelleri.

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Competing interests

Andrew G Bushmakin, Joseph C Cappelleri, Tara Symonds and Vera J Stecher are employees of Pfizer.

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Author contributions

Category 1: (a) Conception and design: Joseph C Cappelleri and Andrew G Bushmakin. (b) Acquisition of data: Andrew G Bushmakin, Joseph C Cappelleri, Tara Symonds and Vera J Stecher. (c) Analysis and interpretation of data: Joseph C Cappelleri, Andrew G Bushmakin. Category 2: (a) Drafting the article: Andrew G Bushmakin, Joseph C Cappelleri, Tara Symonds and Vera J Stecher. (b) Revising it for intellectual content: Andrew G Bushmakin, Joseph C Cappelleri, Tara Symonds and Vera J Stecher. Category 3: (a) Final approval of the completed article: Andrew G Bushmakin, Joseph C Cappelleri, Tara Symonds and Vera J Stecher.

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Bushmakin, A., Cappelleri, J., Symonds, T. et al. Enhanced understanding of the relationship between erection and satisfaction in ED treatment: application of a longitudinal mediation model. Int J Impot Res 26, 20–23 (2014). https://doi.org/10.1038/ijir.2013.26

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  • DOI: https://doi.org/10.1038/ijir.2013.26

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