Assessment of male sexual function

Abstract

Sexuality is a complex entity involving several aspects, including desire, libido, pleasure, sexual life, intercourse, erection, ejaculation, orgasm, happiness and bother. Sexuality can be assessed through patient–doctor interviews as well as through self-completing questionnaires. A number of these have been validated and translated into several languages. It is important that such questionnaires are simple and easy for the patient to complete. One commonly used instrument is the International Index of Erectile Function (IIEF), which involves 15 questions on five domains: erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall satisfaction. This has recently been simplified to five questions (IIEF-5). A number of questionnaires, such as the modified Danish Prostatic Symptom Score (DAN-PSS) and International Continence Society sex (ICS sex), take into account the bother caused by sexual dysfunction. There is expected to be an increasing number of sexually active men consulting with lower urinary tract symptoms (LUTS) as the population ages. Evidence suggests that the severity of LUTS is linked with sexual dysfunction and consequently this significant aspect of life for men of all ages should be taken into consideration in the management of LUTS associated with benign prostatic hyperplasia (BPH).