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Validated questionnaires for assessing sexual dysfunction and BPH/LUTS: solidifying the common pathophysiologic link

Abstract

Erectile dysfunction (ED) and benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS) share many epidemiologic and clinical similarities. First-line therapy for both conditions include oral medications (α blockers, phosphodiesterase inhibitors). The impetus to develop and use questionnaires to characterize these two conditions is based on the trend away from invasive diagnostic testing to the use of patient-reported outcomes or validated self-administered questionnaires. The International Prostate Symptom Score, the International Index of Erectile Function, the Male Sexual Health Questionnaire (MSHQ) and the MSHQ short form are similar patient-reported assessment questionnaires used for research or clinical evaluation of BPH/LUTS, ED and ejaculatory dysfunction. These patient-based self-administered questionnaires are likely to assume an ever increasing important role in the future, as oral BPH therapies are considered for the treatment of ED and oral ED therapies are considered for the treatment of BPH/LUTS.

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References

  1. NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA 1993; 270: 83–90.

    Article  Google Scholar 

  2. Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA . Oral sildenafil in the treatment of erectile dysfunction. Sildenafil Study Group. N Engl J Med 1998; 338: 1397–1404.

    Article  CAS  Google Scholar 

  3. Porst H, Rosen R, Padma-Nathan H, Goldstein I, Giuliano F, Ulbrich E et al. The efficacy and tolerability of vardenafil, a new, oral, selective phosphodiesterase type 5 inhibitor, in patients with erectile dysfunction: the first at-home clinical trial. Int J Impot Res 2001; 13: 192–199.

    Article  CAS  Google Scholar 

  4. Pullman WE, Whitaker JS, Saoud JB, Ferguson KM, Rosen RC, IC351 On-Demand Dosing Study Group. On-demand IC351 (Cialis) enhances erectile function in patients with erectile dysfunction. Int J Impot Res 2001; 13: 2–9.

    Article  Google Scholar 

  5. Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A . The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 1997; 49: 822–830.

    Article  CAS  Google Scholar 

  6. Greco KA, McVary KT . The role of combination medical therapy in benign prostatic hyperplasia. Int J Impot Res 2008; 20 (Suppl 3): S33–S43.

    Article  CAS  Google Scholar 

  7. Kaplan SA . Introduction. Int J Impot Res 2008; 20 (Suppl 3): S1.

    Article  Google Scholar 

  8. Roehrborn CG . The utility of serum prostatic-specific antigen in the management of men with benign prostatic hyperplasia. Int J Impot Res 2008; 20 (Suppl 3): S19–S26.

    Article  Google Scholar 

  9. Roehrborn CG . Pathology of benign prostatic hyperplasia. Int J Impot Res 2008; 20 (Suppl 3): S11–S18.

    Article  Google Scholar 

  10. Abrams P, Feneley RCL . The significance of the symptoms associated with bladder outflow obstruction. Urol Int 1978; 33: 171–174.

    Article  Google Scholar 

  11. Barry MJ, Fowler Jr FJ, O’Leary MP, Bruskewitz RC, Holtgrewe HL, Mebust WK et al. The American Urological Association symptom index for benign prostatic hyperplasia. The Measurement Committee of the American Urological Association. J Urol 1992; 148: 1549–1557.

    Article  CAS  Google Scholar 

  12. Braun M, Wassmer G, Klotz T, Reifenrath B, Mathers M, Engelmann U . Epidemiology of erectile dysfunction: results of the ′Cologne Male Survey′. Int J Impot Res 2000; 12: 305–311.

    Article  CAS  Google Scholar 

  13. Rosen R . Update on the relationship between sexual dysfunction and lower urinary tract symptoms/benign prostatic hyperplasia. Curr Opin Urol 2006; 16: 11–19.

    Google Scholar 

  14. Rosen R . Assessment of sexual dysfunction in patients with benign prostatic hyperplasia. BJU Int 2006; 97 (2): 29–33.

    Article  Google Scholar 

  15. Rosen R, Altwein J, Boyle P, Kirby RS, Lukacs B, Meuleman E et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol 2003; 44: 637–649.

    Article  Google Scholar 

  16. Schou J, Holm NR, Meyhoff HH . Sexual function in patients with symptomatic benign prostatic hyperplasia. Scand J Urol Nephrol Suppl 1996; 179: 119–122.

    CAS  Google Scholar 

  17. Rosen R, Catania J, Pollack L, Althof S, O’Leary M, Seftel A . Male Sexual Health Questionnaire (MSHQ): scale development and psychometric validation. Urology 2004; 64: 777–782.

    Article  Google Scholar 

  18. Rosen R, Althof S, Catania J, O'Leary M, Seftel AD . Lower urinary tract symptoms and sexual dysfunction: epidemiological findings from the Men's Sexual Health Population Survey (abstract). J Urol 2005a; 173 (4 Suppl): Abstract 19.

  19. Rosen R, McVary K, Nuckolls J, Payne R, Seftel AD, Steers W . Lower urinary tract symptoms severity and International Prostate Symptom Score bother question correlate with measures of erectile and ejaculatory dysfunction in benign prostatic hyperplasia. J Urol 2005b; 173 (4 Suppl): Abstract 1242.

    Google Scholar 

  20. Patient-reported outcome measures: use in medical product development to support labeling claims (Draft Guidance). US Department of Health and Human Services, Food and Drug Administration, 2006.

  21. Rosen RC, Cappelleri JC, Gendrano III N . The International Index of Erectile Function (IIEF): a state-of-the-science review. Int J Impot Res 2002; 14: 226–244.

    Article  CAS  Google Scholar 

  22. O’Leary MP, Fowler FJ, Lenderking WR, Barber B, Sagnier PP, Guess HA et al. A brief male sexual function inventory for urology. Urology 1995; 46: 697–706.

    Article  Google Scholar 

  23. Donovan JL, Abrams P, Peters TJ, Kay HE, Reynard J, Chapple C et al. The ICS-‘BPH’ Study: the psychometric validity and reliability of the ICSmale questionnaire. Br J Urol 1996; 77: 554–562.

    Article  CAS  Google Scholar 

  24. Rosen RC, Catania JA, Althof SE, Pollack LM, O’Leary M, Seftel AD et al. Development and validation of four-item version of Male Sexual Health Questionnaire to assess ejaculatory dysfunction. Urology 2007; 69: 805–809.

    Article  Google Scholar 

  25. Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM . Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999; 11: 319–326.

    Article  CAS  Google Scholar 

  26. Roehrborn CG, Nuckolls JG, Wei JT, Steers W . BPH Registry and Patient Survey Steering Committee. The benign prostatic hyperplasia registry and patient survey: study design, methods and patient baseline characteristics. BJU Int 2007; 100: 813–819.

    Article  Google Scholar 

  27. Rosen R, Seftel A, Roehrborn CG . of alfuzosin 10 mg once daily on sexual function in men treated for symptomatic benign prostatic hyperplasia. Int J Impot Res 2007; 19: 480–485, E-pub 2007 Aug 23.

    Article  CAS  Google Scholar 

  28. Stief CG, Porst H, Neuser D, Beneke M, Ulbrich E . A randomised, placebo-controlled study to assess the efficacy of twice-daily vardenafil in the treatment of lower urinary tract symptoms secondary to benign prostatic hyperplasia. Eur Urol 2008; 53: 1236–1244. E-pub 2008 Feb 4.

    Article  CAS  Google Scholar 

  29. McVary KT, Roehrborn CG, Kaminetsky JC, Auerbach SM, Wachs B, Young JM et al. Tadalafil relieves lower urinary tract symptoms secondary to benign prostatic hyperplasia. J Urol 2007; 177: 1401–1407.

    Article  CAS  Google Scholar 

  30. McVary KT, Monnig W, Camps Jr JL, Young JM, Tseng LJ, van den Ende G . Sildenafil citrate improves erectile function and urinary symptoms in men with erectile dysfunction and lower urinary tract symptoms associated with benign prostatic hyperplasia: a randomized, double-blind trial. J Urol 2007; 177: 1071–1077.

    Article  CAS  Google Scholar 

  31. Loughney K, Taylor J, Florio VA . 3′,5′-cyclic nucleotide phosphodiesterase 11A: localization in human tissues. Int J Impot Res 2005; 17: 320–325.

    Article  CAS  Google Scholar 

  32. Uckert S, Sormes M, Kedia G, Scheller F, Knapp WH, Jonas U et al. Effects of phosphodiesterase inhibitors on tension induced by norepinephrine and accumulation of cyclic nucleotides in isolated human prostatic tissue. Urology 2008; 71: 526–530.

    Article  Google Scholar 

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Rosen, R., Seftel, A. Validated questionnaires for assessing sexual dysfunction and BPH/LUTS: solidifying the common pathophysiologic link. Int J Impot Res 20 (Suppl 3), S27–S32 (2008). https://doi.org/10.1038/ijir.2008.52

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