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Predicting erectile dysfunction in sexually active patients seeking prostate health screening: proposal for a multivariable risk stratification

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Abstract

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 (age65 years and IPSS<8 and CCI=0), intermediate (one of the following: age>65 years, IPSS8 or CCI1), high (two of the following: age>65 years, IPSS8 or CCI1) and very high (age >65 years, IPSS8 and CCI1). The prevalence of ED increased with increase of CCI (χ2 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.

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Favilla, V., Russo, G., Reale, G. et al. Predicting erectile dysfunction in sexually active patients seeking prostate health screening: proposal for a multivariable risk stratification. Int J Impot Res 27, 201–205 (2015). https://doi.org/10.1038/ijir.2015.15

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