Predictive correlation between the International Index of Erectile Function (IIEF) and Sexual Health Inventory for Men (SHIM): implications for calculating a derived SHIM for clinical use.
ABSTRACT Validated questionnaires are used to assess postoperative continence, sexual function, and other quality-of-life issues after radical prostatectomy. The International Index of Erectile Function (IIEF) is one such well-tested inventory that is routinely used. However, some centers use the Sexual Health Inventory for Men (SHIM) or the IIEF-6 to record erectile function, and comparison between the three can be difficult.
To define if there was a predictive correlation between IIEF (or IIEF-6) and SHIM, and to explore a strategy for the use of an abbreviated and rapid functional assessment of erectile function in patients.
Preoperative and postoperative IIEF questionnaires from the robotic prostatectomy program at our institution were included in the study. The total IIEF, IIEF-6, and SHIM scores were calculated and correlations between the three were sought. We also looked at the feasibility of using only two questions from the IIEF with an aim of calculating both the SHIM and IIEF scores.
The power to differentiate between patients with SHIM >or=22 from those with SHIM <or=21 for (i) the ratio allowing direct conversion of IIEF (or IIEF-6) to SHIM; and (ii) a two-question-based recalculation of SHIM.
Two hundred seventy-five questionnaires were available for review. If the total IIEF score is known, the IIEF-derived SHIM score can be calculated by dividing the total IIEF score by a factor of 2.8 and then rounding off to a whole number. Furthermore, we have shown that an abbreviated questionnaire using Q5 and Q15 of the IIEF can be used to calculate the SHIM scores (two-question-SHIM).
We described an easy way to calculate the SHIM score when the IIEF (or IIEF-6) score alone is known. The two-question model can be used for a rapid assessment of the patients' sexual function.
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ABSTRACT: Introduction. Prostate cancer is common, and, thus, more men are being treated surgically. Long-term functional outcomes are of significant importance to the patient and their partners. Erectile function (EF) preservation (rehabilitation) has gained significant traction worldwide, despite the absence of definitive evidence supporting its use. Aim. To review the effectiveness of specific pharmacological therapies and other erectogenic aids in the treatment of post-radical prostatectomy (RP) erectile dysfunction. Methods. A systematic literature review of original peer-reviewed manuscripts and clinical trials reported in Medline. Main Outcome Measure. This review focused on the evaluation of interventions that aimed to improve EF recovery following RP. Results. Although well documented in animal models, studies supporting the rehabilitation with phosphodiesterase type 5 inhibitors in humans are scarce. Daily sildenafil has been used in trials (only one randomized placebo-controlled trial) with a significant improvement in erection recovery when compared to placebo or no rehabilitation but with a low return to baseline rates (27% vs. 4% placebo). Nightly vardenafil vs. on demand vs. placebo has been studied in the Recovery of Erections: INtervention with Vardenafil Early Nightly Therapy trial with no difference in erection recovery following RP. Intracavernosal injections, although widely used and attractive from a rehabilitation standpoint, does not yet have definitive supporting its role in rehabilitation. Vacuum erection devices use following RP has been reported, but there are no data to support its role as monotherapy. Intraurethral alprostadil was also studied vs. sildenafil in a multicenter, randomized, open-label trial, and no superiority was found. Conclusions. At this time, we are unable to define what represents the optimal rehabilitation program in regard to strategies utilized, timing of intervention, or duration of treatment. Mulhall JP, Bivalacqua TJ, and Becher EF. Standard operating procedure for the preservation of erectile function outcomes after radical prostatectomy. J Sex Med **;**:**-**.Journal of Sexual Medicine 09/2012; · 3.51 Impact Factor
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ABSTRACT: PURPOSE: Here, we 1) establish erectile dysfunction (ED) as an often neglected but valuable marker of cardiovascular risk, particularly in younger and diabetic men; and 2) review evidence that lifestyle change, combined with informed prescribing of pharmacotherapies used to mitigate cardiovascular risk, can improve overall vascular health and sexual functioning in men with ED. MATERIALS AND METHODS: A PubMed search for articles and guidelines pertinent to relationships between ED and cardiovascular disease (CVD), cardiovascular and all-cause mortality, and pharmacotherapies for dyslipidemia and hypertension was performed. The clinical guidance presented incorporates the current literature and the expertise of the multi-specialty author group. RESULTS: Numerous cardiovascular risk assessment tools exist, but risk stratification remains challenging, particularly for those patients at low or intermediate short-term risk. ED has a predictive value for cardiovascular events that is comparable to or better than traditional risk factors. Interventional studies support lifestyle changes as means of improving overall vascular health as well as sexual functioning. Statins, diuretics, beta blockers, and renin-angiotensin system modifiers may positively or negatively affect erectile function. Furthermore, phosphodiesterase type 5 (PDE5) inhibitors used to treat ED may have systemic vascular benefits. CONCLUSIONS: Treatment of ED should be considered secondary to cardiovascular risk reduction, but informed prescribing may prevent worsening of sexual function in men receiving pharmacotherapy for dyslipidemia and hypertension. As the first point of medical contact for men with ED symptoms, the primary care physician or urologist has a unique opportunity to identify patients who require early intervention to prevent CVD.The Journal of urology 01/2013; · 4.02 Impact Factor
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ABSTRACT: To evaluate the prevalence of depression, anxiety and distress among active surveillance (AS) and radical prostatectomy (RP) patients. To evaluate the impact of these symptoms at baseline on urinary and sexual quality of life at follow-up. Patients managed with AS or RP who completed validated questionnaires assessing levels of depression, anxiety, distress and urinary (UF) and sexual function (SF) and bother comprised the final analytic cohort. These measures were completed at baseline, within 1 year, and between 1 and 3 years from baseline. Mixed model repeated measures analysis was used to examine associations between mental health at baseline and sexual and urinary outcomes in a subset of RP patients with complete follow-up. Among 679 men who comprised the study cohort, baseline prevalence of moderate or higher levels of depression or anxiety were low (<5%), while levels of mild depression or anxiety ranged from 3-16% over time. Baseline levels of elevated distress ranged from 8-20%. Among men who provided data at baseline and follow-up, there were no significant differences between AS and RP patients in the proportion of men with elevated levels of depression, anxiety, or distress. Among 177 men who underwent RP and had complete follow-up moderate or higher levels of depression or anxiety appeared to be associated with post-treatment SF and bother, while elevated levels of distress were associated with post-treatment UF. Moderate or higher levels of depression or anxiety were low in men with localised prostate cancer but were associated with sexual outcomes, while elevated distress was associated with urinary outcomes. Greater attention should be paid to mental health symptoms among men with prostate cancer, as these symptoms may be associated with quality of life outcomes.BJU International 07/2013; 112(2):E67-E75. · 3.05 Impact Factor