Erectile dysfunction (ED) is a major sexual dysfunction involving both physiological and psychological factors. While the primary physiological cause of ED is associated with endocellular degeneration and disorders of neural reflex, its psychological causes are mainly hyposexuality, anxiety and depression. Increasing importance is being attached to the psychological aspects in the diagnosis and management of ED in recent years, and the evaluation questionnaires aimed at the psychosocial significance in ED patients' conditions and psychological interventions solo or combined with drugs have inspired many researches for an optimal solution of the disease. Improvement of the patient's erectile performance is no longer the only outcome we pursue. Instead, the satisfaction of both the patient and his partner has a rising weight in the final evaluation of a therapy. The wide application of PED5 inhibitors and their psychological effect on ED patients makes it necessary for us gain a deeper insight into the combination of psychological intervention and drug therapy in the management of ED.
Erectile Dysfunction ; diagnosis ; psychology ; therapy ; Humans ; Male

OBJECTIVETo investigate the impact of infertility on men's self-esteem, self-confidence, sexual satisfaction and overall relationship with their spouses.

METHODSUsing Self-Esteem and Relationship questionnaire (SEAR), we conducted an investigation among 253 infertile men and 52 fertile male controls. We divided the infertile men into four subgroups according to their perceived causes of infertility: male (M) factors, female (F) factors, both M and F factors, and unknown factors, and compared the SEAR scores among different groups.

RESULTSIn the infertile men, the total SEAR score was significantly higher in those with < 3 years than in those with > or = 3 years of infertility duration (75.50 +/- 17.05 vs 68.66 +/- 17.19, P < 0.05) and so was it in those with above-high-school than in those with high-school or lower education background (81.42 +/- 13.99 vs 67.61 +/- 17. 8, P < 0.01), but showed no significant difference between the > or = 30- and < 30-year-olds (71.77 +/- 17.42 vs 72.74 +/- 18.38, P > 0.05). The total SEAR scores in the M factor, M & F factor, unknown factor and F factor groups were 65.69 +/- 18.68, 68.52 +/- 17.68, 74.85 +/- 15.19 and 83.21 +/- 12.61, respectively, with significant differences between the first two and the latter two groups (P < 0.05), as well as between the unknown factor and F factor groups (P < 0.05). In the fertile male controls, the total SEAR score and subdomain scores on sexual relationship, self-confidence, self-esteem and overall relationship were 90.04 +/- 9.85, 88.40 +/- 10.74, 92.23 +/- 9.41, 91.95 +/- 10.67 and 90.38 +/- 14.14, respectively, all remarkably higher than in the M factor, M&F factor and unknown factor groups of the infertile men after adjustment of their infertility duration and education levels (P < 0.05).

CONCLUSIONInfertility reduces men's self-esteem, self-confidence, sexual satisfaction and relationship with their spouses, and the degree of its impact is correlated with the patients' infertility duration and education level.

Adult ; Erectile Dysfunction ; psychology ; Humans ; Infertility, Male ; psychology ; Male ; Personal Satisfaction ; Self Concept ; Surveys and Questionnaires

There are a number of scales available for evaluating treatments of erectile dysfunction. Since each differs from the other in the formulating process, component items, etc, the results of evaluation may mean different things. This paper makes a comparison of the component items and clinical application of Erectile Dysfunction Inventory of Treatment Satisfaction Questionnaire (EDITS) and Sexual Life Quality Questionnaire (SLQQ).
Erectile Dysfunction ; psychology ; therapy ; Humans ; Male ; Patient Satisfaction ; Quality of Life ; Sexuality ; Surveys and Questionnaires

OBJECTIVESTo investigate the influence of aging on male sexual function.

METHODSThe study selected 93 ED patients, aged from 23 to 64, who responded to the International Index of Erectile Function (IIEF) questionnaire. The questionnaire includes 15 items related to male sexual activity, which are organized into 5 domains, namely, erectile function (EF), orgasmic function (OF), sexual desire (SD), intercourse satisfaction (IS) and overall satisfaction (OS). For statistical analysis, ANOVA with DUNCAN test was conducted, and statistical significance was set at P < 0.05. Some other risk factors of ED such as hypertension, diabetes etc. had been excluded.

RESULTSAccording to the age, the subjects were divided into 5 groups. With age increasing, the proportion of moderate and severe in each group increased from 16.17% to 57.14%, whereas EF score decreased from (19.50 +/- 4.64) to (15.27 +/- 5.64), OF score decreased from (6.93 +/- 2.86) to (5.62 +/- 2.94), SD score decreased from (6.33 +/- 1.63) to (4.50 +/- 2.94), IS score decreased from (10.17 +/- 1.94) to (6.93 +/- 2.90), OS score decreased from (5.00 +/- 0.89) to (3.15 +/- 1.84). The tendency took on linearity (P < 0.01). Aging was negatively correlated to above mentioned scores (r = 0.98, P < 0.01).

CONCLUSIONAging could be thought as a risk factor of ED, which is negatively correlated with male's EF, OF, IS, OS and SD scores, furthermore. IIEF questionnaire is a useful tool assessing epidemiology of ED.

Adult ; Age Factors ; Aging ; physiology ; Erectile Dysfunction ; physiopathology ; psychology ; Humans ; Male ; Middle Aged ; Surveys and Questionnaires

Patient-centered questionnaires, as widely used tools for the diagnosis of erectile dysfunction (ED) and the assessment of ED treatment efficacy, are increasing in number and kinds. This review focuses on a few effective and most commonly used ED-related questionnaires, including the International Index of Erectile Function (IIEF), Sexual Health Inventory for Men (SHIM), Erectile Function Domain of the IIEF (IIEF-EF), Erection Hardness Grading Scale (EHGS), Self-Esteem and Relationship Questionnaire (SEAR), Erection Dysfunction Inventory of Treatment Satisfaction (EDITS), Quality of Erection Questionnaire (QEQ), Treatment Satisfaction Scale (TSS), Psychological and Interpersonal Relationship Scales (PAIRS), and Sexual Experience Questionnaire (SEX-Q). The objectives, contents and characteristics of these questionnaires are explained and discussed.
Erectile Dysfunction ; diagnosis ; drug therapy ; psychology ; Humans ; Male ; Outcome and Process Assessment (Health Care) ; Surveys and Questionnaires

Erectile dysfunction (ED) seriously influences the quality of life of the patients and their partners. There are various methods for the treatment of ED, with medication as the first choice. This paper reviews the advances in the concept of treatment of ED, including regular treatment, maximal therapeutic effects, primary diseases inducing ED, and humanistic environment and ideal goal of ED treatment, aiming to help further understand the therapeutic concept and improve clinical management of the disease.
Erectile Dysfunction ; etiology ; psychology ; therapy ; Humans ; Male ; Quality of Life ; Sexual Partners

There has been increasing interest in the psycho-socio-relational and sexual disorders of infertility, as the risk of psychological burden among infertile men with sexual dysfunctions is significant. The purpose of this study was to develop and to validate a predictive model to estimate individual psychological burden among infertile men with sexual dysfunction and study the association between them. Comprehensive data were collected for infertile men (n = 480) who sought treatment for infertility in a reproductive medicine center between June 2012 and December 2013. Using independent predictors of psychological burden from the least absolute shrinkage and selection operator, univariable and multivariable analyses were developed into two models. Predictive accuracy was compared between the models. We explored the association between sexual dysfunction and psychological burden. A total of 480 patients were analyzed using 10-fold cross-validation. Independent predictors of psychological burden were incorporated into a model to measure anxiety (corrected-area under curve (AUC): 77.3%) and a model to measure depression (corrected-AUC: 70.2%). Anxiety and depression were both associated with erectile dysfunction (P < 0.05), with anxiety demonstrating the strongest association. Only anxiety was associated with premature ejaculation (P < 0.05). Premature ejaculation was not found to be associated with depression (P > 0.05). Predictive models for psychological burden among infertile men with sexual dysfunction are presented, and we found that there is an association between psychological burden and sexual dysfunction. According to the models, proper counseling and treatment of sexual dysfunction in infertile men may reduce the psychological burden, help attain natural pregnancy, and improve the quality of life.
Adolescent ; Adult ; Anxiety/psychology* ; Cross-Sectional Studies ; Depression/psychology* ; Erectile Dysfunction/psychology* ; Humans ; Infertility, Male/psychology* ; Male ; Quality of Life/psychology* ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo investigate the correlation of sexual dysfunction with psychological abnormalities by analyzing the sexual function and mental state of the patients with redundant prepuce or phimosis.

METHODSThis study included 216 randomly selected patients with redundant prepuce or phimosis and 85 normal male controls. We conducted investigations among the subjects using a questionnaire on the general data of the patients, Chinese Index of Sexual Function for Premature Ejaculation (CIPE), International Index of Erectile Function (IIEF), and Symptom Checklist 90 (SCL-90). Then we assessed the status of premature ejaculation (PE) and erectile dysfunction (ED), calculated the incidence of psychological abnormalities, such as depression and anxiety, and analyzed the correlation of PE and ED with the mental state of the patients.

RESULTSThe PE and ED patients scored significantly higher than normal controls on SCL-90, somatization, compulsion, depression, anxiety and other factors (P < 0.05). CIPE scores were correlated with the scores on SCL-90, somatization, compulsion, interpersonal sensitivity, depression, anxiety and other factors, while ED-related scores showed no correlation with the scores on SCL-90 and other factors.

CONCLUSIONPatients with redundant prepuce or phimosis have poor mental health, and there is an interaction between PE and the mental state of the patient.

Adolescent ; Adult ; Case-Control Studies ; Erectile Dysfunction ; etiology ; Humans ; Male ; Middle Aged ; Phimosis ; physiopathology ; psychology ; Sexual Behavior ; Sexual Dysfunction, Physiological ; physiopathology ; psychology

OBJECTIVESThe physicians knowledge and attitude to erectile dysfunction (ED) is very important to the diagnosis and management of this disease. We investigated the physicians and practitioners knowledge of ED, attitude to ED, and if they actively find the underlying ED patients.

METHODSThree hundreds and one physicians and practitioners in Beijing completed a questionnaire. The subjects included urologists, cardiologists, endocrinologists, surgeons, orthopaedicians and community practitioners.

RESULTSThe definition of ED was well known by most subjects (83.4%). Many agreed that ED was a common condition in the aging men (85.0%), and it was an important health problem (78.7%) and it was the local signs of certain systemic diseases (89.7%). The most common risk factors of ED enumerated by the physicians were diabetes (45.5%), hypertension (12.6%) and coronary artery diseases (12.0%). 45.5% physicians met the patients who initiated questions about ED. 32.6% physicians would discuss ED with the patients if the patients initiate questions about ED. 95.0% non-urological physicians would refer the ED patients to urologists or andrologists. 43.5% of all the physicians never asked their patients about erectile function, this proportions in the subgroups of urologists, non-urological physicians and community practitioners were 7.2%, 55.3% and 60.5% respectively (P < 0.01). The most common reasons for the physicians not to initiate the inquiries about ED was "the patients would not have ED if they didnt complain about it" (42.2%), "there was no ED patients in my specialty" (20.9%), "diagnosis and treatment of ED was not my business" (17.3%), "have no time" (15.6%), "feel embarrassed" (13.6%).

CONCLUSIONSMost physicians regarded ED as an important health problem and a common condition in aging men, but they didnt take an active attitude to ED in their clinical practice.

Aging ; Attitude of Health Personnel ; China ; epidemiology ; Education, Medical ; Erectile Dysfunction ; epidemiology ; etiology ; Female ; Humans ; Knowledge ; Male ; Physicians ; psychology ; Risk Factors

Phosphodiesterase type 5 (PDE5) inhibitors, sildenafil, tadalafil and vardenafil, are the first-line drugs for the treatment of erectile dysfunction (ED). Giving ED patients the opportunity to try all the three inhibitors can greatly improve the treatment compliance of the patient, whereas the majority of ED patients prefer one specific drug to the others, frequently tadalafil, irrespective of the severity and etiology of the disease, dosing sequence, age of the patient, or dose of medication. Female partners exhibit a similar preference for tadalafil, which has a significant impact on patients' choice. Due to a 36-hour action of tadalafil, patients are allowed to achieve erection within a flexible window of treatment, and not required to schedule the interval between dosing and sexual attempt. The simultaneously decreased time concern will improve the psychological well-being of ED patients and their interpersonal relationship with female partners. Partners who prefer tadalafil feel a return to relaxed and natural sexual activity and the overall improvement in quality of sexual life. The preference of patients and their partners for a specific PDE5 inhibitor should be considered for the purpose of prescription in clinical practice.
Carbolines ; therapeutic use ; Erectile Dysfunction ; drug therapy ; psychology ; Female ; Humans ; Male ; Patient Preference ; Phosphodiesterase Inhibitors ; therapeutic use ; Sexual Partners ; Tadalafil