Impact of a First Treatment with Phosphodiesterase Inhibitors on Men and Partners’ Quality of Sexual Life: Results of a Prospective Study in Primary Care

Abstract

Introduction Phosphodiesterase type 5 inhibitors (PDE5is) as oral treatment for erectile dysfunction (ED) facilitate the management of ED in primary care. Still, compliance is low and general practitioners (GPs) do not always feel confident with this pathology. Aim The aim of this paper is to evaluate the impact of a first treatment with PDE5i on the patient and his partner and the management of ED by GPs. Methods The Evaluation après traitement de la dyfonction erectile, du bien-êtré émotionnel d'un patient en fonction de la rigidité de son érection survey was a longitudinal, observational French study with prospective collection of data from the GP, the patient, and his partner at baseline and after 3 months of treatment. GPs benefited from a short educational session before starting the survey. Main Outcome Measures The main outcome measures are the Erection Hardness Score (EHS), Self-Esteem and Relationship (SEAR) questionnaire, Index of Sexual Life (ISL), and Erectile Dysfunction Inventory of Treatment Satisfaction. Results A total of 478 men aged 19–80 years (mean 57 years) were included in the survey by 229 GPs. Before treatment, EHS was mostly grade 1 (28%) or 2 (44%). At the end of the survey, an improvement was reported for 88% of the patients and 58% achieved maximum score EHS 4 (penis completely hard and fully rigid). Mean SEAR scores significantly increased after 3 months for self-esteem, overall and sexual relationship, and more notably with greater improvement in EHS (P < 0.001). Improvement in partners’ ISL scores was significantly higher with greater improvement in EHS (P < 0.001) and in SEAR score for self-esteem. The safety profile of PDE5i was good with few adverse events, mostly headaches. More than 80% of the participating GPs considered that the survey had changed their management of ED. Conclusion After 3 months of treatment with PDE5i, a significant improvement in self-esteem was observed in patients with ED, associated with improvement in erection.

Correlation between Erection Hardness Score and Nocturnal Penile Tumescence Measurement

“…Other reports showed correlations between the EHS and other parameters such as the IIEF and successful sexual intercourse [17]. The EHS was again found to be an easy and useful tool for the functional assessment of ED [18][19][20]. In the current study, multivariate analysis showed that the EHS was the only objective predictor of normal erectile function.…”

“…Other reports showed correlations between the EHS and other parameters such as the IIEF and successful sexual intercourse [17]. The EHS was again found to be an easy and useful tool for the functional assessment of ED [18–20].…”

A comparison of the available phosphodie­sterase-5 inhibitors in the treatment of erectile dysfunction: a focus on avanafil

“…Regardless of which of the PDE5Is are chosen, significant improvements can be found to both the patient’s and partner’s sexual lives. 17 Both Self-Esteem and Relationship and International Index of Erectile Function scores can improve for patients who start PDE5I for the first time. The Self-Esteem and Relationship subdomains for self-esteem, overall relationship, and sexual relationship improve significantly with initial therapy for the patient.…”

Analysis of the degree of erectile dysfunction in young adults from Tijuana, Mexico

“…Currently there are efforts to understand the prevalence and variables associated with ed among young adult men, due to its profound effects on fundamental aspects of the identity of this population group (feelings about masculinity, confidence, self-esteem), mental health and satisfaction sexual. 9 Therefore, the objective of this research was to evaluate the degree of ed in young adults from a primary care medical unit in Tijuana, Mexico.…”