PubMed · 13336148
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M FOLMAN. 1956-03-24. [Some impotent geniuses].. https://pubmed.ncbi.nlm.nih.gov/13336148/
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BACKGROUND AND OBJECTIVE: We determined the sensitivity to change and minimally important difference (MID) of the Spanish version of the life-satisfaction check list LISAT-8. PATIENTS AND METHOD: We included a random sample obtained from an open, naturalistic, prospective and multicenter study, which assessed the effectiveness of sildenafil as erectile dysfunction (ED) therapy. A total of 537 patients, males older than 18 years, with ED and > active sexual desire, received flexible and at demand doses of sildenafil for 10 weeks. IIEF and LISAT-8 questionnaires were used. MID was determined from the patient's classification according to change in erectile function domain of the IIEF after treatment as follows: no change (< 5 pts), small change (6 to 10 pts), moderate change (11 to 15 pts) and big change (> 15 pts). RESULTS: Sildenafil significantly modified the baseline punctuation of the LISAT 8 from a crude value of 30.2 (5.9) pts (mean [standard deviation]), at baseline, to 34.7 (5.6) pts after treatment., and from 55.4% (14.7%) to 66.8% (14.3%) in standardized punctuation (p < 0.0001 in both cases). Sildenafil responders showed a response increase of the total punctuation which was significantly higher than non-responders: 12.5% versus 4.3% (p < 0.001). MID was 3.2 pts as crude punctuation, and 8.1% in normalized score. Statistically significant correlations were found between changes in LISAT-8 and changes in IIEF. CONCLUSIONS: The Spanish version of the LISAT-8 showed to be responsive to change in male ED patients. Meaningful MID was 3.1 pts (crude) and 8.1% (normalized).
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OBJECTIVES: The aim of the present study was to determine the prevalence of erectile dysfunction (ED) in patients visiting office-based urologists in Germany because of lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia (BPH), and to evaluate the impact of ED on quality of life (QoL) in these patients. METHODS: 500 office-based urologists in Germany were invited to evaluate 20 consecutive patients for erectile dysfunction, who presented because of BPH-related LUTS. Physicians provided information on demographic factors, duration and treatment history of BPH, severity of LUTS, ED risk factors, and assessed the patient for the clinical diagnosis of ED. Patients were asked to complete the German version of the IPSS to measure LUTS severity. ED-patients quantified erectile dysfunction and impact on quality of life with validated German questionnaires (Cologne assessment of male erectile dysfunction KEED, and Qol-Med). RESULTS: Office-based urologists were aware of ED in 37.3% of 8768 patients presenting for LUTS before the study, 14.7% of patients were treated for ED. After the study-related assessment, physicians diagnosed ED in 62.1% of these patients and planned treatment in 46.9%. Severity of LUTS and ED prevalence correlated significantly after age-stratification. The incidence of ED was increased in patients with established ED risk factors. Mean QoL-Med score (best QoL: 100, worst QoL: 0) was 53.8 in patients with ED and 50.1 in ED-patients considering treatment. CONCLUSION: ED is highly prevalent in LUTS patients visiting an office-based urologist and is accompanied by a profound impact on the quality of life. Apparently, even during an urological consultation many ED-patients are hesitant to actively ask for treatment. Sexual issues should become key considerations for physicians managing patients with LUTS, especially since effective and well established oral treatment for ED is available.