title: Evaluation of the effectiveness of sildenafil using questionnaire methods versus audio-visual sexual stimulation.
abstract: OBJECTIVE
  In the present study, an audio-visual sexual stimulation (AVSS) test was used to evaluate the effectiveness of sildenafil, and the AVSS test was coevaluated with the international index of erectile function (IIEF) questionnaire.
  
  
  METHODS
  Forty-two patients with erectile dysfunction (ED) were examined (age range, 28-73 years; mean, 51.9 +/- 11.4 years). Each patient answered the IIEF questionnaire and underwent laboratory tests and the AVSS test before administration of sildenafil. The IIEF questionnaire and AVSS test (1 h after administration of 25 mg or 50 mg sildenafil) were re-evaluated in the outpatient clinic 4 weeks later. Questions 3 and 4 of the IIEF test were used to evaluate the effectiveness of sildenafil. Sildenafil was determined to be effective if each score totalled four or five after administration.
  
  
  RESULTS
  The rate of effectiveness of sildenafil was 52.4%, and the mean score of the IIEF 5 improved from 7.2 to 15.4 following treatment with sildenafil. The maximum and mean rigidity of the penile tip improved after the sildenafil treatment (36.1%vs 57.7% and 14.2%vs 35.8%, respectively). The maximum and mean rigidity of the penile base rose (42.4%vs 57.7% and 17.9%vs 36.8, respectively). Similarly, following treatment with sildenafil, the penile tumescence increased from 6.6 cm to 7.6 cm at the penile tip and from 7.5 cm to 8.5 cm at the penile base.
  
  
  CONCLUSIONS
  In some ED patients the results of the IIEF questionnaire are not always consistent with those of objective evaluation, including AVSS. In these patients, combined assessment using the IIEF and AVSS might be more useful to evaluate the precise effectiveness of sildenafil, rather than relying on the IIEF results alone.
authors.affiliation: Department of Urology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan. uro_secretary@mail.goo.jp
authors.forename: Takahiro
authors.initials: T
authors.lastname: Suetomi
authors.forename: Fumiyasu
authors.initials: F
authors.lastname: Endo
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Takeshima
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Akaza
mesh_terms: D000328:Adult; D000368:Aged; D001296:Audiovisual Aids; D004305:Dose-Response Relationship, Drug; D007172:Erectile Dysfunction / Q000503:physiopathology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D010410:Penile Erection / Q000187:drug effects / Q000502:physiology; D010812:Physical Stimulation / Q000295:instrumentation*; D010879:Piperazines / Q000008:administration & dosage / Q000627:therapeutic use*; D011687:Purines; D000068677:Sildenafil Citrate; D013450:Sulfones; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D014665:Vasodilator Agents; D000068677:Sildenafil Citrate