Screening for erectile dysfunction in men with lifelong premature ejaculation--Is the Sexual Health Inventory for Men (SHIM) reliable?
BACKGROUND
Some men with premature ejaculation (PE) and normal erectile function record contradictory response/s to The Sexual Health Inventory for Men (SHIM) and may be incorrectly categorized as suffering from erectile dysfunction (ED).


OBJECTIVE
The aim of this study was to evaluate the frequency of false positive SHIM diagnosis of ED in men with lifelong PE.


METHODS
SHIM, stopwatch intravaginal ejaculation latency time (IELT).


METHODS
A prospective observational study of men with normal erectile function and lifelong PE, diagnosed using the ISSM definition of lifelong PE, was conducted. The SHIM was self-administered at Visit 1. Mean per subject stopwatch IELT was determined from four subsequent intercourse attempts.


RESULTS
Seventy-eight subjects with a mean age of 33.2 +/- 8.3 years and a geometric mean IELT of 15.9 +/- 2.3 seconds were enrolled. The mean SHIM score for all subjects was 20.4 +/- 6.0. Fifty-two subjects (66.7%) have SHIM scores of >21 (mean 24.3 +/- 1.1), consistent with normal erectile function, and a geometric mean IELT of 18.3 +/- 2.2 seconds. Twenty-six subjects (33.3%) had SHIM scores <22 (mean 12.7 +/- 3.7), consistent with a false positive diagnosis of ED, and a geometric mean IELT of 10.5 +/- 2.3 seconds. The incidence of false positive SHIM diagnosis of ED (SHIM < 22) was inversely related to the IELT. Although the geometric mean IELT for subjects with SHIM scores <22 was significantly less than that of all subjects and subjects with SHIM scores >21, there were no significant differences between the geometric mean IELT or the IELT distribution of all subjects vs. the normal erectile function IELT (SHIM > 21) cohort.


CONCLUSIONS
This study demonstrates a 33.3% false positive SHIM diagnosis of ED in men with PE. This is likely to limit subject recruitment in clinical trials by exclusion of subjects with low-range IELTs but is unlikely to result in significantly different baseline IELTs or IELT distributions.
McMahon
Chris G
CG
Australian Centre for Sexual Health, University of Sydney, Sydney, NSW, Australia. cmcmahon@acsh.com.au
D000328:Adult; D003075:Coitus; D004311:Double-Blind Method; D004542:Ejaculation / Q000502:physiology*; D007172:Erectile Dysfunction / Q000175:diagnosis* / Q000453:epidemiology*; D005189:False Positive Reactions; D006304:Health Status; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D011446:Prospective Studies; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires