title: [Sexuality after radical prostatectomy: Evaluation of erectile function and patient counseling regarding their sex life].
abstract: BACKGROUND
  Patient counseling by using the IIEF to assess erectile function (EF) before and after radical prostatectomy (RPX) is only possible under limited circumstances. The aim of this study was to evaluate if the Erection Hardness Score (EHS) could be used in addition to the IIEF for the assessment of EF and patient preference regarding counseling for their sex life.
  
  
  METHODS
  EF was evaluated in 307 patients 3-60 months after RPX using the IIEF-EF and EHS. Questionnaires assessed sexual activity/intercourse as well as satisfaction with sex life irrespective of EF (10-point Likert scale). Patients were further asked concerning development of new sexual methods independent of erection firm enough for penetration and further wishes regarding counseling for their sex life.
  
  
  RESULTS
  Of 272 patients, 82.0% underwent bilateral nerve-sparing prostatectomy, 30.5% (n=83; mean age: 68.1 years) had sexual intercourse and 41.9% (n=114) were sexually active. EH Scores 1-2 and 4 coincided with compatible IIEF-EF Scores 1-21, and ≥ 26, respectively. Of the patients with an EHS of 3, 55.9% had an IIEF-EF score that was notably lower. Of patients with sexual intercourse, 65.8% were satisfied with their sex life; 53.2% of sexually active patients were satisfied without sexual intercourse. Alternative methods were manual/oral stimulation, cuddling, and the use of vibrators. Patients request individually tailored, realistic counseling.
  
  
  CONCLUSIONS
  The advantage of the EHS compared to the IIEF is that the erectile function can be assessed irrespective of sexual intercourse and sexual partner. Counseling should assist patients towards the attainment of a satisfying sex life-even without an erection.
authors.affiliation: Klinik und Poliklinik für Urologie, Klinikum rechts der Isar, Technische Universität München, Ismaningerstraße 22, 81675, München, Deutschland.
authors.forename: M L
authors.initials: ML
authors.lastname: Schmidtke
authors.forename: A
authors.initials: A
authors.lastname: Dinkel
authors.forename: J E
authors.initials: JE
authors.lastname: Gschwend
authors.forename: K
authors.initials: K
authors.lastname: Herkommer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003950:Diagnostic Techniques, Urological; D007172:Erectile Dysfunction / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology*; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011468:Prostatectomy / Q000009:adverse effects / Q000523:psychology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012731:Sex Counseling / Q000706:statistics & numerical data*; D012725:Sexual Behavior / Q000523:psychology / Q000706:statistics & numerical data; D019529:Sexuality; D016896:Treatment Outcome