title: Predicting erectile dysfunction in sexually active patients seeking prostate health screening: proposal for a multivariable risk stratification.
abstract: To address the severity of erectile dysfunction (ED) in consecutive sexually active men seeking a prostate health screening through a multivariable risk stratification including comorbidities and lower urinary tract symptoms (LUTS). Four hundred and twenty five consecutive subjects with stable sexual relationship with normal testosterone levels were enrolled. The International Index of Erectile Function (IIEF-5) and the International Prostate Symptom Score (IPSS) questionnaires were collected and health-significant comorbidities were scored with the Charlson comorbidity index (CCI). All the independent predictors of ED were combined to form four different risk categories of ED: low (age⩽65 years and IPSS<8 and CCI=0), intermediate (one of the following: age>65 years, IPSS⩾8 or CCI⩾1), high (two of the following: age>65 years, IPSS⩾8 or CCI⩾1) and very high (age >65 years, IPSS⩾8 and CCI⩾1). The prevalence of ED increased with increase of CCI (χ(2) likelihood ratio: 40.85, P=0.001). The median of the IIEF-5 significantly reduced with the increase of the CCI (P<0.001) and with the worsening of our risk group stratification (P<0.001). At univariate logistic regression analysis very high risk was significantly associated with of ED (odds ratio: 26.85, P<0.001). Very high-risk group predicted ED with 88% and 56% of specificity and sensitivity, respectively. Combining these risk factors through our risk stratification may be usefulness in revealing an underling ED.
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Favilla
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: G I
authors.initials: GI
authors.lastname: Russo
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Reale
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Leone
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: T
authors.initials: T
authors.lastname: Castelli
authors.affiliation: Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology, and Internal Medicine, University of Catania, Catania, Italy.
authors.forename: S
authors.initials: S
authors.lastname: La Vignera
authors.affiliation: Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology, and Internal Medicine, University of Catania, Catania, Italy.
authors.forename: R A
authors.initials: RA
authors.lastname: Condorelli
authors.affiliation: Department of Medical and Pediatric Sciences, Section of Endocrinology, Andrology, and Internal Medicine, University of Catania, Catania, Italy.
authors.forename: A E
authors.initials: AE
authors.lastname: Calogero
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Cimino
authors.affiliation: Department of Urology, University of Catania, Catania, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Morgia
mesh_terms: D000368:Aged; D003920:Diabetes Mellitus / Q000453:epidemiology; D007172:Erectile Dysfunction / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D059411:Lower Urinary Tract Symptoms; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D016017:Odds Ratio; D011467:Prostate; D060728:Reproductive Health; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood
chemical_list: D013739:Testosterone