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Are questions on both achieving and maintaining an erection needed to define erectile dysfunction?
J Koskimäki1, J Häkkinen, M Hakama
1Department of Urology, Tampere University Hospital and Medical School and School of Public Health, University of Tempere, Tempere, Finland. jkoskimaki@kolumbus.fi
International Journal of Impotence Research
|April 22, 2005
Summary
Assessing erectile dysfunction (ED) requires questions on both achieving and maintaining erections for accurate diagnosis, especially in younger men. Combining responses improves diagnostic consistency for various ED severity levels.
Area of Science:
- Urology
- Andrology
- Public Health
Background:
- Erectile dysfunction (ED) is a common condition affecting men's sexual health.
- Accurate assessment of ED severity is crucial for appropriate treatment.
- The necessity of including questions on both erection achievement and maintenance in ED assessment remains debated.
Purpose of the Study:
- To evaluate the agreement between questions assessing the ability to achieve and maintain an erection.
- To determine the optimal method for assessing ED severity using these questions.
- To investigate consistency across different age groups.
Main Methods:
- A population-based study involving 1983 men from the Tampere region, Finland.
- Mailed questionnaires were used to collect data on erectile function.
- Consistency between questions was measured using the kappa coefficient at various severity levels.
Main Results:
- High consistency (kappa=0.71) was observed when ED severity was grouped into four levels.
- Best consistency (kappa=0.86) was achieved when 'never' and 'sometimes' difficulties were combined into three groups.
- Almost perfect consistency (kappa=0.97) was found when ED was dichotomized, with a cutoff between 'quite often' and 'intercourse does succeed'.
- Consistency was highest in older respondents.
Conclusions:
- Both achieving and maintaining erection questions are necessary to differentiate normal function from minimal ED, and minimal from moderate ED, particularly in younger men.
- For distinguishing complete ED from milder forms, a single question may suffice.
- The study highlights the importance of specific question phrasing and categorization for reliable ED assessment.