Modified calculation of the IIEF6-a more accurate assessment of erectile function in middle-aged men

The Erectile Function Domain of the International Index of Erectile Function (IIEF6) is inaccurate in assessing erectile function in men who are not practicing sexual intercourse. Improvement through a modification was recently tested on patients after radical prostatectomy. This study examines the application of this modification in a population-based cohort of middle-aged men.

To assess the feasibility of a modified IIEF6 in a population-based random sample of 50-year old men in Germany.

4924 men were included. IIEF6, Erection Hardness Score (EHS), and causes for the absence of sexual intercourse within the previous 4 weeks were assessed. Modified calculation (double weighting of non-intercourse IIEF6 questions) was applied in case of absence due to external circumstances.

Impact of the modification on erectile dysfunction (ED) prevalence and agreement between IIEF6 and EHS in ED classification.

As a result of the modified calculation, ED prevalence in the overall study sample decreased by 6.2% to a rate of 27.2%. Agreement between IIEF6 and EHS was increased from 2.7% to 73.4% in men with no sexual intercourse due to external circumstances.

An additional inquiry into the reason for the absence of sexual intercourse and modified calculation enhances the accuracy of IIEF6 in evaluating erectile function of the individual man.

This study comprises a large population-based sample. As the study population was exclusively 50-year-old men, results may not be representative of the population average.

A more accurate evaluation of an individual man's erectile function may be achieved by using a modified version of the IIEF6.