Simplified Assessment of Erectile Dysfunction in Adult Men With Sickle Cell Disease: A Cross-Sectional Validation...

Area of Science:

• Urology
• Hematology
• Andrology

Background:

• Sickle cell disease (SCD) is a genetic blood disorder with significant systemic complications.
• Erectile dysfunction (ED) is an underdiagnosed but common comorbidity in adult men with SCD.
• Accurate and accessible screening tools are needed for early identification of ED in this population.

Purpose of the Study:

• To determine the prevalence of ED in adult men with SCD in Brazil.
• To evaluate the diagnostic accuracy of simplified ED assessment tools against a gold standard.
• To assess the utility of the Erection Hardness Score (EHS), Massachusetts Male Aging Study (MMAS) single-item scale, and Erectometer for ED screening in SCD patients.

Main Methods:

• A cross-sectional validation study was conducted with 33 adult men diagnosed with SCD.
• Erectile function was assessed using the International Index of Erectile Function-5 (IIEF-5) as the reference standard.
• The Erection Hardness Score (EHS), MMAS single-item scale, and Erectometer were used for comparison, with Receiver Operating Characteristic (ROC) curve analysis to determine diagnostic accuracy.

Main Results:

• The prevalence of moderate-to-severe ED, as defined by IIEF-5, was 45.5% (15/33 men).
• The Erectometer demonstrated the highest diagnostic accuracy (Area Under the Curve [AUC] = 0.90), followed by EHS (AUC = 0.85) and MMAS (AUC = 0.82).
• All tested simplified tools exhibited high sensitivity (≥81%) and specificity (≥79%) in detecting ED compared to the IIEF-5.

Conclusions:

• ED is highly prevalent among adult men with SCD in Brazil.
• Simplified ED screening instruments, including the Erection Hardness Score, MMAS single-item scale, and Erectometer, show excellent diagnostic performance.
• These brief tools are suitable for routine screening, facilitating earlier detection and multidisciplinary management of ED in SCD patients.