[Questionnaires in sexual medicine].

Screening, diagnosis and assessment of the management of male and female sexual dysfunctions have been greatly improved by the scientific development of self-administered questionnaires. Their use became the rule in clinical trials and epidemiological surveys. Nevertheless, their routine use has not yet become part of daily urological practice. Even if these tools replace neither the patient interview and medical history and the psychological and social context of the sexual behavior, nor clinical examination, they are of great assistance for determining management and are also highly reliable. Medical literature was reviewed and combined with expert opinion of the author. We present here several questionnaires which have been validated in their French version with the methodology for the calculation of the scores. The International Index of Erectile Function (15 items) and two abbreviated versions, the Erectile Function domain (six items) and the Sexual Health Inventory for Men (five questions) are mainly of use for patients with erectile dysfunction. They provide a robust classification of the severity of the condition. The Premature Ejaculation Profile (four questions) is used for patients with premature ejaculation. It describes premature ejaculation with the following criteria: time to ejaculation, control over ejaculation, the level of distress. The Male Health Sexual Questionnaire (25 questions) provides with a wider and more comprehensive approach to male sexuality of male sexuality including: erection, ejaculation, desire and satisfaction. This questionnaire is particularly useful to investigate ejaculatory disorders. Lastly, the Female Sexual Function Index (19 questions) is the tool of choice for female sexuality with questions regarding desire, arousal, lubrication, orgasm, satisfaction and pain. Validated, user-friendly questionnaires are available in French language for the diagnosis and the follow-up of sexual dysfunctions in both men and women.

Giuliano F 《PROGRES EN UROLOGIE》

Chronic pain has a negative impact on sexuality in testis cancer survivors.

Pühse G ，Wachsmuth JU ，Kemper S ，Husstedt IW ，Evers S ，Kliesch S ... -  《-》

Latent structures of male sexual functioning.

Strong debate has been brought out around the upcoming editions of the International Classification of Diseases, the World Health Organization, and the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association) regarding new criteria for sexual dysfunction. Although criteria for male sexual dysfunction have been supported by traditional models of sexual response, recent data suggest that male sexual functioning could be conceptualized differently, offering new directions for diagnostic and assessment tools. The aim of this study was to test, through structural equation modeling, four conceptual alternative models of male sexual response. A modified version of the International Index of Erectile Function was used, assessing sexual desire, erectile function, orgasmic function, and premature ejaculation. A total of 1,558 Portuguese men participated in the study. Participants were divided into two groups according to the presence or absence of sexual difficulties. Findings suggested different factor solutions for men with and without sexual difficulties. Male sexual response of men with sexual difficulties was best characterized by a two-factor structure: (i) a general sexual function factor (including sexual desire, erectile function, and orgasmic function); and (ii) premature ejaculation; while a three-factor solution was the model that best fitted the data regarding men without sexual difficulties: (i) sexual desire; (ii) erectile and orgasmic function (which merged into a single dimension); and (iii) premature ejaculation. Discriminant validity between factors was strongly supported, suggesting that these dimensions measure distinct phenomena in both samples. Results regarding sexually healthy men suggest that erectile function is structurally independent from sexual desire, and that ejaculatory control could be conceptualized as a different phenomenon in relation to the current orgasmic disorders. Additionally, findings related to sexually dysfunctional men suggest the existence of a general sexual distress disorder.

Carvalho J ，Vieira AL ，Nobre P 《-》

Premature ejaculation: on defining and quantifying a common male sexual dysfunction.

Broderick GA 《-》

The comparison of premature ejaculation assessment questionnaires and their sensitivity for the four premature ejaculation syndromes: results from the Turkish society of andrology sexual health survey.

In addition to the previously defined "lifelong" and "acquired" premature ejaculation (PE), the existence of two more subtypes of PE, namely "natural variable PE" and "premature-like ejaculatory dysfunction," has been proposed. To evaluate the diagnostic value of the Premature Ejaculation Diagnostic Tool (PEDT) and Arabic Index of Premature Ejaculation (AIPE) in a population-based study, in relation to their sensitivity across these four different PE syndromes and to assess the Premature Ejaculation Profile (PEP) scores of patients with lifelong, acquired, natural variable PE and premature-like ejaculatory dysfunction. Between June 2009 and December 2009, couples were randomly selected from 17 provinces of Turkey. Subjects with the complaint of ejaculating prematurely were classified as lifelong, acquired, natural variable PE, and premature-like ejaculatory dysfunction according to the medical and sexual history they described. PE status was also assessed with PEDT, AIPE and PEP. The sensitivity, specificity, positive predictive value and negative predictive value were calculated for PEDT and AIPE in the study population whereas detection rates of these two questionnaires were also compared among the four PE syndromes. Moreover, PEP scores of patients with lifelong, acquired, natural variable PE and premature-like ejaculatory dysfunction were compared. Significance level was considered as P < 0.05. Scores obtained from PEDT, AIPE, and PEP questionnaires. A total of 2,593 couples were enrolled where 512 (20.0%) male subjects reported PE. PEDT, AIPE, and PEP measures of the PE patients indicated worse sexual function (P < 0.001 each). Mean scores obtained from questionnaires were significantly better in patients with premature-like ejaculatory dysfunction and they were the worst in patients with acquired PE (P < 0.001 each). The sensitivity values of PEDT and AIPE were 89.3 and 89.5, whereas their specificity values were 50.5 and 39.1, respectively. There were statistically significant differences in detection rates of PEDT and AIPE among the four PE syndromes (P = 0.006 and P < 0.001). They were higher in acquired and lifelong PE and lower in premature-like ejaculatory dysfunction. PEDT and AIPE can diagnose PE with high sensitivity, especially in patients with lifelong and acquired PE. The complaint of patients with acquired PE seems to be more severe than those complaining of lifelong, natural variable PE and premature-like ejaculatory dysfunction patients.

Serefoglu EC ，Yaman O ，Cayan S ，Asci R ，Orhan I ，Usta MF ，Ekmekcioglu O ，Kendirci M ，Semerci B ，Kadioglu A ... -  《-》