Sexual Medicine and Andrology Unit, Department of Clinical Physiopathology, University of Florence, Florence, Italy.
J Sex Med. 2012 Oct;9(10):2698-707. doi: 10.1111/j.1743-6109.2012.02872.x. Epub 2012 Aug 15.
INTRODUCTION: The frequency and the clinical characteristics of erectile dysfunction (ED) and premature ejaculation (PE) in infertile men have been poorly investigated. AIM: To assess the prevalence of ED and PE and their clinical correlates in men seeking medical care for couple infertility. METHODS: A consecutive series of 244 men (mean age 35.2±7.8) with couple infertility was systematically evaluated. Erectile function was investigated with the International Index of Erectile Function-15 erectile function domain (IIEF-15-EFD) whereas ejaculatory status with the PE diagnostic tool (PEDT). MAIN OUTCOME MEASURES: All patients underwent psychological (Middlesex Hospital Questionnaire [MHQ]), prostatitis symptoms (National Institutes of Health-chronic prostatitis symptom index [NIH-CPSI]); hormonal, seminal, and interleukin 8 (sIL-8; a surrogate marker of prostatitis) evaluation; along with scrotal and transrectal color Doppler ultrasound (CDU) assessment. RESULTS: ED was found in 43 (17.8%) and PE in 38 (15.6%) subjects. After adjusting for age, IIEF-15-EFD score was negatively associated with depressive symptoms (MHQ-D score), somatization (MHQ-S score), NIH-CPSI total, and quality of life subdomain score. In a logistic multivariate model, among all these variables, only depression was significantly associated with ED (adjusted odds ratio [OR]=1.19 [1.02-1.39]; P<0.05). PEDT score was positively associated with prostatitis symptoms and signs, such as sIL-8 and prostate CDU abnormalities (including arterial prostatic peak systolic velocity, APPSV), phobic anxiety (MHQ-P score), and calculated free testosterone (cFT). The association between PE and NIH-CPSI score or APPSV was confirmed even after adjustment for age, MHQ-P score and cFT (adjusted OR=1.11 [1.05-1.17]; P<0.0001 and 1.22 [1.03-1.44]; P=0.02, for NIH-CPSI score and APPSV, respectively). CONCLUSIONS: ED and PE are reported by one in six infertile patients. ED is mainly associated with depressive symptoms, while PEDT score is positively associated with prostatitis symptoms and signs, phobic anxiety, and cFT.
简介：勃起功能障碍（ED）和早泄（PE）在不孕男性中的频率和临床特征研究甚少。
目的：评估寻求夫妇不育治疗的男性中 ED 和 PE 的患病率及其临床相关性。
方法：对 244 名（平均年龄 35.2±7.8 岁）有夫妇不育的连续系列男性进行系统评估。使用国际勃起功能指数-15 勃起功能域（IIEF-15-EFD）评估勃起功能，使用 PE 诊断工具（PEDT）评估射精状态。
主要观察指标：所有患者均接受心理（米德尔塞克斯医院问卷[MHQ]）、前列腺炎症状（美国国立卫生研究院-慢性前列腺炎症状指数[NIH-CPSI]）；激素、精液和白细胞介素 8（sIL-8；前列腺炎的替代标志物）评估；以及阴囊和经直肠彩色多普勒超声（CDU）评估。
结果：43 名（17.8%）男性存在 ED，38 名（15.6%）男性存在 PE。调整年龄后，IIEF-15-EFD 评分与抑郁症状（MHQ-D 评分）、躯体化（MHQ-S 评分）、NIH-CPSI 总分和生活质量亚域评分呈负相关。在逻辑多元模型中，在所有这些变量中，只有抑郁与 ED 显著相关（调整后的优势比[OR]=1.19[1.02-1.39]；P<0.05）。PEDT 评分与前列腺炎症状和体征呈正相关，如 sIL-8 和前列腺 CDU 异常（包括动脉前列腺收缩期峰值速度，APPSV）、恐怖焦虑（MHQ-P 评分）和计算游离睾酮（cFT）。PE 与 NIH-CPSI 评分或 APPSV 的相关性在调整年龄、MHQ-P 评分和 cFT 后仍得到证实（NIH-CPSI 评分和 APPSV 的调整后的 OR=1.11[1.05-1.17]；P<0.0001 和 1.22[1.03-1.44]；P=0.02）。
结论：ED 和 PE 报告发生在六分之一的不育患者中。ED 主要与抑郁症状相关，而 PEDT 评分与前列腺炎症状和体征、恐怖焦虑和 cFT 呈正相关。
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