School of Psychology, Deakin University, Burwood, VIC, Australia.
J Sex Med. 2014 Feb;11(2):347-63. doi: 10.1111/jsm.12374. Epub 2013 Nov 20.
The aim of this study was to report and analyze the published data from randomized controlled trials (RCTs) for (i) the psychosocial outcomes associated with erectile dysfunction (ED) before treatment with a phosphodiesterase type 5 (PDE5) inhibitor; and (ii) the change in psychosocial outcomes after the use of a PDE5 inhibitor in men with ED.
The method used was a prospectively designed systematic literature review of publications reported in MEDLINE via PubMed, EMBASE, the Cochrane Library, Science Citation Index Expanded, and PsychINFO from January 1, 1995 to May 14, 2012.
The main outcome measures were scores on psychosocial measures in men who were treated for ED with a PDE5 inhibitor before and after treatment.
A total of 1,714 publications were retrieved; 1,674 publications were excluded because they did not meet the design requirements of the review, and 40 publications (32 RCTs) were retained. Before treatment, men who participated in clinical trials reported relatively good quality of life and overall relationships, but poor sexual relationships and sexual satisfaction, diminished confidence, low self-esteem, and symptoms of depression. After treatment, there were significant improvements from baseline in most of these measures, except for overall life satisfaction and overall relationship satisfaction.
ED and the treatment of ED are associated with substantially broader aspects of a man's life than just erectile functioning. This review demonstrates the importance of evaluating the psychosocial factors associated with ED and its treatment, and the importance of using standardized scales to conduct this evaluation. Further research is needed to better understand the mechanisms underlying the reciprocal relationships among physical and psychological functioning in men with ED.
本研究旨在报告和分析已发表的随机对照试验（RCT）数据，以探讨：（i）在使用磷酸二酯酶 5 型（PDE5）抑制剂治疗勃起功能障碍（ED）之前，与 ED 相关的心理社会结局；以及（ii）ED 男性使用 PDE5 抑制剂后心理社会结局的变化。
采用前瞻性设计，对 1995 年 1 月 1 日至 2012 年 5 月 14 日期间通过 MEDLINE 下的 PubMed、EMBASE、Cochrane 图书馆、科学引文索引扩展版和 PsychINFO 检索到的出版物进行系统文献综述。
主要观察指标为接受 PDE5 抑制剂治疗 ED 的男性在治疗前后心理社会测量评分。
共检索到 1714 篇文献，1674 篇文献因不符合本综述设计要求而被排除，最终保留了 40 篇文献（32 项 RCT）。在治疗前，参与临床试验的男性报告其生活质量和总体关系相对较好，但性关系和性满意度较差，自信心下降，自尊心低，存在抑郁症状。治疗后，除了总体生活满意度和总体关系满意度外，大多数指标与基线相比均有显著改善。
ED 及其治疗与男性生活的多个方面有关，而不仅仅与勃起功能有关。本综述表明评估 ED 及其治疗相关的心理社会因素的重要性，以及使用标准化量表进行评估的重要性。需要进一步研究以更好地理解 ED 男性中生理和心理功能之间相互关系的潜在机制。
