Schmidtke M L, Dinkel A, Gschwend J E, Herkommer K
Klinik und Poliklinik für Urologie, Klinikum rechts der Isar, Technische Universität München, Ismaningerstraße 22, 81675, München, Deutschland.
Urologe A. 2015 May;54(5):696-702. doi: 10.1007/s00120-014-3699-6.
Patient counseling by using the IIEF to assess erectile function (EF) before and after radical prostatectomy (RPX) is only possible under limited circumstances. The aim of this study was to evaluate if the Erection Hardness Score (EHS) could be used in addition to the IIEF for the assessment of EF and patient preference regarding counseling for their sex life.
EF was evaluated in 307 patients 3-60 months after RPX using the IIEF-EF and EHS. Questionnaires assessed sexual activity/intercourse as well as satisfaction with sex life irrespective of EF (10-point Likert scale). Patients were further asked concerning development of new sexual methods independent of erection firm enough for penetration and further wishes regarding counseling for their sex life.
Of 272 patients, 82.0% underwent bilateral nerve-sparing prostatectomy, 30.5% (n=83; mean age: 68.1 years) had sexual intercourse and 41.9% (n=114) were sexually active. EH Scores 1-2 and 4 coincided with compatible IIEF-EF Scores 1-21, and ≥ 26, respectively. Of the patients with an EHS of 3, 55.9% had an IIEF-EF score that was notably lower. Of patients with sexual intercourse, 65.8% were satisfied with their sex life; 53.2% of sexually active patients were satisfied without sexual intercourse. Alternative methods were manual/oral stimulation, cuddling, and the use of vibrators. Patients request individually tailored, realistic counseling.
The advantage of the EHS compared to the IIEF is that the erectile function can be assessed irrespective of sexual intercourse and sexual partner. Counseling should assist patients towards the attainment of a satisfying sex life-even without an erection.
在根治性前列腺切除术（RPX）前后，使用国际勃起功能指数（IIEF）来评估勃起功能（EF）进行患者咨询，仅在有限的情况下可行。本研究的目的是评估勃起硬度评分（EHS）是否可与IIEF一起用于评估EF以及患者对性生活咨询的偏好。
使用IIEF-EF和EHS对307例RPX术后3至60个月的患者进行EF评估。问卷评估了性活动/性交以及对性生活的满意度，而不考虑EF（10分李克特量表）。进一步询问患者关于新的性方式的发展情况，这些方式独立于足以进行插入的勃起，以及对性生活咨询的进一步愿望。
在272例患者中，82.0%接受了双侧神经保留前列腺切除术，30.5%（n = 83；平均年龄：68.1岁）有性交，41.9%（n = 114）有性活动。EHS评分1-2和4分别与IIEF-EF评分1-21和≥26一致。在EHS为3的患者中，55.9%的IIEF-EF评分明显较低。在有性交的患者中，65.8%对其性生活满意；53.2%有性活动的患者在没有性交的情况下也满意。替代方法包括手动/口交刺激、拥抱和使用振动器。患者要求提供个性化、现实的咨询。
与IIEF相比，EHS的优势在于可以独立于性交和性伴侣来评估勃起功能。咨询应帮助患者实现满意的性生活——即使没有勃起。
