Cao Zhi, Zhu Tianle, Yang Peng, Ma Yukuai, Ge Yunlong, Gao Pan, Jiang Hui, Zhang Xiansheng
Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei 241000, China.
Peking University Andrology Center, Peking University First Hospital, Beijing 100034, China.
J Sex Med. 2025 May 10;22(5):719-725. doi: 10.1093/jsxmed/qdaf045.
Psychological stress is closely linked to psychogenic erectile dysfunction (pED). In our recent clinical work, many pED patients report high levels of stress and fatigue, leading us to hypothesize these factors may play a contributory role in the development of pED.
This research aims to elucidate how fatigue may mediate the connection between perceived stress and erectile function in individuals with pED.
We assessed 125 patients diagnosed with pED. Erectile dysfunction severity was measured using the International Index of Erectile Function-5 (IIEF-5) and the Nocturnal Penile Tumescence and Rigidity (NPTR) tests. Perceived stress and fatigue were evaluated with the Perceived Stress Scale-14 and the Multidimensional Fatigue Inventory-20. Data were descriptively analyzed, and correlations among the 3 variables were examined. The mediating effect was assessed using the bootstrap method within the SPSS PROCESS macro.
The outcomes include the relationship between perceived stress and erectile function and the mediating role of fatigue in patients with pED.
Our findings revealed a substantial negative correlation between perceived stress and erectile function (β = -0.604, P < .001). Fatigue emerged as a mediator in this relationship (β = -0.214, P < .05). The significance of the indirect effect of perceived stress via fatigue was confirmed through non-parametric bootstrapping (95% CI = -0.426 to -0.153), with fatigue contributing 26.46% to the total effect.
These findings have provided new ideas for interventions in the clinical management of pED, particularly for improving erectile function by simultaneously managing fatigue and stress.
This study explores the broader context of pED and provides a new perspective on the etiology of pED. The main drawback of this study is its lack of generalizability, as it was conducted within a monocultural and specific social context.
Our findings of this study suggest that targeting both fatigue and perceived stress may be effective strategies for improving erectile function in patients with pED, providing valuable insights for research and clinical practice.
心理压力与心因性勃起功能障碍（pED）密切相关。在我们最近的临床工作中，许多pED患者报告有高水平的压力和疲劳，这使我们推测这些因素可能在pED的发生发展中起促成作用。
本研究旨在阐明疲劳如何介导pED患者感知压力与勃起功能之间的联系。
我们评估了125例被诊断为pED的患者。使用国际勃起功能指数-5（IIEF-5）和夜间阴茎胀大及硬度（NPTR）测试来测量勃起功能障碍的严重程度。使用感知压力量表-14和多维疲劳量表-20来评估感知压力和疲劳。对数据进行描述性分析，并检查这三个变量之间的相关性。使用SPSS PROCESS宏中的自抽样法评估中介效应。
结果包括pED患者感知压力与勃起功能之间的关系以及疲劳的中介作用。
我们的研究结果显示感知压力与勃起功能之间存在显著负相关（β = -0.604，P <.001）。疲劳在这种关系中起到了中介作用（β = -0.214，P <.05）。通过非参数自抽样法证实了感知压力通过疲劳产生的间接效应的显著性（95% CI = -0.426至-0.153），疲劳对总效应的贡献为26.46%。
这些发现为pED的临床管理干预提供了新思路，特别是通过同时管理疲劳和压力来改善勃起功能。
本研究探讨了pED的更广泛背景，并为pED的病因提供了新视角。本研究的主要缺点是缺乏普遍性，因为它是在单一文化和特定社会背景下进行的。
我们的研究结果表明，针对疲劳和感知压力可能是改善pED患者勃起功能的有效策略，为研究和临床实践提供了有价值的见解。
