Christanto Roberto Bagaskara Indy, Wijaya Cindy, Birowo Ponco, Atmoko Widi, Situmorang Gerhard Reinaldi, Agarwal Ashok, Shah Rupin
Department of Urology, Rumah Sakit Dr Cipto Mangunkusumo, Faculty of Medicine, Universitas Indonesia, Central Jakarta, Jakarta, 10430, Indonesia.
Cleveland Clinic, Cleveland, Ohio, USA.
F1000Res. 2025 Jul 30;14:142. doi: 10.12688/f1000research.149499.2. eCollection 2025.
Erectile dysfunction (ED) affects approximately 40% of men; however, the true prevalence remains uncertain owing to various factors. Diagnosing ED is challenging, and tools like the International Index of Erectile Function (IIEF) and its shorter version, the IIEF-5, are commonly used to assess its severity. Although nocturnal penile tumescence and rigidity (NPTR) monitoring, as an objective test, can help diagnose ED, it is complex and not economical. Therefore, this study aimed to compare NPTR with the IIEF to assess the IIEF's potential as a cost-effective diagnostic tool for ED.
A correlation analysis study was performed on 139 men with ED between August 2017 and March 2023 who had undergone NPTR assessment in Jakarta, Indonesia. ED was assessed using detailed evaluations and IIEF-5 questionnaires. NPTR data was collected using a Rigiscan device. Serum testosterone, total cholesterol, HbA1c, and vitamin D-25(OH) from blood samples were also evaluated. Bivariate analysis was used to explore the correlations between IIEF-5 scores, NPTR measurements, and blood parameters.
In total, 139 men with ED (median age: 42 years) were included. The median IIEF-5 score was 11, and comorbidities included dyslipidemia (20%) and diabetes (12%). There are significant correlations between IIEF scores and NPTR variables (number of erections recorded, base tumescence increment, average base tumescence, and duration of base erection with ˃ 60% rigidity). Additionally, significant negative correlations were observed between HbA1c levels and several NPTR variables, including the number and quality of nocturnal erections. Significant correlations were also found between HbA1c and various NPTR variables.
This study underscores the value of subjective questionnaires such as the IIEF-5 in diagnosing ED, especially in the absence of advanced tests like the NPTR assessment. We found correlations between IIEF scores and nocturnal erection frequency, as well as specific erection characteristics. Our findings highlight the importance of a personalized approach to ED diagnosis. We also observed that higher HbA1c levels were associated with reduced nocturnal erection quality, highlighting the metabolic influence on erectile function. Although IIEF aids in cost-effective assessments, it should not replace objective testing.
勃起功能障碍（ED）影响着约40%的男性；然而，由于各种因素，其真实患病率仍不确定。诊断ED具有挑战性，国际勃起功能指数（IIEF）及其简版IIEF-5等工具通常用于评估其严重程度。尽管夜间阴茎勃起和硬度（NPTR）监测作为一种客观测试有助于诊断ED，但它复杂且不经济。因此，本研究旨在比较NPTR和IIEF，以评估IIEF作为ED的一种具有成本效益的诊断工具的潜力。
对2017年8月至2023年3月在印度尼西亚雅加达接受NPTR评估的139名ED男性进行了相关性分析研究。使用详细评估和IIEF-5问卷评估ED。使用Rigiscan设备收集NPTR数据。还评估了血液样本中的血清睾酮、总胆固醇、糖化血红蛋白（HbA1c）和维生素D-25（OH）。采用双变量分析来探讨IIEF-5评分、NPTR测量值和血液参数之间的相关性。
总共纳入了139名ED男性（中位年龄：42岁）。IIEF-5评分中位数为11，合并症包括血脂异常（20%）和糖尿病（12%）。IIEF评分与NPTR变量（记录的勃起次数、基础勃起增量、平均基础勃起、以及硬度>60%时的基础勃起持续时间）之间存在显著相关性。此外，观察到HbA1c水平与几个NPTR变量之间存在显著负相关，包括夜间勃起的次数和质量。HbA1c与各种NPTR变量之间也发现了显著相关性。
本研究强调了诸如IIEF-5等主观问卷在诊断ED中的价值，特别是在没有像NPTR评估这样的先进测试的情况下。我们发现IIEF评分与夜间勃起频率以及特定勃起特征之间存在相关性。我们的研究结果突出了个性化ED诊断方法的重要性。我们还观察到较高的HbA1c水平与夜间勃起质量下降有关，这突出了代谢对勃起功能的影响。尽管IIEF有助于进行具有成本效益的评估，但它不应取代客观测试。
