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首页> 外文期刊>The journal of sexual medicine >Exploring the association between erectile rigidity and treatment adherence with sildenafil
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Exploring the association between erectile rigidity and treatment adherence with sildenafil

机译：西地那非探讨勃起硬度与治疗依从性之间的关系

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Introduction. Erection hardness has been shown to correlate with increased self-confidence, sexual satisfaction, and improvement in psychosocial factors such as sexual and overall relationship. It is estimated that one-third of men using phosphodiesterase type 5 inhibitors (PDE5) cease use of medication after one prescription and one-half cease use by 6 months. Aim. This study was undertaken to explore the link between erection hardness and treatment adherence. Methods. Men presenting with erectile dysfunction (ED) who were candidates for PDE5 therapy constituted the study population. They were assessed at the baseline regarding their erectile function (EF) and rigidity using autoquestionnaires. Patients then received regular follow-up using the same assessment tools and were also asked about continued use of PDE5. The final patient assessment was conducted at a time point no sooner than 12 months after commencing PDE5. Multivariable analysis was conducted to define predictors of continued PDE5 use. Main Outcome Measures. Patients were assessed using the International Index of Erectile Function (IIEF) questionnaire and the Erection Hardness Score (EHS). Adherence was defined as continued use of PDE5 at least once per month. Results. One hundred eighty-six men were analyzed. The mean age and the duration of ED were 61±22 and 2.2±2.9 years, respectively. Sixty-three percent were married or partnered. The mean partner age was 52±18 years. Of the 186 patients, 32% had one vascular comorbidity, 34% had two vascular comorbidities, 26% had three vascular comorbidities, and 6% had ≥4 vascular comorbidities. All patients were treated with sildenafil and were sexually active. The mean time to end-of-treatment (EOT) interview and repeat completion of questionnaires was 17±4 months. At the baseline, 26% were EHS 3 (mild ED), 42% were EHS 2 (moderate ED), and 32% were EHS 1 (severe ED). The mean baseline EF domain score was 14±10, and at the EOT, it was 22±5 (P<0.01). At the follow-up interview, 4% were EHS 1, 12% were EHS 2, 28% were EHS 3, and 56% were EHS 4. Overall, 67% of the men continued to use PDE5 at follow-up. The distribution of patients continuing to use PDE5 after commencement was 15% of those achieving EHS 1, 30% for EHS 2, 66% for EHS 3, and 82% for EHS 4. Based on logistic regression analysis, the factors predictive of continued PDE5 use were being partnered, partner age, frequency of sexual activity, a shift of ≥2 points on the EHS, and reaching level 4 on the EHS scale. Conclusion. There is an excellent relationship between erection hardness and adherence to PDE5 treatment. Driving men to greater erectile rigidity appears to translate into lower dropout rates.
机译：介绍。勃起硬度已显示出与自信心增强，性满足感以及心理社会因素（例如性关系和整体关系）的改善相关。据估计，使用磷酸二酯酶5型抑制剂（PDE5）的男性中有三分之一在一张处方后停止使用药物，一半的人在6个月后停止使用药物。目标。进行这项研究以探索勃起硬度和治疗依从性之间的联系。方法。出现勃起功能障碍（ED）的人是PDE5治疗的候选人，构成了研究人群。使用自动调查表在基线时评估他们的勃起功能（EF）和刚度。然后使用相同的评估工具对患者进行定期随访，并询问患者是否继续使用PDE5。在开始PDE5后不超过12个月的时间点进行最终患者评估。进行多变量分析以定义PDE5持续使用的预测因子。主要观察指标。使用国际勃起功能指数（IIEF）问卷和勃起硬度评分（EHS）对患者进行评估。坚持被定义为每月至少使用一次PDE5。结果。对一百八十六名男子进行了分析。 ED的平均年龄和病程分别为61±22岁和2.2±2.9岁。百分之六十三已婚或伴侣。伴侣的平均年龄为52±18岁。在186例患者中，32例具有1个血管合并症，34％合并2个血管合并症，26％合并3个血管合并症，6％≥4个血管合并症。所有患者均接受西地那非治疗，并且具有性活动能力。结束治疗（EOT）访谈和重复填写问卷的平均时间为17±4个月。基线时，EHS 3（轻度ED）占26％，EHS 2（中度ED）占42％，EHS 1（重度ED）占32％。基线EF域的平均基线评分为14±10，在EOT时为22±5（P <0.01）。在随访访谈中，有4％的人是EHS 1，有12％是EHS 2，有28％是EHS 3，有56％是EHS4。总体上，有67％的男性在随访中继续使用PDE5。开始使用后继续使用PDE5的患者分布是达到EHS 1的患者的15％，EHS 2的30％，EHS 3的66％，EHS 4的82％。基于逻辑回归分析，预测继续PDE5的因素被使用的伴侣，伴侣的年龄，性活动的频率，EHS≥2分的转变，并达到EHS等级4级。结论。勃起硬度和对PDE5处理的依从性之间有着极好的关系。驱使男性提高勃起刚性似乎可以降低辍学率。

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