TY - JOUR
T1 - Should We Tailor the Clinical Management of Erectile Dysfunction According to Different Ages?
AU - Capogrosso, Paolo
AU - Ventimiglia, Eugenio
AU - Boeri, Luca
AU - Pozzi, Edoardo
AU - Chierigo, Francesco
AU - Schifano, Nicolò
AU - Abbate, Costantino
AU - Matloob, Rayan
AU - Montorsi, Francesco
AU - Salonia, Andrea
PY - 2019/7
Y1 - 2019/7
N2 - Introduction: The impact of erectile dysfunction (ED) on patients’ sexual satisfaction and mood profile could differ across different ages. Aim: To investigate the relationship between erectile function (EF), sexual satisfaction, and mood status among patients seeking medical help for ED. Methods: Data from 765 patients presenting at a single center for ED were analyzed. Patients were categorized as young (≤50 years), middle-aged (>50 and ≤65 years), and old (>65 years) individuals and completed the International Index of Erectile Function (IIEF) and the Beck's Inventory for Depression (BDI). Main Outcome Measures: The IIEF overall satisfaction and intercourse satisfaction domain scores and the BDI score were used to investigate sexual life satisfaction and depressive symptoms (defined as BDI > 11) across ages and according to ED severity. Linear and logistic regression analyses assessed the relationship between satisfaction scores and the risk of depressive symptoms with age and EF. Results: Median (interquartile range) age at first assessment for ED was 50 (38, 59) years. Compared with older men, young and middle-aged patients showed significantly higher IIEF-OS and IIEF– Intercourse Satisfaction scores for increasing IIEF-EF scores. Older men showed no difference in terms of satisfaction scores for mild ED and normal EF status. At linear regression analysis, both IIEF-EF and age were significantly associated with sexual satisfaction (all P < .0001). The interaction term between age and EF was also significant, suggesting that the older the patients, the higher the feeling of sexual satisfaction for the same EF status (P = .004). Overall, 25% of patients reported depressive symptoms. Logistic regression analysis showed a 40% risk of depressive symptoms for patients <45 years with severe ED compared to a risk <20% for a man >65 years of age with the same EF status. Clinical Implications: Treating older patients with mild ED may not lead to a further improvement in sexual satisfaction as compared with younger patients with the same ED severity. Younger ED patients suffer more from depressive symptoms compared with older men, regardless of ED severity, thus supporting the need for a comprehensive psychological counseling. Strength & Limitations: The single-center design and the lack of the assessment of the impact of ED treatment are the main limits. Conclusions: The clinical management of ED should be tailored according to different ages: younger patients deserve to be investigated and eventually treated for depressive symptoms. Older patients should be counseled for treatment when a sexual satisfaction improvement is expected. Capogrosso P, Ventimiglia E, Boeri L, et al. Should We Tailor the Clinical Management of Erectile Dysfunction According to Different Ages? J Sex Med 2019;16:999–1004.
AB - Introduction: The impact of erectile dysfunction (ED) on patients’ sexual satisfaction and mood profile could differ across different ages. Aim: To investigate the relationship between erectile function (EF), sexual satisfaction, and mood status among patients seeking medical help for ED. Methods: Data from 765 patients presenting at a single center for ED were analyzed. Patients were categorized as young (≤50 years), middle-aged (>50 and ≤65 years), and old (>65 years) individuals and completed the International Index of Erectile Function (IIEF) and the Beck's Inventory for Depression (BDI). Main Outcome Measures: The IIEF overall satisfaction and intercourse satisfaction domain scores and the BDI score were used to investigate sexual life satisfaction and depressive symptoms (defined as BDI > 11) across ages and according to ED severity. Linear and logistic regression analyses assessed the relationship between satisfaction scores and the risk of depressive symptoms with age and EF. Results: Median (interquartile range) age at first assessment for ED was 50 (38, 59) years. Compared with older men, young and middle-aged patients showed significantly higher IIEF-OS and IIEF– Intercourse Satisfaction scores for increasing IIEF-EF scores. Older men showed no difference in terms of satisfaction scores for mild ED and normal EF status. At linear regression analysis, both IIEF-EF and age were significantly associated with sexual satisfaction (all P < .0001). The interaction term between age and EF was also significant, suggesting that the older the patients, the higher the feeling of sexual satisfaction for the same EF status (P = .004). Overall, 25% of patients reported depressive symptoms. Logistic regression analysis showed a 40% risk of depressive symptoms for patients <45 years with severe ED compared to a risk <20% for a man >65 years of age with the same EF status. Clinical Implications: Treating older patients with mild ED may not lead to a further improvement in sexual satisfaction as compared with younger patients with the same ED severity. Younger ED patients suffer more from depressive symptoms compared with older men, regardless of ED severity, thus supporting the need for a comprehensive psychological counseling. Strength & Limitations: The single-center design and the lack of the assessment of the impact of ED treatment are the main limits. Conclusions: The clinical management of ED should be tailored according to different ages: younger patients deserve to be investigated and eventually treated for depressive symptoms. Older patients should be counseled for treatment when a sexual satisfaction improvement is expected. Capogrosso P, Ventimiglia E, Boeri L, et al. Should We Tailor the Clinical Management of Erectile Dysfunction According to Different Ages? J Sex Med 2019;16:999–1004.
KW - Age
KW - Depression
KW - Erectile Dysfunction
KW - Satisfaction
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U2 - 10.1016/j.jsxm.2019.03.405
DO - 10.1016/j.jsxm.2019.03.405
M3 - Article
C2 - 31053559
AN - SCOPUS:85064909641
VL - 16
SP - 999
EP - 1004
JO - Journal of Sexual Medicine
JF - Journal of Sexual Medicine
SN - 1743-6095
IS - 7
ER -