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Objective: We aimed to evaluate the association between sleep quality and erectile dysfunction in young university students. Methods: A cross-sectional survey was conducted in men aged 18-30 years from Universidad Ricardo Palma, Lima, Peru. The survey comprised the International Index of Erectile Function, Pittsburgh Sleep Quality Index, Berlin questionnaire, and questions related to sociodemographic data. Prevalence ratios were estimated with generalized linear models. Results: Of 381 participants, the median age was 23 years. Half of the students (50.9%) had poor sleep quality, of which 72.7% had mild erectile dysfunction and 20.6% mild to moderate dysfunction. Prevalence of erectile dysfunction was significantly higher in students with poor sleep quality than in students with good sleep quality (aPR = 6.48; 95% CI: 4.58-9.17) after adjusting for age, academic year, nutritional status, and sleep apnea. In a subsequent exploratory analysis, sleep apnea was associated with a higher prevalence of erectile dysfunction (aPR = 1.19; 95% CI: 1.01-1.39), while overweight (aPR = 0.85; 95% CI: 0.76-0.95) and obesity (aPR = 0.65; 95% CI: 0.52-0.82) were associated with a lower prevalence of this condition. Conclusion: Poor sleep quality was independently associated with erectile dysfunction in young university students. This finding suggests that male students are at risk for sexual problems due to possible academic demands and relationship issues.

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Contar con instrumentos validados en Chile para Disfunción Eréctil (DE), motivó el validar la versión española del Índice Internacional de Función Eréctil (IIEF), en población chilena. Se realizó un estudio cuantitativo no experimental transversal, de muestra no probabilística por conveniencia, con 95 varones adultos de tres centros de salud (Concepción, Talcahuano y Santiago), durante Noviembre 2012 y Junio 2013. Expertos ciegos realizaron entrevista clínica utilizando criterios DSM-V y causas médico-quirúrgicas de DE. Luego de aplicación piloto y adaptación del IIEF, se logró la versión IIEF-Ch aplicándola a toda la muestra. Se analizaron los resultados con SPSS 15.0, obteniéndose alta correlación entre variables (X2: 956.533) y alta adecuación muestral (0,893); dos factores que explican el 81.59% de la varianza del instrumento, con alta confiabilidad (.971) y adecuada validez de criterio, alta sensibilidad (84.5%) y especificidad aceptable (91.9%). La IIEF-Ch es un instrumento válido y confiable para estudios sobre DE en Chile.

Having instruments validated in Chile for Erectile Dysfunction (ED), motivated the validation of the Spanish version of the International Index of Erectile Function (IIEF), in Chilean population. A non-experimental quantitative study of non-probabilistic sample was carried out for convenience, with 95 adult males from three health centers (Concepción, Talcahuano and Santiago), during November 2012 and June 2013. Blind experts conducted a clinical interview using DSM-V criteria and medical-surgical causes of ED. After the pilot application and adaptation of the IIEF, version IIEF-Ch was achieved by applying it to the entire sample. The results were analyzed with SPSS 15.0, obtaining high correlation between variables (X2: 956,533) and high sample adequacy (0,893); two factors that explain 81.59% of the variance of the instrument, with high reliability (.971) and adequate criterion validity, high sensitivity (84.5%) and acceptable specificity (91.9%). The IIEF-Ch is a valid and reliable instrument for studies on ED in Chile.

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OBJECTIVES: To measure the impact of psychotherapy associated to the use of Tadalafil in the improvement of erectile function after radical prostatectomy. METHODS: From 132 patients surgically treated for prostate cancer, thirty sequential patients with bilateral nerve sparing, low risk controlled disease and post-surgery erectile dysfunction (ED) took Tadalafil 20mg and underwent psychotherapy sessions, both weekly for three months. Patients were interviewed to establish the quality of erection using the instrument IIEF-5 and to measure psychological features impacting erectile function, aspects related to function, dysfunction, physical and emotional discomfort were evaluated with the help of an intensity scale. RESULTS: The average age was 62.5 (46 to 77 years), 96.7% had a stable relationship, 56.6% of the patients accepted the diagnosis and 43.2% exhibited defense mechanisms (3.3% negation, 6.6% revulsion, 33.3% concern). A positive correlation was observed between erectile function and time exposed to treatment (IIEF-5 - 9.7 to 13.3, p=0.0006), with increased satisfaction with life in general (2.1 to 2.7, P=.028) and sexual life (3.1 to 3.7, P=.028), added to facilitation of expressing feelings/emotions (1.8 to 3.0, P=.0008). Satisfaction with relationship and intimacy with partner did not present significant improve (P=.12 and P=.61, respectively). CONCLUSIONS: A holistic patient care with more complete ED rehabilitation includes psychotherapy with a positive correlation between erectile function and treatment exposition. Psychotherapy allowed the identification of important spouse related factors in this scenario.

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BACKGROUND: The long-term effect of bariatric intervention on androgenic hormones and erectile function is not well known. In a prospective comparative study, the profile of sexual function was ascertained. The setting was a large public academic hospital. METHODS: A total of 51 patients were included in the present study. Of these, 23 were in the bariatric surgery cohort (with 6-14 yr of follow-up), 14 were obese controls, and 14 were lean controls, aged 30-65 years. The groups were matched for age and, in the case of obese controls, the current body mass index. The measurements included orchidometry, an assessment of gynecomastia, the International Index of Erectile Function, the Aging Males Symptoms questionnaire, the measurement of 12 hormones, and general biochemical measurements. RESULTS: Bariatric patients lost substantial weight (59.8 ± 12.1 versus 35.1 ± 7.7 kg/m(2)), albeit residual obesity was the rule, with varying degrees of sleep apnea, hypertension, and glucose/lipid aberrations. The total and free testosterone and sex hormone-binding globulin levels were greater in the gastric bypass patients than in the obese controls and comparable to those of lean individuals. The International Index of Erectile Function final score revealed no differences; however, the domains of erectile dysfunction (P = .015) and overall satisfaction (P = .028) were better than those in the obese controls, although still lower than those in the lean group. The correlation between the body mass index and the International Index of Erectile Function score in the entire population (n = 51) was negative, as expected, with, however, low r and r(2) indexes (.354 and .125, respectively). CONCLUSION: The findings are consistent with long-term normalization of androgenic hormones but less than complete normalization of erectile function. This seeming contradiction might be explained by the remaining or relapsing obesity or its co-morbidities.

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Objetivos. Realizar la validación psicométrica del instrumento Índice Internacional de Función Eréctil (IIFE) en pacientes con Disfunción Eréctil (DE). Materiales y métodos. Serie de casos prospectivo donde se evaluó la validez y confiabilidad del cuestionario. Resultados. Más del 90 por ciento de los expertos consideraron que las preguntas del IIEF evaluaban los dominios y el constructo (validez de contenido). Hubo una concordancia perfecta entre la evaluación del experto y los resultados del IIFE (Kappa = 1). Se encontró diferencias significativas en las medias del puntaje por dominios entre los pacientes con DE y sin DE pero al evaluar la severidad solo hubo diferencias en el dominio de función eréctil (validez discriminante). Con relación a la severidad, el Índice de Síntomas de Prostatitis Crónica (ISPC) y el IIFE mostraron resultados divergentes (Kappa < 0,01, p=0,44), y los puntajes totales no correlacionaron (validez divergente) (rs = - 0,22, p = 0,16). Los coeficientes de correlación por dominios fueron leves a moderados y la correlación entre los puntajes totales fue alta (rs = 0,8, p < 0,001) (fiabilidad test retest). Se encontró un alto grado de consistencia interna con un α-Cronbach > 0,8 en los cinco dominios. Conclusiones. El IIFE validado culturalmente en el Perú es un instrumento válido y confiable para su uso a nivel local en el campo clínico y de investigación.

Objectives. To perform the psychometric validation of the International Index of Erectile Function (IIEF) in patients with erectile dysfunction. Materials and methods. Prospective case series to evaluate the validity and the reliability of the scale. Results. More than 90 percent of experts considered that the IIEF questions evaluated the domains and the construct (content validity). There was a perfect concordance between the expert evaluation and the IIEF results (criteria validity, Kappa = 1). Significant differences were found in the score media by domains between patients with and without ED but when severity was evaluated, only differences in the erectile function domain were found (discriminatory validity). The Chronic Prostatitis Symptom Index (ISPC) and the IIEF showed divergent results (Kappa < 0.01, p = 0.44) in relation with the severity and the total scores showed no correlation (divergent validity) (rs = -0.22, p = 0.16). The correlation coefficients by domains were mild to moderate and the correlation between the total scores was high (rs = 0.8, p < 0.001) (test retest repeatability). A high degree of internal consistency with Cronbach’s alpha values > 0.8 in the five domains was found. Conclusions. The cross-culturally validated IIEF in Peru is a valid and reliable instrument for its local use in the fields of clinics and research.

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