[Erectile dysfunction: an insufficiently valued problem in Internal Medicine. Study of patients and related medication]. / Disfunción eréctil: un problema poco valorado en Medicina Interna. Estudio de pacientes y medicación relacionada.

INTRODUCTION: Erectile dysfunction (ED) is a common disease and may be due to psychological or organic causes. It might point to a silent disease and its value could not only be in life quality but also directly resolving the health problem laying beneath. The evaluation of ED begins with sexual records and physical examination which have been reported to have a 95 percent sensitivity, and a 50 percent specificity. Additional diagnostic tests are needed to maximize specificity. Sexual impairment in general Internal Medicine patients has not been sufficiently studied yet. PATIENTS AND METHODS: Unselected ambulatory and hospital admitted patients were interviewed during 2003 using the International Index of Erectile Function (IIEF) ad the Sexual Health Interview for Men (SHIM). The cut-off point was 21. RESULTS: A total of 51 male patients were interviewed, middle age was 65 years old (30-88). Of these, 27 denied sexual activity (group I). Middle age in this group was 64 years old. In the 24 patients with sexual activity (group II) middle age was 61 years old. The IIEF score was less than 45 in 11 patients (groups I and II of erectile dysfunction) The SHIM middle score was 26 points. The score was < 21 in 10 patients (41.6%). Concordance between both test was 90.9%. Risk factors included: tobacco (12 patients), alcohol (9), hypertension (8), and diabetes (7) among others. CONCLUSION: Our investigation seems to show that a great number of patients attended by Internists have sexual impairment (41.6%). None of these were under specific therapy nor consulted for this disease. Middle age is lower among patients with sexual activity as compared with the group without sexual activity. This assessment should be included in the medical interview with the aim of prescribing specific therapy to improve patient's quality of life.

Disfunción eréctil: un problema poco valorado en Medicina Interna. Estudio de pacientes y medicación relacionada / Erectile dysfunction: a non sufficiently valued problem in internal medicine. Study of patients and related medication

Introducción: La disfunción eréctil (DE) es habitual y puede estar relacionada con causas psicológicas u orgánicas. La realización de una historia sexual y la exploración física, demuestran una sensibilidad del 95%, y especificidad del 50% en la determinación de la causa de la DE. Se precisan test diagnósticos adicionales para incrementar la especificidad. No hay información disponible sobre las alteraciones en la función sexual en pacientes de Medicina Interna. Pacientes y métodos: Entrevistas a pacientes no seleccionados tanto ambulatorios como hospitalizados aplicando el Índice Internacional de Disfunción Eréctil (IIDE) y la Entrevista de Salud Sexual para Hombres (ESSH) durante el año 2003. Resultados: Se entrevistaron 51 varones de edad media 65 años (30-88). Entre ellos, 27 negaron actividad sexual (grupo I), la edad media en este grupo fue de 64 años. En los 24 pacientes con actividad sexual (grupo II) la edad media fue de 61 años. El IIDE mostró puntuaciones menores de 45 puntos en 11 pacientes (grupos I y II de disfunción eréctil). La puntuación media para el ESSH fue de 26 puntos. La puntuación fue < 21 en 10 pacientes (41,6%). La concordancia entre ambos test fue del 90,9%. Los factores de riesgo incluían: tabaco (12 pacientes), alcohol (9), HTA (8) y DM (7). Conclusión: Parece existir una alta prevalencia de DE entre los pacientes atendidos por Internistas (41,6%). Ninguno de éstos recibía tratamiento por esta enfermedad ni habían consultado nunca por ello. La edad media es inferior en los pacientes que mantienen actividad sexual. Consideramos necesario incluir esta patología en la anamnesis a todo paciente asistido para posibilitar la prescripción de tratamiento que podría mejorar notablemente su calidad de vida

Introduction: Erectile dysfunction (ED) is a common disease and may be due to psychological or organic causes. It might point to a silent disease and its value could not only be in life quality but also directly resolving the health problem laying beneath. The evaluation of ED begins with sexual records and physical examination which have been reported to have a 95 percent sensitivity, and a 50 percent specificity. Additional diagnostic tests are needed to maximize specificity. Sexual impairment in general Internal Medicine patients has not been sufficiently studied yet. Patients and methods: Unselected ambulatory and hospital admitted patients were interviewed during 2003 using the International Index of Erectile Function (IIEF) ad the Sexual Health Interview for Men (SHIM). The cut-off point was 21. Results: A total of 51 male patients were interviewed, middle age was 65 years old (30-88). Of these, 27 denied sexual activity (group I). Middle age in this group was 64 years old. In the 24 patients with sexual activity (group II) middle age was 61 years old. The IIEF score was less than 45 in 11 patients (groups I and II of erectile dysfunction) The SHIM middle score was 26 points. The score was < 21 in 10 patients (41,6%). Concordance between both test was 90.9%. Risk factors included: tobacco (12 patients), alcohol (9), hypertension (8), and diabetes (7) among others. Conclusion: Our investigation seems to show that a great number of patients attended by Internists have sexual impairment (41.6%). None of these were under specific therapy nor consulted for this disease. Middle age is lower among patients with sexual activity as compared with the group without sexual activity. This assessment should be included in the medical interview with the aim of prescribing specific therapy to improve patient’s quality of life