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      Evaluación de la autoestima en varones con disfunción eréctil tratados con sildenafilo: Análisis de un grupo de pacientes españoles procedentes de un estudio multicéntrico internacional Translated title: Evaluation of self-esteem in males with erectile dysfunction treated with viagra: Analysis of a Spanish patients group selected from a multicenter, international study

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          Abstract

          Introducción y objetivos: La disfunción eréctil (DE) provoca alteraciones psicológicas, principalmente ansiedad y pérdida de la autoestima. Intentamos conocer los cambios emocionales, basados en la autoestima y las relaciones, en un grupo de varones españoles con DE tras el tratamiento con sildenafilo, utilizando para ello el cuestionario SEAR (Self-Esteem And Resationship). Material y método: De un estudio internacional multicéntrico, randomizado, grupos paralelos, doble ciego y controlado por placebo de sildenafilo diseñado para evaluar la autoestima y relaciones en varones con DE, seleccionamos los pacientes reclutados en España. Se compararon los cambios en los diferentes dominios del cuestionario SEAR (autoestima, actividad sexual, autoconfianza y relaciones generales) que se administró antes y después del tratamiento, así como los diferentes dominios del IIEF. También se calculó la correlación entre el cambio en el dominio autoestima del cuestionario SEAR y el dominio función eréctil del IIEF. El estudio estadístico se basó en un análisis de la covarianza del cambio en las puntuaciones y en un estudio de correlación. Resultados: El grupo español de investigadores incluyó 119 pacientes. La puntuación del dominio función eréctil mostró una mejoría significativamente mayor para el grupo de sildenafilo. La diferencia de cambio en la media de la puntuación total del SEAR tras el tratamiento fue de 16,9 (IC 95%: 8,9; 24,8) a favor de sildenafilo respecto al placebo (p=0,0001), con una mejoría en la puntuación significativamente superior en todos los dominios del SEAR a favor de sildenafilo. Se observó una correlación significativa entre los cambios en el dominio de autoestima del SEAR y el dominio función eréctil del IIEF para ambos grupos de tratamiento. Conclusiones: Se confirma una mejoría emocional en los pacientes tratados con sildenafilo en base a la mejora en la autoestima, autoconfianza y las relaciones. Variaciones en el dominio función eréctil del IIEF muestran correlación con las del dominio autoestima del SEAR.

          Translated abstract

          Introduction and objectives: Erectile dysfunction (ED) leads to psychological disturbances, especially anxiety and loss of self-esteem. We try to understand the emotional changes, based on self-esteem and relationships in a group of Spanish men with ED after sildenafil treatment, with the use of the the SEAR questionnaire (Self-Esteem And Relationship). Materials and methods: The patients recruited in Spain, where selected from an international, multicenter, randomized, parallel-group, double-blind, placebo-controlled, sildenafil study designed to assess self-esteem and relationships in men with ED. We compared the changes in the different domains of the SEAR questionnaire (Self-steem, sexual activity, self-confidence and general relationships) that was administered before and after treatment; the different domains of the IIEF was evaluated aswell. We also calculated the correlation between changes in self-esteem domain of the SEAR questionnaire. The statistical study was based on an analysis of covariance of change in scores and a correlation analysis. Results: The Spanish group of researchers included 119 patients. The erectile function domain score showed significantly greater improvement for the group of sildenafil. The difference in change in total mean score of the SEAR after treatment was 16.9 (95% CI 8.9, 24.8) for sildenafil over placebo (p=0.0001), with a significantly higher score improvement in all the domains of the SEAR for Sildenafil. There was a significant correlation between the changes in the domain of self-esteem of the SEAR and the IIEF erectile function domain for both treatment groups. Conclusions: Emotional improvement was confirmed in patients treated with sildenafil based on improved self-esteem, self-confidence and relationships. Changes in the IIEF erectile function domain correlate with the SEAR self-esteem domain.

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          Most cited references60

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            Prevalence and independent risk factors for erectile dysfunction in Spain: results of the Epidemiologia de la Disfuncion Erectil Masculina Study.

            We determined the prevalence of and risks factors for erectile dysfunction in Spain in a cross-sectional study. A total of 2,476 noninstitutionalized Spanish men 25 to 70 years old were interviewed at home and answered a self-administered questionnaire of 71 items, including 2 instruments to define erectile dysfunction, a simple self-assessment question to estimate erectile function and the International Index of Erectile Function. Data on disease, medication and toxic habits were also obtained. With an overall participation rate of 75% the prevalence of erectile dysfunction according to the simple question was 12.1%. According to the erectile function domain of the International Index of Erectile Function the overall prevalence was 18.9%. Several independent risk factors were significantly associated with the probability of erectile dysfunction. Some differences arose according to the tool used to define the condition. However, there was a strong relationship of patient age with frequency or severity no matter which instrument was used to define erectile dysfunction. Diabetes (age adjusted odds ratio 4), high blood pressure (odds ratio 1.58), high cholesterol (1.63), peripheral vascular disorder (2.63), lung disease (3.11), prostate disease (2.93), cardiac problems (1.79), rheumatism (2.37) and allergy (3.08) were significantly associated with erectile dysfunction. Drug intake, which respondents called medication for nerves and sleeping pills, correlated strongly (odds ratio 2.78 and 4.27, respectively), as did tobacco use (2.5) and alcohol consumption (1.53). This study provides data on the prevalence of and risks factors for erectile dysfunction in Spain. The relationship of erectile dysfunction with certain risk factors, such as cardiovascular risk factors and drugs intake, are well known and our study corroborates these associations. Other associations with erectile dysfunction, such as prostate disease, allergy and rheumatism, support findings in previous reports, although to our knowledge the pathophysiological mechanisms remain unclear. Estimating the strength of the association of erectile dysfunction with distinct risk factors in terms of odds ratios enabled us to identify the factors to pursue when seeking to prevent erectile dysfunction. Furthermore, the relationship of tobacco with erectile dysfunction, which has been controversial in previous series, was well characterized in our study.
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              Health-related quality of life in men with erectile dysfunction.

              To assess health-related quality of life (HRQOL) in men with erectile dysfunction. Descriptive survey with general and disease-specific measures. The instrument contained three established, validated HRQOL measures, a validated comorbidity checklist, and sociodemographics. The RAND 36-Item Health Survey 1.0 (SF-36) was used to assess general HRQOL. Sexual function and sexual bother were assessed using the UCLA Prostate Cancer Index. The marital interaction scale from the Cancer Rehabilitation Evaluation System Short Form (CARES-SF) was used to assess each patient's relationship with his sexual partner. Urology clinics at a university medical center and the affiliated Veterans Affairs (VA) Medical Center. Thirty-five (67%) of 54 consecutive university patients presenting for erectile dysfunction and 22 (42%) of 52 VA patients who were awaiting a previously prescribed vacuum erection device participated. The university respondents scored slightly lower than population normals in social function, role limitations due to emotional problems, and emotional well-being. The VA respondents scored lower than expected in all eight domains. Scores for the VA population were significantly lower than those for the university population in physical function, role limitations due to physical problems, bodily pain, and social function. A significant correlation was seen between marital interaction and sexual function (r = -.33, p = .01) but not between marital interaction and sexual bother (r = -.15, p = .26) in the total sample. Sexual function also correlated significantly with general health perceptions (r = .34, p = .01), role limitations due to physical problems (r = .29, p = .03), and role limitations due to emotional problems (r = .30, p = .03). Sexual bother did not correlate with any of the general HRQOL domains. Affluent men reported better sexual function (p = .03). The emotional domains of the SF-36 are associated with more profound impairment than are the physical domains in men with erectile dysfunction. Erectile dysfunction and the bother it causes are discrete domains of HRQOL and distinct from each other in these patients. With increased attention to patient-centered medical outcomes, greater emphasis has been placed on such variables as HRQOL. This should be particularly true for a patient-driven symptom, such as erectile dysfunction.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                aue
                Actas Urológicas Españolas
                Actas Urol Esp
                Asociación Española de Urología (, , Spain )
                0210-4806
                September 2010
                : 34
                : 8
                : 699-707
                Affiliations
                [03] Zaragoza orgnameHospital Universitario Miguel Servet orgdiv1Servicio de Urología España
                [01] Valencia orgnameHospital Clínico Universitario de Valencia orgdiv1Servicio de Urología España
                [02] Madrid orgnameHospital de la Zarzuela orgdiv1Servicio de Urología España
                [04] orgnameHospital Universitario de Canarias orgdiv1Departamento de Cirugía España
                [05] Madrid orgnamePfizer orgdiv1Departamento Médico España
                Article
                S0210-48062010000800007
                1e7a2915-55a2-4280-9ca4-c529f03b1f1f

                This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

                History
                : 03 February 2010
                : 31 March 2010
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 34, Pages: 9
                Product

                SciELO Spain


                Disfunción eréctil,Sildenafil,Inhibidor fosfodiesterasa tipo 5,Autoestima,Calidad de vida,Erectile dysfunction,Phosphodiesterase type 5 inhibitor,Self concept,Quality of life

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