Self-Esteem And Relationship Questionnaire Research Articles

Stigma and its associations with self-confidence and sexual relations in 4 types of premature ejaculation

BackgroundAlthough men with premature ejaculation (PE) always show more negative emotions, including embarrassment, guilt and worry, this may be related to the stigma of PE. To investigated stigma and its associations with self-confidence and sexual relations in 4 PE syndromes, a survey was conducted in our hospital from December 2018 to December 2019 among 350 men with self-reported PE and 252 men without self-reported PE. The stigma, self-confidence and sexual relations were assessed by the Social Impact Scale (SIS) and Self-Esteem and Relationship questionnaire (SEAR), respectively. Ejaculation control, sexual life satisfaction and distress caused by PE were evaluated by the Index of PE.ResultsMen with self-reported PE had higher internalized shame and social isolation scores and lower SEAR scores than control subjects. The highest score of internalized shame and social isolation and the lowest score of SEAR appeared in men with lifelong PE (LPE). After age adjustment, the positive relationships were stronger between distress about PE and internalized shame. Whereas, the stronger negative associations were found between social isolation and sexual satisfaction. The strongest association was observed between social isolation and sexual relationship. Therefore, the stigma associated with PE adversely affects the self-confidence, self-esteem, and sexual relationships of men with PE.ConclusionMen with PE, especially LPE, have a high level of stigma and disharmonious sexual relations, and often lack self-confidence and self-esteem, which have a certain negative impact on their physical and mental health and life. These will be the key issues to be considered when we formulate a personalized treatment plan for PE.

Mental health changes in partners of transgender and gender nonconforming individuals as a result of partner gender transition: What about me?

Purpose Research on the psychosocial impact of gender transitioning on partners of transgender and gender nonconforming (TGNC) individuals is scarce in the literature. Here, we assessed mental health in partners of TGNC individuals. Methods Anonymous surveys were administered via Amazon Mturk. Eligible participants were ≥ 18 years with a partner who transitioned genders. Relationship satisfaction and mental health were assessed via perceived changes, Personal Health Questionnaire Depression Scale (PHQ-8), General Anxiety Disorder (GAD-7), Self-Esteem and Relationship Questionnaire (SEAR), Resilience Scale, and Difficulties in Emotion Regulation Scale (DERS-5). Multivariable linear regression assessed associations between relationship satisfaction and type of partner transitioning. Results Of the 337 study respondents, 42.4% were assigned male, 57.6% assigned female (43.9% identify as male; 55.8% as female) and 1.76% nonbinary, with a mean age of 35.8. 44.4% had partners who are transgender women, while a third (36.8%) had partners who are transgender men, 7.7% from assigned male to nonbinary, and 11.2% from assigned female to nonbinary. Most (72.4%) partners underwent surgical transitioning (15.1% top surgery; 5.6% bottom; 51.6% both) versus 27.6% non-surgical transitioning. PHQ-8, SEAR, confidence, self-esteem, relationship satisfaction, and resilience scores were higher among respondents whose partners underwent surgical transitioning (p < 0.001). SEAR scores differed significantly among participants whose partners underwent top only versus bottom only surgery (p = 0.004). Conclusion Partner mental health and relationship satisfaction were most impacted by surgical transitioning of their TGNC partner. Supportive services for partners of TGNC individuals during the transition process to protect these romantic relationships should be considered.

Premature Ejaculation-A Taboo in Islamic Culture Effecting Self-Esteem and Relationship of Pakistani Men

Background and Objective: Premature ejaculation is a common sexual dysfunction, severely affecting quality of life and relationship of married men. It is a taboo topic in Muslim population and not much data available in male dominant society like Pakistan. We aim to measure the impact of PE on married men by using Self-esteem and relationship questionnaire (SEAR). Material and Methods: Men presenting in outpatient clinic with features of PE were asked to fill the premature ejaculation diagnostic tool to confirm the diagnosis of PE and Self-esteem and relationship questionnaire (SEAR) to measure the effect of PE on self-esteem and relationship status. Equal numbers of controls were also asked to fill out the SEAR questionnaire. Data was analyzed by R version 5.2. Wilcox test was used to compare continuous variables and p-value of &lt;0.05 considered as significant. Univariate analysis was done to determine factors predicting self-esteem and total relationship score. Results: There were 48 patients in each group. The mean age of PE group was 31.06+/- 8.35 and mean age of control group was 33.67+/-10.79. Mean Self-esteem and total SEAR score of PE group was 11.04+/-2.25 and 39.5+/-7.23 respectively while mean self-esteem and total SEAR score of control group was 18.27+/-0.91 and 64.20+/-3.13 respectively, both of which are statistically significant. We also performed the univariate analysis of self-esteem and total SEAR score but could not find the statistically significant factors predicting self-esteem and total relationship. Conclusion: Premature ejaculation is a significant problem negatively effecting self-esteem and relationship of married Pakistani men. Early diagnosis, treatment and psychological counseling are required to deal with this common problem.

Sexual function assessment in patients with SAPHO syndrome: a cross-sectional study

IntroductionSAPHO syndrome is a group of special syndromes characterized by synovitis, acne, pustulosis, hyperostosis and osteitis. Skin lesions and joint damage are the main clinical manifestations. Among them, females mostly present with palm toe pustulosis, while males have severe acne as the main external manifestation. The bone and joint damage characterized by bone hypertrophy and osteitis is the core manifestation of SAPHO and affects all parts of the body. SAPHO syndrome causes great physical and mental suffering to patients, and it also brings a huge financial burden to the family. The purpose of this study is to explore the impact of SAPHO on the quality of sexual life of patients.MethodsWe screened and included 249 SAPHO patients (169 women and 80 men) from Peking Union Medical College Hospital (Beijing, China). First, we recorded the basic situation of the patient through questionnaires (including gender, age, SAPHO duration, BMI, smoking, drinking, marital status, educational level, occupational status and work status.). Then, the patient needed to fill in the Short Form-36 quality of life questionnaire (SF-36 QoL) to record the quality of life. For Sexual dysfunction (SD), female patients needed to fill in the Female Sexual Function Index (FSFI) to assess the quality of sexual life; while the International Index of Erectile Function (IIEF) was used to assess the SD of male patients. At the same time, we used self-esteem and relationship questionnaire (SEAR) to analyze the psychological state of SAPHO patients. Finally, we performed statistical analysis on the data obtained, and then explored the connection between SAPHO and SD.ResultsIn this cross-sectional study, a total of 249 patients completed the questionnaire and constituted the study population. We found that among 169 female patients, 124 patients had FSD (73.4%); while 45 patients did not have FSD (26.6%); and among 80 male patients, 45 (56.3%) had ED; However, 35 patients did not have ED (43.7%). The results of the quality of life and mental state assessment showed that female patients with SD showed lower scores in terms of mental state. Among all male participants, we found no significant difference in quality of life and mental state among participants with or without SD. In addition, there was no significant difference in the duration of SAPHO between female and male participants with or without SD.ConclusionThis study is the first to evaluate the SD of SAPHO patients. The incidence of SD in female SAPHO patients is higher than that in male patients; the cause of female SD may be mainly psychological factors. These results prove that it is particularly important to focus on regulating their psychological state while diagnosing and treating SAPHO patients in clinical practice.

A Comparison of the Psychosocial Impact of Penile Prosthesis and Intracavernosal Injection Therapy for Erectile Dysfunction Using the Self-Esteem and Relationship (SEAR) Questionnaire

ABSTRACT Introduction The few studies that do compare penile prostheses (PP) and intracavernosal injections (ICI) focus predominantly on sexual function leaving self-esteem and relationships understudied. The Self-Esteem and Relationship (SEAR) questionnaire was developed to provide a reliable tool to assess psychosocial variables of ED treatments. We hypothesized that patients with PP would have higher SEAR scores compared to patients treated with ICI. Objective To compare psychosocial variables of PP and ICI treatments using the SEAR questionnaire. Methods IRB-approval was obtained to interview patients by phone who underwent ED treatment by a single surgeon. SEAR questionnaire results were calculated according to the previously described formula and individual questions and domains were compared using T-test statistics. Results Fifty patients (25 PP, 25 ICI) agreed to be interviewed for this study. Prostate cancer (n=21, 45%) and vascular disease (n=7, 14%) were the leading cause of ED in our cohort. PI patients on average suffered from ED for a longer period than patients on ICI (5.6 vs 2.7 years, p=0.005). There were no differences in age or marital status. PP patients reported numerically higher total SEAR scores than PP patients (63 vs 53, p=0.12). PI patients reported higher sexual relationships domain scores than ICI patients (64 vs 46, p=0.04), especially in “I felt confident that during sex my erection would last long enough” (p=0.004), “I was satisfied with my sexual performance” (p=0.05), and “I felt confident about performing sexually” (p=0.02). There were no statistical differences in the confidence domain (p=0.89) or self-esteem (p=0.68) and overall relationship (p=0.80) sub-domains. Conclusions PP patients reported higher sexual relationship domain scores than ICI patients, while confidence, self-esteem, and overall relationships were similar. Regular use of the SEAR questionnaire may help to identify areas of post-treatment psychosocial needs in ED patients that may benefit from support groups or discussion with a counselor. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Boston Scientific

The Prevalence and Predictors of Penile Pain in Men with Peyronie's Disease.

IntroductionPenile pain is one of the most stressful symptoms in men with Peyronie's disease (PD).AimTo evaluate the prevalence, clinical presentation and risk factors associated with penile pain in men with PD as well as to assess the psychosocial impact.MethodsWe revised our institution's database of men diagnosed with PD. The information collected included penile pain assessments, and the scores of the PD Questionnaire (PDQ), Self-Esteem and Relationship Questionnaire (SEAR) and Center for Epidemiologic Studies Depression Scale Questionnaire (CES-D). Descriptive and comparative statistics were used. Logistic regression analyses were performed to evaluate predictive factors associated with penile pain.Main outcome measuresPenile pain descriptive assessment and factors associated with penile pain in men with PD. Comparison of SEAR, CES-D and PDQ domain scores of men with and without penile pain.Results431 men with PD were included for this analysis with a mean age of 55.9 years. Penile pain was reported by 36.7%; 65.2% of those had painful erection, 7% pain with flaccid state only, and 20% in both stages. The median pain severity was 3 with erection and 1 with flaccid stage. After adjusted logistic regression analyses, advanced age was associated with less pain (OR 0.94, P ≤ 0.001). Men with penile pain had no significant difference in CES-D and SEAR mean scores compared to men without penile pain. The PDQ scores for the physical/psychological symptoms domain and the bother domain were significantly higher in men with penile pain (12 vs 8.7; P < 0.01 and 9 vs 7.1; P < 0.01 respectively). Men with penile pain had a higher rate of clinically significant bother scores than men without penile pain (52% vs 35%, P ≤ 0.001).ConclusionPenile pain is common in men with PD. It was more common in young men and was associated with physical and psychological bothers in this population.Flores JM, Salter CA, Nascimento B, et al. The Prevalence and Predictors of Penile Pain in Men with Peyronie's Disease. Sex Med 2021;9:100398.

Sexual relationship, self-esteem, dysfunction, and sexual satisfaction in treatment naïve men with heroin dependence

ABSTRACT Heroin use, a prevalent and disabling condition, affects sexual functioning and the sexual quality of life. While there is adequate literature on sexual dysfunction with heroin use, the literature is scarce on the emotional aspects of sex, like the perception of sexual relationship, self-esteem, and satisfaction amongst heroin users. The study assessed these parameters among treatment-naïve, sexually active, married, male patients with heroin dependence. We interviewed 63 treatment-naïve men seeking treatment for heroin dependence using Self-esteem and Relationship Questionnaire (SEAR), New Sexual Satisfaction Scale-Short form (NSSS-S), Sexual Quality of Life Questionnaire-Male (SQoL-M), Index of Premature Ejaculation (IPE), and International Index of Erectile Function (IIEF). Overall scores in SEAR, NSSS-S, SQoL-M, IIEF, and IPE were low, suggesting poor self-esteem and relationship, poor sexual quality of life and sexual satisfaction, higher premature ejaculation, and erectile dysfunction. Injecting drug use was associated with lower scores on confidence domain of SEAR, partner activity focused domain of NSSS-S, intercourse-satisfaction, and overall sexual quality of life. Sexual dysfunctions, poor sexual relationship, and sexual quality of life are common among men seeking treatment for heroin dependence. Treatment strategies must not lose focus on this dimension of health during the treatment process.

Increasing access to erectile dysfunction treatment via pharmacies to improve healthcare provider visits and quality of life: Results from a prospective real-world observational study in the United Kingdom.

ObjectivesThe Medicines and Healthcare Products Regulatory Agency in the United Kingdom (UK) formally reclassified sildenafil citrate 50 mg tablets as a pharmacy medicine (sildenafil‐P) in 2017 for adult men with erectile dysfunction (ED). A 1‐year prospective real‐world observational study was conducted to track men's health behaviour, particularly their healthcare resource utilisation (HCRU) and quality of life (QoL) before and after the availability of sildenafil‐P.MethodsAdult men with ED aged ≥18 years provided data at baseline (prior to launch of sildenafil‐P) and every 3 months after the launch. Demographics, health characteristics, treatments at baseline and HCRU, including number of pharmacist and physician/nurse practitioner visits over time are reported. QoL‐related outcomes were assessed via the Self‐Esteem and Relationship Questionnaire (SEAR), 2‐Item Patient Health Questionnaire and ratings of sexual satisfaction. Generalised linear models were used to assess the association of sildenafil‐P use with total physician/nurse practitioner and pharmacist visits and QoL‐related outcomes at 12 months.ResultsOverall, 1162 men completed the survey at all 5 time points. The mean ± SD age was 59.02 ± 12.06 years; 55.42% reported having a moderate‐to‐severe ED. Hypertension (37.52%) and hypercholesterolaemia (31.50%) were the most common risk factors for ED. At baseline, 62.99% were not using any ED treatment. After adjusting for baseline visits/other covariates, mean physician/nurse practitioner (3.68 vs 2.87; P = .003) and pharmacist visits for any reason (2.10 vs 1.34; P < .001) at 12 months were significantly higher among sildenafil‐P users than those who never used sildenafil‐P. Sildenafil‐P users also had significantly higher SEAR total and domain (sexual relationship and self‐esteem) scores at 12 months.ConclusionFollowing the reclassification to a pharmacy medicine in the UK, sildenafil‐P was associated with a higher number of physician/nurse practitioner and pharmacist visits for any reason. Sildenafil‐P use was also associated with better QoL, although group differences were small in magnitude.

Defining the impact of Peyronie's disease on the psychosocial status of gay men.

Little sexual health research has been conducted in gay men. Anecdotally, this population seems to experience more bother related to Peyronie's disease (PD). To examine the impact of PD on psychosocial factors in gay vs straight men. All PD patients who were seen in the sexual medicine clinic were included. They completed three instruments: the PD questionnaire (PDQ), Self-Esteem and Relationship (SEAR) questionnaire, and a depression questionnaire (CES-D). We described demographics and sexual variables by sexual orientation. We then compared PDQ items and summary scores by sexual orientation, using a series of independent samples t tests. 34 consecutive gay and 464 straight men were included. Age and baseline characteristics were similar between the two cohorts, with the exception that fewer gay men were partnered (56% vs 87%, P<.01), and those with a partner had a shorter relationship duration: 109±9months vs 262±175months, P<.01. For the SEAR questionnaire, gay men demonstrated a more significant psychosocial impact of PD overall with lower SEAR sums (41 vs 57, P=.01) and a lower sexual relationship subdomain score (28 vs 47, P<.01). 41% of gay men vs 26% of straight men had CES-D scores consistent with depression as defined by a score of ≥16 (P=.09). In the PDQ domains, gay men scored less favorably with regard to bother scores (7 vs 5, P=.03) and pain scores (8 vs 4, P=.04). Gay men with PD experience significantly more psychosocial impact as evidenced by less favorable SEAR sum and sexual relationship scores, CES-D scores, and PDQ pain and bother domain scores. The psychosocial impact of PD is significant in all men, but it appears to be greater in gay men.

Efficacy and safety of low-intensity pulsed ultrasound at different intervals by mechanical force in treating erectile dysfunction: a preliminary study

Objective: To study the efficacy and safety of low-intensity pulsed ultrasound (LIPUS) at different intervals by mechanical force in treating erectile dysfunction (ED). Method: Forty patients with mild to moderate ED were randomized in a 1∶1 ratio to receive 16-treatment sessions of LIPUS in group A and group B, applied 3 times per week and 2 times per week, respectively. End-point assessments were made at 8th week after treatment. Efficacy were evaluated using International Index of Erectile Function-Erectile Function domain score (IIEF-EF), Erectile Hardness Score (EHS), Self-Esteem and Relationship Questionnaire (SEAR), Sexual Encounter Profile (SEP), Global Assessment Question (GAQ), and pain were assessed by Visual Analogue Score (VAS).Treatment response was confirmed by a minimal clinically importance difference (MCID) at 8th week. Results: Compared with baseline, IIEF-EF score [(17.1±5.48 vs 23.4±3.75, P<0.05) and (18.9±4.34 vs 24.1±4.32, P<0.05)], proportion of EHS 4 [(0 vs 40%, P<0.05) and (16.7% vs 55.6%, P<0.05)], and Overall Relationship score [(50.6 vs 67.5, P<0.05) and (44.4 vs 70.1, P<0.05)] were significantly improved at 8th week in two groups, respectively. Compared with baseline, the positive responses to SEP-3 increased significantly at 8th week in two groups (50.0% vs 80.0%,P<0.05) and (44.4% vs 88.9%, P<0.05), respectively. The positive responses to GAQ-2 were 90.0% and 88.9% at 8th week in two groups, respectively. There were no significant differences in IIEF-EF, EHS, SEAR, SEP and GAQ at 8th week between two groups. There was no significant difference in treatment response using MCID between two groups at end-point (80.5% vs 77.5%). The treatment duration for full sessions were 2.5 weeks less in group A than group B. No adverse effects were reported in all cases. Conclusion: LIPUS at two different intervals is effective and safe for mild to moderate ED, and the regimen at 3 times per week can achieve quite good effect in relatively short duration,while the long-term effects is still be clarified in further study.

Does male factor infertility impact on self‐esteem and sexual relationship?

Nonsomatic factors play a significant role in erectile dysfunction. We assessed the impact on men suffering from male factor infertility by employing the validated Self-Esteem and Relationship questionnaire (SEAR) and compared the scores with controls. Men with primary infertility were asked to fill SEAR questionnaire. Normal fertile men visiting clinic for unrelated problem or normal male accompanying infertile patients constitute the control group. Transformed score of each domain and total score of SEAR questionnaire and means were compared. Data were analysed by R version 5.2. Univariate and multivariate analyses were done to determine factors predicting self-esteem and total relationship score. There were 45 men each in the study and control groups. The mean transformed self-esteem score and total score of infertile men were significantly lower as compared to controls (74.44 versus 95.83) and (73.54 versus 95.86) p-value of <.0001. Longer duration of infertility, advanced age, diabetes and higher education were factors significantly lowering the scores on univariate analysis, and on multivariate analysis, diabetes was the only significant predictor of total SEAR score in infertile men. Infertility leads to lower self-esteem, sexual performance and confidence among infertile men as compared to controls. The relationship score worsens with increasing duration of infertility.

159 Preliminary study of a specific penile prosthesis conceived for phalloplasty, the ZSI® 475 FtM

Assessing security, feasibility and patient satisfaction of a new type of penile prosthesis specifically designed for phalloplasty. Patients were included from June 2016 to September 2017 at a single institution by a single surgeon. Medical data were collected from the patients’ hospital files. Patients were then proposed to answer a satisfaction questionnaire that included IIEF (International Index of Erectile Function) questionnaire, EDITS (Erectile Dysfunction Inventory of Treatment Satisfaction) questionnaire, SEAR (Self-Esteem and Relationship) questionnaire, and specific items. Twenty patients were included, mean age 37.9 years, and 21 prostheses were implanted. All had gender dysphoria and phalloplasty type were forearm flap (n=15, 75%), suprapubic (n=4, 20%) and pedicled inguinal (n=1, 5%). 17 patients (85%) had functional urethroplasty. Complications were 2 (10%) infections medically treated, 1 (5%) infection treated by explantation, 2 (10%) mechanical failures and 1 (5%) malposition. Mean operating time was 102.6 min (SD 13.2) and mean duration of hospitalization was 2.7 days (SD 0.5%). Fourteen patients (70%) answered the satisfaction questionnaire. Twelve (85.7%) patients had sexual relationship regularly. Mean IIEF was 20.2 over 25 (SD 7.9), mean SEAR was 84.5 over 100 (SD 9.9) and mean EDITS was 82 over 100 (SD 17.5). Thirteen patients (92.8%) were satisfied or very satisfied with the prosthesis.

Quality of Life, Psychological Functioning, and Treatment Satisfaction of Men Who Have Undergone Penile Prosthesis Surgery Following Robot-Assisted Radical Prostatectomy

BackgroundPenile prosthesis surgery is last-line treatment to regaining erectile function after radical prostatectomy (RP) for localized prostate cancer. AimsTo assess quality of life, psychological functioning, and treatment satisfaction of men who underwent penile implantation after RP; the psychosocial correlates of treatment satisfaction and sexual function after surgery; and the relation between patients’ and partners’ ratings of treatment satisfaction. Methods98 consecutive patients who underwent penile implantation after RP from 2010 and 2015 and their partners were invited to complete a series of measures at a single time point. Of these, 71 patients and 43 partners completed measures assessing sexual function, psychological functioning, and treatment satisfaction. Proportions of patients who demonstrated good sexual function and satisfaction with treatment and clinical levels of anxiety and depression were calculated. Hierarchical regression analyses were conducted to determine psychosocial factors associated with patient treatment satisfaction and sexual function and patient-partner differences in treatment satisfaction. OutcomesPatients completed the Expanded Prostate Cancer Index Composite Short Form (EPIC-26), Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), Prostate Cancer-Related Quality of Life Scale, Self-Esteem and Relationship Questionnaire (SEAR), Generalized Anxiety Disorder–7 (GAD-7), and Patient Health Questionnaire–9 (PHQ-9). Partners completed the GAD-7, PHQ-9, EDITS (partner version), and SEAR. Results94% of men reported satisfaction with treatment (EDITS score > 50). 77% of men reported good sexual function (EPIC-26 score > 60). Lower depression scores were associated with higher sexual confidence and sexual intimacy, and these were correlated with better treatment satisfaction and sexual function. Patients experienced higher sexual relationship satisfaction (median score = 90.6) than their partners (median score = 81.2), but there was no difference in treatment satisfaction between groups. Higher patient treatment satisfaction was more likely to be reported for couples whose depression scores were more similar. Clinical ImplicationsIt is important to provide preoperative penile implant counseling and encourage patients to seek postoperative counseling if needed. Strengths and LimitationsThis is one of the first Australian-based studies comprehensively assessing treatment satisfaction and psychosocial health of men after penile prosthesis surgery after RP. This was a retrospective cross-sectional study, so there is a possibility of recall bias, and causal associations could not be determined. ConclusionMen in this Australian series who underwent penile prosthesis surgery after RP generally reported good sexual function and treatment satisfaction. Nevertheless, patient and partner mental health influenced their reported experience of the treatment.Pillay B, Moon D, Love C, et al. Quality of Life, Psychological Functioning, and Treatment Satisfaction of Men Who Have Undergone Penile Prosthesis Surgery Following Robot-Assisted Radical Prostatectomy. J Sex Med 2017;14:1612–1620.

MP84-03 DEVELOPMENT OF A CUT-OFF FOR THE PEYRONIE's DISEASE QUESTIONNAIRE (PDQ) BOTHER SCORE

You have accessJournal of UrologySexual Function/Dysfunction: Evaluation II1 Apr 2017MP84-03 DEVELOPMENT OF A CUT-OFF FOR THE PEYRONIE's DISEASE QUESTIONNAIRE (PDQ) BOTHER SCORE Jean-Etienne Terrier, Christian J Nelson, and John P Mulhall Jean-Etienne TerrierJean-Etienne Terrier More articles by this author , Christian J NelsonChristian J Nelson More articles by this author , and John P MulhallJohn P Mulhall More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2644AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The Peyronie's Disease Questionnaire (PDQ is a validated self-reported questionnaire that measures the impact and severity of Peyronie's Disease (PD) in 3 domains, including Symptom Bother (6 items, score range 0-16). Mean baseline bother score in the IMPRESS trials was 8 (7.8±3.7). However, the clinical significance of the PDQ bother score has not been evaluated. We aimed to find the optimal PDQ symptom bother score cut-off predicting the presence of clinical bother and distress. METHODS Men with PD completed a series of validated questionnaires at initial consultation, including the PDQ, the Center for Epidemiological Studies-Depression scale (CESD), and the Self-Esteem and Relationship questionnaire (SEAR). We used a receiver operating characteristic (ROC) curve to determine the optimal cutoff score of PDQ bother by separately predicting: (1) depressive symptoms as defined as a score of ≥16 on the CESD (2) low sexual self-esteem defined as a score of ≤35 on the SEAR (the score reported by those with severe ED) and (3) the combination of depressive symptoms and low sexual self-esteem. The Youden index was used to determine the optimal cut-off maximizing both sensitivity and specificity. RESULTS The mean age of the 204 men was 56±12 years of age. 82% of the sample had a partner, with an average length of relationship of 16±14 years. The mean duration of PD was 16±21 months and the average curvature was 39±20 degrees. When using depressive symptoms (CESD) as the criterion, the ROC curve analysis produced an area under the curve (AUC) of 0.61 (p=0.04), indicating a cut-off score of 8, which produced the best sensitivity (0.61) and specificity (0.58). When using low sexual self-esteem (SEAR) as the criterion, the ROC curve analysis produced an AUC of 0.70 (p=0.001), and indicated a cut-off score of 9 producing the optimum sensitivity (0.67) and specificity (0.69). The combination of both criteria failed to produce a significant AUC (0.48, p=0.56). Since using sexual self-esteem as the criterion produced better AUC and higher sensitivity and specificity, the cut-off score of 9 is suggested. CONCLUSIONS A bother score of 9 on the PDQ appears to represent the optimal cut-off score indicating clinically significant bother. In our opinion, such a score warrants a consideration to refer the patient to a mental health professional. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1139 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Jean-Etienne Terrier More articles by this author Christian J Nelson More articles by this author John P Mulhall More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Sexuality, Self-Esteem and Partnership Quality in Infertile Women and Men.

Introduction: Infertile couples often report quality-of-life impairments, especially in terms of sexuality, self-esteem and partnership quality. So far, there have been no systematic studies of the sex lives and behaviour of infertile women and men before and after the emergence of their mutual desire for a child. Materials and Methods: From February 2010 to August 2010 all couples starting treatment either at Heidelberg University's Women's Hospital or at the Fertility Center Berlin were asked to fill out the Self-Esteem and Relationship Questionnaire (SEAR). A total of n = 158 women and n = 153 men participated in the study. Results: Decreasing tendencies were observable for both partners in the domains Sexual Relationship Satisfaction and Confidence and in the subscales Self-Esteem and Overall Relationship Satisfaction. There were especially clear indications of a loss of spontaneous sexuality during the experience of infertility. We were also able to establish that infertility has a negative impact on women's self-esteem. Discussion: The results of this study indicate that SEAR can be used as a feasible instrument for identifying infertile women and men whose infertility has a negative effect on their relationship quality and/or sex lives.

Cumulative response curves to enhance interpretation of treatment differences on the Self‐Esteem And Relationship questionnaire for men with erectile dysfunction

What's known on the subject? and What does the study add? Studies on erectile dysfunction (ED) therapies rely heavily on patient-reported outcomes (PROs) to measure efficacy on treatment response. A challenge when using PROs is interpretation of the clinical meaning of changes in scores. A responder analysis provides a threshold score to indicate whether a change in score qualifies a patient as a responder. However, a major consideration with responder analysis is the sometimes arbitrary nature of defining the threshold for a response. By contrast, cumulative response curves (CRCs) display patient response rates over a continuum of possible thresholds, thus eliminating problems with a rigid threshold definition, allowing for a variety of response thresholds to be examined simultaneously, and encompassing all data. With respect to the psychosocial factors addressed in the Self-Esteem And Relationship questionnaire in ED, CRCs clearly, distinctly, and meaningfully highlighted the favourable profiles of responses to sildenafil compared with placebo. CRCs for PROs in urology can provide a clear, transparent and meaningful visual depiction of efficacy data that can supplement and complement other analyses. To use cumulative response curves (CRCs) to enrich meaning and enhance interpretation of scores on the Self-Esteem And Relationship (SEAR) questionnaire with respect to treatment differences for men with erectile dysfunction (ED). This post hoc analysis used data from all patients who took at least one dose of study drug and had at least one post-baseline efficacy evaluation in a previously published 12-week, multicentre, randomized, double-blind, placebo-controlled trial of flexible-dose (25, 50, or 100 mg) sildenafil citrate (Viagra) in adult men with ED who had scored ≤ 75 out of 100 on the Self-Esteem subscale of the SEAR questionnaire. CRCs were used on the numeric change in transformed SEAR scores from baseline to end-of-study for each SEAR component. The horizontal axis of the CRC represented change from baseline on the SEAR score, and the vertical axis represented the percentage of patients experiencing that change or greater. The differences between CRCs for the sildenafil group vs the placebo group were assessed using the Kolmogorov-Smirov test. For each of the SEAR components, there was essentially no overlap in the CRCs between the sildenafil group (n = 113) and placebo group (n = 115 or 116, depending on the component), showing that a greater percentage of sildenafil recipients compared with placebo recipients had a more favourable change across the spectrum of response thresholds (P ≤ 0.01). Previous research showed that a 10-point score increase is the minimal clinically meaningful improvement for most SEAR components. In the sildenafil vs placebo groups, a ≥10-point score increase occurred in 72 vs 37% of patients, respectively, on the Sexual Relationship Satisfaction domain, 71 vs 41% on the Confidence domain, 76 vs 49% on the Self-Esteem subscale, 60 vs 44% on the Overall Relationship Satisfaction subscale, and 75 vs 38% on the Overall score. With respect to the psychosocial factors addressed in the SEAR questionnaire, CRCs clearly, distinctly, and meaningfully highlighted the favourable profiles of responses to sildenafil compared with placebo. CRCs for patient-reported outcomes in urology can provide a clear, transparent, and meaningful visual depiction of efficacy data that can supplement and complement other analyses.

The Psychosocial Impact of Penile Reconstructive Surgery for Congenital Penile Deviation

A variety of surgical techniques to correct congenital penile deviation (CPD) have been described. Although surgical outcomes have been reported, the impact of this treatment on sexual relationship, confidence, self-esteem, and sexual function has never been established. To assess the impact of surgical treatment for CPD on sexual relationship, confidence, self-esteem, and sexual function, employing validated instruments. The Self-Esteem and Relationship (SEAR) and International Index of Erectile Function (IIEF) questionnaires. Prospective, longitudinal, uncontrolled study of 32 men undergoing penile reconstructive surgery for CPD. Assessment of change in sexual relationship, confidence, self-esteem, and sexual function scores. Twenty (37.5%) patients had ventral and 12 (62.5%) had lateral curvature, mean magnitude was 37 +/- 12 degrees . Significant improvement in SEAR domains scores was observed in sexual relationship (82 vs. 40, P < 0.01), overall relationship (86 vs. 62, P < 0.01), and confidence (88 vs. 58, P < 0.001). While mean IIEF erectile function domain score was unchanged: 24 +/- 3.6 and 25 +/- 2.5, before and after surgery, respectively (P = 0.85), significant improvements were observed in the libido (8 vs. 5, P = 0.02) and satisfaction (22 vs. 15, P < 0.01) domains of the IIEF. Predictors of improvement in SEAR and IIEF scores were perceived complete straightening and penile length preservation. Penile reconstructive surgery for CPD is associated with significant improvements in overall relationship, sexual relationship, confidence, libido, and satisfaction, as reflected by higher scores in three of the four domains of the SEAR questionnaire and improvements in two of the four domains of the IIEF.

Scoring Correspondence in Outcomes Related to Erectile Dysfunction Treatment on a 4-Point Scale (SCORE-4)

The Erection Hardness Score (EHS), a validated single-item patient-reported outcome (PRO), may provide a simple method to capture erectile dysfunction (ED) symptoms and to monitor treatment outcome. To map the relationship between the EHS, which was used as the anchor, and other validated PROs: International Index of Erectile Function (IIEF), Quality of Erection Questionnaire (QEQ), Sexual Experience Questionnaire (SEX-Q), and Self-Esteem and Relationship questionnaire (SEAR). Methods. Data were from a trial of flexible-dose sildenafil (50 or 100 mg) in 209 men with ED. A mixed-effects repeated-measures model with EHS as a categorical explanatory variable and each of the other PROs, as a separate dependent variable, was applied to analyze the longitudinal data from randomization to the end of the 10-week, double-blind, placebo-controlled phase and the 6-week open-label phase. EHS data, which were generated at each sexual encounter (event), were averaged per patient over the same recall period that preceded administration of the other PRO questionnaires. Scores on all domains of the IIEF and SEX-Q, as well as the SEAR total score and SEAR Sexual Relationship domain, discriminated on all EHS categories. The QEQ total score discriminated on all EHS categories except EHS 1 and EHS 2. Although the model did not impose any functional relationship between PRO score and EHS, an approximately linear relationship existed between the EHS and all other PROs, which was especially pronounced for those PROs that were more directly related to erectile quality or function. The relationship between discrete EHS categories and PRO scores demonstrates the close correspondence of erectile hardness with erectile function (IIEF), erection quality (QEQ), overall sexual experience (SEX-Q), and ED-related psychosocial factors (SEAR) in men with ED.

Self-Esteem, Confidence, and Relationships in Brazilian Men with Erectile Dysfunction Receiving Sildenafil Citrate: A Randomized, Parallel-Group, Double-Blind, Placebo-Controlled Study in Brazil

Psychosocial manifestations of erectile dysfunction (ED) differ across cultures. Understanding the treatment response to ED medications within cultural groups can aid in resource allocation and in developing treatment strategies. Evaluate the effect of sildenafil treatment on self-esteem, confidence, and sexual relationship satisfaction in Brazilian men with ED. The Self-Esteem and Relationship (SEAR) questionnaire, a validated, 14-question instrument developed to specifically address self-esteem and relationship issues within the context of ED. Men aged 18 years or older with a clinical diagnosis of ED (< or = 21 on the Sexual Health Inventory for Men) and in a stable relationship with a partner during the study were eligible. The primary end point was a change from baseline in the self-esteem subscale of the SEAR questionnaire. Thirteen Brazilian sites participated in a randomized, double-blind, placebo-controlled trial of sildenafil treatment for ED. Patients were randomized to receive either 50 mg of sildenafil (adjustable to 25 mg or 100 mg based on patient response) or matching placebo approximately 1 hour before anticipated sexual activity but not more than once a day. At the end of double-blind treatment, 63 and 66 patients in the placebo and sildenafil groups, respectively, from 13 Brazilian sites were assessed for efficacy. Brazilian patients receiving sildenafil had significantly greater improvements in their scores on the SEAR self-esteem subscale (42.9 [95% confidence interval 35.7-50.0]) compared with placebo (21.1 [95% confidence interval 13.7-28.6]; P < 0.0001). Effect sizes ranged from 0.91 to 1.25 for individual SEAR components. The psychosocial parameters in Brazilian men with ED assessed by the SEAR questionnaire showed significant improvements in self-esteem, confidence, and relationships after treatment with sildenafil.

Effect of Sildenafil on Middle-Aged Sexually Active Males with No Erectile Complaints: A Randomized Placebo-Controlled Double-Blind Study

BackgroundIn clinical practice, we commonly encounter sexually healthy males who use phosphodiesterase type 5 (PDE5) inhibitors and report a beneficial effect to their sex life. ObjectiveIn this study, we aimed to evaluate in a controlled manner the true effect of sildenafil 50mg on the quality of sexual life (QSL) in a group of sexually active males who do not have erectile complaints. Design, setting, and participantsThis prospective, placebo-controlled, double-blind, crossover study included sexually active middle-aged males who were never evaluated/treated for erectile dysfunction (ED) and who had an International Index of Erectile Function (IIEF) Erectile Function (EF) Domain score ≥22. The study included four visits in which subjects randomly received six tablets of sildenafil 50mg or placebo in a crossover manner. MeasurementsAssessment of efficacy was performed by subjects filling out the following QSL questionnaires: the Self-Esteem and Relationship Questionnaire (SEAR), the IIEF, the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), and additional questions regarding sexual performance (SAQ). Results and limitationsFrom a group of 65 screened subjects, 47 were eligible for analysis (28 without ED and 19 with mild ED). Average age was 52.1±10, mostly married (88%), with an IIEF–EF Domain score of 25.6±3.1. We found significant differences between the sildenafil vs placebo groups in the EDITS (70.8±18 vs 60.3±19, p=0.013), SEAR (57.6±1 vs 51±1. p<0.0001), and IIEF–EF Domain score (25.1±4.8 vs 23±5.3, p=0.013). All of our structured questionnaires showed significant improvement in the treated group. We did not find significant differences between the groups in the total IIEF score. We also performed individual analysis in the subgroup of subjects (mild ED vs normal EF), and no significant differences were demonstrated in the results of these groups with regard to total scores on all questionnaires employed. ConclusionsThis is the first placebo-controlled study performed on a selected group of individuals suggesting that middle-aged subjects without complaints of ED may have real benefit when using sildenafil. This study provides some preliminary data regarding the use of a phosphoesterase type 5 inhibitor (PDE5-I) in this unexplored population, but more data are needed in order to seriously consider extending their use in these males and perhaps in the younger population.