The Correlation Between Erectile Function and Patient Satisfaction


John Mulhall, MD, Weill Medical College of Cornell University, Department of Urology, New York, NY 10021, USA. Tel: (212) 746-5653; Fax: (212) 746-0403, E-mail:


Introduction.  The International Index of Erectile Function (IIEF) has become the gold standard inventory for the assessment of sexual function in drug trials and in clinical research. Normalization of the erectile function domain (EFD) score, an end of treatment score of 26 or higher, is an end-point that is currently being used routinely in drug trials. It has been our experience that some men with scores less that 26 on a sexual pharmaceutical are content with their sexual function. We undertook this study to define what proportion of men with EFD scores <26 are satisfied with their therapeutic response.

Methods.  100 consecutive patients who had presented to a sexual health clinic and who had used sildenafil citrate on at least 4 occasions completed the IIEF pertaining to their sildenafil response. They were also asked questions, pertaining to their ability to have sexual intercourse (Q1), their satisfaction with their erectogenic medication (Q2), the ability of the medication to improve erectile rigidity (Q3), and the ability of the medication to improve their ability to have sexual intercourse (Q4). Patients were subcategorized into 4 groups based on treatment IIEF scores (≥26, 22–25, 18–21, and 11–17). The IIEF scores were compared to the responses to the global assessment questions.

Main Outcome Measures.  The mean patient age was 58 ± 22 years. For Q1 and Q2, for each subcategory, there was a significant difference in the percentage of men answering definitely, somewhat, or not at all. In the group with EFD scores 22–25, 67% agreed at least somewhat with Q1 and 66% with Q2. In this group 84% and 78% responded in the affirmative to Q3 and Q4, respectively. No patient with an EFD score <22 definitely agreed with Q1 or Q2.

Conclusions.  These data indicate that a significant proportion of patients with EFD scores 21–25 can have sexual relations that are satisfactory and that they are satisfied with their erectogenic medication. Teloken P, Valenzuela R, Parker M, and Mulhall J. The correlation between erectile function and patient satisfaction. J Sex Med 2007;4:472–476.