Commentary RE: The International Index of Erectile Function (IIEF): A Multidimensional Scale for Assessment of Erectile Dysfunction

  • Arthur L. Burnett
    Address correspondence to: Arthur Burnett, Johns Hopkins Medical Institutions, 601 Caroline St, 4th Floor, Baltimore, MD 21287.
    Johns Hopkins Medical Institutions, Baltimore, MD
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      The advent of effective oral pharmacotherapy for erectile dysfunction (ED) signified the modern era of clinical management of this condition. Albeit a critical piece of this new paradigm, the relevance of sexual function questionnaires is often overlooked despite their indispensable use by which new therapies have come to be evaluated and accepted. So goes the storyline hailing the launch of sildenafil, which occurred in conjunction with the construction of the International Index of Erectile Function (IIEF) questionnaire in the mid 1990s. In many respects, were it not for the construction of the IIEF that filled the need for a methodology to prove the drug worked to alleviate ED it may be readily concluded that the rapid clinical introduction and widespread acceptance of sildenafil in the late 1990s would have been dramatically altered.
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        • NIH Consensus Conference
        Impotence: NIH consensus development panel on impotence.
        JAMA. 1993; 270: 83-90
        • Padma-Nathan H
        • McMurray JG
        • Pullman WE
        • et al.
        IC351 On-Demand Dosing Study Group: On-demand IC351 (Cialis) enhances erectile function in patients with erectile dysfunction.
        Int J Impot Res. 2001; 13: 2-9
        • Porst H
        • Rosen R
        • Padma-Nathan H
        • et al.
        The efficacy and tolerability of vardenafil, a new, oral, selective phosphodiesterase type 5 inhibitor, in patients with erectile dysfunction: the first at-home clinical trial.
        Int J Impot Res. 2001; 13: 192-199
        • Dula E
        • Keating W
        • Siami PF
        • Edmonds A
        • O'Neil J
        • Buttler S
        Efficacy and safety of fixed-dose and dose-optimization regimens of sublingual apomorphine versus placebo in men with erectile dysfunction. The Apomorphine Study Group..
        Urology. 2000; 56: 130-135
        • Shabsigh R
        • Padma-Nathan H
        • Gittleman M
        • McMurray J
        • Kaufman J
        • Goldstein I
        Intracavernous alprostadil alfadex is more efficacious, better tolerated, and preferred over intraurethral alprostadil plus optional actis: a comparative, randomized, crossover, multicenter study.
        Urology. 2000; 55: 109-113
        • Reiter WJ
        • Pycha A
        • Schatzl G
        • et al.
        Dehydroepiandrosterone in the treatment of erectile dysfunction: a prospective, double-blind, randomized, placebo-controlled study.
        Urology. 1999; 53: 590-594
        • Montorsi F
        • McDermott TE
        • Morgan R
        • et al.
        Efficacy and safety of fixed-dose oral sildenafil in the treatment of erectile dysfunction of various etiologies.
        Urology. 1999; 53: 1011-1018
        • Tan HM
        • Moh CL
        • Mendoza JB
        • et al.
        Asian sildenafil efficacy and safety study (ASSESS-1): a double-blind, placebo-controlled, flexible-dose study of oral sildenafil in Malaysian, Singaporean, and Filipino men with erectile dysfunction. The Assess-1 Study Group.
        Urology. 2000; 56: 635-640
        • Rendell MS
        • Rajfer J
        • Wicker PA
        • Smith MD
        Sildenafil for treatment of erectile dysfunction in men with diabetes: a randomized controlled trial. Sildenafil Diabetes Study Group.
        JAMA. 1999; 281: 421-426
        • Giuliano F
        • Hultling C
        • El Masry WS
        • et al.
        Randomized trial of sildenafil for the treatment of erectile dysfunction in spinal cord injury. Sildenafil Study Group.
        Ann Neurol. 1999; 46: 15-21
        • Conti CR
        • Pepine CJ
        • Sweeney M
        Efficacy and safety of sildenafil citrate in the treatment of erectile dysfunction in patients with ischemic heart disease.
        Am J Cardiol. 1999; 86: 29C-34C
        • Seidman SN
        • Roose SP
        • Menza MA
        • Shabsigh R
        • Rosen RC
        Treatment of erectile dysfunction in men with depressive symptoms: results of a placebo-controlled trial with sildenafil citrate.
        Am J Psychiatry. 2001; 158: 1623-1630
        • Tokatli Z
        • Akand M
        • Yaman O
        • Gulpinar O
        • Anafarta K
        Comparison of international index of erectile function with nocturnal penile tumescence and rigidity testing in evaluation of erectile dysfunction.
        Int J Impot Res. 2006; 18: 186-189
        • Montorsi F
        • Padma-Nathan H
        • Glina S
        Erectile function and assessments of erection hardness correlate positively with measures of emotional well-being, sexual satisfaction, and treatment satisfaction in men with erectile dysfunction treated with sildenafil citrate (Viagra).
        Urology. 2006; 68: 26-37
        • Rosen RC
        • Cappelleri JC
        • Smith MD
        • Lipsky J
        • Peña BM
        Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction.
        Int J Impot Res. 1999; 11: 319-326