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November 24, 2004

Erectile Dysfunction in Obese Men

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(20):2466-2467. doi:10.1001/jama.292.20.2466-c

To the Editor: In the study by Dr Esposito and colleagues,1 the authors used the modified version of the International Index of Erectile Function (IIEF-5)2 to determine outcome. However, we are not given intercourse attempt or success rates, which may be a more robust measure of treatment outcome, success, or efficacy.3 It is difficult to assess the clinical significance of the reported outcomes without intercourse data—a 4-point change in the IIEF-5 score may have only a modest clinical impact. The marital or partner status is not discussed, which has a major impact on erectile dysfunction treatment success.4 Finally, the mild increase in IIEF-5 score from 13.9 to 17 in the intervention group rather than to normal levels (>22) may be attributable to the majority of the treated men still having a significantly elevated body mass index (31.2) at the end of the treatment.

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