Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
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.
Seftel AD. Erectile Dysfunction in Obese Men. JAMA. 2004;292(20):2466-2467. doi:10.1001/jama.292.20.2466-c