For women

Female Sexual Function Index

The female sexual function index is a 19-question,

6-domain questionnaire that assess various aspects

of female sexual function.

Based on clinical

interpretations of a principal components analysis,

six-domain

structure

was

identified,

which

included desire, subjective arousal, lubrication,

orgasm, satisfaction and pain. The survey is highly

regarded because it covers a broad range of cate-

gories relating to female sexual health, although it is

difficult to score. It has also been suggested

that a cutoff score (26.55) can be used to delineate

women

high

risk

for

sexual

dysfunction,

making this instrument much more efficient to

interpret in clinic.

Female Sexual Distress Score—Revised

The female sexual distress score—revised (FSDS-R)

is a 13-question survey that adds a 13th item to the

already validated FSDS.

In the validation study,

mean total FSDS, FSDS-R and FSDS-R item 13

scores with either recall period were significantly

higher (

0.0001) in women with female sexual

dysfunction or hypoactive sexual desire disorder

than in women with no female sexual dysfunction.

This questionnaire offers rapid insight into the

desire domain for the sexual partner with more

detail than the FSFI desire domain.

Baylor College of Medicine EP Program

There are no standard EP programs and numerous

institutions have developed similar variations of

this therapeutic strategy. Here, we describe a

program currently used at Baylor College of Medi-

cine (‘

The BCM EP Program

’). When reviewing the

protocol, it is critical to appreciate that the lack of

definitive evidence in support of a singular strategy

requires us to consider the incremental value that

each therapeutic modality offers. For instance,

while the role of the VED in post-RP ED remains

controversial, there have been no studies to advo-

Office visit

Nightly PDE-5 inhibitor

25mg

Months after surgery

Frequency

MUSE

250mcg

VED

10m of suction

ICI

Trimix

Testosterone replacement

TBD

Nightly

As prescribed

2-3 times per week

Daily

2-3 times per week

01234567891

Dose

Figure 1

Overview of introduction, dosage and frequency for the components in the BCM EP program. Note that the diagonal shading

implies the therapies are mutually exclusive and only one is used. Abbreviations: PDE-5, phosphodiesterase-5; ICI, intracavernosal

injection; MUSE, medicated urethral suppository system; VED, vacuum erection device; TBD, to be determined.

Table 1

Overview of some commonly used sexual function assessment tools

Survey name

Abbreviation

Number

of items

Domains

Estimated time

to complete (m)

Relationship adjustment scale

RAS

—

For men

International index of erectile function

IIEF

Erectile function

Orgasmic function

Sexual desire

Intercourse satisfaction

Overall sexual satisfaction

Sexual health inventory in men

SHIM (IIEF-5)

—

Erection hardness scale

EHS

—

For female

Female sexual dysfunction index

FSFI

Desire

Arousal

Lubrication

Orgasm

Satisfaction

Pain

Female sexual distress score—revised

FSDS-R

—

Review and treatment protocol: erectile preservation for RP patients

DJ Moskovic

et al

188

International Journal of Impotence Research