The Application Research Of PDE-5I With AVSS Test In Diagnosis And Treatment Of ED

Objective A comparative study of PDE-5I with Audiovisual Sexual Stimulation(AVSS)test,Nocturnal Penile Tumescence and Rigidity(NPTR)test and AVSS test were carried out and we followed up the treatment effect.Our goal is to explore the clinical value of PDE-5I with AVSS test in the evaluation of erectile dysfunction(ED)and to optimize the operation process of detection.Methods A total of 166 patients with ED was enrolled from 2017 to 2018 and the cause of these patients is unknown,including 25 unmarried patients and 141 married patients,aged 21-63 years old,with a median age of 31 years old.The duration of the disease ranged from 3 months to 10 years,with an average of 14.3 months.There were 57 patients with concomitant diseases(alone or at the same time with diabetes,hypertension,hyperlipidemia,obesity,etc.)and 109 patients without concomitant diseases.Each patient underwent a detailed medical history,careful physical examination,and associated laboratory tests,including routine blood,urine,and biochemical tests,and serum free testosterone(FT),luteinizing hormone(LH),follicle-stimulating hormone(FSH),and prolactin(PRL)measurements.The patients were instructed to complete the International Erectile Function Questionnaire-5(IIEF-5).Patients with sleep disorders,abnormal reproductive system development,abnormal sexual desire,abnormal sexual orientation,mental nervous system disorders,inadmissible pornographic videos,surgical operations and trauma were excluded.Each patient has completed NPT test,AVSS test and PDE-5I combined AVSS test successively,and compared the test results.When PDE-5I combined with AVSS was tested,the patients were randomly divided into two groups according to their medical numbers: sildenafil(Viagra)100mg group(84 people)and tadalafil(Cialis)20mg group(82 people).The patients with normal NPT patterns were presumed to have a psychogenic etiology of their ED and those with abnormal NPT patterns to have an organic etiology.Then according to the test results,the patients were treated and followed up to evaluate the therapeutic effect.Results The IIEF-5 score of patients was 4-21,with an average of 11 points,including 84 patients with mild ED,43 patients with moderate ED,and 39 patients with severe ED.According to NPT Test,the final diagnosis was psychogenic ED in123 patients,whereas 43 patients were found to have organic ED.Compared with NPT test,AVSS test discriminated psychogenic ED with 66.7% sensitivity and 74.1%accuracy,and PDE-5I combined with AVSS test discriminated psychogenic ED with78.9% sensitivity and 81.9% accuracy.Further more,there was no significant difference of the accuracy rate between Viagra combined with AVSS test and Cialis combined with AVSS test(P>0.05).The results showed that patients with normal PDE-5I with AVSS test results had better therapeutic effect on PDE-5I than patients with abnormal results.In addition,ED patients with concomitant disease were less likely than ED patients without concomitant disease to have effective penile erection detection rates or subsequent treatment outcomes.Conclusions The operation process of PDE-5I combined with AVSS test was optimized.Compared with AVSS test,this test has better sensitivity and accuracy,and is beneficial to outpatient service.It can replace AVSS test as the preferred screening method for the etiology assessment of ED patients in outpatient service,and it can also play a very good guiding role in the next treatment of patients.However,in the etiological assessment of ED,it cannot completely replace NPT test,just like AVSS test.For patients with abnormal test results,further NPT test or other ED assessment methods should be performed to assess the etiological factor of ED.