Comparison of validated instruments measuring sexual function in men

Adam W. Levinson, Nicholas T. Ward, Martin G. Sanda, Lynda Z. Mettee, John T. Wei, Li Ming Su, Mark S. Litwin, Christian P. Pavlovich

Research output: Contribution to journalArticlepeer-review


Objectives: There is no universally accepted instrument to measure sexual function (SF) in men. We compare validated SF measures in a single cohort. Methods: We compare the Sexual Health Inventory for Men (SHIM), Expanded Prostate Cancer Index Composite SF domain (EPIC-SF), and a reconstructed University of California Los Angeles Prostate Cancer Index SF domain (PCI-SF) in 856 men scheduled for radical prostatectomy. We define potency thresholds for the PCI-SF and EPIC-SF. Results: Mean age, body mass index, Gleason sum, and PSA were 57 years, 26.7 kg/m2, 6.3, and 5.9 ng/mL, respectively. Mean instrument scores were as follows: SHIM 20.1; EPIC-SF 65; PCI-SF 71. All instruments were significantly intercorrelated (r = 0.99 for EPIC-SF vs PCI-SF, r = 0.75 for SHIM vs EPIC-SF, r = 0.77 for SHIM vs PCI-SF, all P < .001). The SHIM had the greatest negative skew and ceiling effect (P < .001). Although high scores on either the EPIC-SF or PCI-SF translated reliably to high SHIM scores, the reverse was not true. Subjects who reported no erectile dysfunction (ED) on the SHIM (<22) had diverse overall SF, whereas those who scored highly on the EPIC-SF or PCI-SF had both excellent erectile function (potency) and overall SF (including orgasmic function, erectile function, and sexual desire). EPIC-SF scores <65 and PCI-SF scores <75 define men that are both potent and have good SF. Conclusions: The SHIM is intended as an instrument to assess ED. It is, however, inadequate as a measure of overall SF. The EPIC-SF and PCI-SF capture gradations of both sexual and erectile function and may also be used to define potency more comprehensively.

Original languageEnglish (US)
Pages (from-to)380-386
Number of pages7
Issue number2
StatePublished - Aug 2010
Externally publishedYes

ASJC Scopus subject areas

  • Urology

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