Date of Award


Document Type


Degree Name

Master of Medicine (MMed)

First Supervisor/Advisor

Dr. Asad J. Raja

Second Supervisor/Advisor

Dr. Aideed Kahie


General Surgery (East Africa)


Background: Men with lower urinary tract symptoms (LUTS) are at risk of erectile dysfunction (ED) and other co - morbidities. The clinical assessment of ED is unreliable and the International Index of Erectile Function – 5 (IIEF – 5) a widely used tool is not validated in our setting. We aimed to validate the IIEF – 5 as a screening tool for ED in men with LUTS visiting the outpatient services.

Methodology: In the study, 99 men above 40 years with LUTS attending the urology clinics were consecutively enrolled, administered with the IIEF – 5 and assigned an ED status. Socio – demographic data and risk factors were captured in a separate questionnaire. A blinded urologist made an independent clinical assessment of ED following this.

Results: In this study involving 99 men with LUTS, 45.5% had mild ED, 24.2% had no ED, 17.2% had mild-moderate ED, while 13.1% had moderate ED based on IIEF – 5 score. In comparison, 84.8% had no ED and 15.2% had ED based on clinical assessment. The questionnaire items were very correlated as determined by a Cronbach's alpha of 0.920. Determination of ceiling and floor effects was based on a cutoff of at least 15% of patients obtaining the least points of 5/25 for the floor effect or best points of 25/25 for the ceiling effect. 7.1% of patients scored 25/25 and none scored 5/25 hence no ceiling or floor effect was observed. The area under the curve 0.884 (p = 0.000002) demonstrated good diagnostic performance with favourable sensitivity and specificity.

Conclusion: For men above 40 years with LUTS, the IIEF-5 is a valid and reliable tool to screen for ED. These results, taken with results from previous validation studies of the IIEF – 5 suggest that it should complement clinical assessment of ED.

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