The instrument consists of 7 questions:
(1) the first 2 determine if there is a problem with sexual activity and the cause
(2) the next 3 deal with
(2a) difficulty with an erection
(2b) difficulty with control of ejaculation
(2c) effect of radiation therapy on sex habits
(3) satisfaction with sexual activity
(4) list of medications
The responses to questions 3 and 4 are scored from 0 (normal) to 4 (severe problem).
The response to question 5 is from 0 (none) to 3 (major).
score for questions 3 to 5 =
= SUM(points for all 3 questions)
Interpretation:
• minimum score for questions 3-5: 0
• maximum score for questions 3-5: 11
• A poor sexual outcome from the radiation therapy would be indicated by (a) a "no" response for question 1 with a "yes" for question 2, (b) a high score for questions 3 to 5, and (c) a "no" for question 6.
