(108) Validation of the Eretometer as a Novel Visual Penile Rigidity Scale to Assess Male Erectile Function

Abstract Introduction Screening for erectile dysfunction (ED) in primary care requires simple tools, particularly where educational levels are low and multi-item instruments such as the International Index of Erectile Function (IIEF) may be impractical. Likert-type visual scales for erection hardness are widely and intuitively used, but few have been formally validated. The Erection Hardness Score (EHS; 1–4) is the most common visual scale, yet it provides only categorical, subjective grades of rigidity. The Eretometer is a 0–10 visual penile rigidity scale proposed as a continuous alternative to EHS Objective To evaluate the diagnostic accuracy, correlation, and reliability of the Eretometer as an index test, using the EHS as the reference standard. Methods We conducted a cross-sectional diagnostic accuracy study, designed and reported according to STARD recommendations, including 280 men aged 18–80 years from primary care and urology clinics. Erectile rigidity was self-assessed using the EHS (reference standard; moderate-to-severe ED = EHS ≤2) and the Eretometer (0–10 visual scale inspired by the Orgasmometer-F). Sociodemographic data and comorbidities were recorded. Spearman’s correlation and linear regression were used to evaluate the association and agreement. Receiver operating characteristic (ROC) analysis estimated area under the curve (AUC) and the optimal Eretometer cutoff for EHS ≤2. Test–retest reliability and internal consistency (Cronbach’s α) were examined in a subsample.in accordance with STARD recommendations, involving Results Median age was 54 years (interquartile range IQR 45–63); 62% had ≤8 years of schooling. Median EHS was 3 (IQR 2–4) and median Eretometer score 6.5 (IQR 5–8). The Eretometer correlated strongly with the EHS (ρ = 0.82; p 0.001). For detecting EHS ≤2, the Eretometer showed an AUC of 0.94 (95% confidence interval 0.91–0.97); a cutoff of ≤5 yielded 89% sensitivity and 86% specificity. Test–retest reliability was excellent (r = 0.91), and internal consistency was high (Cronbach’s α = 0.88). Conclusions The Eretometer showed strong correlation and diagnostic agreement with the EHS and appears to be a valid, reliable visual tool for assessing penile rigidity. Its continuous 0–10 format offers finer discrimination of erectile function than categorical scales and may be particularly useful for ED screening and counseling in settings with low literacy, while remaining applicable to broader male populations. It demonstrated a strong correlation and diagnostic agreement with the EHS, indicating it to be a valid and Disclosure No