Médecine de la Reproduction


The medicine of erectile dysfunction: Why? When? How? Volume 13, supplement 1, Décembre 2011

Centre Hospitalier Universitaire Carremeau, place du Pr Debré, 30029 Nîmes Cedex 9, France

Erectile dysfunction (ED) is the inability, persistent or repeated, to acquire and/or to support a sufficient erection to allow a satisfactory sexual activity. It can lead to important suffering for the patient subject to the dysfunctionand, most often, has consequences on his partner, her sexuality and the sexual activity of the couple. Its frequency is variable according to the studied populations or parameters. The pathophysiological mechanisms of erection and ED are better identified and studied.This allows a better care of these disturbances thanks to the discovery of efficient treatments. ED can lead to an important suffering at the individual and its partner. It is not only a symptom, but often the indicator of a co-morbidity. There are many efficient treatments of ED, particularly the oral treatment type 5phospho-diesterase inhibitors (IPDE5). This therapy has brought a real benefit to the patients’ symptom but also on their quality of life. Intracavernous injections of prostaglandins supplement the panel of medicinal treatements. The therapy is also a true “sexual coaching” in several stages. It is recommended to inform the patient, by explaining him the physiology of erection, the mechanism of breakdowns and that of the anxiety of performance, as well as the prevalence of ED and the evolution of sexuality with age. The therapy of ED requires a certain practice, knowledge of the physiology of erection, of physiopathology of sexual disturbances of the man, but especially experience. The Association inter-hospitalo universitaire de Sexologie (AIHUS) has issued a procedure for professionals interested in this health issue.