A treatment algorithm for healthy young men with erectile dysfunction

Wiggins, Adam; Tsambarlis, Peter; Abdelsayed, George A.; Levine, Laurence A.

doi:10.1111/bju.14458

Cited by 14 publications

(18 citation statements)

References 27 publications

(43 reference statements)

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“…In one such study, 52% of the participants benefitted from the daily administration of PDE5i, but they did not resolve the ED completely. 53 The participants did report an improvement in erectile function but did not report improvement in intercourse satisfaction. The pharmacological agents do not provide a full recovery in cases of NOED.…”

Section: Introductionmentioning

confidence: 80%

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Cognitive Behavioral Sex Therapy: An Emerging Treatment Option for Nonorganic Erectile Dysfunction in Young Men: A Feasibility Pilot Study

Bilal

Abbasi

2020

Sexual Medicine

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Introduction An increasing number of young men have been found to develop nonorganic erectile dysfunction (NOED) in recent years. The NOED has been shown to respond better to cognitive behavior sex therapy (CBST) in a few past studies. Aim The present research aims to establish the efficacy of CBST as a promising treatment option in young men suffering from NOED by administering a feasibility pilot trial. Methods 28 young men (M = 31 years) out of a total of 39 men (7 excluded, 4 quit treatment) diagnosed with NOED from sexual health clinics in Pakistan were recruited to receive CBST treatment (n = 13) on average twice a week for a period of 50 minutes per session for a period of 4, 6, 8, and 12 weeks for the mild, mild to moderate, moderate, and severe forms of NOED, respectively, and sildenafil citrate group (n = 15) receiving sildenafil citrate 50 mg on demand. The trial design was sequential random assignment clinical trial. Main Outcome Measures International Index of Erectile Functoning-5 and Depression Anxiety Stress Scale-21 were used before treatment, after treatment, and in follow-up as the main outcome measures. Results The repeated measures analysis of covariance established a nonsignificant difference between CBST and sildenafil citrate 50 mg in NOED scores improvement, NOED severity reduction, and reduction in depression scores at posttreatment assessment. There were significant differences among different CBST modalities in improving NOED scores, reduction in NOED severity, and depression scores. There was significant difference in CBST and sildenafil citrate 50 mg in anxiety reduction at posttreatment assessment. The covariates age, age groups, and NOED duration did not significantly impact the treatment outcome for both treatment groups except age which impacted the interaction of treatment and anxiety scores. Conclusion The CBST is an emerging and promising treatment choice in younger men suffering from NOED. Bilal A, Abbasi NuH. Cognitive Behavioral Sex Therapy: An Emerging Treatment Option for Nonorganic Erectile Dysfunction in Young Men: A Feasibility Pilot Study. J Sex Med 2020;8:396–407.

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Section: Introductionmentioning

confidence: 80%

“… 54 Those who respond to PDE5i do so only intermittently. 50 This is the area where PDE5i such as SC fails to address the issue, 53 especially if it is related to psychological or relationship factors. 39 The CBST has been shown to be a promising therapeutic approach for such individuals.…”

Section: Introductionmentioning

confidence: 99%

Cognitive Behavioral Sex Therapy: An Emerging Treatment Option for Nonorganic Erectile Dysfunction in Young Men: A Feasibility Pilot Study

Bilal

Abbasi

2020

Sexual Medicine

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“…Because young men with ED report higher levels of distress and less satisfaction, they have a special need for psychological treatment. 116,117 Older men, on the other hand, are more likely to accept their ED as a normal part of aging, which might be a barrier to seeking help. Although men typically report less distress about changes in their sexual life as they grow older, stigma around sexuality in later life may confuse them about the impact of the sexual problem on their well-being.…”

Section: Practical Approachmentioning

confidence: 99%

A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM)

et al. 2021

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Introduction: Although erectile dysfunction (ED) involves an interaction between physiological and psychological pathways, the psychosocial aspects of ED have received considerably less attention so far. Aim: To review the available evidence on the psychosocial aspects of ED in order to develop a position statement and clinical practice recommendations on behalf of the European Society of Sexual Medicine (ESSM). Method: A comprehensive, narrative review of the literature was performed.Main outcome measures: Specific statements and recommendations according to the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence criteria were provided. Results: A multidisciplinary treatment, in which medical treatment is combined with a psychological approach, is preferred over unimodal treatment. There is increasing evidence that psychological treatments of ED can improve medical treatments, the patient's adherence to treatment, and the quality of the sexual relationship. The main components of psychological treatment of ED involve cognitive and behavioral techniques aimed at reducing anxiety, challenging dysfunctional beliefs, increasing sexual stimulation, disrupting sexual avoidance, and increasing intimacy and communication skills in a relational context. When applicable and possible, it is strongly recommended to include the partner in the assessment and treatment of ED and to actively work on interpartner agreement and shared decision-making regarding possible treatment options. To ensure a better integration of the biopsychosocial model into clinical practice, developing concrete treatment protocols and training programs are desirable. Conclusion: Because the psychosocial approach to ED has been underexposed so far, this position statement provides valuable information for clinicians treating ED. Psychological interventions on ED are based on existing theoretical models that are grounded in empirical evidence. However, the quality of available studies is low, which calls for further research. The sexual medicine field would benefit from pursuing more diversity, inclusivity, and integration when setting up treatments and evaluating their effect.

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“…Many adolescents experience pubertal development, relationship with their body and with their partners in an increasingly confused context, deeply affected by complex social stereotypes. A recent study pointed out that the main problems reported in addition to pain during intercourse were erectile dysfunction and premature ejaculation (25)(26)(27). This latter aspect is difficult to be properly evaluated, since very often it is not clear what teenagers mean by "premature" ejaculation and if the real situation clashes with their expectations, or with what is considered as acceptable by their friends, by their readings on the internet or on the social media, as reported by many patients who accessed the Authors' Clinic.…”

Section: Discussionmentioning

confidence: 99%

Pediatric-adolescent andrology: Single centre experience

Zampieri

Camoglio

2020

Arch Ital Urol Androl

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Introduction: Andrology is the medical specialty dealing with men’s health and reproductive system from birth to adulthood, including genital, hormonal, reproductive, sexual as well as psychological aspects; the aim of this study is to report our 10 year-experience Material and methods: In September 2009, a Pediatric Andrology Outpatient Clinic was opened at the Authors’ Institution. The continuous request for access to the service, together with an increasingly helpful collaboration with local clinicians, has led to an increase in the number of treated patients. At the Clinic, visits are performed for both surgical and medical consultations by the multidisciplinary medical group for the treatment of conditions in the adolescent patient. All patients are followed every 3, 6 and 12 months when indicated. Patients with undescended testes were excluded because managed into a specific protocol. Also patients with syndrome or metabolic diseases are excluded from the analysis. Results: During the study period, September 2009-September 2019, the following conditions were managed: varicocele - 1436 patients; gynecomastia - 18 patients; penile curvature - 89 patients; webbed penis - 132 patients; hypospadias-related diseases - 39 patients; erectile dysfunction - 14 patients; obesity and abnormal semen analysis - 47 patients. During the study period there was an increase for each category especially for medical reasons. Conclusions: Pediatric-adolescent andrology clinics should count on the expertise of different skilled professionals to cope with an ever-increasing number of requests and to offer the timely management of conditions that until very recently were considered social taboos or caused concern only in adulthood like the erectile dysfunction. The evolution of our society, which also means evolution of the mass media, should go hand in hand with the development of Medicine, which needs to adjust to and prevent new healthcare issues.

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A treatment algorithm for healthy young men with erectile dysfunction

Cited by 14 publications

References 27 publications

Cognitive Behavioral Sex Therapy: An Emerging Treatment Option for Nonorganic Erectile Dysfunction in Young Men: A Feasibility Pilot Study

Cognitive Behavioral Sex Therapy: An Emerging Treatment Option for Nonorganic Erectile Dysfunction in Young Men: A Feasibility Pilot Study

A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM)

Pediatric-adolescent andrology: Single centre experience

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