Number №4, 2013 - page 58-64

Symptomatic sexual dysfunctions in urological practice

Holodnyy V.A.

In this article a classification of the urological diseases, which could cause sexual dysfunctions, based on the principle of the copulative constituents’ disturbances (according to Vasilchenko G.S.) adopted in the Russian sexology, could be seen the first time. The mechanisms of development are systemized symptomatic sexual disturbances. Specific mechanisms are being realized via the disturbances, generated by pathogenetic factors of the disease at the neurohumoral, erectile and ejaculatory parts of the copulative cycle. Unspecific mechanisms are formation of the pathological dominant, development of the somatogenic psychogenic disorders (asthenic syndrome, depression, hypochondriac and phobic anxiety disorders), sexual behavior deactualization and detraining. The complexity of the diagnostics of the sexual dysfunctions is in their polyetiological features. The verification of the organic pathology could not be always linked to the causation of the disease and be treated as single and main cause of it. The therapeutic impact on the organic pathology is an important backbone etiotropic component of the treatment, but it is not always the case, that sexual dysfunction will be eliminated. Operative treatment, which stays without wishful result, leads to the decrease in the sexual satisfaction as a consequence of the stigmatization (scars, anatomical alterations, subjective appearance of the body and postoperative pain) and psychological trauma.

The full-fledged care consists of the combination of diagnostic modalities and specific sexological treatment approaches. Among the latter central place takes the variant of the bodyoriented psychotherapy – sex-therapy, which according to the tasks could be divided between the analytical, training, correctional, supportive, reactivative and adaptive-compensatory.

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