Perelman Michael A
The New York Presbyterian Hospital, Weill Medical College of Cornell University, New York, NY 10021, USA.
Urol Clin North Am. 2005 Nov;32(4):431-45, vi. doi: 10.1016/j.ucl.2005.08.010.
The Sexual Tipping Point forms the foundation of a biopsychosocial model to help conceptualize a combination treatment, where sex coaching and sexual pharmaceuticals are integrated into a clinical approach, which addresses organic, psychologic, and cultural issues for men with erectile dysfunction (ED). At any moment in the intervention pro-cess, the clinician determines the most elegant solution, which focuses the majority of effort on fixing the predominant factor while not ignoring the others. Clinicians using this model, can fully conceptualize ED by understanding the predisposing, precipitating,and maintaining psychosocial aspects of their patient's diagnosis and management, as well as organic causes and risk factors. The sex status or focused sex history, and continuous reassessment based on follow-up are the core elements of this method. Restoration of lasting and satisfying sexual function requires a multidimensional understanding of all of the forces that created the dysfunction, whether a solo clinician or multidisciplinary team approach is used. Each clinician needs to carefully evaluate their own competence and interests when considering the treatment of a man's ED, so that regardless of the modality used, the patient receives optimized care to restore sexual function and satisfaction.
