Cour F, Corman A, Costa P
Service d'urologie, hôpital Foch, université de Versailles-Saint-Quentin-en-Yvelines, 40, rue Worth, 92150 Suresnes, France.
Prog Urol. 2013 Jul;23(9):734-44. doi: 10.1016/j.purol.2012.11.005. Epub 2013 Jan 5.
To evaluate the urological management of the relationship of the couple with both male and female sexual dysfunction.
Review of the guidelines published on this subject in the Medline database together with our own clinical experience in this field.
To optimize therapy the urologist should consider the couple when a patient presents with a sexual symptom otherwise the risk of inappropriate, unsuccessful treatment is high. If a dysfunctional relationship is clearly present, with major conflict between the partners or a marked lack of communication, these negative couples must be seen for sex therapy within a multidisciplinary approach. Even with a positive couple, without major conflict, it is advisory to include the partner in the diagnosis and the treatment, for her attitude as a factor which can influence the sexual motivation of the couple, the means and results of the management. In addition, poor knowledge of a sexual problem concerning the woman, whether this predates the partner's dysfunction or not, can impede the efficacy of pharmaceutical treatment.
Thus, the couple should be seen as a clinical entity with its own fulfillment, which plays an important role in treatment effectiveness, in compliance. Adapting the management to the real expectations of the patient and the couple is essential. With the possible help of the pharmacological treatments of sexual symptoms, a work on all aspects of the couple's dysfunction should bring a new harmony in sexual and affectionate aspects of the relationship.
评估针对伴有男性和女性性功能障碍的夫妻关系的泌尿外科处理方法。
回顾Medline数据库中关于该主题发布的指南以及我们在该领域的临床经验。
为优化治疗，当患者出现性症状时，泌尿科医生应考虑夫妻双方的情况，否则不恰当、不成功治疗的风险很高。如果明显存在功能失调的关系，伴侣之间存在重大冲突或明显缺乏沟通，这些负面夫妻必须在多学科方法中接受性治疗。即使是关系良好、没有重大冲突的夫妻，也建议让伴侣参与诊断和治疗，因为她的态度是影响夫妻性动机、管理方式和结果的一个因素。此外，对女性性问题的了解不足，无论这是否早于伴侣的功能障碍，都可能妨碍药物治疗的效果。
因此，夫妻应被视为一个有自身满足感的临床实体，这在治疗效果和依从性方面起着重要作用。使处理方法适应患者和夫妻的实际期望至关重要。在性症状药物治疗的可能帮助下，针对夫妻功能障碍各方面的工作应能为关系中的性和情感方面带来新的和谐。
