Urologie pro praxi 1/2021

Psychogenic erectite dysfunction

Psychogenic erectile dysfunction occurs in 20 % of all cases of erectile dysfunction. It should be highligted that organic erectile dysfunction is very often complicated by psychological factors that lead to the fixation of the disorder. These include fear, depression, anticipatory tension (anxiety about expecting an erectile failure), personality characteristics and conflicts in a relationship – a partner's sexual incompatibility. The primary psychogenic erectile dysfunction is the inability to achieve and maintain the erection of sufficient rigidity for the implementation of satisfactory sexual intercourse, if we have ruled out an organic cause by a comprehensive andrological examination. The first step is education and rational psychotherapy, consisting in clarifying the physiology of erection and the pathophysiology of erectile dysfunction, promoting self-confidence and providing information on therapeutic options. Sexual skills training, communication, marital therapy and psychosexual education are pillars of treatment. Cognitive-behavioral psychotherapy as a combined psychological approach together with the use of PDE5 inhibitors brings the maximum therapeutic effect.

Keywords: erectile dysfunction, psychogenic factors, education, cognitive-behavioral therapy.