Much is known about the prevalence of male sexual dysfunction. Average prevalence rates indicate that 20–30% of adult men have at least one manifest sexual dysfunction [1–3]. The Pfizer Global Study of Sexual Attitudes and Behaviors found that an average of 42% of men aged 40–80 years reported sexual difficulties lasting two or more months within the preceding 12 months . These prevalences can vary by region and severity of the condition . Detailed results from a decade of research on the prevalence of sexual dysfunction have been reported by Simons and Carey .
Studies that focus on how general practitioners (GPs) deal with male sexual dysfunction report that many hesitate to address sexual issues, although patients would appreciate their doctor initiating such a discussion [4,7–10]. GPs are normally considered the first medical contacts for men with sexual dysfunction because they usually know about the personal and family situation of their patients [11,12]. Many of them refer their patients with sexual problems to urologists , especially in cases where the effect of specific medication such as phosphodiesterase type 5 (PDE5) inhibitors is limited. Although urologists are often confronted with sexual dysfunction in men, little is known about their sexological skills or what approach they take with patients for whom psychosocial factors are identified as the main cause of the sexual dysfunction [10,13–15].
This pilot study examines the possible effects of the introduction of PDE5 inhibitors on how physicians address sexual problems with their male patients. For the purpose of the study, we developed a two-part semi-structured interview to be used in face-to-face encounters with GPs in the greater Basel area and with urologists in six of the main urban areas in German-speaking Switzerland. We examined three hypotheses: (i) the introduction of PDE5 inhibitors has led GPs and urologists in our region to regularly ask their male patients about sexual problems; (ii) the introduction of PDE5 inhibitors has contributed to a strong focus on erectile dysfunction by GPs and urologists, and (iii) the introduction of PDE5 inhibitors has increased the feeling of competence in dealing with sexual issues for a majority of GPs and urologists. Part I of the semi-structured interview aimed to determine how actively these physicians explore male sexual dysfunction, what they focus on, and how competent they feel in talking about and in treating male sexual dysfunction. In part II, we explored the detailed characteristics of sexual history taking (SHT) and therapeutic decision making. The results of part II will be reported separately.