Partner satisfaction and successful treatment outcomes for men with erectile dysfunction (ED)

As first-line treatment for erectile dysfunction (ED), phosphodiesterase type 5 (PDE5) inhibitors are highly effective and well tolerated, making it possible for the majority of men with ED to experience better sex in terms of the restoration or improvement of erection rigidity and durability. Better erectile function can also improve the quality of the couple's relationship and the sexual satisfaction of female partners, yet a high proportion of men discontinue treatment even though the use of a PDE5 inhibitor has restored erection rigidity and durability. In the past, research focused on the influence of the drug regimen and side-effects on noncompliance and premature discontinuation. However, it is apparent that health professionals must also provide pretreatment education on the impact of drug therapy on the broader sexual experience for men and their partners, rather than limiting themselves to a discussion of erectile function alone. This education should be further reinforced through adequate and timely follow-up to optimise treatment outcome. In addition, any ED treatment plan must consider the context of a man's relationship with his partner, since a partner's encouragement is often crucial in motivating a man to continue with treatment. The partner's motivation to maintain or return to sexual intimacy, her satisfaction with sex, and his perception of that satisfaction are central to the restoration of a satisfactory sexual experience. These beneficial outcomes can best be achieved by adopting a holistic approach that recognises the complexities of ED, and the importance of the partner's central role in the success of treatment and the experience of better sex. (c) 2006 European Association of Urology. Published by Elsevier B.V. All rights reserved.