Seksuele Klachten M87 (Actualisering en herziening november 2015 van NHG-Standaard Erectiele disfunctie 2008). Hieronder volgt de oude richtlijn...
Erectiele disfunctie houdt in dat er voortdurend een onvermogen tot erectie optreedt die voldoende is voor seksuele activiteit.
Anamnese bij erectiele disfunctie
De vragen die gesteld worden bij de erectiele disfunctie is hoe lang het al bestaat en hoe het verloop is, of het altijd al aanwezig is, pijnklachten, hoe stijf de erectie is, of er seksueel voldoende stimulatie is, of er wel erectie bij masturbatie plaatsvindt, of u ’s nachts of ’s ochtends wel erecties heeft. Verder kan gevraagd worden naar de zin in seks, seksueel verlangen, problemen met klaarkomen of te snel. Verder vragen omtrent de communicatie kunnen zijn of de man zelf erectieproblemen ervaart, wat hij zelf denkt dat het is, wat de partner ervan vindt, hoe de seksuele relatie met de partner is, wat hebben ze zelf gedaan, welke hulp wordt gewenst. Specifieke oorzaken zijn de voorgeschiedenis en comorbiditeit, medicatie, cardiovasculaire risicofactoren.
Behandeling bij erectiele disfunctie
Er moet voorlichting gegeven worden over meer bewegen, begeleidende gesprekken, medicamenteuze therapie bij een somatische oorzaak. De hulpmiddelen bestaan uit prikkelingintensiverende middelen, elastische penisring en vacuümpomp. De medicamenteuze behandeling bestaat uit PDE-5-remmers, zoals sildenafil, vardenafil, tadalafil.
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