42
17
th
Congress of the European Society for Sexual Medicine
Workshops
Summary of contents
Tips and tricks for the everyday clinical practice
Sexual history is difficult to learn. The physician may use
typical questions to explore the problem. Several times how
ever it is difficult to understand for example, if it is a prob-
lem of sexual desire or arousal. Or if it is an organic problem
due to diabetes or the psychogenic consequences of diabe-
tes. Even in organic cases, it is challenging to differentiate
if the ultrastructural changes that lead to the dysfunction
are permanent, or there is a way to restore them. Therefore,
we will present the ways to identify the severity of each
aetiological factor of the problem and an approach to treat
each one of them. Diagnostic procedures on the other hand
allows a more comprehensive work-up, however, as erectile
mechanism is under control of the sympathetic nervous
system, in many cases incomplete relaxation of the corporal
smooth muscle may lead to a false diagnosis of vasculoge-
nic ED, or to the diagnosis of severe vasculogenic ED in
cases of mild or moderate vasculogenic problems. Metho-
dologies to overpass the problem will be presented. Finally,
in 30% of patients the PDE5 inhibitors do not work. Patient
education, selection of the appropriate drug or dosages may
solve the problem. We will present such practical tricks and
salvage techniques. And if the solution is intracavernosal
injection therapy, the steps to teach patients self-injecting
without complications is easy. A step-wise practical appro-
ach will be discussed in details.
WS-03
WORKSHOP
11:00–12:00
Auditorium 12
Genital surgery – how to avoid complications
Experts: David Ralph, Giulio Garaffa, United Kingdom
Chair: Fabrizio Palumbo, Italy
Aim:
Complications in all surgery occur. The aim is to reduce
their incidence and be able to manage them quickly and
effectively and thereby minimise the usual poor outcome.
With increasing experience, surgeons learn from their mis-
takes and are therefore more likely to know how to avoid
specific complications. Avoidance of genital surgery com-
plications is discussed in this workshop.
Learning objectives
e
To identify the correct operation for the patient
e
To give patients realistic expectations
e
Informed consent is imperative
e
To identify specific issues in Peyronie's surgery and
penile implants that will help in minimising early and
late complications
e
To discuss common genital operations that frequently
are associated with complications
Summary of contents
Peyronie's surgery
/ Giulio Garaffa, 20 min
Indications, expectations and consent
Complication prevention – shortening, recurrent curvature,
ED, foreskin issues, sutures
Penile prosthesis
/ Fabrizio Palumbo, 20 min
Indications, expectations and consent
Complication prevention – infection, erosion, positioning,
revision surgery, deformities
Penile reconstruction
/ David Ralph, 20 min
Complication prevention in – augmentation surgery, skin
grafting, circumcision
6 February 2015
WS-04
WORKSHOP
08:30–10:00
Auditorium 12
Hormonal difficulties in men and women
Experts: Mario Maggi, Linda Vignozzi, Italy
Chair:
Giovanni Corona, Italy
Audience:
The workshop has been designed for physicians
and sexologists who regularly treat patients with sexual
dysfunction. The lecture includes two parts: the first one
deals with the contribution of the endocrine system in the
physiology and pathophysiology of male sexual problems.
The second part is on female sexual dysfunction. A series
of clinical cases would be presented in order to involve the
audience in the right evidence-based choice.
Aim:
Hormones represent one of the most common forms
of sexual communication. Therefore, when sexual commu-
nication is problematic, such as in the case of endocrine
disorders, investigating sexual dysfunction is mandatory.
Many endocrine disorders, or their treatments, are charac-
terized by several alterations in sexual response. Endocrine
disorders are usually considered easy to diagnose and of-
ten-remediable, however, they frequently receive little at-
tention. In addition, it should be recognized that the assess-
ment of endocrine disorders can uncover serious diseases,
such as pituitary tumors, or can help in stratifying the CV
risk of ED patients. All these points would be analyzed du-
ring the presentations and specific practical take home
messages would be delivered.
Learning objectives
e
To learn the role of the endocrine system in the
physiology of male and female sexual responses
e
To learn how to recognize the symptoms and signs of
the most important endocrine diseases involved in the
pathogenesis of male and female sexual dysfunction
