(363) A Global Survey of Sexual Dysfunction Management Among Urologists and Sexual Medicine Experts
Authors: Hammad MAM , Barham DW , Loeb CA , Sanford D , Miller J , Carvajal A , Rubin R , Vasan SS , Chung E , Chubak B , Fode M , Hotaling J , Fegahli J , Facio Jr FN , Yafi FA 
Published: February 2024

Abstract

Introduction
Understanding and addressing sexual dysfunction is of paramount importance to enhance the overall well-being and quality of life of individuals worldwide. While significant progress has been made in the field of sexual medicine, variability in practice patterns among healthcare professionals remains a potential barrier to optimal patient care. To bridge this knowledge gap and identify the prevailing trends in sexual dysfunction management, we conducted an international survey targeting urologists specializing in Andrology, Sexual Medicine, and related fields.

Objective
This international survey aimed to assess male and female sexual dysfunction management practices among sexual medicine physicians across to globe to identify variability in practice patterns.

Methods
A survey was distributed globally to urologists specializing in Andrology, Sexual Medicine, and related fields who are members of International Society for Sexual Medicine (ISSM) or affiliated regional societies (SMSNA, ESSM, MESSM, APSSM, SASSM, SLAMS, ISSWSH, SIU). Demographic information (age, gender, specialty, and practice setting) and treatment approaches for male and female sexual dysfunction were collected. Respondents also reported the percentage of their practice dedicated to sexual dysfunction and whether treatments were covered by health insurance.

Results
A total of 200/3000 practitioners participated, with 101 (50.7%) identifying as urologists. The majority were male (72.9%) and worked in private practice or community hospitals (32.7%) or a mixture of both (34.2%). Male sexual dysfunction was treated by 71.4% of respondents, with 25.7% dedicating 75-100% of their practice to it. Female sexual dysfunction was treated by 36.9% of respondents, with 64% dedicating 0-25% of their practice to it. Health insurance covered 25-49% of their care for 41.2% of respondents, predominantly provided by private companies (45.9%). The most common treatments for erectile dysfunction were oral medications (86.5%), injections (61.7%), and inflatable penile prostheses (45.1). For Peyronie's disease, oral therapies (59.1%) and penile traction therapy (34.4%) were most frequently offered, while surgical treatment for Peyronie's disease was offered by 58.2% of respondents, with penile prostheses being the primary choice (79.7%). Regarding female sexual dysfunction, 58.4% of respondents offered treatments for genitourinary syndrome of menopause/atrophic vaginitis, with vaginal estrogen being the most common choice (50%). For dyspareunia due to vaginismus/hypertonic pelvic floor dysfunction, 50.3% of respondents offered treatment, with pelvic floor exercise/physiotherapy being the most recommended (66%).

Conclusions
This study provides valuable insights for healthcare professionals, policymakers, and researchers regarding the current landscape of sexual dysfunction management. The results underscore the importance of continuous efforts to develop comprehensive and individualized approaches, ensuring that both male and female patients receive effective and accessible care for their sexual health concerns. By addressing issues related to insurance coverage and fostering interdisciplinary collaboration, the medical community can collectively work towards improving sexual well-being and quality of life for patients worldwide.

Disclosure
Any of the authors act as a consultant, employee or shareholder of an industry for: Advisory board and speaker for Coloplast; consultant for Cynosure; advisory board and speaker for Halozyme; intellectual property with Masimo; advisory board for Promescent; consultant for Sprout; advisory board for Xialla.