(479) Diabetic ED Treatment by Treating Psychosocial Factors

Abstract

Abstract Introduction ED is either predominantly psychogenic or predominantly organic. Psychosocial factor prevalence in diabetic ED varies in different cultures and societies. Psychosocial factor is quite prevalent in Pakistan for e.g in Pakistani national language (Urdu) ED is named ‘NAMARDI’ meaning that ‘he is not a man’, so ED has a lot of psychosocial effect on a patient and treatment of this factor is significant in restoring normal sexual functions Objective The aim of this study is to find the outcome by treating psychosocial factors in diabetic ED patients by sex therapy, counselling and psychotropic drugs supported by good glycemic control and methyl cobalamin. Methods 74 patients of diabetic ED were treated at Nasim Fertility Centre during Sep 2020 - Jan 2021 Aging from 42 years to 62 years. Duration of diabetes was from 3 to 24 years. Diagnostic work up included detailed medical and sexual history. HbA1c, testosterone and prolactin level were documented. These patients were treated on weekly basis for 10 weeks by sex therapy and counselling. Minimum effective doses of SSRI’s, benzodiazepines, yohimbine and I/M Testosterone were also prescribed. PDE-5 Inh were also prescribed as per requirement. Patients were also advised a healthy change in lifestyle, good glycemic control and regular sexual activity. Results Patients were divided in three groups depending upon the presenting complaints A- 36 out of 74 patients had presenting complaint of less erection and less time. By treatment mentioned above, normal sexual functions were restored in 30 patients (83%) and 6 patients (17%) needed PDE- 5 inh. B- 16 out of 74 patients had presenting complaint of using PDE-5 inh which was becoming less effective. By treatment mentioned above in 11 patients (69%) natural sexual functions were restored and 5 patients (31%) they had to use PDE-5 inh in less dose with better effects C- 22 out of 74 patients had presenting complaint that PDE-5 inh has become non effective. In 6 patients (27%) normal sexual functions were restored, in 12 patients (55%) PDE -5 inh became effective and in 4 patients (18%) PDE-5 inh was still non effective so they were advised I/D inj or vacuum constriction device. Conclusions Psychosocial factors in diabetic ED is quite prevalent in Pakistani society and treating this psychosocial factor helps to restore natural normal sexual response or improve the efficacy of PDE-5 inh in less dose. Disclosure No