[The couple: An essential entity?]

To evaluate the urological management of the relationship of the couple with both male and female sexual dysfunction.

Review of the guidelines published on this subject in the Medline database together with our own clinical experience in this field.

To optimize therapy the urologist should consider the couple when a patient presents with a sexual symptom otherwise the risk of inappropriate, unsuccessful treatment is high. If a dysfunctional relationship is clearly present, with major conflict between the partners or a marked lack of communication, these negative couples must be seen for sex therapy within a multidisciplinary approach. Even with a positive couple, without major conflict, it is advisory to include the partner in the diagnosis and the treatment, for her attitude as a factor which can influence the sexual motivation of the couple, the means and results of the management. In addition, poor knowledge of a sexual problem concerning the woman, whether this predates the partner's dysfunction or not, can impede the efficacy of pharmaceutical treatment.

Thus, the couple should be seen as a clinical entity with its own fulfillment, which plays an important role in treatment effectiveness, in compliance. Adapting the management to the real expectations of the patient and the couple is essential. With the possible help of the pharmacological treatments of sexual symptoms, a work on all aspects of the couple's dysfunction should bring a new harmony in sexual and affectionate aspects of the relationship.