A pragmatic approach to sexual dysfunction in diabetic men: psychosexual counselling

In order to avoid the problems inherent in the assessment of any organic component of impotence, a consecutive series of 20 diabetics were treated with psychotherapy after a detailed assessment of the psychological components of their disability. Only three patients improved in the long term and responders could not be identified from pretreatment characteristics. However, most of the patients had been impotent for several years and their successful adaptation may have limited the success of psychotherapy. There is a need to identify the impotent patient at an early stage in order to offer more effective treatment. This might also avoid the problems of adaptation and the need for detailed investigations of pelvic nervous and vascular function.