Erectile Dysfunction:
A guide to diagnosis and management


University of wales

College of Medicine

 

The Diploma in Practical Dermatology

Department of Dermatology
(A leader in E-Learning in Medical Education)

This is a highly interactive online programme designed to equip the general practitioner with a sound understanding of skin disease as it presents in practice.

The programme has been completely revamped and now delivers high level dermatological teaching covering all subject areas of interest to those in General Practice.  30 weekly modules have been written by leading UK dermatologists and provide up-to-date clinical information with treatment and referral guidelines for the common skin conditions seen in practice.

Through dedicated online tutorial support, discussion forums and online assessments, course participants become members of an enthusiastic and supportive online community of doctors with an interest in dermatology.  This environment allows collaboration, both academic and clinical, which extends beyond the life of the programme.

This diploma has gained increasing recognition among Primary Care Trusts in the UK as the qualification of choice for GPs seeking to establish themselves as having a special interest in Dermatology.  To date 900 UK GPs and 700 International GPs currently hold this diploma

The next academic year will start on 6th September 2004 and is open to all general practitioners.  The fee for each semester is £850.00.   Doctors will have the opportunity to be part of a large international community of likeminded professionals.

For further details and an application form, please contact: Miss Julie Williams or Miss Claire Hall, Postgraduate Course Co-ordinator, Department of Dermatology (Box 27), University of Wales College of Medicine, Heath Park, Cardiff, CF14 4XN. Telephone: +29 2074 2885, Fax: +29 2074 4312, Email: dpduk@cardiff.ac.uk

For further information on the Department of Dermatology at the University of Wales College of Medicine, please visit our website at www.ukdermatology.co.uk

 

 

An affirmative reply is permission to discuss. If the reply is 'No' when in fact he is concerned, there remains an invitation for him to return. A patient coming in for a repeat prescription provides an opportunity to discuss possible side effects: 'It is not uncommon that treatment may also cause difficulty with sexual activity; have you any concerns about this?'

Opportunities are endless as to how the GP may ask about sexual concerns in a nonthreatening way. Patients are often very relieved and, not infrequently, the atmosphere of trust reaches a new level. The patient may return to discuss other related and non-related personal concerns in his life. 

Assessing ED
History taking is the mainstay of diagnosis. It is crucial to ascertain that the patient has a clear complaint of ED and not any other symptom (e.g. loss of libido or premature ejaculation which may be related to ED).

When a patient's presenting complaint is one of a loss of interest in sexual activity, this may be secondary to organic or psychological ED. However, it is important to exclude hypogonadism (testosterone deficiency). Conway et al. (7) give a clear guide as to what constitutes androgen deficiency. It affects approximately one in 200 men and while these men may present with ED, on careful history taking, they actually lack libido (desire) rather than having ED. Not uncommonly, it is the partner who suggests seeking medical opinion.