Frequency and focus of sexual history taking in male patients : a pilot study conducted among Swiss general practitioners and urologists

INTRODUCTION: General practitioners (GPs) and urologists are the first medical contacts for men with sexual dysfunction. Previous studies have shown that many GPs hesitate to address sexual issues and little is known about the sexological skills of urologists. AIM: To analyze sexual history taking (SHT) by Swiss GPs and urologists, in terms of active exploration, focus, and competence in discussing and treating sexual dysfunction. METHODS: A semi-structured interview was developed and used in face-to-face encounters with 25 GPs and 25 urologists. MAIN OUTCOME MEASURES: Content and frequency of interview responses. RESULTS: Urologists reported a significantly higher frequency of actively asking male patients about sexual dysfunction (22.80% vs. 10.42%, P = 0.01). GPs and urologists avoided actively asking certain patient groups about sexual dysfunction (e.g., "immigrants,""macho men"). GPs reported a significantly lower percentage of male patients who spontaneously address sexual problems (6.35% vs. 18.40%, P > 0.001). Both physician groups emphasized erectile dysfunction in SHT. Eight percent of GPs and 28% of urologists considered their competence in discussing sexual dysfunction as very good. No GP and 20% of urologists considered their competence in treating sexual dysfunction as very good. Urologists reported having significantly greater competence in discussing (P = 0.02) and treating (P > 0.001) sexual dysfunction than the GPs. Competence in discussing correlated positively with competence in treating sexual dysfunction for GPs (P = 0.01) and urologists (P > 0.001). The majority of GPs (92%) and urologists (76%) reported a need for continuing education in sexual issues. CONCLUSIONS: Our results justify establishing guidelines for SHT in Switzerland to better meet the sexual health needs of male patients. Physicians should be encouraged to routinely inquire about sexual issues, overcome their discomfort with the subject, and regard male sexuality as more than erectile function. A clear need exists for relevant continuing education for Swiss GPs and urologists.