Introduction to the integrated model: medical, surgical and psychological therapies for the couple.

The integrated model is the interplay of behavioural, cognitive, medical, and surgical approach to sexual problems. Research demonstrates that prognosis and outcome of patients with sexual diseases dramatically improve when medical solutions are proposed along with the evaluation of the therapies' sexual impact on the couple's dynamics. Current classification of treatments for erectile dysfunction (here used as a paradigm of sexual disorder therapies) distinguishes between central and peripheral "initiators" and "conditioners" of erection. However, such a taxonomy does not take into account the impact on the couple, the final recipient of the treatment. For this reason, we propose here a new, couple-based sexological taxonomy which divides therapies into "harmonious" and "inharmonious". Pilot data are also presented on the use of a carnitine analogue as a model of an etiological, harmonious therapy for impotence. The integrated model suggests a strict collaboration between sexologists of different areas. Considering the growing complexity of therapies for sexual symptoms and diseases, there seems to be a need for the new professional figure of the medical sexologist.