PD-3-02-01
ON MANAGEMENT OF SEXUAL DISABILITY IN REHABILITATION MEDICINE Axel R. Fugl-Meyer (Department of Rehabilitation Medicine, Uppsala University, Uppsala, Sweden)
From the rehabilitative perspective sexual disabilities are among the most common long term sequelae of physical impairments. This presentation will first focus the extent to which sexual disabilities in people with physical impairments are addressed in Scandinavian, particularly in Swedish, rehabilitation medicine.
I shall then introduce a model for differential diagnostic identification of sexual impairments and disabilities in rehabilitation practice. Such identification serves to avoid diffuse phrases such as "sexual dysfunction", "sexuality and disability", hence clarifying what treatment to use in order to minimize the prevalence of sexual problems.
Finally a brief survey of different treatment modalities available for men with erectile disability will be given. These modalities include: Sexual counselling, sexological psychotherapy, assistive devices, intracavernous self-injections or topological use of vasoactive substances, oral drug treatment and - in a few cases - penile surgery.
PD-3-02-02
Sexuality and Disability Services In Israel
R. Aloni
An holistic approach to the rehabilitation process should address issues of sexuality as an integral part of the team approach. Sexuality issues just like any other professional intervention should start as early as possible to achieve better prognosis.
The sexual identity, orientation, and behavior is a major part of the personality which should not be denied especially so when the person is young, no matter how severe the disability is. It is our responsibility as the professional team to provide permission to behave like a sexual being, to provide the relevant information for each person, and the possible therapy means. It is the patient decision to receive it or leave it to a later stage.
Older people with physical disabilities should also be addressed with positive attitudes regarding sexual issues. We must also try to approach the partners in order to maintain the relationship. Sexual rehabilitation is not solely for people who acquired disability as adults, it is also relevant for people with congenital disabilities - physical, mental, emotional or a combination of both - who needs an "acceleration of the adolescence process".
Sex therapy for people with disability must be adopted to their abilities. We must expand our boarders and flex our attitudes to allow enough possibilities for them to find ways to express their sexuality, in receiving and giving pleasure. Surrogate therapy can be considered as "Cultivated Sex Education" for practice in a safe environment before trying in the outside world.
Israel experience with educational, counseling and therapeutic services as inpatient services and as community services will be described and discussed.
