EDITORIALE
Disfunzione erettile, diritto alla salute sessuale maschile e livelli essenziali di assistenza (LEA) Enrico Caraceni 1, Angelo Marronaro 1, Edoardo Pescatori 2, Andrea Benedetto Galosi 3. 1 2 3
U.O.C. Urologia, Asur Area Vasta 3 PO, - Civitanova Marche; Andrologist, Hesperia Hospital Modena; Division of Urology, University Hospital “Ospedali Riuniti”, School of Medicine, Department of Clinical, Special and Dental Sciences, Marche Polytechnic University, Ancona;
SUMMARY
Erectile dysfunction, human right to male sexual health and essentials level of assistance (LEA)
The essential levels of assistance (LEA) are the performances and services that the Italian National Health Service (SSN) is required to provide to all citizens, free of charge or upon payment of a participation fee (ticket), with the public resources collected through the general taxation (taxes). They are established by a law every several years according to financial and national health programming. The last version was enacted on the 18 of March, 2017, the Decree of the President of the Council of Ministers (DPCM) of January 12, 2017 with the new essential levels of assistance was published in the Official Gazette (Ordinary Supplement No. 15) Previous decree was enacted the November 29 of 2001. LEA is mandatory for the regions in order to ensure a homogeneous provision of health services in the different regions. The individual regions are required to provide only the services expressly mentioned in this law. The LEA application regarding male sexual health and penile prosthesis implantation generates in Italy some paradoxical situations. Number 1: too low number of penile implant cases. Number 2: important territorial inhomogeneity in the number of prosthetic implants. Number 3: recognition of the right to sexual health as an exclusive prerogative of the female gender. Number 4: Penile prosthetic devices too expensive in Italy versus Europe and USA. In conclusions the treatment of impotence in Italy is not an available possibility for all the Italian Citizen and this represents, especially for cancer patients but not only, a very heavy burning. In Italy it is necessary and urgent to update the LEA so that this inequality is overcome.
KEY WORDS: Penile prosthesis, erectile disfunction,male sexual health,LEA, essentials level of assistance, IPP, impotence.
INTRODUZIONE Si intende per disfunzione erettile (DE) l’incapacità ad ottenere e/o mantenere una erezione sufficiente al completamento di un rapporto sessuale penetrativo. Il sinto-
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Advances in Urological Diagnosis and Imaging - 2021; 4,2
mo è molto frequente soprattutto dopo i 60 anni e arriva in alcune fasce di età ad interessare 1 italiano su 3 (Parazzini et al.) (1). La disfunzione erettile non è considerata in senso stretto una malattia essendo di per sé espressione di numerose
