Kuhn, Annette

Mohr, Stefan

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EDITORIALHolism and sexual function: the difference between sexand atomsStefan Mohr & Annette KuhnPublished online: 2 September 2011# The International Urogynecological Association 2011The ancient greek term Holism (from ὂλος holos) meansall, whole, entire, total. The term holism in its narrowersense describes the idea that all the properties of a givensystem (scientific, physical, social, economic, aesthetic,linguistic, etc.) cannot be determined or explained by itscomponent parts alone. Instead, the system as a wholedetermines in an important way how the parts behave andthe whole of a system is always greater than the sum of itsparts.If we look at urogynecologic studies involving sexualfunction, we find only few that involve social circum-stances, comorbidities or general medications [1, 2].Furthermore, the focus is laid on the women‘s sexualfunction, thus ignoring the sexual well-being of theirsignificant others.Social scientist and physician Nicholas A. Christakisexplains that "for the last few centuries, the Cartesianproject in science has been to break matter down into eversmaller bits, in the pursuit of understanding. This works tosome extent; however, putting things back together in orderto understand them is harder, and typically comes later inthe development of a scientist or in the development ofscience."[3]As cited above, the scientific trend towards breakingevery kind of system down into its elementary units for abetter understanding of the whole works well in somedomains. This trend is going back to René Descartes’(1596–1650) dualism, which pleaded for a separationbetween body and mind. The idea was further developed,resulting in today’s reductionism or atomism with theassumption that all systems are made up of ultimate,indivisible parts [4]. We can understand matter by breakingit down to atoms, then protons, electrons and neutrons,quarks, gluons, and so on. In the same way we canunderstand organisms by breaking them down into organs,then tissues, cells, organelles, proteins, DNA, etc. Likewise,in human medicine the growing knowledge takes its toll asthe incremental specialization breaks the patient down intoseparate components.However, analyzing sexual function we will have tounderstand sexuality as a holistic system. How can femalesexual function improve if—for whatever reason—thesexual function of the partner deteriorates [5]? Holism isan appreciation not of the simple, but of the complex, or atleast of the simplicity and coherence in complex findings.Moreover, unlike curiosity or empiricism, holism takes awhile to acquire and to appreciate. It is a very grown-updisposition.For the determination of clinical sexual function,atomism does not really make sense. In studies, weshould address the sexual function of our patients andof their partners, probably take social influences andcomorbidities into consideration and not concentrate onone single issue.The scientific concept that would enrich everyone'scognitive toolkit is holism: The abiding recognition thatholistic sexual function, involving the sexual function ofS. Mohr (*) :A. KuhnDepartment of Obstetrics and Gynecology, Urogynecology,Inselspital, Bern University Hospital, University of Bern,Effingerstrasse 102,3010 Bern, Switzerlande-mail: s.mohr@gmx.chInt Urogynecol J (2012) 23:139–140DOI 10.1007/s00192-011-1557-2the patients and of their partners, has properties notpresent in the parts and not reducible to the study of theparts.References1. De Souza A, Dwyer P, Rosamilia A, Hiscock R, Lim Y, Murray C,Thomas E, Conway C, Schierlitz L. Sexual function followingretropubic TVT and transobturator Monarc sling in women withintrinsic sphincter deficiency: a multicentre prospective study. IntUrogynecol J Pelvic Floor Dysfunct doi:10.1007/s00192-011-1461-92. Khandwala S, Jayachandran C (2011) Transvaginal mesh surgeryfor pelvic organ prolapse—Prolift+M: a prospective clinical trial.Int Urogynecol J Pelvic Floor Dysfunct. doi:10.1007/s00192-011-1482-43. Christakis NA, Fowler JH (2009) The surprising power of oursocial networks and how they shape our lives4. Ackoff RL (1974) Redesigning the future; a systems approach tosocietal problems5. Mohr S, Kuhn P, Mueller MD, Kuhn A (2011) Painful love—"hispareunia" after sling erosion of the female partner. J Sex Med8:1740–1746140 Int Urogynecol J (2012) 23:139–140

Holism and sexual function: the difference between sex and atoms

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Holism and sexual function: the difference between sex and atoms

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