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European association of urology guidelines for sexual and reproductive health 2020: what is new?

International Journal of Impotence Research volume 32, pages 477–479 (2020)Cite this article

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The European Association of Urology Guidelines has initially been published in 1996 and 4 years later, the sections on ejaculation disorders and erectile dysfunction (ED) were included. Since then, each year these sections have been updated by specialists from different European countries. After the significant revisions on premature ejaculation (PE) section, the text was renamed to “EAU Guidelines on Male Sexual Dysfunction” in 2009. In 2011 and 2014, sections on penile curvature and priapism have been included and the “Male Sexual Dysfunction” guideline maintained until 2019 [1]. In 2020, the guidelines on male sexual dysfunction, male infertility, hypogonadism, and penile curvature were gathered in a single chapter entitled “Sexual and Reproductive Health (SRH)” with extensive content that is worth consulting.

The guidelines on “SRH” include a lot of novelties that can revolutionize our daily practice. One of the most important changes is abandoning the “step-wise” approach in the management of ED. In the previous versions, patients with ED were offered phosphodiesterase type 5 inhibitors (PDE5is) initially (first-line therapy) and those who were not responding to these oral medications were offered intracavernosal injections, intraurethral/topical alprostadil, vacuum erection devices (VED), and shock wave therapy (Li-SWT) (second-line therapy). Penile prosthesis implantation constituted the third-line therapy for ED patients who do not respond to first- and second-line therapies. Considering the fact that a significant number of patients prefer a permanent solution (e.g., penile prosthesis) for their ED problem [2], this step-wise approach has been discarded and patients were given the opportunity of selecting the treatment which suits them the most after they are being informed about all the available treatment modalities. This novel decision-making approach is a more realistic alternative to the traditional three-level concept and it has been adopted by the most recent AUA guidelines as well [3].

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Authors and Affiliations

  1. Department of Urology, Selcuk University School of Medicine, Konya, Turkey

    Murat Gul

  2. Departamento de Urologìa, Universidad CES, Medellìn, Colombia

    Alejandro Carvajal

  3. Department of Urology, Biruni University Faculty of Medicine, Istanbul, Turkey

    Ege Can Serefoglu

  4. Department of Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK

    Suks Minhas

  5. Division of Experimental Oncology/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy

    Andrea Salonia

  6. University Vita-Salute San Raffaele, Milan, Italy

    Andrea Salonia

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  1. Murat Gul
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  4. Suks Minhas
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  5. Andrea Salonia
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Correspondence to Ege Can Serefoglu.

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Gul, M., Carvajal, A., Serefoglu, E.C. et al. European association of urology guidelines for sexual and reproductive health 2020: what is new?. Int J Impot Res 32, 477–479 (2020). https://doi.org/10.1038/s41443-020-0335-4

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