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Cited by 1,223Sexual function and dysfunction studiesUrological Disorders and TreatmentsSexuality, Behavior, and Technology

Guidelines on male sexual dysfunction: erectile dysfunction and premature ejaculation

Hatzimouratidis, Konstantinos, Amar, Edouard, Eardley, Ian, Giuliano, Francois, Hatzichristou, Dimitrios, Montorsi, Francesco, Vardi, Yoram, Wespes, Eric·2010·European Urology
DOI 10.1016/j.eururo.2010.02.020
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Abstract

Context Erectile dysfunction (ED) and premature ejaculation (PE) are the two most prevalent male sexual dysfunctions.Objective To present the updated version of 2009 European Association of Urology (EAU) guidelines on ED and PE.Evidence acquisition A systematic review of the recent literature on the epidemiology, diagnosis, and treatment of ED and PE was performed. Levels of evidence and grades of recommendation were assigned.Evidence synthesis ED is highly prevalent, and 5-20% of men have moderate to severe ED. ED shares common risk factors with cardiovascular disease. Diagnosis is based on medical and sexual history, including validated questionnaires. Physical examination and laboratory testing must be tailored to the patient's complaints and risk factors. Treatment is based on phosphodiesterase type 5 inhibitors (PDE5-Is), including sildenafil, tadalafil, and vardenafil. PDE5-Is have high efficacy and safety rates, even in difficult-to-treat populations such as patients with diabetes mellitus. Treatment options for patients who do not respond to PDE5-Is or for whom PDE5-Is are contraindicated include intracavernous injections, intraurethral alprostadil, vacuum constriction devices, or implantation of a penile prosthesis. PE has prevalence rates of 20-30%. PE may be classified as lifelong (primary) or acquired (secondary). Diagnosis is based on medical and sexual history assessing intravaginal ejaculatory latency time, perceived control, distress, and interpersonal difficulty related to the ejaculatory dysfunction. Physical examination and laboratory testing may be needed in selected patients only. Pharmacotherapy is the basis of treatment in lifelong PE, including daily dosing of selective serotonin reuptake inhibitors and topical anaesthetics. Dapoxetine is the only drug approved for the on-demand treatment of PE in Europe. Behavioural techniques may be efficacious as a monotherapy or in combination with pharmacotherapy. Recurrence is likely to occur after treatment withdrawal.Conclusions These EAU guidelines summarise the present information on ED and PE. The extended version of the guidelines is available at the EAU Web site (http://www.uroweb.org/nc/professional-resources/guidelines/online/).

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Authors
Hatzimouratidis, K., Amar, E., Eardley, I., Giuliano, F., Hatzichristou, D., Montorsi, F., Vardi, Y., & Wespes, E.
Affiliations
  • Hôpital Bichat-Claude-Bernard (FR)
  • Assistance Publique – Hôpitaux de Paris (FR)
  • Aristotle University of Thessaloniki (GR)
  • Vita-Salute San Raffaele University (IT)
  • Technion – Israel Institute of Technology (IL)
  • Erasmus Hospital (BE)
ORCID
Venue
European Urology
Publisher
Elsevier BV
Published
2010-05
Volume
57
Issue
5
Pages
804-814
ISSN
0302-2838 (ISSN-L)
DOI
10.1016/j.eururo.2010.02.020
OpenAlex
W2128056532
Cited by
1,223
References
240
Citations by year
2026: 32 · 2025: 35 · 2024: 42 · 2023: 50 · 2022: 52 · 2021: 84 · 2020: 83 · 2019: 83 · 2018: 72 · 2017: 108 · 2016: 114 · 2015: 98 · 2014: 106 · 2013: 88 · 2012: 94
FWCI
56.49
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • European Urology (publishedVersion)
  • PubMed (publishedVersion)
  • Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
  • Health Sciences › Medicine › Urology › Urological Disorders and Treatments
  • Social Sciences › Psychology › Clinical Psychology › Sexuality, Behavior, and Technology
Keywords
erectile dysfunction, premature ejaculation, male sexual dysfunction, phosphodiesterase-5 inhibitors, sildenafil, tadalafil, vardenafil, intracavernous injection, vacuum constriction devices, penile prosthesis, selective serotonin reuptake inhibitors, topical anesthetics, dapoxetine, behavioural techniques, diagnosis, treatment, prevalence, risk factors, diabetes mellitus
MeSH terms
Algorithms, Decision Trees, Ejaculation, Humans, Erectile Dysfunction, Male, Sexual Dysfunction, Physiological, Time Factors

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