Lue Tom F, Giuliano François, Montorsi Francesco, Rosen Raymond C, Andersson Karl-Erik, Althof Stanley, Christ George, Hatzichristou Dimitrios, Hirsch Mark, Kimoto Yasasuke, Lewis Ronald, McKenna Kevin, MacMahon Chris, Morales Alvaro, Mulcahy John, Padma-Nathan Harin, Pryor John, de Tejada Inigo Saenz, Shabsigh Ridwan, Wagner Gorm
Department of Urology, UCSF, San Francisco, CA, USA.
J Sex Med. 2004 Jul;1(1):6-23. doi: 10.1111/j.1743-6109.2004.10104.x.
There are few published guidelines for the management of sexual dysfunctions in men and women, despite the prevalence and lack of attention to these problems. Disorders of sexual function in men include erectile dysfunction, orgasm/ejaculation disorders, priapism, and Peyronie's disease.
To provide evidence-based and expert-opinion consensus guidelines for the clinical management of men's sexual dysfunctions.
An International Consultation in collaboration with major urological and sexual medicine societies assembled over 200 multidisciplinary experts from 60 countries into 17 consultation committees. Committee members established the scope and objectives for each chapter. Following intensive review of available data and publications, committees developed evidence-based guidelines in each area.
New algorithms and guidelines for assessment and treatment of men's sexual dysfunction were developed. The Oxford system of evidence-based review was systematically applied. Expert opinion was based on systematic grading of the medical literature, in addition to cultural and ethical considerations.
Recommendations and guidelines for men's sexual dysfunction are presented. These guidelines were developed as evidence-based, patient-centered, and multidisciplinary in focus. For the clinical assessment and diagnosis of ED, a basic evaluation was recommended for all patients, with optional and specialized testing reserved for special cases. A new treatment algorithm is proposed. This algorithm provides a clinically relevant guideline for managing ED in the large majority of men. New treatment guidelines and algorithms are provided for men's orgasm and ejaculation disorders, including premature ejaculation, retrograde and delayed ejaculation. Finally, expert opinion-based guidelines for the clinical management of priapism and Peyronie's disease are provided.
Additional research is needed to validate and extend these guidelines. Nonetheless, this summary encompasses the recommendations concerning men's sexual dysfunctions presented at the 2nd International Consultation on Sexual Medicine in Paris, France, June 28-July 1, 2003.
尽管性功能障碍问题普遍存在且未得到足够重视，但针对男性和女性性功能障碍管理的已发表指南却很少。男性性功能障碍包括勃起功能障碍、性高潮/射精障碍、阴茎异常勃起和佩罗尼氏病。
为男性性功能障碍的临床管理提供基于证据和专家意见的共识指南。
与主要的泌尿外科和性医学学会合作开展了一次国际咨询会议，召集了来自60个国家的200多名多学科专家组成17个咨询委员会。委员会成员确定了每章的范围和目标。在对现有数据和出版物进行深入审查之后，各委员会在每个领域制定了基于证据的指南。
制定了男性性功能障碍评估和治疗的新算法及指南。系统应用了牛津循证审查体系。除文化和伦理考量外，专家意见还基于对医学文献的系统分级。
给出了男性性功能障碍的建议和指南。这些指南是基于证据、以患者为中心且多学科的。对于勃起功能障碍的临床评估和诊断，建议对所有患者进行基本评估，特殊情况可进行选择性和专门检测。提出了一种新的治疗算法。该算法为大多数男性勃起功能障碍的管理提供了具有临床相关性的指南。还给出了男性性高潮和射精障碍（包括早泄、逆行射精和射精延迟）的新治疗指南和算法。最后，给出了基于专家意见的阴茎异常勃起和佩罗尼氏病临床管理指南。
需要更多研究来验证和扩展这些指南。尽管如此，本综述涵盖了2003年6月28日至7月1日在法国巴黎举行的第二届性医学国际咨询会议上提出的有关男性性功能障碍的建议。
