Heartlands Hospital, Birmingham, United Kingdom.
Prostate Center, London, United Kingdom.
J Sex Med. 2018 Apr;15(4):430-457. doi: 10.1016/j.jsxm.2018.01.023. Epub 2018 Mar 14.
This is an update of the 2008 British Society for Sexual Medicine (BSSM) guidelines.
To provide up-to-date guidance for U.K. (and international) health care professionals managing male sexual dysfunction.
Source information was obtained from peer-reviewed articles, meetings, and presentations. A search of Embase, MEDLINE, and Cochrane Reviews was performed, covering the search terms "hypogonadism," "eugonadal or hypogonadism or hypogonadal or gonadal," and "low or lower testosterone," starting from 2009 with a cut-off date of September 2017.
We offer evidence-based statements and recommendations for clinicians.
Expert guidance for health care professionals managing male sexual dysfunction is included.
Current U.K. management has been largely influenced by non-evidence guidance from National Health Service departments, largely based on providing access to care limited by resources. The 2008 BSSM guidelines to date have been widely quoted in U.K. policy decision making.
There is now overwhelming evidence that erectile dysfunction is strongly associated with cardiovascular disease, such that newly presenting patients should be thoroughly evaluated for cardiovascular and endocrine risk factors, which should be managed accordingly. Measurement of fasting serum glucose, lipid profile, and morning total testosterone should be considered mandatory in all newly presenting patients. Patients attending their primary care physician with chronic cardiovascular disease should be asked about erectile problems. There can no longer be an excuse for avoiding discussions about sexual activity due to embarrassment. Hackett G, Kirby M, Wylie K, et al. British Society for Sexual Medicine Guidelines on the Management of Erectile Dysfunction in Men-2017. J Sex Med 2018;15:430-457.
这是 2008 年英国性医学学会（BSSM）指南的更新。
为英国（和国际）医疗保健专业人员管理男性性功能障碍提供最新指导。
来源信息来自同行评议的文章、会议和演讲。对 Embase、MEDLINE 和 Cochrane 综述进行了搜索，使用的搜索词为“性腺功能减退症”、“正常生育力或性腺功能减退症或性腺功能减退症或性腺功能低下”和“低或更低的睾丸激素”，从 2009 年开始，截止日期为 2017 年 9 月。
为临床医生提供了基于证据的陈述和建议。
目前英国的管理主要受到国民保健署部门的非循证指导的影响，主要是为了提供受资源限制的护理。迄今为止，2008 年 BSSM 指南在英国的政策决策中被广泛引用。
现在有压倒性的证据表明，勃起功能障碍与心血管疾病密切相关，因此新出现的患者应彻底评估心血管和内分泌危险因素，并相应地进行管理。建议所有新出现的患者都应强制性检测空腹血清葡萄糖、血脂谱和早晨总睾酮。在患有慢性心血管疾病的患者就诊于初级保健医生时，应询问他们的勃起问题。由于尴尬而避免讨论性活动的借口不再成立。Hackett G、Kirby M、Wylie K 等人。2017 年英国性医学学会男性勃起功能障碍管理指南。性医学杂志 2018;15:430-457.
