Guidelines on Male Sexual Dysfunction: Erectile Dysfunction and Premature Ejaculation
Guidelines on Male Sexual Dysfunction: Erectile Dysfunction and Premature Ejaculation
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DOI：
10.1016/j.eururo.2010.02.020
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发表时间：
2010-05-01
期刊：
影响因子：
23.4
通讯作者：
Wespes, Eric
中科院分区：
文献类型：
--
作者：
Hatzimouratidis, Konstantinos;Amar, Edouard;Wespes, Eric
内容：勃起功能障碍（艾德）和早泄（PE）是最常见的两种男性性功能障碍。目的：介绍2009年欧洲泌尿外科协会（EAU）关于艾德和PE指南的最新版本。证据获取：对艾德和PE的流行病学、诊断和治疗的最新文献进行系统综述。证据综合：艾德是一种高度流行的疾病，5-20%的男性患有中度至重度ED。艾德与心血管疾病有共同的危险因素。诊断基于病史和性史，包括有效的问卷调查。体格检查和实验室检查必须根据患者的主诉和风险因素量身定制。治疗基于磷酸二酯酶5型抑制剂（PDE 5-Is），包括西地那非、他达拉非和伐地那非。PDE 5-Is具有较高的疗效和安全性，即使在难以治疗的人群中，如糖尿病患者。对PDE 5-Is无反应或PDE 5-Is禁忌的患者的治疗选择包括海绵体内注射、尿道内注射阿替洛尔、真空缩窄装置或阴茎假体植入。PE可分为终身性（原发性）或获得性（继发性）。诊断是基于医疗和性史评估阴道内射精潜伏期时间，感知控制，痛苦和人际关系的困难与射精功能障碍。只有在选定的患者可能需要体格检查和实验室检查。药物治疗是终身PE治疗的基础，包括每日服用选择性5-羟色胺再摄取抑制剂和局部麻醉剂。达泊昔单抗是欧洲唯一获批用于按需治疗PE的药物。行为技术作为单一疗法或与药物疗法联合使用可能是有效的。复发很可能发生后treatmentwithdrawing.Conclusions：这些EAU指南总结了目前的信息艾德和PE。该准则的扩展版可在EAU网站上查阅（http：//www.uroweb.org/nc/professionalresources/guidelines/online/）。(C)2010年欧洲泌尿外科协会。由Elsevier B出版。V.保留所有权利。
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/professionalresources/guidelines/online/). (C) 2010 European Association of Urology. Published by Elsevier B. V. All rights reserved.