• Tom F Lue, François Giuliano, Francesco Montorsi, Raymond C Rosen, Karl-Erik Andersson, Stanley Althof, George Christ, Dimitrios Hatzichristou, Mark Hirsch, Yasasuke Kimoto, Ronald Lewis, Kevin McKenna, Chris MacMahon, Alvaro Morales, John Mulcahy, Harin Padma-Nathan, John Pryor, Inigo Saenz de Tejada, Ridwan Shabsigh, and Gorm Wagner.
• Department of Urology, UCSF, San Francisco, CA, USA. Tlue@urol.ucsf.edu
• J Sex Med. 2004 Jul 1;1(1):6-23.

IntroductionThere 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.AimTo provide evidence-based and expert-opinion consensus guidelines for the clinical management of men's sexual dysfunctions.MethodsAn 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.Main Outcome MeasureNew 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.ResultsRecommendations 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.ConclusionsAdditional 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.

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