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. 2019 Sep;7(3):292-302.
doi: 10.1016/j.esxm.2019.04.001. Epub 2019 Jun 10.

Diagnostic and Therapeutic Workup of Erectile Dysfunction: Results From a Delphi Consensus of Andrology Experts

Andrea M Isidori  1 , Bruno Giammusso  2 , Giovanni Corona  3 , Paolo Verze  4
Affiliations

Diagnostic and Therapeutic Workup of Erectile Dysfunction: Results From a Delphi Consensus of Andrology Experts

Andrea M Isidori et al. Sex Med. 2019 Sep.

Abstract

Introduction: Erectile dysfunction is a highly prevalent condition. Existing guidelines provide recommendations for diagnosis and treatment, but they are often disregarded in clinical practice in favor of a "patient-tailored" approach.

Objectives: We planned a Delphi consensus method to bridge the gap between evidence-based medicine and the real-life approach in daily practice.

Materials and methods: The Advisory Board prepared 15 statements on debated topics in andrology, each including 4-6 items designed as a 5-point Likert scale. After a validation phase, the questionnaire was sent by e-mail to a panel of experts for a first round of voting; members of the panel were later invited to a second round of voting, preceded by discussion of the "hot topics" identified in the first round.

Results: The first round of the Delphi consensus involved 101 experts; 71 (70%) also took part in the second round of voting. The Advisory Board deemed 22 items to be worthy of debate, and these underwent the second round of voting. "Real-life" results from the survey proved quite different from evidence-based recommendations.

Conclusion: Although guidelines suggest the best approach for a "standard" patient, real-life settings require flexibility. Diagnostic and therapeutic approaches should be tailored to the patients' needs. Phosphodiesterase type 5 inhibitors are recognized as the first-line therapy in both settings, including the newly introduced sildenafil orodispersible film. Indications from the panel might help close the gap between recommendations from guidelines and real-life practice in relation to the diagnosis and treatment of erectile dysfunction. Isidori AM, Giammusso B, Corona G, et al. Diagnostic and Therapeutic Workup of Erectile Dysfunction: Results From a Delphi Consensus of Andrology Experts. Sex Med 2019;7:292-302.

Keywords: Consensus; Delphi; Erectile Dysfunction; PDE5 Inhibitors; Treatment.

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Figures

Figure 1
Figure 1
The modified Delphi method used in this Consensus.
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