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. 2023 Jun;46(6):1241-1274.
doi: 10.1007/s40618-023-02015-5. Epub 2023 Jan 25.

The Italian Society of Andrology and Sexual Medicine (SIAMS), along with ten other Italian Scientific Societies, guidelines on the diagnosis and management of erectile dysfunction

G Corona  1 , D Cucinotta  2 , G Di Lorenzo  3   4 , A Ferlin  5 , V A Giagulli  6   7 , L Gnessi  8 , A M Isidori  9 , M I Maiorino  10 , P Miserendino  11 , A Murrone  12 , R Pivonello  13   14 , V Rochira  15 , G M Sangiorgi  16 , G Stagno  17 , C Foresta  5 , A Lenzi  8 , M Maggi  18 , E A Jannini  19
Affiliations

The Italian Society of Andrology and Sexual Medicine (SIAMS), along with ten other Italian Scientific Societies, guidelines on the diagnosis and management of erectile dysfunction

G Corona et al. J Endocrinol Invest. 2023 Jun.

Abstract

Purpose: Erectile dysfunction (ED) is one of the most prevalent male sexual dysfunctions. ED has been in the past mistakenly considered a purely psycho-sexological symptom by patients and doctors. However, an ever-growing body of evidence supporting the role of several organic factors in the pathophysiological mechanisms underlying ED has been recognized.

Methods: The Italian Society of Andrology and Sexual Medicine (SIAMS) commissioned an expert task force involving several other National Societies to provide an updated guideline on the diagnosis and management of ED. Derived recommendations were based on the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system.

Results: Several evidence-based statements were released providing the necessary up-to-date guidance in the context of ED with organic and psychosexual comorbidities. Many of them were related to incorrect lifestyle habits suggesting how to associate pharmacotherapies and counseling, in a couple-centered approach. Having the oral therapy with phosphodiesterase type 5 inhibitors as the gold standard along with several other medical and surgical therapies, new therapeutic or controversial options were also discussed.

Conclusions: These are the first guidelines based on a multidisciplinary approach that involves the most important Societies related to the field of sexual medicine. This fruitful discussion allowed for a general agreement on several recommendations and suggestions to be reached, which can support all stakeholders in improving couple sexual satisfaction and overall general health.

Keywords: Erectile dysfunction; Obesity; Phosphodiesterase type 5 inhibitors; Premature ejaculation; Sexual desire; Testosterone.

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Conflict of interest statement

EAJ is or has been consultant and/or paid speaker for Bayer, Ibsa, Menarini, Merk, Otsuka, Pfizer, Shionogi, and Viatris. Other authors do not display CoI.

Figures

Fig. 1
Fig. 1
Flowchart of the management of the symptom erectile dysfunction according to the diagnosis and the therapeutic outcome. ED erectile dysfunction; SED subclinical erectile dysfunction; PCDU penile color-doppler ultrasonography; LUTS lower urinary tract symptoms; PDE5i type 5 phosphodiesterase inhibitor
See this image and copyright information in PMC

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