Guideline of guidelines: a scoping review on comparison of major clinical guidelines for erectile dysfunction
Abstract
Background: There are numerous published societal guidelines for the management of men with erectile dysfunction (ED), often with specific nuances and some variations in diagnostic and treatment strategies based on relevant locoregional factors such as sociocultural barriers and differences in emphasis between urological organisations versus sexual medicine societies. This "guideline of guidelines" narrative format will enable clinicians to identify best clinical practices, standardize the delivery of healthcare and address any inconsistencies so that future research can be undertaken to improve ED care pathways.
Methods: The review was conducted as a scoping review with a structured comparison of international clinical practice guidelines for the assessment and management of ED. Guidelines were identified through searches of official websites of major urological organisations and sexual medicine societies and published literature, with further review of references within each guideline. A total of eleven national and international ED guidelines were selected for inclusion in this study.
Results: Although first-line pharmacotherapy is well established, recommendations for patient assessment, investigation and further treatment differ across various guidelines. There was a wide consensus in the evaluation of men with ED, especially concerning cardiovascular risk assessment. Divergence was noted in testosterone screening thresholds, adoption of a stepwise management approach…
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