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.
Diagnostic and Therapeutic Workup of Erectile Dysfunction: Results From a Delphi Consensus of Andrology Experts / Isidori, A. M.; Giammusso, B.; Corona, G.; Verze, P.; Albanesi, L.; Antomarchi, F.; Arcaniolo, D.; Balercia, G.; Barbonetti, A.; Barletta, D.; Barrese, F.; Bellastella, G.; Biggio, A.; Bitelli, M.; Botturi, A.; Brancato, T.; Branchina, A.; Cai, T.; Canale, D.; Capone, L.; Capone, M.; Carluccini, A.; Citarrella, R.; Cocci, A.; Corvese, F.; Cozza, P. P.; Creta, M.; D'Andrea, S.; Dalena, G.; Damiano, R.; Defeudis, G.; Del Grasso, A.; Delbarba, A.; Delle Rose, A.; Di Crosta, G.; Di, Filippo; Di Lena, S.; Di Martino, M.; Di Millo, F.; Di Palma, P.; Diazzi, D.; Dicuio, M.; Diosi, D.; Fabbri, A.; Fattorini, G.; Florio, M.; Formiconi, A.; Franco, G.; Galdiero, M.; Giambersio, A. M.; Gianfrilli, D.; Giovannone, R.; Granata, A. M.; Iafrate, M.; Iapicca, G.; Iatrino, G.; Ilacqua, N.; Innocenti, F.; Italiano, E.; Izzo, A.; Izzo, P.; Lamartina, M.; Ledda, A. F.; Lepri, L.; Lo, C. F.; Lombardo, F.; Luca, G.; Macchione, L.; Maga, T.; Matteo, M.; Malvestiti, G. M.; Marella, G.; Maretti, C.; Maturo, G.; Mazzaferro, D.; Mazzilli, R.; Migliorini, F.; Milardi, D.; Minardi, V.; Moiso, A.; Mondaini, N.; Moretti, M.; Motta, G.; Nerva, F.; Pastore, A. L.; Paulis, G.; Piazza, N.; Pili, M.; Pistone, A.; Pivonello, R.; Pizzocaro, A.; Polverini, M.; Provinzano, V.; Rastrelli, G.; Risi, O.; Rocchegiani, A.; Rolle, L.; Romanelli, F.; Romano, G.; Russo, G. I.; Salemi, G.; Salzano, C.; Sanna, F.; Sansone, A.; Santi, D.; Scalese, G. A.; Scarano, P.; Scroppo, F. I.; Serrao, M. F.; Sidoti, G.; Silvestre, G.; Simone, O.; Sorrentino, M.; Tallis, V.; Tammaro, R.; Ughi, G.; Vagnoni, V.; Vavallo, A.; Vecchio, D.; Vita, A.; Zicarelli, P.; Zucchi, A.. - In: SEXUAL MEDICINE. - ISSN 2050-1161. - 7:3(2019), pp. 292-302. [10.1016/j.esxm.2019.04.001]
Diagnostic and Therapeutic Workup of Erectile Dysfunction: Results From a Delphi Consensus of Andrology Experts
Santi D.;
2019
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.
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