UK management guidelines for erectile dysfunction

doi:10.1136/bmj.321.7259.499

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David Ralph, consultant (dralph@andrology.co.uk)a,
Tom McNicholas, consultant
for the Erectile Dysfunction Alliance
b

^a Institute of Urology, London W1P 7PN
^b Lister Hospital, Stevenage, Hertfordshire SG1 4AB

Correspondence to: D Ralph, Taylor Patten Communications, Ashtead, Surrey KT21 2BT

Accepted 25 April 2000

In 1998, a working party of experts in different aspects of erectile dysfunction was drawn together to develop guidelines for managing the condition, with the support of other experts and professional bodies.1 Throughout the period of the development of these guidelines, input from the professional community was invited at every opportunity possible. This article covers the main points and recommendations of the guidelines.

Summary points

Erectile dysfunction is common and is easily assessed and treated
A detailed history is most important, and for many patients examination can be limited to blood pressure and examination of the genitalia
Patients should be informed about the advantages and disadvantages of each treatment and given advice on treatment outcome as well as ease of use
Patients should be advised on what to do and who to contact if there are problems or complications due to treatment
Follow up should be tailored to goals established at the start of treatment

Chairman's introduction

Erectile dysfunction is a major healthcare issue and acts as a marker for other common major diseases. It therefore deserves attention, consideration, proper investigation, and appropriate treatment. These guidelines should help in facilitating proper management and avoiding unnecessary expense and inconvenience. We have set out minimum standards for the investigation and management of erectile dysfunction, with comments on what should be added to the barest acceptable minimum to achieve a better standard of management. The guidelines are evidence based, as far as possible.

Methods

Information came from peer reviewed articles, meetings, and presentations. Articles were chosen by electronically searching the Cochrane Library, Excerpta Medica, Medline, and Embase for randomised controlled trials on erectile dysfunction and related topics. The abstracts of all resulting references were reviewed, and original papers concerning large numbers of subjects or addressing important or contentious issues were analysed. We …