John D Dean1, Chris G McMahon2, Andre T Guay3,4, Abraham Morgentaler5, Stanley E Althof6, Edgardo F Becher7, Trinity J Bivalacqua8, Arthur L Burnett9, Jacques Buvat10, Amr El Meliegy11, Wayne J G Hellstrom12, Emmanuele A Jannini13, Mario Maggi14, Andrew McCullough15, Luiz Otavio Torres16, Michael Zitzmann17. 1. Gender and Sexual Medicine, Devon Partnership NHS Trust, Exeter, UK. 2. Australian Center for Sexual Health, Sydney, NSW, Australia. 3. Center for Sexual Function, Lahey Clinic Northshore, Peabody, MA, USA. 4. Endocrinology, Harvard Medical School, Boston, MA, USA. 5. Department of Urology, Harvard Medical School, Boston, MA, USA. 6. Urology, Case Western Reserve, University School of Medicine, West Palm Beach, FL, USA. 7. Division of Urology, Hospital de Clinicas, University of Buenos Aires School of Medicine, Buenos Aires, Argentina. 8. The James Buchanan Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, MD, USA. 9. Department of Urology, Johns Hopkins Medical Institutions, Baltimore, MD, USA. 10. Centre d'Etudes et de Traitement de la Pathologie de l'Appareil Reproducteur et de la Psychosomatique, Lille, France. 11. Department of Andrology, Sexology and STDs, Faculty of Medicine, Cairo University, Cairo, Egypt. 12. Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA. 13. Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy. 14. Department Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy. 15. Division of Urology, Albany Medical College, Albany, NY, USA. 16. Clinica de Urologia e Andrologia, Belo Horizonte, Brazil. 17. Centre for Reproductive Medicine and Andrology/Clinical Andrology, University Clinics Müenster, Münster, Germany.
Abstract
INTRODUCTION: In 2014, the International Society for Sexual Medicine (ISSM) convened a panel of experts to develop an evidence-based process of care for the diagnosis and management of testosterone deficiency (TD) in adult men. The panel considered the definition, epidemiology, etiology, physiologic effects, diagnosis, assessment and treatment of TD. It also considered the treatment of TD in special populations and commented on contemporary controversies about testosterone replacement therapy, cardiovascular risk and prostate cancer. AIM: The aim was to develop clearly worded, practical, evidenced-based recommendations for the diagnosis and treatment of diagnosis and management of TD for clinicians without expertise in endocrinology, such as physicians in family medicine and general urology practice. METHOD: A comprehensive literature review was performed, followed by a structured, 3-day panel meeting and 6-month panel consultation process using electronic communication. The final guideline was compiled from reports by individual panel members on areas reflecting their special expertise, and then agreed by all through an iterative process. RESULTS: This article contains the report of the ISSM TD Process of Care Committee. It offers a definition of TD and recommendations for assessment and treatment in different populations. Finally, best practice treatment recommendations are presented to guide clinicians, both familiar and unfamiliar with TD. CONCLUSION: Development of a process of care is an evolutionary process that continually reviews data and incorporates the best new research. We expect that ongoing research will lead to new insights into the pathophysiology of TD, as well as new, efficacious and safe treatments. We recommend that this process of care be reevaluated and updated by the ISSM in 4 years.
INTRODUCTION: In 2014, the International Society for Sexual Medicine (ISSM) convened a panel of experts to develop an evidence-based process of care for the diagnosis and management of testosterone deficiency (TD) in adult men. The panel considered the definition, epidemiology, etiology, physiologic effects, diagnosis, assessment and treatment of TD. It also considered the treatment of TD in special populations and commented on contemporary controversies about testosterone replacement therapy, cardiovascular risk and prostate cancer. AIM: The aim was to develop clearly worded, practical, evidenced-based recommendations for the diagnosis and treatment of diagnosis and management of TD for clinicians without expertise in endocrinology, such as physicians in family medicine and general urology practice. METHOD: A comprehensive literature review was performed, followed by a structured, 3-day panel meeting and 6-month panel consultation process using electronic communication. The final guideline was compiled from reports by individual panel members on areas reflecting their special expertise, and then agreed by all through an iterative process. RESULTS: This article contains the report of the ISSM TD Process of Care Committee. It offers a definition of TD and recommendations for assessment and treatment in different populations. Finally, best practice treatment recommendations are presented to guide clinicians, both familiar and unfamiliar with TD. CONCLUSION: Development of a process of care is an evolutionary process that continually reviews data and incorporates the best new research. We expect that ongoing research will lead to new insights into the pathophysiology of TD, as well as new, efficacious and safe treatments. We recommend that this process of care be reevaluated and updated by the ISSM in 4 years.
Authors: Thiago Gagliano-Jucá; Zhuoying Li; Karol M Pencina; Yusnie M Beleva; Olga D Carlson; Josephine M Egan; Shehzad Basaria Journal: Endocrine Date: 2018-09-06 Impact factor: 3.633
Authors: G Corona; S Filippi; P Comelio; N Bianchi; F Frizza; M Dicuio; G Rastrelli; S Concetti; A Sforza; L Vignozzi; M Maggi Journal: Int J Impot Res Date: 2021-03-21 Impact factor: 2.896