In a panel chaired by UCSF Urology’s Alan Shindel, MD, MAS, the American Urological Association (AUA) and the Sexual Medicine Society of North America (SMSNA) released new clinical practice guidelines to aid in the diagnosis and treatment of ejaculatory disorders in men.
Ejaculatory disorders include premature or delayed ejaculation as well as other conditions such as hematospermia, retrograde ejaculation or evenshanejaculation. At present, there are a number of psychological health, behavioral and pharmacotherapy options available for these disorders; however, no drug has been approved by the U.S. Food and Drug Administration (FDA) and use of these agents to treat premature ejaculation is considered off-label.
“Ejaculatory disorders are not rare and can cause significant distress for patients,” said Panel Chair Dr. Shindel. “It’s important for clinicians to understand how to recognize and treat these conditions, in particular the role that mental health can play. We were pleased to partner with the SMSNA on this critical guidance.”
The role of the clinician in managing these conditions is to conduct appropriate investigation, provide education and offer available treatments that are rational and based on sound scientific data, and the guideline includes 26 recommendation statements to guide this process. Recommendations include a conducting a thorough assessment of medical, relationship and sexual history in addition to a focused physical exam, additional testing with validated instruments as appropriate and, in some cases, additional support from or consultation with a mental health professional who specializes in sexual health. The Panel also acknowledges that shared decision-making is fundamental in the management of ejaculatory disorders and recommends involving sexual partner(s) in decision making when possible.
Dr. Shindel’s leadership in this important work gathered input from many experts, including mental health professionals. “The resulting recommendations now provide uniform advice on a multi-disciplined approach to treatment for these disorders,” says Raj S. Pruthi, MD, MHA, FACS, UCSF Department of Urology. “Dr. Shindel is a national expert in men’s health and his leadership in these guidelines is a great accomplishment and one that will have a lasting affect for patients.”