1. INTRODUCTION
1.1. Aims and Objectives
The European Association of Urology (EAU) Sexual and Reproductive Health Guidelines aim to provide a comprehensive overview of the medical aspects relating to sexual and reproductive health in adult men.
It must be emphasised that guidelines present the best evidence available to the experts. However, following guideline recommendations will not necessarily result in the best outcome. Guidelines can never replace clinical expertise when making treatment decisions for individual patients, but rather help to focus decisions - while taking personal values and preferences/individual circumstances of patients into account. Guidelines are not mandates and do not purport to be a legal standard of care.
1.2. Panel Composition
The EAU Sexual and Reproductive Health Guidelines Panel consists of an international multi-disciplinary group of urologists and endocrinologists. All experts involved in the production of this document have submitted potential conflict of interest statements which can be viewed on the EAU website:
http://www.uroweb.org/guideline/sexual-and-reproductive-health/.
1.3. Available Publications
A quick reference document, the Pocket Guidelines, is available. This is an abridged versions that may require consultation together with the full text version. A number of scientific publications are also available. All documents can be viewed through the EAU website:
http://www.uroweb.org/guideline/sexual-and-reproductive-health/. An EAU Guidelines App for iOS and Android devices is also available containing the Pocket Guidelines, interactive algorithms and calculators, clinical decision support tools, guidelines cheat sheets and links to the extended guidelines.
1.4. Publication History
The EAU Sexual and Reproductive Health Guidelines were first published in 2020. This 2025 document presents a limited update of the 2024 publication.
1.5. Summary of Changes
For the 2025 Guidelines new and relevant evidence was identified, collated and appraised through a structured assessment of the literature for all sections of the Guidelines. This resulted in the inclusion of 76 updated studies across the Guidelines. Key changes include:
- Significant changes to section 5.4.4 Cardiovascular system and sexual activity: the patient at risk. This section has been completely restructured and updated including two new figures 5.2 and 5.3.
- Two new recommendations in section 5.6.12 Summary of evidence and recommendations for treatment of ED.
- Modification of the recommendation for penile surgery for adult acquired buried penis in section 9.3.2.2.5.
- Addition of a new sections – section 11.3.5.4 Exome sequencing and 11.5.1.3 Probiotic treatment.
- Update of the recommendations in section 11.3.7.