Guidelines

2. METHODOLOGY

2.1. Methods

For the 2026 Sexual and Reproductive Health Guidelines, new and relevant evidence has been identified, collated, and appraised through a structured assessment of the literature for Chapters: 3. Male Hypogonadism, 6. Disorders of Ejaculation, 8. Penile Curvature, and 10 Priapism. Databases searched included Medline, EMBASE and the Cochrane Libraries, covering a time frame between 1 January 2019 and 25 May 2025. A total of 1,118 unique records were identified, retrieved and screened for relevance for chapter 3, 811 for chapter 6, 712 for chapter 8, and 640 for chapter 10, respectively. Detailed search strategies are available online: https://uroweb.org/guidelines/sexual-and-reproductive-health/publications-appendices.

Recommendations within the Guidelines are developed by the Panels to prioritise clinically important care decisions. The strength of each recommendation is determined by the balance between desirable and undesirable consequences of alternative management strategies, the quality of the evidence (including certainty of estimates), and the nature and variability of patient values and preferences. This decision process, which can be reviewed in the strength rating forms which accompany each Guidelines recommendation, addresses a number of key elements:

  1. the overall quality of the evidence which exists for the recommendation [1];
  2. the magnitude of the effect (individual or combined effects);
  3. the certainty of the results (precision, consistency, heterogeneity and other statistical or study-related factors);
  4. the balance between desirable and undesirable outcomes; and
  5. the impact and certainty of patient values and preferences on the intervention.

Strong recommendations typically indicate a high degree of evidence quality and/or a favourable balance of benefit to harm and patient preference. Weak recommendations typically indicate availability of lower quality evidence, and/or equivocal balance between benefit and harm, and uncertainty or variability of patient preference [2].

Additional information and a list of associations endorsing the EAU Guidelines can be found online at the EAU website: http://www.uroweb.org/guidelines/.

2.2. Review

The EAU Sexual and Reproductive Health Guidelines were peer reviewed prior to publication in 2020. The priapism section was reviewed prior to publication in 2021. In 2023, the newly added section on penile size abnormalities and dysmorphophobia was reviewed prior to publication. The 2026 Sexual and Reproductive Health Guidelines will be peer reviewed following publication. All reviewer comments and discussions points will be incorporated into the 2027 edition of the guidelines.