Sexual and Reproductive Health


2.1. Methods

For the 2022 Sexual and Reproductive Health Guidelines, further new evidence has been identified, collated and appraised through a structured assessment of the literature.

For each recommendation within the Guidelines there is an accompanying online strength rating form; the basis of which is a modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology [1,2]. Each strength rating form addresses several key elements namely:

  1. the overall quality of the evidence which exists for the recommendation, references used in this text are graded according to a classification system modified from the Oxford Centre for Evidence-Based Medicine Levels of Evidence [3];
  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;
  5. the impact of patient values and preferences on the intervention;
  6. the certainty of those patient values and preferences.

These key elements are the basis that panels use to define the strength rating of each recommendation. The strength of each recommendation is represented by the term ‘strong’ or ‘weak’ [4]. 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 nature and variability of patient values and preferences. Additional information can be found in the general Methodology section of this print, and online at the European Association of Urology (EAU) website: A list of associations endorsing the EAU Guidelines can also be viewed online at this address.

2.2. Review

The existing sections of the Sexual and Reproductive Health Guidelines were peer reviewed prior to publication in 2020. The new section for priapism was reviewed prior to publication in 2021.

2.3. Future goals

The results of ongoing and new systematic reviews will be included in the 2023 update of the Sexual and Reproductive Health Guidelines. Systematic reviews planned for 2022 are:

  • Penile augmentation surgery;
  • Vasectomy and male contraception;
  • Penile prosthesis implantation peri-operative complications;
  • Importance of psychology/psychosexology in the field of urology;
  • Sexual function outcomes in men undergoing interventions for prostate cancer.