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Guidelines

Sexual and Reproductive Health

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For the 2022 Sexual and Reproductive Health Guidelines, new and relevant evidence was identified, collated and appraised through an assessment of the literature. 

Key changes in the 2022 publication:

  • Section 3.4 - Classification and causes of male hypogonadism: update on effects of coronavirus 2 (SARS-CoV-2) infection (COVID-19);
  • Section 5.6.2.8.1 – Treatment of Erectile Dysfunction - Platelet Rich Plasma (PRP): addition to the text and a new recommendation;
  • Section 6.2.6.2.4  - Treatment of Premature Ejaculation – Tramadol: amendment to the text and amended recommendation;
  • Section 8.2.3.1 -  Conservative Treatment of Penile Curvature - Platelet Rich Plasma (PRP): addition to the text and new recommendation;
  • Section 10.3 – Diagnostic Evaluation of Male Infertility: the text has been amended in light of the 6th edition of the WHO Manual for the Examination and Processing of Human Semen;
  • Section 10.6.2 Male Infertility - Non-obstructive azoospermia: text and recommendation amended for indications   and techniques of sperm retrieval relating to conventional and microdissection TESE.

New recommendations

5.6.3       Recommendations for treatment of ED

Recommendation

Strength rating

Do not use platelet-rich plasma (PRP) to treat ED outside the confines of a clinical trial.

Weak

6.2.8       Recommendations for the treatment of PE

Recommendation

Strength rating

Use off-label tramadol with caution as a viable on-demand alternative to on demand SSRIs.

Strong

8.2.3.1.6 Recommendations for non-operative treatment of Peyronie’s disease

Recommendation

Strength rating

Do not use intralesional platelet-rich plasma (PRP) or hyaluronic acid – either alone or in combination with oral treatment - to reduce penile curvature, plaque size or pain outside the confines of a clinical trial.

Weak

10.3.7     Recommendations for the diagnostic work-up of male infertility

Recommendation

Strength rating

Perform semen analyses according to the most recent WHO Laboratory Manual for the Examination and Processing of Human Semen (6th edn.) indications and reference criteria or according to the previous version (5th edn.) until a formal and complete adoption of the newly-released parameters will be implemented.

Strong

 10.6.2.3 Recommendations for Non-Obstructive Azoospermia

Recommendation

Strength rating

Microdissection TESE (mTESE) is the technique of choice for retrieving sperm in patients with NOA.

Weak


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