JSSM Guidelines for erectile dysfunction

要旨

The preparation of these Guidelines was decided upon by the Board of Directors of the Japanese Society for Sexual Medicine (JSSM) in 2006. It was then approved by the Society members, and developed with the support of the Japanese Urological Association. The need for these Guidelines arose in 1999, when oral medication for the treatment of erectile dysfunction (ED) was approved for sale in Japan. Until that time, only a few specialists were involved in the treatment of ED. With the appearance of an effective oral agent, general physicians had more opportunities to treat ED. This led to our decision to produce these Guidelines for the diagnosis and treatment of ED, suitable for general physicians. The funding came entirely from the Japanese Society for Sexual Medicine, with the approval of the Board of Directors. As mentioned above, these Guidelines are aimed at the general physician. In this case, the term general physician includes most urologists who do not specialize in the area of sexual dysfunctions. We initially based our deliberations on the record of the International Consultation on Erectile and Sexual Dysfunctions,1 and the 2005 version of the European Association of Urology (EAU) ED Guidelines,2 the most recent guidelines available at present. We searched specialist ED journals, The Journal of Sexual Medicine, International Journal of Impotence Research, and journals published by the Japanese Society for Sexual Medicine, for papers published after the above guidelines were issued. We also searched the specialist urology journals, Journal of Urology, Urology, BJU International, and European Urology. We confined our PubMed search to 'review OR meta-analysis' from 2005 or later, using the key words 'erectile dysfunction OR sexual dysfunction'. Based on the resulting material, preparation committee members Drs Kimoto, Nagao, Sasaki and Marumo (all urologists) gathered and conferred together at branch meetings of the Japanese Society for Sexual Medicine and the general meeting of the Japanese Urological Association, and produced some draft guidelines. These were sent to committee members Drs Ishikura, Takahashi, Nishi and Ms Futamatsu for their opinions in their specialist fields. The draft guidelines, revised according to their opinions, were then presented to the General Council of the Japanese Society for Sexual Medicine. Further changes were made following their deliberations, and the Guidelines were ratified. Levels of evidence for the references quoted in the Guidelines, and the recommendation grades, were based on the 'Minds 2007 Manual for Production of Clinical Practice guidelines'3 (see Table 1). The Third International Consultation on Erectile and Sexual Dysfunctions is scheduled for 2009, and the proceedings should be release in 2010. We plan to prepare a Japanese version based on their deliberations, work progressing through 2010 and 2011, and the revised Japanese Guidelines should be ready for publishing in 2011. The production committee for the revised edition will be selected mainly from participants in the 2009 International Consultation. All of the members of the Guidelines preparation committee have over the past 3 years received payments in their respective specialty fields, in the form of lecture fees and teaching fees, from Pfizer, Bayer, and Eli-Lilly Japan. The authors would like to express their gratitude to the representatives of the Japanese Urological Association, and in particular Dr Akihiko Okuyama, the Association President, for their invaluable assistance in the preparation of these Guidelines. A recent review article4 estimated that at present 5–20% of all adult males worldwide experience moderate to complete ED.NB This proportion is expected to further increase with the aging population, doubling by the year 2025.5 An epidemiological survey was conducted in Japan with a questionnaire using the same format as the Massachusetts Male Aging Study (MMAS).6 Subject selection was based on the b

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