Diagnóstico, tratamiento y seguimiento de la eyaculación precoz: recomendaciones de experto / Diagnosis, treatment and follow-up of premature ejaculation: expert's recommendations

Objetivos. Elaborar recomendaciones sobre el diagnóstico, tratamiento y seguimiento de la eyaculación precoz (EP). Material y método. Un grupo multidisciplinar de expertos planteó las preguntas clínicas. En base a una revisión sistemática no exhaustiva y la experiencia clínica, se elaboraron recomendaciones que fueron validadas en una ronda Delphi y, posteriormente, en una reunión presencial. Resultados. El interrogatorio es básico para el diagnóstico de la EP, que se complementará con una exploración física y con el uso de cuestionarios específicos. El tratamiento psicológico de la EP con terapia sexual y técnicas conductuales es eficaz, siendo más eficaz combinado con tratamiento farmacológico. No se recomienda el uso de agentes anestésicos ni las intervenciones quirúrgicas. Los inhibidores selectivos de la recaptación de serotonina (ISRS) son eficaces y seguros, siendo la dapoxetina el único fármaco con indicación. Los inhibidores de la fosfodiesterasa tipo5 no tienen suficiente evidencia que avale su uso. No existen estrategias estandarizadas de seguimiento de esta patología, si bien se pueden utilizar herramientas como escalas, cuestionarios o la autoestimación del tiempo de latencia intravaginal para la evaluación de la respuesta, y un seguimiento específico de visitas en caso de la toma de ISRS. Conclusiones. El presente consenso propone diversas recomendaciones referidas al manejo de la EP fundamentadas en la evidencia y en la experiencia clínica y que pretende ser un instrumento útil al clínico implicado en el manejo de estos pacientes (AU)

Objectives. To develop recommendations on the diagnosis, treatment and monitoring of premature ejaculation (PE). Material and method. A multidisciplinary group of experts created clinical questions. Based on a non-exhaustive systematic review and their clinical experience, recommendations were developed and validated in a Delphi round and, after that, in a meeting. Results. Interviews are essential for the diagnosis of PE, which has to be complemented with a physical examination and the use of specific questionnaires. Psychological treatment of PE with sex therapy and behavioral techniques is effective, and it is more effective when combined with drug treatment. The use of anesthetic agents or surgical interventions is not recommended. Selective serotonin reuptake inhibitors (SSRIs) are effective and safe, being dapoxetine the only drug with specific indication for PE. Inhibitors of phosphodiesterase type5 have not enough evidence to support their use. There are no standardized monitoring strategies for this disease, although tools such as scales, questionnaires or self-esteem intravaginal latency time for response assessment can be used, in addition to specific follow-up visits if the patient is taking SSRIs. Conclusions. This consensus proposes several recommendations regarding the management of PE according to evidence and clinical experience and aims at being a useful clinical instrument for the management of these patients (AU)

Spanish consensus on sexual health in men and women over 50.

Sexual health has been defined as "the state of physical, emotional and social wellbeing related to sexuality. However, there are medical, psychological and social reasons that complicate full sexual health that are frequently not attended to sufficiently. The objective of this guide will be to analyze the factors that impact the sexual health of men and women over 50 and to provide recommendations for the most appropriate diagnostic and therapeutic measures for this age group. A panel of experts from various Spanish scientific societies related to sexual health (Spanish Menopause Society, SMS; Asociación Española de Andrología, Medicina Sexual y Reproductiva, ASESA; Federación Española de Sociedades de Sexología, FESS; and Sociedad Española de Médicos de Atención Primaria SEMERGEN) met to reach a consensus on these issues and to decide the optimal timing and methods based on the best evidence available.