Abstract：
These clinical practice recommendations by the Urological Society of Australia and New Zealand (USANZ) and the Australasian Chapter of Sexual Health Medicine (AChSHM) for the Royal Australasian College of Physicians (RACP) provide evidence-based clinical guidelines on the management of erectile dysfunction (ED) in Australia.
A comprehensive clinical history and a tailored physical examination are essential (Level of evidence [LoE] 3; GRADE B). Laboratory testing should include fasting glucose, lipid profile and total testosterone level (LoE 3; GRADE A). Specialised diagnostic tests are recommended in selected cases and the patient should be counselled accordingly (LoE 4; GRADE B). Lifestyle changes and optimisation of existing medical conditions should accompany all ED treatment regimens (LoE 1; GRADE A). Oral phosphodiesterase type 5 inhibitor (PDE5i) is an effective first line medical therapy (LoE 1; GRADE A). Intracavernosal injections and vacuum erection devices are recommended as second line therapy (LoE 1; GRADE B). A penile prosthesis implant can be considered in men who are medically refractory or unable to tolerate the side effects of medical therapy (LoE 4; GRADE B). Pro-erectile regenerative therapy remains largely experimental (LoE 3; GRADE B).
Modification of lifestyle behaviour, management of reversible risk factors and optimisation of existing medical conditions remain pivotal, and existing standard ED therapies are often effective and safe following cardiovascular risk stratification. Caution should be exercised on the use of regenerative technology in ED due to unknown long term outcomes.
A comprehensive clinical history and a tailored physical examination are essential (Level of evidence [LoE] 3; GRADE B). Laboratory testing should include fasting glucose, lipid profile and total testosterone level (LoE 3; GRADE A). Specialised diagnostic tests are recommended in selected cases and the patient should be counselled accordingly (LoE 4; GRADE B). Lifestyle changes and optimisation of existing medical conditions should accompany all ED treatment regimens (LoE 1; GRADE A). Oral phosphodiesterase type 5 inhibitor (PDE5i) is an effective first line medical therapy (LoE 1; GRADE A). Intracavernosal injections and vacuum erection devices are recommended as second line therapy (LoE 1; GRADE B). A penile prosthesis implant can be considered in men who are medically refractory or unable to tolerate the side effects of medical therapy (LoE 4; GRADE B). Pro-erectile regenerative therapy remains largely experimental (LoE 3; GRADE B).
Modification of lifestyle behaviour, management of reversible risk factors and optimisation of existing medical conditions remain pivotal, and existing standard ED therapies are often effective and safe following cardiovascular risk stratification. Caution should be exercised on the use of regenerative technology in ED due to unknown long term outcomes.
摘要：
澳大利亚和新西兰泌尿外科学会（USANZ）和澳大利亚皇家内科医学院（RACP）的性健康医学澳大利亚分会（AChSHM）的这些临床实践建议提供了有关治疗的循证临床指南。澳大利亚的勃起功能障碍（ED）。
全面的临床病史和量身定制的体格检查至关重要（证据等级[LoE]3；B级）。实验室检查应包括空腹血糖，血脂和总睾酮水平（LoE3；A级）。在选定的病例中，建议进行专门的诊断测试，并对患者进行相应的咨询（LoE4；B级）。生活方式的改变和现有医疗条件的优化应伴随所有ED治疗方案（LoE1；A级）。口服5型磷酸二酯酶抑制剂(PDE5i)是一种有效的一线药物治疗(LoE1;A级)。推荐使用海绵体内注射和真空勃起装置作为二线治疗（LoE1；B级）。对于医学上难治或无法耐受药物治疗副作用的男性，可以考虑使用阴茎假体植入物（LoE4；B级）。促勃起再生疗法在很大程度上仍是实验性的(LoE3;B级)。
改变生活方式的行为，可逆风险因素的管理和现有医疗条件的优化仍然至关重要，和现有的标准ED疗法在心血管危险分层后通常是有效和安全的。由于长期结果未知，应谨慎使用再生技术。
全面的临床病史和量身定制的体格检查至关重要（证据等级[LoE]3；B级）。实验室检查应包括空腹血糖，血脂和总睾酮水平（LoE3；A级）。在选定的病例中，建议进行专门的诊断测试，并对患者进行相应的咨询（LoE4；B级）。生活方式的改变和现有医疗条件的优化应伴随所有ED治疗方案（LoE1；A级）。口服5型磷酸二酯酶抑制剂(PDE5i)是一种有效的一线药物治疗(LoE1;A级)。推荐使用海绵体内注射和真空勃起装置作为二线治疗（LoE1；B级）。对于医学上难治或无法耐受药物治疗副作用的男性，可以考虑使用阴茎假体植入物（LoE4；B级）。促勃起再生疗法在很大程度上仍是实验性的(LoE3;B级)。
改变生活方式的行为，可逆风险因素的管理和现有医疗条件的优化仍然至关重要，和现有的标准ED疗法在心血管危险分层后通常是有效和安全的。由于长期结果未知，应谨慎使用再生技术。
