Male infertility (MI) and male sexual dysfunction (MSD) can often coexist together due to various interplay factors such as psychosexual, sociocultural and relationship dynamics. The presence of each form of MSD can adversely impact male reproduction and treatment strategies will need to be individualized based on patients\' factors, local expertise, and geographical socioeconomic status. The Asia Pacific Society of Sexual Medicine (APSSM) and the Asian Society of Men\'s Health and Aging (ASMHA) aim to provide a consensus statement and practical set of clinical recommendations based on current evidence to guide clinicians in the management of MI and MSD within the Asia-Pacific (AP) region. A comprehensive, narrative review of the literature was performed to identify the various forms of MSD and their association with MI. MEDLINE and EMBASE databases were searched for the following English language articles under the following terms: \"low libido\", \"erectile dysfunction\", \"ejaculatory dysfunction\", \"premature ejaculation\", \"retrograde ejaculation\", \"delayed ejaculation\", \"anejaculation\", and \"orgasmic dysfunction\" between January 2001 to June 2022 with emphasis on published guidelines endorsed by various organizations. This APSSM consensus committee panel evaluated and provided evidence-based recommendations on MI and clinically relevant MSD areas using a modified Delphi method by the panel and specific emphasis on locoregional socio-economic-cultural issues relevant to the AP region. While variations exist in treatment strategies for managing MI and MSD due to geographical expertise, locoregional resources, and sociocultural factors, the panel agreed that comprehensive fertility evaluation with a multidisciplinary management approach to each MSD domain is recommended. It is important to address individual MI issues with an emphasis on improving spermatogenesis and facilitating reproductive avenues while at the same time, managing various MSD conditions with evidence-based treatments. All therapeutic options should be discussed and implemented based on the patient\'s individual needs, beliefs and preferences while incorporating locoregional expertise and available resources.

The diagnosis and treatment of lower urinary tract symptoms (LUTS) due to benign prostatic enlargement plays an important role in daily urological practice. Therefore, a targeted and resource-saving approach is essential. A rational base-line work-up of our patients provides the necessary information for obtaining the diagnosis and only needs to be expanded in individual cases. In addition to drug therapy, the modification of lifestyle and the possibility of watchful waiting must not be underestimated. Simple measures such as a timed fluid intake, double micturition in the case of residual urine development, but also bladder reconditioning can significantly improve the quality of life of our patients. Regarding surgical treatment, laser procedures have found their way into many departments and have established themselves in daily routine as a reference procedure in addition to transurethral resection of the prostate (TUR-P) and simple open prostatectomy. New, minimally invasive procedures-such as prostatic artery embolization (PAE), the Rezum™- (NxThera Inc., Maple-Grove, MN, USA) or the Aquabeam® (Procept, Redwood City, CA, USA) procedure, but also nonablative procedures such as iTind© (TIND, Medi-Tate, Or Akiva, Israel) or Urolift® (Neotract Inc., Pleasanton, CA, USA)-offer new treatment options to those affected, with the potential to maintain patient\'s sexual function. As a result, individual risk assessment and advice on the advantages and disadvantages of all available treatment options-even more than today-will be an important part of LUTS treatment. An individual approach, similar to that used in the treatment of oncological disease, will become standard also in the treatment of benign prostatic syndrome.

BACKGROUND: In 2009, the International Society for Sexual Medicine (ISSM) convened a select panel of experts to develop an evidence-based set of guidelines for patients suffering from lifelong premature ejaculation (PE). That document reviewed definitions, etiology, impact on the patient and partner, assessment, and pharmacological, psychological, and combined treatments. It concluded by recognizing the continually evolving nature of clinical research and recommended a subsequent guideline review and revision every fourth year. Consistent with that recommendation, the ISSM organized a second multidisciplinary panel of experts in April 2013, which met for 2 days in Bangalore, India. This manuscript updates the previous guidelines and reports on the recommendations of the panel of experts.
OBJECTIVE: The aim of this study was to develop clearly worded, practical, evidenced-based recommendations for the diagnosis and treatment of PE for family practice clinicians as well as sexual medicine experts.
METHODS: A comprehensive literature review was performed.
RESULTS: This article contains the report of the second ISSM PE Guidelines Committee. It offers a new unified definition of PE and updates the previous treatment recommendations. Brief assessment procedures are delineated, and validated diagnostic and treatment questionnaires are reviewed. Finally, the best practices treatment recommendations are presented to guide clinicians, both familiar and unfamiliar with PE, in facilitating treatment of their patients.
CONCLUSIONS: Development of guidelines is an evolutionary process that continually reviews data and incorporates the best new research. We expect that ongoing research will lead to a more complete understanding of the pathophysiology as well as new efficacious and safe treatments for this sexual dysfunction. We again recommend that these guidelines be reevaluated and updated by the ISSM in 4 years.

BACKGROUND: Over the past 20 years our knowledge of premature ejaculation (PE) has significantly advanced. Specifically, we have witnessed substantial progress in understanding the physiology of ejaculation, clarifying the real prevalence of PE in population-based studies, reconceptualizing the definition and diagnostic criterion of the disorder, assessing the psychosocial impact on patients and partners, designing validated diagnostic and outcome measures, proposing new pharmacologic strategies and examining the efficacy, safety and satisfaction of these new and established therapies. Given the abundance of high level research it seemed like an opportune time for the International Society for Sexual Medicine (ISSM) to promulgate an evidenced-based, comprehensive and practical set of clinical guidelines for the diagnosis and treatment of PE.
OBJECTIVE: Develop clearly worded, practical, evidenced-based recommendations for the diagnosis and treatment of PE for family practice clinicians as well as sexual medicine experts. Method.  Review of the literature.
RESULTS: This article contains the report of the ISSM PE Guidelines Committee. It affirms the ISSM definition of PE and suggests that the prevalence is considerably lower than previously thought. Evidence-based data regarding biological and psychological etiology of PE are presented, as is population-based statistics on normal ejaculatory latency. Brief assessment procedures are delineated and validated diagnostic and treatment questionnaires are reviewed. Finally, the best practices treatment recommendations are presented to guide clinicians, both familiar and unfamiliar with PE, in facilitating treatment of their patients.
CONCLUSIONS: Development of guidelines is an evolutionary process that continually reviews data and incorporates the best new research. We expect that ongoing research will lead to a more complete understanding of the pathophysiology as well as new efficacious and safe treatments for this sexual dysfunction. Therefore, it is strongly recommended that these guidelines be re-evaluated and updated by the ISSM every 4 years.

BACKGROUND: Erectile dysfunction (ED) and premature ejaculation (PE) are the two most prevalent male sexual dysfunctions.
OBJECTIVE: To present the updated version of 2009 European Association of Urology (EAU) guidelines on ED and PE.
METHODS: A systematic review of the recent literature on the epidemiology, diagnosis, and treatment of ED and PE was performed. Levels of evidence and grades of recommendation were assigned.
RESULTS: ED is highly prevalent, and 5-20% of men have moderate to severe ED. ED shares common risk factors with cardiovascular disease. Diagnosis is based on medical and sexual history, including validated questionnaires. Physical examination and laboratory testing must be tailored to the patient\'s complaints and risk factors. Treatment is based on phosphodiesterase type 5 inhibitors (PDE5-Is), including sildenafil, tadalafil, and vardenafil. PDE5-Is have high efficacy and safety rates, even in difficult-to-treat populations such as patients with diabetes mellitus. Treatment options for patients who do not respond to PDE5-Is or for whom PDE5-Is are contraindicated include intracavernous injections, intraurethral alprostadil, vacuum constriction devices, or implantation of a penile prosthesis. PE has prevalence rates of 20-30%. PE may be classified as lifelong (primary) or acquired (secondary). Diagnosis is based on medical and sexual history assessing intravaginal ejaculatory latency time, perceived control, distress, and interpersonal difficulty related to the ejaculatory dysfunction. Physical examination and laboratory testing may be needed in selected patients only. Pharmacotherapy is the basis of treatment in lifelong PE, including daily dosing of selective serotonin reuptake inhibitors and topical anaesthetics. Dapoxetine is the only drug approved for the on-demand treatment of PE in Europe. Behavioural techniques may be efficacious as a monotherapy or in combination with pharmacotherapy. Recurrence is likely to occur after treatment withdrawal.
CONCLUSIONS: These EAU guidelines summarise the present information on ED and PE. The extended version of the guidelines is available at the EAU Web site (http://www.uroweb.org/nc/professional-resources/guidelines/online/).

BACKGROUND: Until recently, premature ejaculation (PE) was believed to have a psychologic etiology requiring psychosexual therapy. Recognition of a neurobiologic component to the etiology of PE has since highlighted the need for diagnostic and management guidelines for this common sexual problem. One major medical organization-the American Urological Association (AUA)--has established such guidelines. In addition, the Second International Consultation on Sexual Dysfunctions (ICSD) in 2003 developed a set of recommendations for PE, as well as for other sexual dysfunctions.
OBJECTIVE: To review the current guidelines for the diagnosis and treatment of PE.
METHODS: The Sexual Medicine Society of North America hosted a State of the Art Conference on Premature Ejaculation on June 24-26, 2005 in collaboration with the University of South Florida. The purpose was to have an open exchange of contemporary research and clinical information on PE. There were 16 invited presenters and discussants; the group focused on several educational objectives.
METHODS: Data from the AUA Guideline on the Pharmacologic Management of Premature Ejaculation and the Second ICSD.
RESULTS: Both documents emphasize the importance of a sexual history in diagnosing PE, and each of these two documents recognizes that diagnosis involves a shortened intravaginal latency time as well as patient reports of poor control over ejaculation and patient distress over the condition.
CONCLUSIONS: Condensed guidelines for the diagnosis and treatment of PE are presented. Once diagnosis is suspected, optimal treatment regimens should be established utilizing randomized placebo-controlled trials.

In the 1960s, premature ejaculation was considered a learned behaviour that had to be treated by behavioural therapy, such as the so-called stop-start technique. The efficacy of this method was questioned. Physicians have always looked for medication that could delay ejaculation. Many studies, controlled and open label, have now clearly shown that rapid ejaculation can be treated quickly and effectively with clomipramine and SSRIs. This article describes the guidelines for the pharmacological treatment of premature ejaculation. These guidelines were developed to ensure that medication are used when clear indications are present.

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Paraphilic syndromes, of which there are at least 40, are known legally as perversions and on the street as kinky and bizarre sex. Paraphilia accounts for a very high proportion of sex-offending that is prosecuted as criminal. A new treatment which combines a hormonal antiandrogen with sexological counseling therapy is becoming widely adopted in America and Europe. The treatment is available also to noncriminal paraphiliacs whose syndrome is a source of interpersonal suffering and crisis.