ESSM Newsletter # 40

3 ESSM Today What’s new? News from the Scientific Committee of the European Society for Sexual Medicine by Giovanni Corona and Yacov Reisman Sexual Medicine has tremendously expanded in the last 20 years becoming one of the most important multidisciplinary medical fields in- cluding urology, gynecology, venereology, psy- chiatry, cardiology, endocrinology, and primary care physician competences. One of the major aims of the European Society for Sexual Medi- cine (ESSM) is to guarantee and promote high standards of medical care. For this purpose in 2011 due to an initiative of the ESSM, the Union Européenne des Médecins Spécialistes (UEMS) established a Multidisciplinary Joint Committee on Sexual Medicine (MJCSM), with the primary purpose of developing the high- est possible standards of training in Sexual Medicine in Europe. In order to address this task, the ESSM Edu- cation Committee has been created to build an educational program for different levels of professions in Sexual Medicine, to increase the knowledge and quality of patient care, and to support trainees in Sexual Medicine. Finally, in 2017 ESSM launched the Young Sexual Medicine Academy (YoSeMa), a new committee to promote sexual medicine among young clinicians from various disciplines. In line with these activities, in 2018 the Sci- entific Committee was renewed and expanded giving a larger space to emerging topics such as “Transgender” and introducing new topic sections such as the “New developments sec- tion” mainly related to the latest news in the field of Sexual Medicine and “New technolo- gies and sexual function” dealing with the role and the contribution of social media and the web to our files (https://www.essm.org/society/ committees/). In addition, new tasks have been attributed to the Scientific Committee. In particular, after an adequate discussion, each sub-section has identified specific hot topics in the field of Sexual Medicine not covered, or only partially covered, by the current guidelines. After the initial decision, each subsection of the Scien- tific Committee was involved in the preparation of specific ESSM statements with the intent of providing an evidence-based European posi- tion on these specific issues. The established program includes a rigorous review process including 4 reviewers and at least 2 waves of revision. The final results will be submitted to the attention of all the presidents of the ESSM affiliated societies who can make requests for only minor changes. Finally, the final version of the statements will be presented in two different sessions at the next ESSM congress in Ljubljana for further discussion. The last version of the paper will be submitted to the official Journal of the society “The Journal of Sexual Medicine”. The first topic covered deals with “The use of the cavernous nerve injury model to study post radical prostatectomy erectile dysfunction”. Several preclinical studies, using bilateral nerve sparing radical prostatectomy (NSRP) rat models, have documented that different medications (i.e. alprostadil injections, vac- uum erection devices, and phosphodiesterase type 5 inhibitors etc.) are able to promote erectile function recovery, improve cavern- osal smooth-muscle/collagen ratio, increase penile smooth-muscle replication, reduce penile apoptosis, preserve penile endothelial function, increase antioxidant enzymes and promote neuroprotection during and following neuropraxia. However, clinical human studies have been inconclusive. A lack of consensus among guidelines and possible pitfalls in the methodology used have led to the publication of studies whose results are often equivocal and difficult to compare. The ESSM basic sci- ence subcommittee reviewed the current state of the articles, highlighting possible pitfalls and suggesting a consensus experimental guideline for the use of the NSRP rat model. The “Male sexual health and dysfunction” sub-committee addressed the topic related to the role of “Shockwave therapy in Sexual Medicine”. In the last decade, low-intensity shockwave therapy (LISWT) has been tested in several uro-andrological diseases including erectile dysfunction (ED), Peyronie’s Disease (PD) and chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). The supposed mecha- nism of action is related to mechanical shear stress provoked by LISWT on the treated tis- sue which induces neovascularization and enhances local blood flow. Although several randomized clinical trials (RCTs) and meta- analyses have investigated the role of LISWT for the treatment of ED, PD and CPPS, the clinical significance of this treatment modality and the effect duration remain controversial within the scientific community. The ESSM reviewed the available evidence providing re- commendations for the use of this approach in the field of Sexual Medicine. The “Male and Female genito-urinary recon- structive surgery” specifically evaluated the “Penile prosthesis outcomes” providing the available evidence related to possible risk fac- tors underlining surgery complications and the female and male short and long term expecta- tions and overall sexual satisfaction. The topic covered by the “Female sexual health and dysfunction” sub-committee was related to “Hormonal Contraception and fe- male sexuality”. Hormonal contraception is the most commonly reversible method used in European countries. However, its impact on female sexual function is complex and under- Giovanni Corona Endocrinology Unit, Medical Department Maggiore-Bellaria Hospital Largo Nigrisoli 2 40133, Bologna, Italy jocorona@libero.it Yacov Reisman Urologist, Sexologist Chair Men’s Health Clinics Amstelland Hospital Amstelveen, The Netherlands uro.amsterdam@gmail.com