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Endocrine

, Volume 23, Issue 2–3, pp 149–155 | Cite as

Intracavernous pharmacotherapy for erectile dysfunction

Article

Abstract

With the advent of phosphodiesterase type-5 inhibition as oral therapy, intracavernous injection of vasoactive agents has been relegated to second-line therapy for most patients with erectile dysfunction. However, the future of this category of agents remains bright as an ever-expanding number and combination of agents in use and under investigation will likely make intracavernous injection more appealing as greater efficacy, tolerability, and more rapid onset is attained. In this article, functional anatomy and physiology of human penile erection is reviewed, as are current clinical vasoactive agents including prostaglandin E-1, papaverine, and phentolamine. Emerging therapies discussed include guanylate cyclase activators, potassium channel openers, nitric oxide donors, vasoactive intestinal polypeptide, calcitonin gene-related peptide, selective alpha-1 receptor antagonists, and gene therapy. Ongoing research continues to define new roles for this effective and safe technique, which has withstood the test of time, restoring erectile function among patients with diverse ED etiologies and a variety of co-morbidities.

Key Words

Impotence penile erection pharmacotherapy vasodilator agents injections 

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References

  1. 1.
    Virag, G. (1982). Lancet ii, 938.CrossRefGoogle Scholar
  2. 2.
    Brindley, G. (1983). Brit. J. Psychiatry 143, 332–337.CrossRefGoogle Scholar
  3. 3.
    Zorgniotti, A. W. and Lefleur, R. S. (1985). J. Urol. 133, 39–41.PubMedGoogle Scholar
  4. 4.
    Porst, H., Buvat, J., Meuleman, E., Michal, V., and Wagner, G. (1998). Int. J. Impot. Res. 10, 225–231.PubMedCrossRefGoogle Scholar
  5. 5.
    Sunderam, C. P., Thomas, W., Pryor, L. E., Sidi, A. A., Billups, K., and Pryto, J. L. (1997). Urology 49, 932–935.CrossRefGoogle Scholar
  6. 6.
    Andersson, K. E. and Wagner, G. (1995). Physiol. Rev. 75, 191.PubMedGoogle Scholar
  7. 7.
    Burnett, A. L. (1997). J. Urol. 157, 320.PubMedCrossRefGoogle Scholar
  8. 8.
    Stief, C. G., Uckert, S., Becker, A. J. et al. (1997). J. Urol. 157, 355 (abstract).Google Scholar
  9. 9.
    de Tajada, I. S., Garvey, D. S., Schroeder, J. D., et al. (1999). J. Pharmacol. Exp. Ther. 290(1), 121–128.Google Scholar
  10. 10.
    Truss, M. C., Becker, A. J., Djamilian, M. H., Stief, C. G., and Jonas, U. (1994). Urology 44, 553–556.PubMedCrossRefGoogle Scholar
  11. 11.
    Sazova, O., Kadioglu, A., Gurkan, L., et al. (2002). Int. J. Impot. Res. 14, 44–49.PubMedCrossRefGoogle Scholar
  12. 12.
    Vick, R. N., Benevides, M., Patel, M., et al. (2002). J. Urol. 167, 2618–2623.PubMedCrossRefGoogle Scholar
  13. 13.
    Bivalacqua, T. J., Champion, H. C., Abdel-Mageed, A. B., Kadowitz, P. J., and Hellstrom, W. J. (2001). Biol. Reprod. 65, 1371–1377.PubMedCrossRefGoogle Scholar
  14. 14.
    Marquer, C. and Bressolle, F. (1998). Fund. Clin. Pharmacol. 12, 377–387.Google Scholar
  15. 15.
    Mizusawa, H., Hedlund, P., Brioni, J. D., et al. (2002). J. Urol. 167, 2276–2281.PubMedCrossRefGoogle Scholar
  16. 16.
    WHO International Society for Impotence Research: (2000). Erectile dysfunction, Health Publication Ltd.Google Scholar
  17. 17.
    Canadian Urological Association Guidelines Committee. (2002). Can. J. Urol. 9, 1583–1587.Google Scholar
  18. 18.
    Porst, H. (2000). Int. J. Impot. Res. 12(Suppl. 4), S91-S100.PubMedCrossRefGoogle Scholar
  19. 19.
    Nehra, A. (2001). Curr. Urol. Rep. 2, 468–472.PubMedCrossRefGoogle Scholar
  20. 20.
    Lue, T. F. and Dahiya, R. (1997). Mol. Urol. 1, 55.Google Scholar
  21. 21.
    Montorsi, F., Guazzoni, G., Strambi, L. F., et al. (1997). J. Urol. 158, 1408–1410.PubMedCrossRefGoogle Scholar
  22. 22.
    Escrig, A., Marin, R., and Mas, M. (1999). J. Urol. 162, 2205–2210.PubMedCrossRefGoogle Scholar
  23. 23.
    Andersson, K. E. and Hedlund, P. (2002). Int. J. Impot. Res. 14(Suppl. 1), S82-S92.PubMedCrossRefGoogle Scholar
  24. 24.
    Magee, T. T., Ferrini, M., Garban, H. J., et al. (2002). Biol. Reprod. 67, 1033–1041.PubMedCrossRefGoogle Scholar
  25. 25.
    Christ, G. J., Rehman, J., Day, N., et al. (1998). Am. J. Physiol. 275, H600.Google Scholar
  26. 26.
    deGroat, W. C. and Steers, W. D. (1988). In: Contemporary management of impotence and infertility. Tanagho, E. A., Lue, T. F., and McClure, R. D. (eds.). Williams & Wilkins: Baltimore.Google Scholar
  27. 27.
    Hsu, G. L., Brock, G. B., Martinez-Pineiro, L., et al. (1992). Int. J. Impot. Res. 4, 117–129.Google Scholar
  28. 28.
    Aboseif, S. R. and Lue, T. (1998). Urol. Clin. North Am. 15, 1–7.Google Scholar
  29. 29.
    Moreland, R. B. (2000). Int. J. Impot. Res. 12(Suppl. 4), S39-S46.PubMedCrossRefGoogle Scholar
  30. 30.
    Benard, F. and Lue, T. F. (1990). Drugs 39, 394–398.PubMedGoogle Scholar
  31. 31.
    Richter, S., Vardi, Y., Ringel, A., et al. (2001). Int. J. Impot. Res. 13, 172–175.PubMedCrossRefGoogle Scholar
  32. 32.
    Karkonis, T., DeYoung, L., Brock, G. B., and Sims, S. M. (2003). J. Appl. Physiol. 94, 301–313.CrossRefGoogle Scholar
  33. 33.
    Zaslau, S., Nicolis, C., Galea, G., Britanico, J., and Vapnek, J. M. (1999). J. Spinal Cord. Med. 22, 303–307.PubMedGoogle Scholar
  34. 34.
    Heaton, J. P., Lording, D., Liu, S. N., et al. (2001). Int. J. Impot. Res. 13, 317–321.PubMedCrossRefGoogle Scholar
  35. 35.
    Kurzrock, R. and Lieb, C. (1930). Proc. Soc. Exp. Biol. Med. 28, 268.Google Scholar
  36. 36.
    Adaikan, P. G., Kottegoda, S. R., and Ratnam, S. S. (1986). In: Abstract Book 2nd World Meeting on Impotence. Prague Czechoslovakia.Google Scholar
  37. 37.
    Ishii, N., Watanabe, H., Irisawa, C., et al. (1986). In: Abstract Book 2nd World Meeting on Impotence. Prague Czechoslovakia.Google Scholar
  38. 38.
    Porst, H. (1996). J. Urol. 155, 802–815.PubMedCrossRefGoogle Scholar
  39. 39.
    Paoletti, R. (1986). In: Prostaglandin E1 in atherosclerosis. Sinzinger, H. and Rogatti, W. (eds.). Springer-Verlag: New York.Google Scholar
  40. 40.
    Molderings, G. J., van Ahlen, H., and Gothert, M. (1992). Int. J. Impot. Res. 4, 19.Google Scholar
  41. 41.
    Italiano, G., Calabro, A., Pescatori, E. S., Marin, A., and Pagano, F. (1994). Int. J. Impot. Res. 6(Suppl. 1), A22.Google Scholar
  42. 42.
    Cawello, W., Schweer, H., Dietrich, B., et al. (1997). J. Urol. 158, 1403–1407.PubMedCrossRefGoogle Scholar
  43. 43.
    The European Alprostadil Study Group. (1998). Br. J. Urol. 82, 538–543.Google Scholar
  44. 44.
    Linet, O. I. and Ogrinc, F. G. (1996). N. Engl. J. Med. 334, 873–877.PubMedCrossRefGoogle Scholar
  45. 45.
    Choi, H. K., Adimoelja, A., Kim, S. C., et al. (1997). Int. J. Impot. Res. 1, 47–51.CrossRefGoogle Scholar
  46. 46.
    Hauck, E. W., Altinkilic, B. M., Schroder-Printzen, I., Rudnick, J., and Weidner, W. (1999). Andrologia 31, S99-S103.CrossRefGoogle Scholar
  47. 47.
    McMahon, C. G. (1992). Int. J. Impot. Res. 4, 179–186.Google Scholar
  48. 48.
    Wespes, E., Sattar, A. A., Noel, J. C., and Schulman, C. C. (2000). J. Urol. 163, 464–466.PubMedCrossRefGoogle Scholar
  49. 49.
    Maniam, P., Seftel, A. D., Corty, E. W., Rutchik, S. D., Hampel, N., and Althof, S. E. (2001). J. Urol. 165, 830–832.PubMedCrossRefGoogle Scholar
  50. 50.
    Brock, G., Lei, M. T., and Linet, O. I. (2001). Urology 57, 536–541.PubMedCrossRefGoogle Scholar
  51. 51.
    Simonsen, U., Garcia-Sacristan, A., and Prieto, D. (2002). J. Vasc. Res. 39, 283–303.PubMedCrossRefGoogle Scholar
  52. 52.
    Nehra, A. (2001). Curr. Urol. Rep. 2, 468–472.PubMedCrossRefGoogle Scholar
  53. 53.
    Shabsigh, R., Padma-Nathan, H., Gittleman, M., et al. (2000). Urology 55, 477–480.PubMedCrossRefGoogle Scholar
  54. 54.
    Rowland, D. L., Boedhoe, H. S., Dohle, G., and Slob, A. K. (1999). Int. J. Impot. Res. 11, 145–151.PubMedCrossRefGoogle Scholar
  55. 55.
    Mulhall, J. P., Jahoda, A. E., Cairney, M., et al. (1999). J. Urol. 162, 1291–1294.PubMedCrossRefGoogle Scholar
  56. 56.
    Purvis, K., Egdetveit, I., and Christiansen, E. (1999). Int. J. Impot. Res. 11, 287–299.PubMedCrossRefGoogle Scholar
  57. 57.
    de la Taille, A., Delmas, V., Amar, E., and Boccon-Gibod, L. (1999). Eur. Urol. 35, 312–317.PubMedCrossRefGoogle Scholar
  58. 58.
    Elhanbly, S., Schoor, R., Elmogy, M., et al. (2002). J. Urol. 167, 192–196.PubMedCrossRefGoogle Scholar
  59. 59.
    Brading, A. F., Burdyga, T. V., and Scripnyuk, Z. D. (1983). J. Physiol. 334, 79–89.PubMedGoogle Scholar
  60. 60.
    Kattan, S., Collins, J. P., and Mohr, D. (1997). Urology 37, 516–518.CrossRefGoogle Scholar
  61. 61.
    Sahin, M., Basar, M. M., Bozdogan, O., and Atan, A. (2001). Urology 58, 487–492.PubMedCrossRefGoogle Scholar
  62. 62.
    Moriel, E. Z. and Rajfer, J. (1993). J. Urol. 149(Pt. 2), 1299–1300.PubMedGoogle Scholar
  63. 63.
    Domer, F. R., Wessler, G., Brown, R. L., and Charles, H. C. (1978). Invest. Urol. 15, 404–407.PubMedGoogle Scholar
  64. 64.
    Stief, C. G. and Wetterauer, U. (1988). J. Urol. 140, 1415–1416.PubMedGoogle Scholar
  65. 65.
    Juenemann, K. P., Lue, T. F., Fournier, G. R., and Tanagho, E. A. (1986). J. Urol. 136, 158–161.PubMedGoogle Scholar
  66. 66.
    Zorgniotti, A. W. and Lefleur, R. S. (1985). J. Urol. 133, 39–41.PubMedGoogle Scholar
  67. 67.
    Keogh, E. J., Watters, G. R., Earle, C. M., et al. (1989). J. Urol. 142, 726–728.PubMedGoogle Scholar
  68. 68.
    Armstrong, D. K., Convery, A., and Dinsmore, W. W. (1993). Int. J. STD AIDS 4, 214–216.PubMedGoogle Scholar
  69. 69.
    Soli, M., Bertaccini, A., Carparelli, F., et al. (1998). J. Urol. 160(2), 551–555.PubMedCrossRefGoogle Scholar
  70. 70.
    Bennett, A. H., Carpenter, A. J., and Barada, J. H. (1991). J. Urol. 146, 1564–1565.PubMedGoogle Scholar
  71. 71.
    McMahon, C. G. (1991). Int. J. Impot. Res. 3, 113.Google Scholar
  72. 72.
    Shmueli, J., Israilov, S., Segenreich, E., Baniel, J., and Livne, P. M. (1999). Int. J. Impot. Res. 11(1), 15–19.PubMedCrossRefGoogle Scholar
  73. 73.
    Baniel, J., Israilov, S., Engelstein, D., Shmueli, J., Segenreich, E., and Livne, P. M. (2001). Urology 56, 647–652.CrossRefGoogle Scholar
  74. 74.
    Miller, L. N., Nakane, M., Hsieh, G. C., et al. (2003). Life Sci. 72, 1015–1025.PubMedCrossRefGoogle Scholar
  75. 75.
    Kalsi, J. S., Rees, R. W., Hobbs, A. J., et al. (2003). J. Urol. 169, 761–766.PubMedCrossRefGoogle Scholar
  76. 76.
    Andersson, K. E. (2001). Pharmacol. Rev. 53, 417.PubMedGoogle Scholar
  77. 77.
    Brioni, J. D., Nakane, M., Hsieh, G. C., et al. (2002). Int. J. Impot. Res. 14, 8–14.PubMedCrossRefGoogle Scholar
  78. 78.
    Adaikan, P. G., Kottegoda, S. R., and Ratnam, S. S. (1986). J. Urol. 135, 638–640.PubMedGoogle Scholar
  79. 79.
    Kiely, E. A., Bloom, S. R., and Williams, G. (1989). Br. J. Urol. 64, 191–194.PubMedCrossRefGoogle Scholar
  80. 80.
    Becker, A. J., Uckert, S., Stief, C. G., et al. (2002). World J. Urol. 20, 59–63.PubMedCrossRefGoogle Scholar
  81. 81.
    Sandhu, D., Curless, E., Dean, J., et al. (1999). Int. J. Impot. Res. 11, 91–97.PubMedCrossRefGoogle Scholar
  82. 82.
    Trigo-Rocha, F., Martinez-Pineiro, L., Donatucci, C. F., Hsu, G. L., Lue, T. F., and Tanagho, E. A. (1995). Int. J. Impot. Res. 7, 49–56.PubMedGoogle Scholar
  83. 83.
    Brock, G., Breza, J., and Lue, T. F. (1993). J. Urol. 150, 864–867.PubMedGoogle Scholar
  84. 84.
    Martinez-Pinerio, L., Cortes, R., Cuervo, E., Lopez-Tello, J., Cisneros, J., and Martinez-Pineiro, J. A. (1998). Eur. Urol. 4, 350–354.Google Scholar
  85. 85.
    Stief, C. G., Holmquist, F., Djamilian, M., Krah, H., Andersson, K. E., and Jonas, U. (1992). J. Urol. 148, 1437–1440.PubMedGoogle Scholar
  86. 86.
    von Heyden, B., Brock, G. B., Martinez-Pineiro, L., and Lue, T. F. (1996). Eur. Urol. 30, 502–505.Google Scholar
  87. 87.
    Stief, C. G., Benard, F., Bosch, R., et al. (1993). Urology 41, 397–401.PubMedCrossRefGoogle Scholar
  88. 88.
    Djamilian, M., Stief, C. G., Kuczyk, M., and Jonas, U. (1993). J. Urol. 149(Pt. 2), 1296–1298.PubMedGoogle Scholar
  89. 89.
    Truss, M. C., Becker, A. J., Thon, W. F., et al. (1994). Eur. Urol. 26, 40–45.PubMedGoogle Scholar
  90. 90.
    Giraldi, A., Wyllie, M., and Wagner, G. (2000). Int. J. Impot. Res. 12(S1), S37-S40.PubMedCrossRefGoogle Scholar
  91. 91.
    Marquer, C. and Bressolle, F. (1998). Fundam. Clin. Pharmacol. 12, 377–387.PubMedCrossRefGoogle Scholar
  92. 92.
    Buvat, J., Buvat-Herbaut, M., Lemaire, A., and Marcolin, G. (1993). Contracept. Fertil. Sex. 21, 173–176.PubMedGoogle Scholar
  93. 93.
    Hedlund, P., Holmquist, F., Hedlund, H., and Andersson, K. E. (1990). J. Urol. 144, 146–151.PubMedGoogle Scholar
  94. 94.
    Trigo-Rocha, F., Donatucci, C. F., Hsu, G. L., Nunes, L., Lue, T. F., and Tanagho, E. A. (1995). Int. J. Impot. Res. 7, 41–48.PubMedGoogle Scholar
  95. 95.
    Venkateswarlu, K., Giraldi, A., Zhao, W., et al. (2002). J. Urol. 168, 355–361.PubMedCrossRefGoogle Scholar
  96. 96.
    Tirney, S., Mattes, C. E., Yoshimura, N., et al. (2001). Mol. Urol. 5, 37–43.PubMedCrossRefGoogle Scholar
  97. 97.
    Bivalacqua, T. J., Champion, H. C., Abdel-Mageed, A. B., Kadowitz, P. J., and Hellstrom, W. J. (2001). Biol. Reprod. 65, 1371–1377.PubMedCrossRefGoogle Scholar
  98. 98.
    Christ, G. J. (2002). Curr. Opin. Urol. 12, 497–501.PubMedCrossRefGoogle Scholar

Copyright information

© Humana Press Inc. 2004

Authors and Affiliations

  1. 1.The Department of Surgery, Division of Urology, St. Joseph’s Health CenterThe University of Western OntarioLondonCanada

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