Pharmacotherapy and External Devices for Erectile Dysfuncton

  • James K. Kuan
  • Gerald B. Brock


Through history societies have searched for potions, elixirs, and aphrodisiacs, hoping to find a simple, effective means to enhance male sexual performance. Until recently the role of the male sexual health specialist in this matter was limited. Since the elucidation of the NO/cGMP second messenger pathway of cavernous smooth muscle, we have learned that erectile function can be enhanced with inhibition of phosphodiesterase 5 (PDE5) enzyme activity. Sildenafil citrate was the first of such agents available under US Food and Drug Administration approval, now joined by vardenafil and tadalafil. The availability of these agents has ignited a revolution in the management of erectile dysfunction (ED), resulting in the development of drugs that target other important signaling pathways. One such agent is apomorphine, a centrally acting dopaminergic drug. Thus, the previously designated first-line modalities (intracavernous injection, intraurethral suppository, vacuum constriction device) are now considered as second-line and are reserved for those in whom oral agents fail.


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© Springer Science+Business Media New York 2004

Authors and Affiliations

  • James K. Kuan
  • Gerald B. Brock

There are no affiliations available

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