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Nonsurgical Treatments for Erectile Dysfunction: Oral, Topical, Intracavernous, and Vacuum Devices

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Impotence and Infertility

Abstract

The availability of vasoactive drugs for intracavernosal injection has been one of the most significant milestones in the treatment of male erectile dysfunction. It has allowed meticulous investigation of the physiologic process of penile erection and opened up viable therapeutic alternatives for the patient with mild to moderate alterations at the level of the corpora. Equally important, the advent of injectable vasoactive drugs has permitted large strides in our understanding of the physiologic mechanisms of erection. The elucidation of many of those mechanisms at the cellular level has permitted the development of therapeutic strategies based on sound pharmacologic principles. We are getting closer to the availability of effective, noninvasive medications. This accomplishment is not the result of fortuitous progress: it is the culmination of dedicated and applied research to an area that for decades has remained in the background of medical interest.

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References

  1. Heaton J: Penile erections: what, where, when and how? In Pharmacotherapy of Erectile Dysfunction. Seminar 9771. American Urological Association; 1997.

    Google Scholar 

  2. Heaton JPW, Adams MA, Morales A: A therapeutic taxonomy of treatments for erectile dysfunction: an evolutionary imperative. Int J Impotence Res 1997, 9:117–121.

    Article  Google Scholar 

  3. Heaton JWP, Morales A, Adams M, et al.: Resolution of erectile failure after oral treatment with apomorphine. Urology 1995, 45:200–203.

    Article  PubMed  CAS  Google Scholar 

  4. Linet OI, Ogrinc FG: Efficacy and safety of intracavernosal alprostadil in men with erectile dysfunction. N Engl J Med 1996, 334:873–877.

    Article  PubMed  CAS  Google Scholar 

  5. Padma-Nathan H, Auerbach S, Barada J, et al.: Treatment of men with erectile dysfunction with transurethral alprostadil. N Engl J Med 1997, 336:1–7.

    Article  PubMed  CAS  Google Scholar 

  6. Kurt U, Ozkarde SH, Altug U, et al.: The efficacy of antiserotoninergic agents in the treatment of erectile dysfunction. J Urol 1994, 152:407–409.

    PubMed  CAS  Google Scholar 

  7. Montague DK, Barada JH, Belker AM, et al.: Clinical guidelines panel on erectile dysfunction: summary report on the treatment of organic erectile dysfunction. J Urol 1996, 157:2006–211.

    Google Scholar 

  8. Bresolle F, Costa P, Rouzier-Panis R, et al.: Pharmacokinetics of moxisylyte in healthy volunteers after intracavernous injection of increasing doses. Eur J Clin Pharmacol, 1996, 49:411–415.

    Article  Google Scholar 

  9. Segraves RT, Bari M, Segraves K, et al.: Effect of apomorphine on penile tumescence in men with psychogenic impotence. J Urol 1991, 145:1174–1175.

    PubMed  CAS  Google Scholar 

  10. Manning M, Junemann KP: Pharmacotherapy of Erectile Dysfunction. In Male Infertility and Sexual Dysfunction. Edited by Hellstrom WJG. New York: Springer-Verlag; 1997:440–451.

    Chapter  Google Scholar 

  11. McMahon CG: A pilot study of the role of intracavernous injection of vasoactive intestinal peptide and phentolamine mesylate in the treatment of erectile dysfunction. Int J Impotence Res 1996, 8:233–236.

    CAS  Google Scholar 

  12. Porst H: Vasoactive substances in erectile dysfunction: a survey of 10 years global experience. In Penile Disorders. Edited by Porst H. Berlin: Springer-Verlag; 1977:175–196.

    Google Scholar 

  13. Ismail M, Abbot L, Hirsh IH: Experience with intracavernous PGE1 in the treatment of erectile dysfunction: dose considerations and efficacy. Int J Impotence Res 1997, 9:39–42.

    Article  CAS  Google Scholar 

  14. Morales A, Condra MS, Owen JE, et al.: Oral and transcutaneous pharmacological agents in the treatment of impotence. Urol Clin North Am 1988, 15:87–93.

    PubMed  CAS  Google Scholar 

  15. Giuliano FA, Rampin O, Benoit G: Neural control of penile erection. Urol Clin North Am 1995, 22:747–766.

    PubMed  CAS  Google Scholar 

  16. Vermuleen A: Androgens in the aging male. J Clin Endocrinol Metab 1991, 73:221–224.

    Article  Google Scholar 

  17. Clark JG: Suppression of copulatory behavior in male rats following central administration of clonidine. Neuropharmacology 1991, 30:373–382.

    Article  PubMed  CAS  Google Scholar 

  18. Boolell M, Allen MJ, Ballard SA, et al.: Sildenafil: an orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction. Int J Impotence Res 1996, 8:47–52.

    CAS  Google Scholar 

  19. Bhsin S: Androgen treatment of hypogonadal men. J Clin Endocrinol Metab 1992, 74:1221–1225.

    Article  Google Scholar 

  20. Bardin CW, Swerdloff RS, Santen RJ: Androgens: risks and benefits. J Clin Endrocrinol Metab 1991, 73:4–10

    Article  CAS  Google Scholar 

  21. Morales A, Johnston B, Heaton JWP, et al.: Oral androgens in the treatment of hypogonadal impotent men. J Urol 1994, 152:1115–1118.

    PubMed  CAS  Google Scholar 

  22. Morales A, Johnston B, Heaton JPW, et al.: Testosterone supplementation for hypogonadal impotence: assessment of biochemical measures and therapeutic outcomes. J Urol 1997, 157:849–854.

    Article  PubMed  CAS  Google Scholar 

  23. Morales A, Bain J, Ruijs A, et al.: Clinical practice guidelines for screening and monitoring male patients receiving testosterone supplementation therapy. Int J Impotence Res 1996, 8:95–97.

    CAS  Google Scholar 

  24. Leonard M, Nickel JC, Morales A: Hyperprolactinemia and impotence: why, when and how to investigate and treat. J Urol 1989, 142:992–994.

    PubMed  CAS  Google Scholar 

  25. Guay AT, Varma S, Sabharwal P, et al.: Macroprolactinemia causing delay in the diagnosis of psychological impotence. J Clin Endocrinol Metab 1996, 81:2512–2514.

    Article  PubMed  CAS  Google Scholar 

  26. Lewis R: Twenty years of vacuum therapy for erectile dysfunction in the United States. In Penile Disorders. Edited by Porst H. Berlin: Springer-Verlag; 1997:162–174.

    Google Scholar 

  27. Nadig PW: Vacuum erection devices: a review. World J Urol 1990, 8:114–118.

    Article  Google Scholar 

  28. Burnett AL: Role of nitric oxide in the physiology of erection. Biol Reprod 1995, 52:485–489.

    Article  PubMed  CAS  Google Scholar 

  29. Burnett AL: Nitric oxide in the penis: physiology and pathology. J Urol 1997, 157:320–324.

    Article  PubMed  CAS  Google Scholar 

  30. Ignarro LJ, Lippton H, Edwards JC, et al.: Mechanism of vascular smooth muscle relaxation by organic nitrtates, nitrites, nitropresside, and nitric oxide: evidence of the involvement of S-nitrosothiols as active intermediates. J Pharmacol Exp Ther 1981, 218:739–749.

    PubMed  CAS  Google Scholar 

  31. Lugnier C, Komas N: Modulation of vascular cyclic nucleotide phosphodiesterases by cyclic CMP: role in vasodilation. Eur Heart J 1993, 14(suppl):141–148.

    Article  PubMed  CAS  Google Scholar 

  32. Boolell M, Allen MJ, Ballard SA, et al.: Sildenafil: an orally active type 5 cyclic GMP-specific phosphodiesterase inhibitor for the treatment of penile erectile dysfunction. Int J Impot Res 1996, 8:47–52.

    PubMed  CAS  Google Scholar 

  33. Giuliano F, Jardin A, Gingell CJ, et al.: Sildenafil, an oral treatment for erectile dysfunction: a 1-year, open-label extension study [abstract]. Br J Urol 1997, 80:93.

    Google Scholar 

  34. Buvat J, Gingell CJ, Jardin A, et al.: Sildenafil (Viagra), an oral treatment for erectile dysfunction: a 1-year, open-label extension study, J Urol 1997, 157(suppl):204.

    Article  Google Scholar 

  35. Padma-Nathan H, Sildenafil Study Group: Oral Viagra in the treatment of erectile dysfunction: assessment of erections hard enough for sexual intercourse. J Urol 1998, (suppl): in press.

    Google Scholar 

  36. Goldstein I, Lue TF, Padma-Nathan H, et al.: Oral sildenafil in the treatment of erectile dysfunction: Sildenafil Study Group. N Engl J Med 1998: 338:1397–1404.

    Article  PubMed  CAS  Google Scholar 

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Authors
  1. Alvaro Morales
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  2. Jeremy P. W. Heaton
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Editor information

Editors and Affiliations

  1. Department of Urology, University of California, San Francisco, USA

    Tom F. Lue MD (Professor, Chief of Urology) (Professor, Chief of Urology)

  2. Mt. Zion Hospital, San Francisco, California, USA

    Tom F. Lue MD (Professor, Chief of Urology) (Professor, Chief of Urology)

  3. Department of Urology, Joan and Sanford I. Weill Medical College and Graduate School of Medical Sciences of Cornell University, New York, New York, USA

    Marc Goldstein MD (Professor, Director, Staff Scientist) (Professor, Director, Staff Scientist)

  4. Center for Male Reproductive Medicine and Microsurgery, Department of Urology, New York Presbyterian Hospital, New York, New York, USA

    Marc Goldstein MD (Professor, Director, Staff Scientist) (Professor, Director, Staff Scientist)

  5. Center for Biomedical Research, The Population Council, New York, New York, USA

    Marc Goldstein MD (Professor, Director, Staff Scientist) (Professor, Director, Staff Scientist)

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© 1999 Springer Science+Business Media New York

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Morales, A., Heaton, J.P.W. (1999). Nonsurgical Treatments for Erectile Dysfunction: Oral, Topical, Intracavernous, and Vacuum Devices. In: Lue, T.F., Goldstein, M. (eds) Impotence and Infertility. Current Medicine Group, London. https://doi.org/10.1007/978-1-4613-1105-8_4

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  • DOI: https://doi.org/10.1007/978-1-4613-1105-8_4

  • Publisher Name: Current Medicine Group, London

  • Print ISBN: 978-1-4757-0803-5

  • Online ISBN: 978-1-4613-1105-8

  • eBook Packages: Springer Book Archive

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