Erectile dysfunction (ED) affects 20-30 million American men, most of whom are over 50 years of age. In a UK-based study, 32% of British men had difficulty obtaining an erection, 20% with maintaining an erection. In recent years the physiology and pathophysiology of ED have changed our understanding of what ED is from a purely psychological-based disorder to a multifactorial one, with neurological, endocrinological, psychological factors and the role of the vascular system. Recently identified risk factors include diabetes, cardiovascular disease, spinal cord injury, smoking, depression, atherosclerosis, hypertension, pelvic surgery and trauma, pharmacological medications, arthritis, peripheral vascular disease, substance abuse, endocrine abnormalities and peptic ulcer disease. Many ED patients have a combination of these risk factors, thus exacerbating ED further. The treatment of ED was revolutionized in 1998 with the introduction of sildenafil. Beside these oral treatments, newer injectable agents are being investigated as are topical preparations. However, not all patients are tolerant of oral agents, many patients still require penile reconstruction with penile implants, an option with low complications and morbidity. There are options for all patients and this excellent, updated text, edited by some of the world's leading authorities - Culley Carson, Roger Kirby and Irwin Goldstein - discusses them all.
Section I Basic Science 1. History of Erectile Dysfunction 2. The history of the International Society for Sexual Medicine 3. Epidemiology of Erectile Dysfunction 4. Anatomy of Erectile Function 5. Microscopic Anatomy of Erectile Tissue 6. Vascular Physiology of Erectile Function 7. Central Nervous System Control of Sexual Function in the Male and Female 8. Ejaculatory Physiology 9. Endocrinology of Male Sexual Function 10. Pathophysiology of Erectile Dysfunction: Molecular Basis 11. Neurotransmitters in the Corpus Cavernosum: Nitric Oxide and Beyond 12. Receptor Pharmacology Related to Erectile Dysfunction 13. Environmental Erectile Dysfunction 14. Erectile Dysfunction and Treatment of Carcinoma of the Prostate Section II Risk Factors and Clinical Evaluation 15. Vascular Risk Factors for Erectile Dysfunction 16. Mediterranean Diet and Erectile Dysfunction 17. Pharmacologic Risk Factors for Altered Male Sexual Function 18. Male Sexual Dysfunction and the Prostate 19. Basic Clinical Assessment of the Patient with Erectile Dysfunction 20. The Contemporary Role of Penile Duplex Scanning 21. Imaging in Erectile Dysfunction 22. Neurophysiologic Testing in Erectile Dysfunction 23. Biopsy of the Corpus Cavernosum 24. Endocrine Evaluation of Male Sexual Dysfunction 25. The Biopsychosocial Evaluation of Erectile Dysfunction 26. Erectile Dysfunction: the Couple Context 27. Primary Care Evaluation and Treatment of Erectile Dysfunction Section III Treatment of Sexual Dysfunction 28. PDE5 Inhibitors: Molecular Basis 29. PDE5 Inhibitors: Non ED Vascular Effects 30. Sildenafil: Pharmacologic and Clinical Treatment of Erectile Dysfunction 31. Tadalafil: Long Acting PDE5 Inhibitor 32. Vardenafil: Biochemically Potent PDE5 Inhibitor 33. The Princeton Guidelines for Treatment 34. PDE5: Safety and Adverse Events 35. Diagnosis and Treatment of Hypogonadism 36. Central Nervous System Agents for the Treatment of Erectile Dysfunction 37. Intracavernosal Therapy for Erectile Dysfunction 38. Invicorp in Erectile Dysfunction 39. Vacuum Systems for Erectile Dysfunction 40. Integrated Sex Therapy 41. Gene Therapy in Erectile Dysfunction 42. Stem and Endothelial Progenitor Cells in Erectile Biology 43. Mechanical, Malleable, and Soft Semi-rigid Penile Implants 44. Inflatable Penile Protheses in Erectile Dysfunction 45. Inflatable Penile Prostheses 46. Design, Development, and Use of Questionnaires and Surveys in the Evaluation and Management of Sexual Dysfunction: Erectile Dysfunction 47. Assessment of Male Ejaculatory Disorders 48. Clinical Trial Design for Erectile Dysfunction 49. Sexual Function in Congential Anomalies 50. Veno-occlusive impotence 51. Penile Fracture Section IV Special Problems 52. Risks, Complications, and Outcomes of Penile Lengthening and Augmentation Procedures 53. Peyronie’s Disease: Evaluation and Medical Treatment 54. Peyronie’s Disease: Surgical Treatment 55. Priapism 56. PDE5 Inhibitor Therapy for Priapism 57. Augmentation of PDE5 Inhibitor Response 59. Diabetic ED 60. Chronic Renal Failure and Sexual Dysfunction 61. Evaluation of Ejaculatory Disorders 62. Medical Treatment of Ejaculatory Dysfunction 63. Topical Agents for the Treatment of Premature Ejaculation 64. Potency Preserving Surgery: Radical Prostatectomy and other Pelvic Surgery 65. Rehabilitation of Sexual Function following Prostatectomy 66. Sexual Dysfunction and Prostate Cancer Therapy 67. Gender Reassignment Surgery