Male Sexual Function

418 Pages·2010·3.77 MB·English

Male
Sexual
Function
A Guide to Clinical
Management
Edited by
John J. Mulcahy, ,
MD PhD
Humana Press
M S F
ALE EXUAL UNCTION
C C U
URRENT LINICAL ROLOGY
Eric A. Klein, MD, SERIES EDITOR
Male Sexual Function: A Guide to Clinical Management, edited by John J.
Mulcahy, 2001
Prostate Cancer Screening, edited by Ian M. Thompson, Martin I. Resnick,
and Eric A. Klein, 2001
Bladder Cancer: Current Diagnosis and Treatment, edited by Michael J. Droller,
2001
Office Urology: The Clinician’s Guide, edited by Elroy D. Kursh and James C.
Ulchaker, 2001
Voiding Dysfunction: Diagnosis and Treatment, edited by Rodney A. Appell, 2000
Management of Prostate Cancer, edited by Eric A. Klein, 2000
M S
ALE EXUAL
F
UNCTION
A G C
UIDE TO LINICAL
M
ANAGEMENT
Edited by
J J. M , ,
OHN ULCAHY MD PhD
Indiana University Medical Center,
Indianapolis, Indiana
H P
UMANA RESS
T , N J
OTOWA EW ERSEY
© 2001 Humana Press Inc.
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Printed in the United States of America. 10 9 8 7 6 5 4 3 2 1
Male sexual function: a guide to clinical management / edited by John J. Mulcahy.
p. ; cm.—(Current clinical urology)
Includes bibliographical references and index.
ISBN 0-89603-917-X (alk. paper)
1. Impotence. I. Mulcahy, John J. (John Joseph), 1941- II. Series.
[DNLM: 1. Impotence--therapy. WJ 709 M24565 2001]
RC889 .M3475 2001
616.6'92--dc21
00-067292
P
REFACE
Thirty years ago there was no effective treatment of erectile dysfunction. In the late
1940s the Kinsey Report tried to define a consensus regarding male sexual function.
These conclusions were based more on opinion than on any hard scientific data. In the
1960s, Masters and Johnson published a treatise on sexual response that shocked many
people in that era with the techniques used to collect data.
Penile prostheses were introduced in the early 1970s. These were the first effective
treatment for erectile dysfunction. A decade later intracorporal injections arrived on the
scene, and in the late 1980s, vacuum erection devices were popularized. Widespread
publicity in 1997 with the introduction of Muse, the intraurethral pellet for enhancing
erections, resulted in astounding initial sales. This was soon followed by the introduction
of Viagra, an oral medication that is effective about two-thirds of the time. This effective,
simple treatment has swelled the ranks of patients seeking treatment and has overwhelmed
the system, so to speak. Primary care physicians had not received much training in
erectile dysfunction and are not very knowledgeable about approaching
patients and discussing this topic comfortably. Symposiums, dinner talks, teleconfer-
ences, and other educational programs have been convened to educate practitioners in
this area. Viagra is now a household word and its common use has softened many taboos
that once prevented open discussion of sexual matters. Advances in our understanding
of the anatomy and physiology of erections are progressing rapidly. The financial suc-
cess of even marginally effective treatments for erectile dysfunction has encouraged
vendors to develop new and improved products.
Female sexual function is now being addressed as well, as many of the products
effective in men may have a similar end-organ response in women.
The need for an up-to-date, comprehensive overview of the field of male dysfunction
is evident. New practitioners without extensive prior experience are entering the field
and those already treating erectile dysfunction are faced with changing concepts and
trends, especially in the areas of evaluation and medical therapy. Male Sexual Function
is an aggregate of the efforts of international experts in presenting a comprehensive
overview of the areas of erectile dysfunction, female sexual dysfunction, and ejaculatory
disorders. It has certain information that will be helpful to all who are involved in these
areas and should be especially helpful for those in primary care specialties who wish to
become acquainted with the field of sexual function because increasing numbers of their
patients are coming forward seeking advice and treatment.
Anatomy, physiology, and epidemiology related to erectile function and dysfunction
are first addressed. A comprehensive chapter for primary care practitioners follows; this
outlines ways to approach sexual function evaluation and treatment and, one hopes, will
allow these practitioners to feel more comfortable when discussing this topic with their
patients. Female sexual dysfunction, ejaculatory disorders, Peyronie's disease, and pri-
apism are covered, in addition to comprehensive chapters on diagnosis and treatment.
Practitioners at all levels of interest or expertise in sexual function will find practical,
highly useful information in these pages.
John J. Mulcahy, MD,PhD
v

C
ONTENTS
Preface........................................................................................................v
List of Contributors ..................................................................................ix
Color Plates...............................................................................................xi
1 Normal Anatomy and Physiology....................................................1
Jamil Rehman and Arnold Melman
2 Epidemiology of Erectile Dysfunction...........................................47
Matthew S. Anderson and John P. Mulhall
3 How a Primary Care Clinician Approaches
Erectile Dysfunction..................................................................57
Richard Sadovsky and Kevin Custis
4 Psychogenic Erectile Dysfunction in the Era of Effective
Pharmacotherapy: A Theoretical Approach..............................79
John Bancroft and Erick Janssen
5 Medications Affecting Erectile Function.......................................91
Derek Bochinski and Gerald B. Brock
6 Management of Erectile Dysfunction Following Radical
Prostatectomy...........................................................................109
Thomas E. Novak, Trinity J. Bivalacqua, Rodney Davis,
and Wayne J.G. Hellstrom
7 Female Sexual Dysfunction: Epidemiology, Physiology,
Evaluation, and Treatment.......................................................123
Jennifer R. Berman, Laura A. Berman, Hugh Lin,
and Irwin Goldstein
8 Hormonal Evaluation and Treatment ...........................................141
Jeremy P.W. Heaton and Alvaro Morales
9 Nocturnal Penile Tumescence and Rigidity Testing....................151
Laurence A. Levine and Lev Elterman
10 Vascular Evaluation of Erectile Dysfunction...............................167
Ricardo F. Sánchez-Ortiz and Gregory A. Broderick
11 Oral Pharmacotherapy ..................................................................203
Harin Padma-Nathan and Francois Giuliano
12 Topical and Intraurethral Therapy................................................225
John C. Hairston, Edgardo F. Becher, and Kevin T. McVary
13 Intracorporal Therapy...................................................................245
Ridwan Shabsigh
vii
viii Contents
14 Vacuum Erection Devices ............................................................253
Craig F. Donatucci
15 Penile Implants: Types and Current Indications..........................263
Run Wang and Ronald W. Lewis
16 Penile Implant Complications: Prevention and Management.....279
John J. Mulcahy
17 Vascular Surgery for Erectile Dysfunction..................................293
Jonathan P. Jarow
18 Peyronie's Disease: History and Medical Therapy......................307
Judy Chun, Marc Richman, and Culley C. Carson, III
19 Surgical Treatment of Peyronie's Disease....................................321
Tulio M. Graziottin, Julio Resplande, and Tom F. Lue
20 Priapism.........................................................................................335
Hunter Wessells
21 Ejaculatory Disorders ...................................................................351
Andrew R. McCullough
22 Gene Therapy for Erectile Dysfunction .......................................371
Nestor F. Gonzalez-Cadavid, Louis J. Ignarro, and Jacob Rajfer
Index.......................................................................................................387
C
ONTRIBUTORS
MATTHEW S. ANDERSON,MD• Department of Urology, Loyola University Medical
Center, Maywood, Illinois
JOHN BANCROFT,MD • Kinsey Institute, Indiana University, Bloomington, Indiana
EDGARDO F. BECHER,MD • Private Practice, Buenos Aires, Argentina
JENNIFER R. BERMAN,MD • Department of Urology, UCLA Medical Center,
Los Angeles, California
LAURA A. BERMAN, PhD • Department of Urology, UCLA Medical Center,
Los Angeles, California
TRINITY J. BIVALACQUA,MD • Department of Urology, Tulane University,
New Orleans, Louisiana
DEREK BOCHINSKI,MD•St. Joseph's Health Center, London, Ontario, Canada
GERALD B. BROCK,MD • St. Joseph's Health Center, London, Ontario, Canada
GREGORY A. BRODERICK,MD • Department of Urology, Mayo Clinic Jacksonville,
Jacksonville, Florida
CULLEY C. CARSON, III, MD • Division of Urology, Department of Surgery, University
of North Carolina, Chapel Hill, North Carolina
JUDY CHUN,MD• Division of Urology, Department of Surgery, University
of North Carolina, Chapel Hill, North Carolina
KEVIN CUSTIS,MD • Department of Family Practice, SUNY-Health Science Center,
Brooklyn, New York
RODNEY DAVIS,MD • Department of Urology, UCLA Medical Center,
Los Angeles, California
CRAIG F. DONATUCCI,MD • Division of Urology, Department of Surgery, Duke
University Medical Center, Durham, North Carolina
LEV ELTERMAN,MD • Department of Urology, Rush-Presbyterian-St. Luke's Medical
Center, Chicago, Illinois
FRANCOIS GIULIANO, MD • Department of Urology, Medical University of Paris (South),
Paris, France
IRWIN GOLDSTEIN,MD • Urology Department, Boston University School of Medicine,
Boston, Massachusetts
NESTOR F. GONZALEZ-CADAVID,PhD • Division of Urology, Department of Surgery,
Harbor UCLA Medical Center, Los Angeles, California
TULIO M. GRAZIOTTIN, MD• Department of Urology, University of California-
San Francisco, San Francisco, California
JOHN C. HAIRSTON,MD • Department of Urology, Northwestern University Medical
School, Chicago, Illinois
JEREMY P.W. HEATON,MD • Department of Urology, Queen's University,
Kingston, Ontario, Canada
WAYNE J.G. HELLSTROM,MD • Department of Urology, UCLA Medical Center,
Los Angeles, California
LOUIS J. IGNARRO,PhD•Division of Urology, Department of Surgery, Harbor UCLA
Medical Center, Los Angeles, California
ix