You are here : health.am > Sexual Health Center > Male Sexual Dysfunction Male Sexual Dysfunction Male Sexual Dysfunction Involving Emission, Ejaculation, & Orgasm • Male Sexual Dysfunction • May 05 06 Physiology of Emission, Ejaculation, & Orgasm Different mechanisms are involved in erection, emission, ejaculation, and orgasm, and these events can be dissociated from one another (eg, a frequent complaint… Erectile Dysfunction - Intracavernous Injection • Male Sexual Dysfunction • May 05 06 One of the most dramatic changes in urology has been the introduction of intracavernous injection of vasoactive drugs for the diagnosis and treatment of ED. A list of drugs that have been… Vacuum Constriction Device • Male Sexual Dysfunction • May 05 06 The vacuum constriction device consists of a plastic cylinder connected directly or by tubing to a vacuum-generating source (manual or battery-operated pump). After the penis is engorged by the negative pressure, a constricting ring… Penile Vascular Surgery • Male Sexual Dysfunction • May 05 06 Isolated stenosis or occlusion of the extrapenile arteries is amenable to surgical repair. Restoration of potency has been reported after surgery of the internal iliac and internal pudendal arteries. Currently, the most commonly used… Erectile Dysfunction Transurethral Therapy • Male Sexual Dysfunction • May 05 06 Alprostadil, the synthetic formulation of PGE1, is the only pharmacologic agent approved by the FDA for the management of ED via intracavernous and transurethral routes. Alprostadil stimulates adenyl cyclase to increase intracellular levels… Phosphodiesterase (PDE) Inhibitors • Male Sexual Dysfunction • May 05 06 Sildenafil citrate (Viagra, Pfizer Pharmaceuticals) is a selective inhibitor of phosphodiesterase-5 (PDE5), the enzyme that breaks down the intracellular second messenger of erection cGMP and thus enhances penile erection. The clinical efficacy and safety… Erectile Dysfunction Hormonal Therapy • Male Sexual Dysfunction • May 05 06 Referral to endocrinology is recommended for patients with thyroid, adrenal, pituitary or hypothalamic dysfunction. The urologist should be aware that aging men with ED may show a variety of symptoms when hypogonadism coexists:… Nonsurgical Treatment of Erectile Dysfunction • Male Sexual Dysfunction • May 05 06 Although the penile prosthesis remains one of the most effective treatments for all types of ED, nonsurgical management has replaced prosthetic surgery as the preferred choice in the last decade. Both specific… Advanced Testing for ED • Male Sexual Dysfunction • May 05 06 A. Nocturnal Penile Tumescence (NPT) Test Nocturnal erections occur in healthy males of all ages. Of the nocturnal erections, about 80% occur during REM sleep. The average man has 3-5 episodes of… Male Sexual Dysfunction Diagnosis & Treatment • Male Sexual Dysfunction • May 05 06 A detailed medical and psychosexual history and a thorough physical examination are the most important steps in the differential diagnosis of sexual dysfunction. Interviewing the partner, if available, is very helpful… Male Sexual Dysfunction Other Causes • Male Sexual Dysfunction • May 05 06 Other causes may affect one or more of the factors controlling the erectile mechanism. Because of the lack of scientific studies, however, their precise pathogenetic relationship remains speculative. A. Drugs Many… Mechanism of Penile Erection • Male Sexual Dysfunction • May 05 06 The anatomic mechanism of penile erection was discovered in the 1980s by electron microscopy of corrosion penile casts made in the flaccid state and during erection (Fournier et al, 1987; Banya et al,… Male Sexual Dysfunction Epidemiology • Male Sexual Dysfunction • May 05 06 In the Massachusetts Male Aging Study, a community-based survey of men between 40 and 70 years of age, 52% of respondents reported some degree of ED: 17% mild, 25% moderate, and 10% complete.… Male Sexual Dysfunction • Male Sexual Dysfunction • May 05 06 Male sexual dysfunction, denoting the inability to achieve a satisfactory sexual relationship, may involve inadequacy of erection or problems with emission, ejaculation, or orgasm. Erectile dysfunction (impotence) is the inability to obtain or maintain… Anatomy & Hemodynamics of Penile Erection • Male Sexual Dysfunction • May 05 06 The tunica of the corpora cavernosa is a bilayered structure with multiple sublayers. The inner circular bundles support and contain the cavernous tissue. From this inner layer radiate intracavernosal pillars that… Physiology of Penile Erection • Male Sexual Dysfunction • May 05 06 Innervation of the Penis The autonomic spinal erection center is located in the intermediolateral nuclei of the spinal cord at levels S2-S4 and T12-L2. Nerve fibers from the thoracolumbar (sympathetic) and sacral (parasympathetic)… Signal Transduction in Penile Erection • Male Sexual Dysfunction • May 05 06 During sexual stimulation, NO released from nerve ending and endothelium diffuses into the trabecular and arterial smooth-muscle cells to activate guanylyl cyclase, which catalyzes the formation of second messenger cyclic guanosine monophosphate… Hormones & Sexual Function • Male Sexual Dysfunction • May 05 06 Androgens are essential for male sexual maturity. Testosterone regulates gonadotropin secretion and muscle development; dihydrotestosterone mediates all other aspects of male sexual maturation, including hair growth, acne, male pattern baldness, and spermatogenesis. In… Male Sexual Dysfunction Introduction • Male Sexual Dysfunction • May 05 06 by Tom F. Lue, MD A better understanding of male sexual dysfunction has been made possible by innovative laboratory and clinical research in the mechanism, neurophysiology, and pharmacology of penile erection. Erectile… Page 2 of 2 pages < 1 2 << Back to main
