By Roger S. Kirby
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Additional info for An Atlas of Erectile Dysfunction, Second Edition (Encyclopedia of Visual Medicine)
ISBN 1-84214-241-0 (alk. paper) 1. Impotence–Atlases. I. Title: Erectile dysfunction. II. Title. III. Series. [DNLM: 1. Impotence–Atlases. S. —2nd ed. 1. Impotence—Atlases I. 6′92 ISBN 0-203-00892-8 Master e-book ISBN ISBN 1-84214-241-0 (Print Edition) First published in 2004 This edition published in the Taylor & Francis e-Library, 2005. uk. No part of this book may be reproduced in any form without permission from the publishers except for the quotation of brief passages for the purposes of review Composition by The Parthenon Publishing Group Page 5 Contents Foreword 7 Preface 9 Section 1 A Review of Erectile Dysfunction 11 Section 2 Erectile Dysfunction lllustrated 47 Index 107 Page 6 This page intentionally left blank.
It is my hoped-for intention that this second edition of the atlas will provide clinicians with easy access to the information that they require to bring up the subject with their patients and alleviate the often considerable anxiety and distress endured not only by the many men afflicted by erectile dysfunction, but by their partners as well. Kirby London Page 10 This page intentionally left blank. Page 11 Section I: A Review of Erectile Dysfunction Introduction 13 Anatomy 14 Arterial blood supply 14 Venous drainage 15 Lymphatic drainage 15 Neuroanatomy 15 Central nervous system connections 15 Mechanisms of erection 17 Regulation of intracavernosal smooth muscle contractility 18 Adrenergic vasoconstrictor mechanisms 18 Cholinergic mechanisms 18 Non-adrenergic non-cholinergic mechanisms 18 Endothelial mechanisms 18 Hemodynamics of erection 19 Orgasm and ejaculation 19 Pathophysiology of erectile dysfunction 20 Vasculogenic causes 20 Neurogenic causes 21 Endocrinological causes 22 Priapism and postpriapism erectile dysfunction 23 Psychogenic causes 23 Epidemiology of erectile dysfunction 24 Risk factors for erectile dysfunction 25 Diabetes mellitus 25 Hypertension 25 Hyperlipidemia 25 Smoking 25 Peyronie’s disease 25 Previous surgery 26 Depression 26 Page 12 Diagnosis of erectile dysfunction 27 History 27 Physical examination 28 Special investigations 29 Treatment options for erectile dysfunction 31 Psychosexual counseling 31 Medical therapies 31 Vacuum devices 34 Surgical therapies 34 Conclusions 36 Bibliography 37 Appendix 41 Page 13 Introduction Until recently, a man unable to develop or sustain an erection sufficient for penetrative sexual intercourse has been referred to as ‘impotent’.
A buccal preparation with a shorter onset of action has also been used, with a success rate of 30–40%. Safety worries, however; have prevented its approval by the regulatory authorities. Dopamine agonists There are five specific dopamine membrane receptors that have been isolated and categorized into two sub-families, D1-like and D2-like. Apomorphine has been shown to be a dopamine agonist with somewhat more potent D2-like effects than D1-like effects. The presence of dopaminergic pathways in the paraventricular nucleus, which is known to be important in engendering the erectile response; provides the rationale for the use of dopamine agonists in erectile dysfunction (Figures 55 and 56).
An Atlas of Erectile Dysfunction, Second Edition (Encyclopedia of Visual Medicine) by Roger S. Kirby