Mulcahy Male Sexual Function

A Guide to Clinical Management
2. Auflage 2006
ISBN: 978-1-59745-155-0
Verlag: Humana Press
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 494 Seiten

Reihe: Current Clinical Urology

The first edition of Male Sexual Function: A Guide to Clinical Management was published in 2001. Since that time, two new oral medications for erectile dysfunction ® ® (ED), Vardenafil (Levitra ) and Tadalafil (Cialis ), have been introduced. Links between ED and lower urinary tract symptoms have been postulated, advances in the basic science of erectile physiology have occurred, and the appreciation of ED as a form of endothelial dysfunction and a harbinger of other more potentially lethal forms of vascular disease has become more widespread. In some instances, third-party payers have reduced or eliminated coverage for ED treatments in an attempt to cut costs. They have classified sexual activity as 'recreational,' 'lifestyle,' or not medically necessary, but have failed to appreciate the negative consequences of ED, such as depression with all of its ramifications. Male Sexual Function: A Guide to Clinical Management, Second Edition is a comp- hensive overview of the field of male sexual function and includes a chapter on female sexual dysfunction, an emerging field with a very high incidence in the population and an ever-growing following.

Autoren/Hrsg.

Mulcahy, John J.

Inhaltsverzeichnis

1;Preface;6
2;Contents;7
3;Contributors;9
4;Normal Anatomy and Physiology;11
4.1;INTRODUCTION;11
4.2;FUNCTIONAL VASCULAR AND MICROSCOPIC ANATOMY OF PENILE ERECTION;12
4.3;FUNCTIONAL NEUROANATOMY OF PENILE FUNCTION;17
4.4;PENILE ERECTION AND FLACCIDITY: PHYSIOLOGICAL MECHANISMS;21
4.5;PENILE ERECTION AND FLACCIDITY: MOLECULAR MECHANISM OF CORPORAL SMOOTH MUSCLE RELAXATION AND CONTRACTION;25
4.6;SMOOTH MUSCLE CONTRACTION AND RELAXATION IS REGULATED BY Ca2+- INDUCED MYOSIN PHOSPHORYLATION AND DEPHOSPHORYLATION;25
4.7;MODES OF PENILE ERECTION;34
4.8;CENTRAL MECHANISMS OF PENILE ERECTION AND FLACCIDITY;36
4.9;SPINAL MECHANISMS AND PATHWAYS;39
4.10;PENILE ERECTION AND FLACCIDITY: CENTRAL NEUROPHYSIOLOGY;39
4.11;REFERENCES;44
5;Epidemiology of Erectile Dysfunction;56
5.1;INTRODUCTION;56
5.2;PREVALENCE AND INCIDENCE OF ERECTILE DYSFUNCTION;56
5.3;AGING AND ERECTILE DYSFUNCTION;59
5.4;RISK FACTORS FOR ERECTILE DYSFUNCTION;60
5.5;IMPACT OF ERECTILE DYSFUNCTION;62
5.6;TREATMENT-SEEKING BEHAVIOR;64
5.7;CONCLUSION;65
5.8;REFERENCES;65
6;Cardiac Issues Related to Erectile Dysfunction;69
6.1;INTRODUCTION;69
6.2;IS THE PATIENT PRESENTING WITH ED A CARDIAC PATIENT?;71
6.3;WHAT IS THE ADEQUATE RECOMMENDATION FOR PATIENTS WITH CARDIOVASCULAR DISEASE SEEKING TREATMENT FOR ED?;74
6.4;CONCLUSION;80
6.5;REFERENCES;80
7;How a Primary Care Clinician Approaches Erectile Dysfunction;84
7.1;INTRODUCTION;84
7.2;NATURE OF PRIMARY CARE;85
7.3;TRENDS IN PRIMARY CARE INVOLVEMENT IN SEXUAL HEALTH;86
7.4;LEARNING TO COMMUNICATE WITH PATIENTS ABOUT SEXUAL ACTIVITY;87
7.5;NOT ALL MEN ARE HETEROSEXUAL;88
7.6;SCREENING FOR ED;89
7.7;PATIENTS AND PARTNERS INITIATE DISCUSSIONS ABOUT SEXUAL PROBLEMS;91
7.8;POTENTIAL VALUE OF ED INQUIRY AND MANAGEMENT ( TABLE 9);92
7.9;BARRIERS PREVENTING MEN FROM DISCUSSING ED;94
7.10;THE NEXT STEP AFTER IDENTIFYING ED;95
7.11;CHARACTERISTICS OF A SEXUAL PROBLEM;96
7.12;EVALUATING THE MAN WITH ED;96
7.13;TREATMENT OF ED;101
7.14;ISSUES AMONG OLDER MEN;104
7.15;FOLLOW-UP OF TREATMENT FOR ED;105
7.16;CONSULTATION;105
7.17;MANAGING SEXUAL HEALTH PROBLEMS CAN ENHANCE A PRACTICE;106
7.18;REFERENCES;108
8;Psychosocial Aspects Related to Erectile Dysfunction;112
8.1;INTRODUCTION;112
8.2;A MULTIDIMENSIONAL COMBINATION TREATMENT APPROACH;113
8.3;THE SEXUAL TIPPING POINT MODEL;114
8.4;DEFINITION;115
8.5;ETIOLOGY;115
8.6;ASSESSMENT;117
8.7;SEXUAL STATUS EXAMINATION;119
8.8;EXPLORING OTHER PSYCHOSOCIAL ISSUES;120
8.9;PREVIOUS TREATMENT APPROACHES;121
8.10;PSYCHIATRIC CONSIDERATIONS;121
8.11;FAMILY AND EARLY PSYCHOSEXUAL HISTORY;122
8.12;PARTNER–RELATIONSHIP ISSUES;122
8.13;THE SINGLE PATIENT;122
8.14;QUESTIONNAIRES;122
8.15;TREATMENT;123
8.16;FOLLOW-UP AND THERAPEUTIC PROBE;124
8.17;WEANING AND RELAPSE PREVENTION;124
8.18;COMBINATION THERAPY MATRIX;125
8.19;REFERRAL;126
8.20;CONCLUSION;127
8.21;REFERENCES;127
9;Hormonal Evaluation and Treatment;130
9.1;INTRODUCTION;130
9.2;EFFECTS OF TESTOSTERONE ON SEXUAL FUNCTION;131
9.3;CLINICAL PICTURE OF HYPOGONADISM;131
9.4;OTHER HORMONES;133
9.5;LABORATORY DETERMINATION OF HYPOGONADISM;133
9.6;TREATMENT OF HYPOGONADISM;134
9.7;CAUTIONS IN TESTOSTERONE SUPPLEMENTATION;136
9.8;TESTOSTERONE FOR ERECTILE DYSFUNCTION;137
9.9;CONCLUSIONS;137
9.10;POSITION STATEMENT: UNITED STATES;138
9.11;REFERENCES;138
10;Radical Prostatectomy and Other Pelvic Surgeries;141
10.1;INTRODUCTION;141
10.2;EPIDEMIOLOGY;142
10.3;PATHOPHYSIOLOGY;143
10.4;FACTORS ASSOCIATED WITH RECOVERY OF ERECTILE FUNCTION FOLLOWING RADICAL PROSTATECTOMY;145
10.5;TREATMENT OF ED AFTER RADICAL PROSTATECTOMY;148
10.6;ED AFTER PELVIC SURGERY;150
10.7;BASIC SCIENCE AND FUTURE PERSPECTIVES;154
10.8;CONCLUSION;155
10.9;REFERENCES;155
11;Drugs That Affect Male Sexual Function;161
11.1;INTRODUCTION;161
11.2;PATHOPHYSIOLOGY;162
11.3;ANTIHYPERTENSIVES;164
11.4;ANTIDEPRESSANTS;171
11.5;ANTIPSYCHOTICS;176
11.6;BENZODIAZEPINES;178
11.7;H2- BLOCKERS;178
11.8;DIGOXIN;179
11.9;ANTILIPEMICS;180
11.10;ANTICONVULSANTS;180
11.11;HORMONAL AGENTS;182
11.12;RECREATIONAL DRUGS;183
11.13;CONCLUSION;187
11.14;REFERENCES;187
12;Neurogenic Sexual Dysfunction in Men and Women;200
12.1;INTRODUCTION;200
12.2;NEUROANATOMY OF THE PENIS;201
12.3;NEUROANATOMY OF THE FEMALE GENITALS;202
12.4;NEUROPHYSIOLOGY OF SEXUAL RESPONSE IN MEN;203
12.5;NEUROPHYSIOLOGY OF SEXUAL RESPONSE IN WOMEN;208
12.6;NEUROLOGICAL CAUSES OF SEXUAL DYSFUNCTION;211
12.7;REFERENCES;222
13;Female Sexual Dysfunction;232
13.1;INTRODUCTION;232
13.2;SEXUAL HEALTH CARE DELIVERY TO WOMEN WILL INCREASE IN THE FUTURE;233
13.3;EPIDEMIOLOGY AND CLASSIFICATION;234
13.4;PHYSIOLOGY AND PATHOPHYSIOLOGY: EFFECT OF THE MALE PARTNER WHO HAS ERECTILE DYSFUNCTION;236
13.5;WOMEN WITH MEN WHO SUFFER FROM PREMATURE EJACULATION;237
13.6;PHYSIOLOGY AND PATHOPHYSIOLOGY: CHANGES IN THE FEMALE GENITALIA WITH AGING;238
13.7;PHYSIOLOGY AND PATHOPHYSIOLOGY: EFFECTS OF SEX STEROID HORMONES ON THE VAGINA;239
13.8;DIAGNOSIS OF WOMEN WITH SEXUAL HEALTH CONCERNS;240
13.9;TREATMENT;245
13.10;SEXUAL PAIN MANAGEMENT;248
13.11;SURGICAL THERAPY FOR GENITAL SEXUAL PAIN DISORDERS;251
13.12;OTHER SURGICAL PROCEDURES;252
13.13;CONCLUSIONS;252
13.14;REFERENCES;252
14;Evaluation of the Patient With Erectile Dysfunction;257
14.1;INTRODUCTION;257
14.2;ROUTINE PATIENT ASSESSMENT;258
14.3;ADDITIONAL TESTING;262
14.4;HEALTH BENEFITS OF ED EVALUATION;271
14.5;CONCLUSION;271
14.6;REFERENCES;271
15;Oral Therapy for Erectile Dysfunction;275
15.1;INTRODUCTION;275
15.2;HISTORY;275
15.3;SCIENTIFIC DISCOVERY;276
15.4;PHARMACOLOGY OF PHOSPHODIESTERASE INHIBITORS;276
15.5;PHARMACOKINETICS AND PHARMACODYNAMICS: DOSING ISSUES AND LIMITATIONS;278
15.6;SAFETY PROFILE OF PDE-5 INHIBITORS;280
15.7;DRUG INTERACTIONS AND CONTRAINDICATIONS;282
15.8;CLINICAL EXPERIENCE AND POSTMARKETING ANALYSIS;282
15.9;OPTIMIZING ORAL THERAPY: FAILURES OF PDE-5 INHIBITOR;284
15.10;PATIENT COMPLIANCE;285
15.11;PATIENT PREFERENCE ISSUES;285
15.12;FUTURE TARGETS AND HOMEOPATHIC REMEDIES;286
15.13;CONCLUSION;286
15.14;REFERENCES;287
16;Intracavernosal Injection of Vasoactive Agents;291
16.1;INTRODUCTION;291
16.2;HISTORY;292
16.3;ALPROSTADIL;292
16.4;PAPAVERINE;294
16.5;PHENTOLAMINE;295
16.6;COMBINATION PRODUCTS;296
16.7;NEWER AGENTS;299
16.8;PRACTICAL ISSUES ON SELF-INJECTION THERAPY (TABLE 10);300
16.9;RELATIVE CONTRAINDICATIONS;300
16.10;MANAGEMENT OF COMPLICATIONS RESULTING FROM SELF- INJECTION THERAPY;302
16.11;CONCLUSIONS;303
16.12;REFERENCES;304
17;Topical and Intra-Urethral Therapy;307
17.1;INTRODUCTION;307
17.2;INTRA-URETHRAL THERAPY;308
17.3;INTRA-URETHRAL THERAPY FOR ED: BACKGROUND;308
17.4;INTRA-URETHRAL PGE1;309
17.5;GENERAL PRINCIPLES OF TOPICAL AGENTS;313
17.6;TOPICAL THERAPY FOR ED: BACKGROUND;315
17.7;TOPICAL PGE1;315
17.8;TOPICAL MINOXIDIL;317
17.9;TOPICAL PAPAVERINE;319
17.10;TOPICAL NITROGLYCERIN;321
17.11;CONCLUSION;322
17.12;REFERENCES;322
18;Vacuum Erection Devices;326
18.1;INTRODUCTION;326
18.2;HEMODYNAMICS OF VACUUM-INDUCED ERECTION;327
18.3;DEVICE REQUIREMENTS;328
18.4;PATIENT SELECTION;328
18.5;EFFICACY;329
18.6;PATIENT SATISFACTION AND LONG-TERM USE;330
18.7;COMPLICATIONS;331
18.8;ROLE IN TREATMENT;331
18.9;CONCLUSIONS;331
18.10;REFERENCES;332
19;Penile Implants;334
19.1;INTRODUCTION;334
19.2;TYPES OF PENILE IMPLANTS;335
19.3;MARKETING ERECTILE RESTORATION IN THE 21st CENTURY;342
19.4;INTERNAL MARKETING OF PROSTHETIC UROLOGY;344
19.5;EXTERNAL MARKETING FOR PROSTHETIC UROLOGY;345
19.6;PATIENT SELECTION AND INFORMED CONSENT;346
19.7;PRE-OPERATIVE PREPARATION AND POSTOPERATIVE CARE;347
19.8;INCISIONS;349
19.9;ANESTHESIA;352
19.10;OPERATIVE TECHNIQUE;353
19.11;RESULTS;359
19.12;IMPLANT REPAIR;360
19.13;SCARRED CORPORAL BODIES;361
19.14;CORPOROPLASTY: GLANS FIXATION;368
19.15;INFECTION;371
19.16;VISCUS INJURY;378
19.17;SATISFACTION;379
19.18;REFERENCES;380
20;Peyronie’s Disease;383
20.1;INTRODUCTION;383
20.2;CLINICAL CHARACTERISTICS AND EPIDEMIOLOGY;384
20.3;HISTOLOGICAL CHARACTERISTICS;384
20.4;ETIOLOGY;385
20.5;DIAGNOSIS;387
20.6;TREATMENT;388
20.7;ORAL THERAPY;389
20.8;LOCAL DRUG THERAPY: INTRALESIONAL AND IONTOPHORESIS;391
20.9;EXTRACORPOREAL SHOCK-WAVE THERAPY AND OTHER FORMS OF ENERGY DELIVERY;394
20.10;TREATMENT OF ERECTILE DYSFUNCTION IN MEN WITH PEYRONIE’S DISEASE;395
20.11;SURGERY;395
20.12;CONCLUSION AND PRACTICAL DISEASE MANAGEMENT;395
20.13;REFERENCES;396
21;Peyronie’s Disease;402
21.1;INTRODUCTION;402
21.2;ANATOMY OF THE CORPORA CAVERNOSA;403
21.3;ETIOLOGY OF PEYRONIE’S DISEASE;403
21.4;ASSESSMENT OF PEYRONIE’S DISEASE;405
21.5;SURGICAL TREATMENT OF PEYRONIE’S DISEASE;406
21.6;SURGICAL TECHNIQUE;409
21.7;PENILE PROSTHESIS IN PEYRONIE’S DISEASE;415
21.8;CONCLUSION;416
21.9;REFERENCES;416
22;Vascular Surgery for Erectile Dysfunction;419
22.1;INTRODUCTION;419
22.2;PENILE VASCULAR ANATOMY (FIG. 1);419
22.3;EVALUATION OF PENILE VASCULAR PHYSIOLOGY AND ANATOMY;421
22.4;ARTERIAL RECONSTRUCTIVE SURGERY;424
22.5;COMPLICATIONS;426
22.6;VENOUS LIGATION SURGERY;426
22.7;RESULTS OF PENILE VENOUS SURGERY;427
22.8;CONCLUSIONS;430
22.9;REFERENCES;431
23;Priapism;435
23.1;INTRODUCTION;435
23.2;ISCHEMIC PRIAPISM;436
23.3;NONISCHEMIC (HIGH-FLOW) PRIAPISM;440
23.4;CONCLUSION;443
23.5;REFERENCES;445
24;Ejaculatory Disorders;446
24.1;INTRODUCTION;447
24.2;PHYSIOLOGY OF EJACULATION;447
24.3;PREMATURE EJACULATION;448
24.4;INHIBITED EJACULATION, ANEJACULATION, AND ANORGASMIA;457
24.5;RETROGRADE EJACULATION;459
24.6;OFFICE MANAGEMENT OF INHIBITED EJACULATION, ANEJACULATION, AND ANORGASMIA;460
24.7;REFERENCES;461
25;Gene Therapy for Erectile Dysfunction;466
25.1;INTRODUCTION;466
25.2;GENERAL STRATEGIES OF GENE THERAPY;467
25.3;GENE THERAPY WITH NOS cDNA CONSTRUCTS FOR CONDITIONS OTHER THAN ED;470
25.4;GENE THERAPY OF ED WITH NOS cDNA CONSTRUCTS;472
25.5;GENE THERAPY OF ED WITH cDNA CONSTRUCTS FOR OTHER GENES;475
25.6;FUTURE DIRECTIONS;477
25.7;REFERENCES;478
26;Index;483