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Chapter 39 - Medical and Surgical Management of Erectile Dysfunction

from Section 5 - Medical and Surgical Management of Issues of Male Health

Published online by Cambridge University Press:  06 December 2023

Douglas T. Carrell
Affiliation:
Utah Center for Reproductive Medicine
Alexander W. Pastuszak
Affiliation:
University of Utah
James M. Hotaling
Affiliation:
Utah Center for Reproductive Medicine
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Summary

Erectile dysfunction (ED) is a complex, multifactorial disease caused by multiple factors including difficulty with erection initiation, arterial filling, and occlusion to maintain turgor. It may be a manifestation of poor overall health or specific medical conditions. Treatment of underlying causative conditions may resolve ED. Medical treatment options for ED include oral medications, such as phosphodiesterase type-5 inhibitors, as well as locally acting agents and nonsurgical devices. Locally acting agents include alprostadil, which may be administered by intracavernosal injection, intraurethral suppository, or topical cream, as well as other intracavernosal injection agents. Vacuum erection devices are available. Surgical management options for ED include penile prosthesis placement or vascular surgery. Penile prostheses may be malleable or inflatable. Arterial vascular surgery has shown some efficacy in ideal candidates, but venous surgery is not recommended. Treatment options that are currently being studied and show promise include low-intensity extracorporeal shockwave therapy and regenerative treatments such as stem cells and platelet-rich plasma.

Type
Chapter
Information
Men's Reproductive and Sexual Health Throughout the Lifespan
An Integrated Approach to Fertility, Sexual Function, and Vitality
, pp. 308 - 314
Publisher: Cambridge University Press
Print publication year: 2023

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