MALE SEXUAL FUNCTION SECOND EDITION

MALE SEXUAL FUNCTION SECOND EDITION

CURRENT CLINICAL UROLOGY Eric A. Klein, MD, SERIES EDITOR Male Sexual Function: A Guide to Clinical Management, Second Edition, edited by John J. Mulcahy, 2006 Advanced Endourology: The Complete Clinical Guide, edited by Stephen Y. Nakada and Margaret S. Pearle, 2005 Oral Pharmacotherapy of Male Sexual Dysfunction: A Guide to Clinical Management, edited by Gregory A. Broderick, 2005 Urological Emergencies: A Practical Guide, edited by Hunter Wessells and Jack W. McAninch, 2005 Management of Prostate Cancer, Second Edition, edited by Eric A. Klein, 2004 Essential Urology: A Guide to Clinical Practice, edited by Jeannette M. Potts, 2004 Management of Benign Prostatic Hypertrophy, edited by Kevin T. McVary, 2004 Pediatric Urology, edited by John P. Gearhart, 2003 Laparoscopic Urologic Oncology, edited by Jeffrey A. Cadeddu, 2004 Essential Urologic Laparoscopy: The Complete Clinical Guide, edited by Stephen Y. Nakada, 2003 Urologic Prostheses: The Complete Practical Guide to Devices, Their Implantation, and Patient Follow-Up, edited by Culley C. Carson, III, 2002 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

MALE SEXUAL FUNCTION A GUIDE TO CLINICAL MANAGEMENT SECOND EDITION Edited by JOHN J. MULCAHY, MD, PhD Professor Emeritus of Urology Indiana University Medical Center, Indianapolis, IN

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Preface 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 comprehensive 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. The goal is to educate all disciplines in the facts of sexual function and dysfunction in the hope that practitioners will feel comfortable assessing and counseling patients about their sexual needs and concerns and will be able to treat basic problems with easily prescribed therapies and know when and where to refer more complex cases. More money is now spent on advertising ED drugs than any other medical product in the world. Viagra is the second most recognized product in the world after Coke. Patients know that treatments are available and, with more openness in discussing sexual matters, are less hesitant to discuss these with their physician. Polls have shown that an overwhelming majority of patients (96%) believe that ED should be treated and 75% feel that physicians should address this area in a comprehensive evaluation. Hence, it behooves practitioners to become familiar with this area and to keep up to date on the latest developments. Male Sexual Function: A Guide to Clinical Management, Second Edition should accomplish that goal. John J. Mulcahy, MD, PhD v

Contents Preface... v List of Contributors...ix 1 Normal Anatomy and Physiology... 1 Paul Milhoua, Daniel Lowe, and Arnold Melman 2 Epidemiology of Erectile Dysfunction... 47 Ridwan Shabsigh 3 Cardiac Issues Related to Erectile Dysfunction... 61 Thorsten Reffelmann and Robert A. Kloner 4 How a Primary Care Clinician Approaches Erectile Dysfunction... 77 Richard Sadovsky and Kevin Custis 5 Psychosocial Aspects Related to Erectile Dysfunction... 105 Michael A. Perelman 6 Hormonal Evaluation and Treatment... 123 Jeremy P. W. Heaton and Alvaro Morales 7 Radical Prostatectomy and Other Pelvic Surgeries: Effects on Erectile Function... 135 Muammer Kendirci, Jeffrey Bejma, Wayne J. G. Hellstrom 8 Drugs That Affect Male Sexual Function... 155 Benjamin K. Yang and Craig F. Donatucci 9 Neurogenic Sexual Dysfunction in Men and Women... 195 Kazem M. Azadzoi and Mike B. Siroky 10 Female Sexual Dysfunction... 227 Irwin Goldstein 11 Evaluation of the Patient With Erectile Dysfunction... 253 Jeffrey C. La Rochelle and Laurence A. Levine 12 Oral Therapy for Erectile Dysfunction... 271 Raymond W. Pak and Gregory A. Broderick 13 Intracavernosal Injection of Vasoactive Agents... 287 Alice K. Tsao and Ajay Nehra 14 Topical and Intra-Urethral Therapy... 303 John C. Hairston, Edgardo Becher, and Kevin T. McVary 15 Vacuum Erection Devices... 323 Hunter Wessells 16 Penile Implants... 331 Steven K. Wilson and John J. Mulcahy 17 Peyronie s Disease: History and Medical Therapy... 381 J. Slade Hubbard and Culley C. Carson vii

viii Contents 18 Peyronie s Disease: Surgical Therapy... 401 Gerald H. Jordan 19 Vascular Surgery for Erectile Dysfunction... 419 William O. Brant, Anthony J. Bella, Maurice M. Garcia, and Tom F. Lue 20 Priapism... 435 Lawrence S. Hakim 21 Ejaculatory Disorders... 447 Chris G. McMahon 22 Gene Therapy for Erectile Dysfunction... 467 Thomas R. Magee, Jacob Rajfer, and Nestor F. Gonzalez-Cadavid Index... 485

Contributors KAZEM M. AZADZOI, MD Departments of Urology and Pathology, Boston University School of Medicine, Boston, MA EDGARDO BECHER, MD Centro de Diagnostico Urologico, Buenos Aires, Argentina JEFFREY BEJMA, MD Department of Urology, Tulane University Health Science Center, New Orleans, LA ANTHONY J. BELLA, MD Department of Urology, University of California, San Francisco, CA WILLIAM O. BRANT, MD Department of Urology, University of California, San Francisco, CA GREGORY A. BRODERICK, MD Department of Urology, Mayo Clinic, Jacksonville, FL CULLEY C. CARSON, MD Division of Urology, Department of Surgery, University of North Carolina, Chapel Hill, NC KEVIN CUSTIS, MD Department of Family Practice, Downstate Medical Center, SUNY, Brooklyn, NY CRAIG F. DONATUCCI, MD Division Of Urology, Department of Surgery, Duke University Medical Center, Durham, NC MAURICE M. GARCIA, MD Department of Urology, University of California, San Francisco, CA IRWIN GOLDSTEIN, MD The Journal of Sexual Medicine, Milton, MA NESTOR F. GONZALEZ-CADAVID, PhD Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA JOHN C. HAIRSTON, MD Department of Urology, Northwestern University, Chicago, IL LAWRENCE S. HAKIM, MD, FACS Department of Urology, Cleveland Clinic Florida, Weston, FL JEREMY P. W. HEATON, MD Department of Urology, Queens University, Kingston, Ontario, Canada WAYNE J. G. HELLSTROM, MD Department of Urology, Tulane University Health Science Center, New Orleans, LA J. SLADE HUBBARD, MD Division of Urology, Department of Surgery, University of North Carolina, Chapel Hill, NC GERALD H. JORDAN, MD Department of Urology, East Virginia Medical School, Norfolk, VA MUAMMER KENDIRCI, MD Department of Urology, Tulane University Health Science Center, New Orleans, LA ROBERT A. KLONER, MD Division of Cardiovascular Medicine, Department of Medicine, Heart Institute, Good Samaritan Hospital, University of Southern California, Keck School of Medicine, Los Angeles, CA JEFFREY C. LA ROCHELLE, MD Department of Urology, Rush University Medical Center, Chicago, IL LAURENCE A. LEVINE, MD Department of Urology, Rush University Medical Center, Chicago, IL DANIEL LOWE, MD Department of Urology, Montefiore Medical Center, Bronx, NY ix

x Contributors TOM F. LUE, MD Department of Urology, University of California, San Francisco, CA THOMAS R. MAGEE, PhD Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA CHRIS G. MCMAHON, MBBS, FAChSHM Australian Center for Sexual Health, St. Leonards, New South Wales, Australia KEVIN T. MCVARY, MD Department of Urology, Northwestern University, Chicago, IL ARNOLD MELMAN, MD Department of Urology, Albert Einstein College of Medicine, Bronx, NY PAUL MILHOUA, MD Department of Urology, Montefiore Medical Center, Bronx, NY ALVARO MORALES, MD Department of Urology, Queens University, Kingston, Ontario, Canada JOHN J. MULCAHY, MD, PhD Professor Emeritus of Urology, Indiana University Medical Center, Indianapolis, IN AJAY NEHRA, MD Department of Urology, Mayo Clinic, Rochester, MN RAYMOND W. PAK, MD, PharmD Department of Urology, Mayo Clinic, Jacksonville, FL MICHAEL A. PERELMAN, PhD Departments of Psychiatry and Urology, The New York Presbyterian Hospital, Weill Medical College of Cornell University, New York, NY JACOB RAJFER, MD Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA THORSTEN REFFELMANN, MD Division of Cardiovascular Medicine, Good Samaritan Hospital, University of Southern California, Keck School of Medicine, Los Angeles, CA RICHARD SADOVSKY, MD Department of Family Practice, Downstate Medical Center, SUNY, Brooklyn, NY RIDWAN SHABSIGH, MD Urology Department, College of Physicians and Surgeons of Columbia University, New York, NY MIKE B. SIROKY, MD Department of Urology, Boston University School of Medicine, Boston, MA ALICE K. TSAO, MD Department of Urology, Mayo Clinic, Rochester, MN HUNTER WESSELLS, MD Department of Urology, Harborview Medical Center, University of Washington, Seattle, WA STEVEN K. WILSON, MD Department of Urology, University of Arkansas for Medical Sciences, Little Rock, AK BENJAMIN K. YANG, MD Division of Urology, Department of Surgery, Duke University Medical Center, Durham, NC