ABSTRACT
Epidemiology 195
Risk Factors 195
Penile Prosthesis 197
Arterial and Venous Revascularization 199
Vacuum Erection Device 201
Intracavernous Injection Therapy 202
Papaverine and Phentolamine 203
Alprostadil 204
Moxisylyte Chlorhydrate (Icavex) 205
Vasoactive Intestinal Polypeptide 206
Medicated Urethral System for Erection 206
Sildenafil (Viagra) 208
Other Oral Agents 211
Herbal Therapy 211
Trazadone 211
Yohimbine 212
Delaquamine and Phentolamine (Vasomax) 212
L-Arginine 213
Apomorphine (Uprima) 213
Cialis and Vardenafil 214
Gene Therapy 214
Conclusions 215
References 216
The association between the testes, male behavior, potency, and fertility has been
recognized since man began the practice of castration to domesticate animals as
early as 4000 BC. From the early 19th to the mid-20th centuries, the cause of
erectile dysfunction (ED), traditionally referred to as impotence, was believed
to be an endocrine imbalance. Treatments ranged from ligation of the vas
deferens to promotion of endogenous male hormone production to surgical trans-
plantation of testicular grafts from apes (1,2). Fortunately, in 1934, Lower (3)
demonstrated the pituitary gonadotrophic control of the testis to elucidate the
male genitourinary and reproductive physiology which curtailed these question-
able treatment practices.
