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The aging penis: Erectile dysfunction

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Geriatric Nephrology and Urology

Abstract

Over 30 million men and their partners suffer the effects of erectile dysfunction. Erectile dysfunction results in significant psychological, social and physical morbidity; requiring a comprehensive and compassionate approach by the health care provider.

The article reviews the epidemiology, pathophysiology and clinical presentation of erectile dysfunction. It provides a comprehensive, outcome-based evaluation of current treatment modalities.

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References

  1. Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61.

    Google Scholar 

  2. Vanden Berg TL, Hellstrom WJG. Individualizing androgen replacement therapy. Contemp Urol 1997; 9: 25–40.

    Google Scholar 

  3. Hinman F, Jr. Structure and function of the penis and male urethra. In: Atlas of urosurgical anatomy. Philadelphia: W.B. Saunders, 1993: 430–441.

    Google Scholar 

  4. Saenz de Tejada I, Carson MP, Morenas A, Goldstein I, Traish AM. Endothelin: localization, synthesis, activity and receptor types in human penile corpus cavernosum. Am J Physiol 1991; 261(4 Pt 2): H1078–H1085.

    Google Scholar 

  5. Dohi Y, Kojima M, Sato K, Luscher TF. Age-related changes in vascular smooth muscle and endothelium. Drugs Aging 1995; 7: 278–291.

    Google Scholar 

  6. Diver MJ, Cross N, Gosney M, Fraser WD. Indices of androgen status in elderly men. British Geriatrics Society Annual Meeting. 1997, Abstr #110.

  7. Morley JE, Kaiser F, Raum WJ, Perry 3d HM, Flood JF, Jensen J et al. Potentially predictive and manipulable blood serum correlates of aging in the healthy human male: progressive decreases in bioavailable testosterone, dehydroepiandrosterone sulfate, and the ratio of insulin-like growth factor 1 to growth hormone. Proc Natl Acad Sci USA 1997; 94: 7537–7542.

    Google Scholar 

  8. Schiavi RC, White D, Mandeli J, Schreiner-Engel P. Hormones and nocturnal penile tumescence in healthy aging men. Arch Sex Behav 1993; 22: 207–215.

    Google Scholar 

  9. Weiner CP, Lizasoain I, Baylis SA, Knowles RG, Charles IG, Moncada S. Induction of calcium-dependent nitric oxide synthase by sex hormones. Proc Natl Acad Sci USA 1994; 91: 5212–5216.

    Google Scholar 

  10. Chamness SL, Ricker DD, Crone JK, Dembeck CL, Maguire MP, Burnett AL, Chang TS. The effect of androgen on nitric oxide synthase in the male reproductive tract of rat. Fertil Steril 1995; 63: 1101–1107.

    Google Scholar 

  11. Buvat J, Lemaire A. Endocrine screening in 1,022 men with erectile dysfunction: clinical significance and cost-effective strategy. J Urol 1997; 158: 1764–1767.

    Google Scholar 

  12. Konen JC, Curtis LG, Summerson JH. Symptoms and complications of adult diabetic patients in a family practice. Arch Fam Med 1996; 5: 135–145.

    Google Scholar 

  13. Mellinger BC, Weiss J. Sexual dysfunction in the elderly male. AUA Update Series 1992, Vol XI, Lesson 19, 1992; 11: 146–151.

    Google Scholar 

  14. Eardley I. New oral therapies for the treatment of erectile dysfunction. Br J Urol 1998; 81: 122–127.

    Google Scholar 

  15. Raviv G, Vanegas JP, Petein M, Schulman C, Danguy A, Kiss R et al. Biochemical alterations of the tunica albuginea in impotence. J Urol 1997; 158: 1778–1782.

    Google Scholar 

  16. Berger RE, Rothman I, Rigaud G. Nonvascular causes of impotence. In: Bennett AH, editor. Impotence. Philadelphia: W.B. Saunders, 1994.

    Google Scholar 

  17. Rowland DL, Greenleaf W, Mas M, Myers L, Davidson JM. Penile and finger sensory thresholds in young, aging and diabetic males. Arch Sex Behav 1989; 18: 1–12.

    Google Scholar 

  18. Walsh PC. Radical prostatectomy, preservation of sexual function, cancer control. The controversy. Urol Clin North Am 1987; 14: 663–673.

    Google Scholar 

  19. Quinlan DM, Epstein JI, Carter BS, Walsh PC. Sexual function following radical prostatectomy: influence of preservation of neurovascular bundles. J Urol 1991; 145: 998–1002.

    Google Scholar 

  20. Montorsi F, Guazzoni G, Strambi LF, Da Pozzo LF, Nava L, Barbieri L et al. Recovery of spontaneous erectile function after nerve-sparing radical retropubic prostatectomy with and without early intracavernous injections of alprostadil: results of a prospective randomized trial. J Urol 1997; 158: 1408-1410.

    Google Scholar 

  21. Hojo K, Vernava AM 3d, Sugihara K, Katumata K. Preservation of urine voiding and sexual function after rectal cancer surgery. Dis Colon Rectum 1991; 34: 532–539.

    Google Scholar 

  22. Banker FL. The preservation of potency after external beam irradiation for prostate cancer. Int J Radiat Oncol Biol Phys 1988; 15: 219–220.

    Google Scholar 

  23. Monga U, Tan G, Ostermann HJ, Monga T. Sexuality in head and neck cancer patient. Arch Phys Med Rehabil 79: 298–304, 1997.

    Google Scholar 

  24. Kaye KW, Olson DJ, Payne JT. Detailed preliminary analysis of 125Iodine implantation for localized prostate cancer using percutaneous approach. J Urol 1995; 153(3 Pt 2): 1020–1025.

    Google Scholar 

  25. Porter AT, Forman JD. Prostate brachytherapy. An overview. Cancer 1993; 71(3 Suppl): 953–958.

    Google Scholar 

  26. Benet AE, Melman A. The epidemiology of erectile dysfunction. Urol Clin North Am 1995; 22: 699–709.

    Google Scholar 

  27. Peeling WB. Phase III studies to compare goserelin (Zoladex) with orchiectomy and with diethylstilbestrol in treatment of prostatic carcinoma. Urology 1989; 33(5 Suppl): 45–52.

    Google Scholar 

  28. Padma-Nathan H, Cheung D, Perelman et al. The effects of aging, diabetes and vascular ischemia on the biochemical composition of collagen found in the corpora and tunica of potent and impotent men. Int J Impotence Res 1990; 2: 75

    Google Scholar 

  29. Kumazaki T, Fugii T, Kobayashi M, Mitsui Y. Aging-and growth-dependent modulation of endothelin-1 gene expression in human vascular endothelial cells. Exp Cell Res 1994; 211: 6–11.

    Google Scholar 

  30. Roberts E, Fitten LJ: In: Kalimi M, Regelson W, editors. The biological role of Dehydroepiandosterone (DHEA). Berlin: de Gruyster, 1990: 43–63.

    Google Scholar 

  31. Tenover JS. Effects of testosterone supplementation in the aging male. J Clin Endocrinol Metab 1992; 75: 1092–1098.

    Google Scholar 

  32. Behre HM, Bohmeyer J, Nieschlag E. Prostate volume in testosterone-treated and untreated hypogonadal men in comparison to age-matched normal controls. Clin Endocr 1994; 40: 341

    Google Scholar 

  33. Morales A, Johnston B, Heaton JP, Lundie M. Testosterone supplementation for hypogonadal impotence: assessment of biochemical measures and therapeutic outcomes. J Urol 1997 157: 849–854.

    Google Scholar 

  34. Arver S, Dobs AS, Meikle AW et al. Allen RP, Sanders SW, Mazer NA. Improvement of sexual function in testosterone deficient men treated for 1 year with a permeation enhanced testosterone transdermal system. J Urol 1996; 155: 1604–1608.

    Google Scholar 

  35. Teloken C, Rhoden EL, Sogari P, Dambros M, Souto CAV. Therapeutic effects of high dose yohimbine hydrochloride on organic erectile dysfunction. J Urol 1998; 159: 122–124.

    Google Scholar 

  36. Goldstein I, Lue TF, Padma-Nathan H, Rosen RC, Steers WD, Wicker PA. Oral sildenafil in the treatment of erectile dysfunction. NEJM 1998; 338: 1397–1404.

    Google Scholar 

  37. Padma-Nathan H, Hellstrom WJ, Kaiser FE, Labasky RF, Lue TF, Nolten WE, Norwood PC. Treatment of men with erectile dysfunction with transurethral alprostadil. Medicated Urethral System for Erection (MUSE) Study Group. New Engl J Med 1997; 336: 1–7.

    Google Scholar 

  38. Werthman P, Rajfer J. MUSE therapy: preliminary clinical observations. Urology 1997; 50: 809–811.

    Google Scholar 

  39. Sexton WJ, Benedict JF, Jarow JP. Comparison of long-term outcomes of penile prostheses and intracavernosal injection therapy. J Urol 1998; 159: 811–815.

    Google Scholar 

  40. Fallon B. Intracavernous injection therapy for male erectile dysfunction. Urol Clin North Am 1995; 22: 833–845

    Google Scholar 

  41. Nadig PW. Vacuum therapy and other devices. In: Bennett AH, editor. Impotence. Philadelphia: W.B. Saunders, 1994.

    Google Scholar 

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Authors and Affiliations

  1. Division of Urology, University of California, San Diego, CA

    Manoj Monga

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  1. Manoj Monga
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Monga, M. The aging penis: Erectile dysfunction. Geriatric Nephrology and Urology 9, 27–37 (1999). https://doi.org/10.1023/A:1008340506011

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  • DOI: https://doi.org/10.1023/A:1008340506011

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