Abstract
Erectile dysfunction (ED) refers to the persistent inability to achieve and maintain an erection adequate for sexual intercourse with a global prevalence in excess of 150 million and, left untreated, is widely recognized to decrease quality of life. Over one half of US males between the ages of 40 and 70 years report some degree of ED with the prevalence increasing with age and with the presence of cardiovascular risk factors such as smoking, diabetes mellitus, hyperlipidemia, and hypertension. ED may have numerous etiologies and its occurrence is often multifactorial with vasculogenic, hormonal, and emotional/psychological factors all contributing. As noted above, patients with ED frequently have cardiovascular risk factors or manifest cardiovascular disease, and indeed, many commonly prescribed pharmacotherapies for hypertension, heart disease, etc. can also promote ED. Prior pelvic trauma and central or peripheral neurologic disease may also be contributory. Despite the myriad factors listed however most ED ultimately is linked to a disorder of vascular structure or function and may relate to inadequate arterial flow, impaired cavernosal smooth muscle relaxation, or veno-occlusive dysfunction. It should be noted that given the coexistence of various contributory disease processes, evaluation and therapy for ED necessitate the coordinated, multidisciplinary efforts of urologists, vascular and sexual medicine specialists, and primary care physicians.
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References
NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA. 1993;270:83–90.
Smith KJ, Roberts MS. The cost-effectiveness of sildenafil. Ann Intern Med. 2000;132:933–7.
Willke RJ, Yen W, Parkerson Jr GR, Linet OI, Erder MH, Glick HA. Quality of life effects of alprostadil therapy for erectile dysfunction: results of a trial in Europe and South Africa. Int J Impot Res. 1998;10:239–46.
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.
McKinlay JB. The worldwide prevalence and epidemiology of erectile dysfunction. Int J Impot Res. 2000;12 Suppl 4:S6–11.
Rosen RC, Cappelleri JC, Gendrano 3rd N. The International Index of Erectile Function (IIEF): a state-of-the-science review. Int J Impot Res. 2002;14:226–44.
Lue TF. Erectile dysfunction. N Engl J Med. 2000;342:1802–13.
Gazzaruso C, Giordanetti S, De Amici E, Bertone G, Falcone C, Geroldi D, et al. Relationship between erectile dysfunction and silent myocardial ischemia in apparently uncomplicated type 2 diabetic patients. Circulation. 2004;110:22–6.
Rosen MP, Greenfield AJ, Walker TG, Grant P, Dubrow J, Bettmann MA, et al. Cigarette smoking: an independent risk factor for atherosclerosis in the hypogastric-cavernous arterial bed of men with arteriogenic impotence. J Urol. 1991;145:759–63.
El-Sakka AI, Morsy AM, Fagih BI, Nassar AH. Coronary artery risk factors in patients with erectile dysfunction. J Urol. 2004;172:251–4.
Campbell HE. Clinical monograph for drug formulary review: Âerectile dysfunction agents. J Manag Care Pharm. 2005;11:151–71.
Hatzichristou D, Goldstein I. Penile microvascular arterial bypass: indications and surgical considerations. Surg Annu. 1993;25(Pt 2):207–29.
Bookstein JJ, Valji K, Parsons L, Kessler W. Pharmacoarteriography in the evaluation of impotence. J Urol. 1987;137:333–7.
Mueller SC, von Wallenberg-Pachaly H, Voges GE, Schild HH. Comparison of selective internal iliac pharmaco-angiography, penile brachial index and duplex sonography with pulsed Doppler analysis for the evaluation of vasculogenic (arteriogenic) impotence. J Urol. 1990;143:928–32.
Rosen MP, Greenfield AJ, Walker TG, Grant P, Guben JK, Dubrow J, et al. Arteriogenic impotence: findings in 195 impotent men examined with selective internal pudendal angiography. Young Investigator’s Award. Radiology. 1990;174:1043–8.
Rogers JH, Karimi H, Kao J, Link D, Javidan J, Yamasaki DS, et al. Internal pudendal artery stenoses and erectile dysfunction: correlation with angiographic coronary artery disease. Catheter Cardiovasc Interv. 2010;76:882–7.
Bradley WE, Timm GW, Gallagher JM, Johnson BK. New method for continuous measurement of nocturnal penile tumescence and rigidity. Urology. 1985;26:4–9.
Uflacker R et al. Arteries of the pelvis. In: Uflacker R, editor. Atlas of vascular anatomy: an angiographic approach. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2007. p. 655–98.
Yamaki K, Saga T, Doi Y, Aida K, Yoshizuka M. A statistical study of the branching of the human internal iliac artery. Kurume Med J. 1998;45:333–40.
Zorgniotti AW. Practical diagnostic screening for impotence. Urology. 1984;23:98–102.
Kaufman JM, Borges FD, Fitch 3rd WP, Geller RA, Gruber MB, Hubbard JG, et al. Evaluation of erectile dysfunction by dynamic infusion cavernosometry and cavernosography (DICC). Multi-institutional study. Urology. 1993;41:445–51.
Kropman RF, Schipper J, van Oostayen JA, Lycklama a Nijeholt AA, Meinhardt W. The value of increased end diastolic velocity during penile duplex sonography in relation to pathological venous leakage in erectile dysfunction. J Urol. 1992;148:314–7.
Lue TF, Hricak H, Marich KW, Tanagho EA. Evaluation of arteriogenic impotence with intracorporeal injection of papaverine and the duplex ultrasound scanner. Semin Urol. 1985;3:43–8.
Patel U, Amin Z, Friedman E, Vale J, Kirby RW, Lees WR. Colour flow and spectral Doppler imaging after papaverine-induced penile erection in 220 impotent men: study of temporal patterns and the importance of repeated sampling, velocity asymmetry and vascular anomalies. Clin Radiol. 1993;48:18–24.
Valji K, Bookstein JJ. Diagnosis of arteriogenic impotence: efficacy of duplex sonography as a screening tool. Am J Roentgenol. 1993;160:65–9.
Forsberg L, Ekelund L, Hederstrom E, Olsson AM. Pharmacoangiography of the penile arteries. Urol Radiol. 1988;10:132–5.
Gray RR, Keresteci AG, St Louis EL, Grosman H, Jewett MA, Rankin JT, et al. Investigation of impotence by internal pudendal angiography: experience with 73 cases. Radiology. 1982;144:773–80.
Rosen MP, Walker TG, Greenfield AJ. Arteriography and radiology of impotence. Urol Radiol. 1988;10:136–43.
Rogers JH, Goldstein I, Kandzari DE, Kohler TS, Stinis CT, Wagner PJ, Popma JJ, Jaff MR, Rocha-Singh KJ. Zotarolimus-eluting peripheral stents for the treatment of erectile dysfunction in subjects with suboptimal response to phosphodiesterase-5 inhibitors. J Am Coll Cardiol. 2012;60(25):2618–27. Accessed online at www.cardiosource.org on 1 Dec 2012.
Castaneda-Zuniga WR, Smith A, Kaye K, Rusnak B, Herrerra M, Miller R, et al. Transluminal angioplasty for treatment of vasculogenic impotence. Am J Roentgenol. 1982;139:371–3.
Van Unnik JG, Marsman JW. Impotence due to the external iliac steal syndrome treated by percutaneous transluminal angioplasty. J Urol. 1984;131:544–5.
Goldwasser B, Carson 3rd CC, Braun SD, McCann RL. Impotence due to the pelvic steal syndrome: treatment by iliac transluminal angioplasty. J Urol. 1985;133:860–1.
Becker GJ, Rowe DM, Holden RW, Dalsing MC, Bendick PJ. Percutaneous transluminal angioplasty for vasculogenic impotence. Indiana Med. 1986;79:256–62.
Angelini P, Fighali S. Early experience with balloon angioplasty of internal iliac arteries for vasculogenic impotence. Cathet Cardiovasc Diagn. 1987;13:107–10.
Valji K, Bookstein JJ. Transluminal angioplasty in the treatment of arteriogenic impotence. Cardiovasc Intervent Radiol. 1988;11:245–52.
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Paul, J.D., Rogers, J.H., Shah, A.P., Nathan, S. (2014). Endovascular Treatment of Erectile Dysfunction. In: Dieter, R., Dieter, Jr., R., Dieter, III, R. (eds) Endovascular Interventions. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7312-1_102
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