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Diagnosis and Management of Erectile Dysfunction in Men

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Advanced Practice in Endocrinology Nursing

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Abstract

Erectile Dysfunction (ED) has been defined as a persistent inability to attain or maintain erection adequate to permit satisfactory sexual function (National Institute of Health 1993). It is estimated that a third of men will be affected by ED at some point during their lives (Heidelbaugh 2010). Whilst published figures provide an indication of the prevalence of ED, they are likely to underestimate the true number as many men will not seek help either due to embarrassment or through acceptance that ED is inevitable with advancing age (Hatzimouratidis et al. 2010).

The pathophysiology of ED may be neurogenic, hormonal, vasculogenic, drug-induced, anatomical, and/or psychogenic. However, regardless of the pathological basis for ED, the condition can have a profoundly negative psychological impact on relationships, quality of life and overall affect self-esteem (Gruenwald 2012). Therefore, to establish an effective ED management plan in a timely fashion is of paramount importance for the well-being of the sufferer and partner.

By the end of this chapter we hope that you will have a better understanding of the pathophysiology and management of ED.

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Abbreviations

ATP:

Adenosine Triphosphate

cAMP:

Cyclic adenosine monophosphate

cGMP:

Cyclic guanosine monophosphate

CVD:

Cardiovascular disease

EAU:

European Association of Urology

ED:

Erectile dysfunction

IIEF:

International Index for Erectile Function

MUSE:

Medicated Urethral System for Erection

NO:

Nitric oxide

NPT:

Nocturnal penile tumescence

PDE5i:

Phosphodiesterase 5 inhibitor

PGE1:

Prostaglandin E1

PSA:

Prostate-specific antigen

VED:

Vacuum erection device

VIP:

Vasoactive intestinal peptide

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Key Reading

  1. Gresser U, Gleiter CH. Erectile dysfunction: comparison of efficacy and side effects of PDE5 inhibitors sildenafil, vardenafil, and tadalafil. Review of the literature. Eur J Med Res. 2002;7:435–46.

    CAS  PubMed  Google Scholar 

  2. Hackett G, Kell P, Ralph D, Dean J, Price D, Speakman M, Wylie K. British Society for Sexual Medicine guidelines on the management of erectile dysfunction. J Sex Med. 2008;5(8):1841–65.

    Article  PubMed  Google Scholar 

  3. Hatzimouratidis K, Giuliano F, Moncada I, Muneer A, Salonia A, Verze P. EAU guidelines on erectile dysfunction, premature ejaculation, penile curvature and priapism. European Association of Urology. 2016. https://uroweb.org/wp-content/uploads/EAU-Guidelines-Male-Sexual-Dysfunction-2016-3.pdf.

  4. Heidelbaugh JJ. Management of erectile dysfunction. Am Fam Physician. 2010;81(3):305–12.

    PubMed  Google Scholar 

  5. Heidenreich A, Bellmunt J, Bolla M, et al. European Association of Urology. EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease. Eur Urol. 2011;59(1):61–71.

    Article  PubMed  Google Scholar 

  6. McVary KT. Sexual dysfunction, chapter 19. In: Jameson LJ, editor. Harrison’s Endocrinology, 4th Edition. New York: McGraw-Hill Education; 2017. p. 241–50.

    Google Scholar 

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Acknowledgments

With special thanks to the European Association of Urology Patient Information (https://patients.uroweb.org), for their permission to use images and illustrations in our chapter.

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Authors and Affiliations

  1. Urology Department, Westmorland Street Hospital, University College London Hospitals NHS Foundation Trust, London, UK

    Fiona Holden & Clare Akers

  2. School of Health Sciences, City, University of London, London, UK

    Sofia Llahana

Authors
  1. Fiona Holden
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  2. Clare Akers
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  3. Sofia Llahana
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Corresponding author

Correspondence to Fiona Holden .

Editor information

Editors and Affiliations

  1. School of Health Sciences, City, University of London, London, UK

    Sofia Llahana

  2. Department of Oncology, Skåne University Hospital, Lund, Sweden

    Cecilia Follin

  3. Northwest Pituitary Center Oregon Health and Sciences University, Portland, OR, USA

    Christine Yedinak

  4. Churchill Hospital, University of Oxford, Oxford, UK

    Ashley Grossman

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Holden, F., Akers, C., Llahana, S. (2019). Diagnosis and Management of Erectile Dysfunction in Men. In: Llahana, S., Follin, C., Yedinak, C., Grossman, A. (eds) Advanced Practice in Endocrinology Nursing. Springer, Cham. https://doi.org/10.1007/978-3-319-99817-6_48

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