The management of erectile dysfunction has made tremendous strides over the past four decades, owing to concomitant advances in our understanding of the complex neurovascular, hormonal, and psychologic processes involved in penile erectile. The field has transitioned from predominantly psychotherapy-based management to focused treatment modalities that have been rigorously tested for both safety and efficacy in the clinical setting. The etiology of the erectile dysfunction must first be ascertained through careful history-taking, physical examination, laboratory testing, and in select cases, imaging. Once the etiology is known, the urologist has numerous options in their armamentarium to improve symptomatology and quality of life. The use of psychotherapy, pharmacologic therapy, injectable therapy, intraurethral suppositories, topical agents, and vacuum-assist erection devices can be used as monotherapy or in combination to tailor treatment to patient needs. Future directions in erectile dysfunction management are focusing on therapies that alter the course of the disease and permanently restore erectile function, rather than simply treating the symptomatology. The continued advancements taking place in the preclinical setting demonstrate considerable promise for the treatment and ultimate cure for this disease.
This review contains 6 figures, 1 table, and 50 references.
Key Words: alprostadil, emerging therapies, erectile dysfunction, intracavernosal injection therapy, intraurethral suppository, medical management, papaverine, phentolamine, phosphodiesterase-5 inhibitors, vacuum erection device, vasoactive intestinal peptide
From Chest Wall Resection to Medical Management: The Continued Saga of Parapneumonic Effusion Management and Future Directions
