Surgical Treatment of Erectile Dysfunction

Bertero, Eduardo B.; Antunes, Dimas L.

doi:10.1002/smrj.60

Cited by 17 publications

(2 citation statements)

References 72 publications

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“…Sural nerve grafts and/or neurorrhaphy have been used to reinstate lesioned nerve function at the cavernous level after pelvic trauma and after radical prostatectomy [262][263][264][265][266], which remains one of the major causes of ED in spite of the use of robot-assisted nerve sparing surgery compared to conventional surgical laparoscopy/open surgery methods. In fact, irrespective of the surgical technique used, prostatectomy causes disruption of normal pelvic anatomy and alters both the nerve and vascular supply to the penis [267,268]. Additionally, in this case, few studies are available, and the number of patients is very low.…”

Section: Surgical Treatment Of Edmentioning

confidence: 99%

Erectile Dysfunction: Treatments, Advances and New Therapeutic Strategies

Argiolas

et al. 2023

Brain Sciences

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Erectile dysfunction (ED) is the inability to get and maintain an adequate penile erection for satisfactory sexual intercourse. Due to its negative impacts on men’s life quality and increase during aging (40% of men between 40 and 70 years), ED has always attracted researchers of different disciplines, from urology, andrology and neuropharmacology to regenerative medicine, and vascular and prosthesis implant surgery. Locally and/or centrally acting drugs are used to treat ED, e.g., phosphodiesterase 5 inhibitors (first in the list) given orally, and phentolamine, prostaglandin E1 and papaverine injected intracavernously. Preclinical data also show that dopamine D4 receptor agonists, oxytocin and α-MSH analogues may have a role in ED treatment. However, since pro-erectile drugs are given on demand and are not always efficacious, new strategies are being tested for long lasting cures of ED. These include regenerative therapies, e.g., stem cells, plasma-enriched platelets and extracorporeal shock wave treatments to cure damaged erectile tissues. Although fascinating, these therapies are laborious, expensive and not easily reproducible. This leaves old vacuum erection devices and penile prostheses as the only way to get an artificial erection and sexual intercourse with intractable ED, with penile prosthesis used only by accurately selected patients.

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Section: Surgical Treatment Of Edmentioning

confidence: 99%

Erectile Dysfunction: Treatments, Advances and New Therapeutic Strategies

Argiolas

et al. 2023

Brain Sciences

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“…Penile prostheses are the only surgical therapy option maintaining its significance as a cure for ED. There are convincing long-term results with a high degree of patient and partner satisfaction, high patient acceptance, and good functional durability of the mostly three-piece inflatable devices (10). In patients where pharmacological therapy is unhelpful or contraindicated, another option is the surgical approach.…”

Section: Introductionmentioning

confidence: 99%

Erectile dysfunction in common neurological conditions: A narrative review

Moussa

Papatsoris

Chakra

et al. 2020

Arch Ital Urol Androl

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Neurogenic erectile dysfunction (NED) can be defined as the inability to achieve or maintain an erection due to central or peripheral neurologic disease. Neurologic diseases can also affect the physical ability and psychological status of the patient. All these factors may lead to a primary or secondary NED. Medication history plays an important role since there are many drugs commonly used in neurologic patients that can lead to ED. The assessment of NED in these patients is generally evolving with the application of evoked potentials technology in the test of somatic and autonomic nerves, and functional magnetic resonance imaging. With the electrophysiological examinations, neurogenic causes can be determined. These tools allow to categorize neurologic lesion and assess the patient prognosis. The first-line treatment for NED is phosphodiesterase inhibitors. Second-line treatments include intracavernous and intraurethral vasoactive injections. Third-line treatments are penile prostheses. The efficacy and safety of each treatment modality depend on the specific neurologic condition. This review discusses the physiology, pathophysiology, diagnosis, and treatment of ED in multiple peripheral and central neurologic conditions, as well as for future research.

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