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Chapter 8. Pharmacological Therapy for the Treatment of Erectile Dysfunction

1999; Elsevier BV; Linguagem: Inglês

10.1016/s0065-7743(08)60570-9

1557-8437

Graham N. Maw,

Pharmacology and Obesity Treatment

This chapter elaborates pharmacological therapy for the treatment of erectile dysfunction (ED), which is defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance. Erection is triggered and maintained via central nervous control through two different nerve pathways. Reflex erections are under spinal control and psychogenic erections under direct central control. In healthy males, these two mechanisms are believed to work synergistically in the control of erections. Therefore any reduction of neuronal function by peripheral neuropathy associated with diabetes, for example, can also lead to ED. In addition, spinal cord injury can also contribute to the presence of ED through loss of central control, although the reflexogenic pathway still operates. Basics of physiology of the penis and mechanism of erection are elaborated in the chapter. Drugs approved for the treatment of ED are described and central control of penile erection is explained. Concepts related to investigational drugs for ED are discussed. Novel PDE5 inhibitors are elaborated and also non-selective PDE5 inhibitors are analyzed.