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Male Sexual Function A Guide to Clinical Management

:	John J. Mulcahy
:	John Mulcahy
:	Male Sexual Function A Guide to Clinical Management
:	Humana Press
:	9781597451550
:	2
:	CHF 95.00
:

:	Klinische Fächer
:	English

:	494
:	Wasserzeichen
:	PC/MAC/eReader/Tablet
:	PDF

The first edition of Male Sexual Function: A Guide to Clinical Management was published in 2001. Since that time, two new oral medications for erectile dysfunction ® ® (ED), Vardenafil (Levitra ) and Tadalafil (Cialis ), have been introduced. Links between ED and lower urinary tract symptoms have been postulated, advances in the basic science of erectile physiology have occurred, and the appreciation of ED as a form of endothelial dysfunction and a harbinger of other more potentially lethal forms of vascular disease has become more widespread. In some instances, third-party payers have reduced or eliminated coverage for ED treatments in an attempt to cut costs. They have classified sexual activity as 'recreational,' 'lifestyle,' or not medically necessary, but have failed to appreciate the negative consequences of ED, such as depression with all of its ramifications. Male Sexual Function: A Guide to Clinical Management, Second Edition is a comp- hensive overview of the field of male sexual function and includes a chapter on female sexual dysfunction, an emerging field with a very high incidence in the population and an ever-growing following.

	Preface	6
	Contents	7
	Contributors	9
	Normal Anatomy and Physiology	11
	INTRODUCTION	11
	FUNCTIONAL VASCULAR AND MICROSCOPIC ANATOMY OF PENILE ERECTION	12
	FUNCTIONAL NEUROANATOMY OF PENILE FUNCTION	17
	PENILE ERECTION AND FLACCIDITY: PHYSIOLOGICAL MECHANISMS	21
	PENILE ERECTION AND FLACCIDITY: MOLECULAR MECHANISM OF CORPORAL SMOOTH MUSCLE RELAXATION AND CONTRACTION	25
	SMOOTH MUSCLE CONTRACTION AND RELAXATION IS REGULATED BY Ca2+- INDUCED MYOSIN PHOSPHORYLATION AND DEPHOSPHORYLATION	25
	MODES OF PENILE ERECTION	34
	CENTRAL MECHANISMS OF PENILE ERECTION AND FLACCIDITY	36
	SPINAL MECHANISMS AND PATHWAYS	39
	PENILE ERECTION AND FLACCIDITY: CENTRAL NEUROPHYSIOLOGY	39
	REFERENCES	44
	Epidemiology of Erectile Dysfunction	56
	INTRODUCTION	56
	PREVALENCE AND INCIDENCE OF ERECTILE DYSFUNCTION	56
	AGING AND ERECTILE DYSFUNCTION	59
	RISK FACTORS FOR ERECTILE DYSFUNCTION	60
	IMPACT OF ERECTILE DYSFUNCTION	62
	TREATMENT-SEEKING BEHAVIOR	64
	CONCLUSION	65
	REFERENCES	65
	Cardiac Issues Related to Erectile Dysfunction	69
	INTRODUCTION	69
	IS THE PATIENT PRESENTING WITH ED A CARDIAC PATIENT?	71
	WHAT IS THE ADEQUATE RECOMMENDATION FOR PATIENTS WITH CARDIOVASCULAR DISEASE SEEKING TREATMENT FOR ED?	74
	CONCLUSION	80
	REFERENCES	80
	How a Primary Care Clinician Approaches Erectile Dysfunction	84
	INTRODUCTION	84
	NATURE OF PRIMARY CARE	85
	TRENDS IN PRIMARY CARE INVOLVEMENT IN SEXUAL HEALTH	86
	LEARNING TO COMMUNICATE WITH PATIENTS ABOUT SEXUAL ACTIVITY	87
	NOT ALL MEN ARE HETEROSEXUAL	88
	SCREENING FOR ED	89
	PATIENTS AND PARTNERS INITIATE DISCUSSIONS ABOUT SEXUAL PROBLEMS	91
	POTENTIAL VALUE OF ED INQUIRY AND MANAGEMENT ( TABLE 9)	92
	BARRIERS PREVENTING MEN FROM DISCUSSING ED	94
	THE NEXT STEP AFTER IDENTIFYING ED	95
	CHARACTERISTICS OF A SEXUAL PROBLEM	96
	EVALUATING THE MAN WITH ED	96
	TREATMENT OF ED	101
	ISSUES AMONG OLDER MEN	104
	FOLLOW-UP OF TREATMENT FOR ED	105
	CONSULTATION	105
	MANAGING SEXUAL HEALTH PROBLEMS CAN ENHANCE A PRACTICE	106
	REFERENCES	108
	Psychosocial Aspects Related to Erectile Dysfunction	112
	INTRODUCTION	112
	A MULTIDIMENSIONAL COMBINATION TREATMENT APPROACH	113
	THE SEXUAL TIPPING POINT MODEL	114
	DEFINITION	115
	ETIOLOGY	115
	ASSESSMENT	117
	SEXUAL STATUS EXAMINATION	119
	EXPLORING OTHER PSYCHOSOCIAL ISSUES	120
	PREVIOUS TREATMENT APPROACHES	121
	PSYCHIATRIC CONSIDERATIONS	121
	FAMILY AND EARLY PSYCHOSEXUAL HISTORY	122
	PARTNER–RELATIONSHIP ISSUES	122
	THE SINGLE PATIENT	122
	QUESTIONNAIRES	122
	TREATMENT	123
	FOLLOW-UP AND THERAPEUTIC PROBE	124
	WEANING AND RELAPSE PREVENTION	124
	COMBINATION THERAPY MATRIX	125
	REFERRAL	126
	CONCLUSION	127
	REFERENCES	127
	Hormonal Evaluation and Treatment	130
	INTRODUCTION	130
	EFFECTS OF TESTOSTERONE ON SEXUAL FUNCTION	131
	CLINICAL PICTURE OF HYPOGONADISM	131
	OTHER HORMONES	133
	LABORATORY DETERMINATION OF HYPOGONADISM	133
	TREATMENT OF HYPOGONADISM	134
	CAUTIONS IN TESTOSTERONE SUPPLEMENTATION	136
	TESTOSTERONE FOR ERECTILE DYSFUNCTION	137
	CONCLUSIONS	137
	POSITION STATEMENT: UNITED STATES	138
	REFERENCES	138
	Radical Prostatectomy and Other Pelvic Surgeries	141
	INTRODUCTION	141
	EPIDEMIOLOGY	142
	PATHOPHYSIOLOGY