Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-22T17:37:49.547Z Has data issue: false hasContentIssue false
  • English
  • Français

New Treatments for Erectile Impotence

Published online by Cambridge University Press:  02 January 2018

Alain Gregoire
Alain Gregoire*
Affiliation:
Academic Department of Psychological Medicine, King's College Hospital and Institute of Psychiatry, London SE5 9RS
Get access Rights & Permissions [Opens in a new window]

Abstract

The range of interventions available for the treatment of erectile failure has increased in the past ten years. A significant development is intracavernosal injection of vasoactive drugs, but this treatment is far from ideal. Other, less invasive, pharmacological interventions are being investigated; as yet, none of these appear effective enough to have any significant clinical impact. External vacuum devices are a viable option for some patients, and penile prostheses have become increasingly sophisticated, although research examining their benefits has not. The range of available treatment methods and the growing complexity of the assessment for erectile problems demands an eclecticism of approach which can best be provided by multidisciplinary clinics specialising in sexual dysfunctions.

Type
Review Articles
Information
The British Journal of Psychiatry , Volume 160 , Issue 3 , March 1992 , pp. 315 - 326
Copyright
Copyright © Royal College of Psychiatrists, 1992 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abozeid, M., Juenemann, K. P., Luo, J. A., et al (1987) Chronic papaverine treatment: the effect of repeated injections on the simian erectile response and penile tissue. Journal of Urology, 138, 1263.Google Scholar
Ambrosi, B., Bara, R., Travaglini, P., et al (1977) Study of the effects of bromocriptine on sexual impotence. Clinical Endocrinology, 7, 417–421.Google Scholar
Asopa, R. & Williams, G. (1989) Use of the Correctaid device in the management of impotence. British Journal of Urology, 63, 546–547.Google Scholar
Benassi-Benelli, A., Ferrari, F. & Pellegrini-Quarantotti, B. (1979) Penile erection induced by apormorphine and N-n-propylnorapomorphine in rats. Archives of International Psychodynamic Therapy, 242, 241–247.Google Scholar
Bennett, A. H., Rivard, D. J., Blanc, R. P., et al (1986) Reconstructive surgery for vasculogenic impotence. Journal of Urology, 136, 599–601.Google Scholar
Berendsen, H. H. G. & Gower, A. J. (1986) Opiate: androgen interactions in drug-induced yawning and penile erections in the rat. Neuroendocrinology, 42, 185–190.Google Scholar
Berg, R., Mindus, P., Berg, G., et al (1984) Penile implants and erectile impotence: outcome and prognostic indicators. Scandinavian Journal of Urology and Nephrology, 18, 277–282.Google Scholar
Brindley, G. S. (1983) Cavernosal alpha-blockade: a new technique for investigating and treating erectile impotence. British Journal of Psychiatry, 143, 332–337.Google Scholar
Brindley, G. S. (1984) New treatment for priapism. Lancet, ii, 220–221.Google Scholar
Brindley, G. S. (1986) Maintenance treatment of erectile impotence by cavernosal unstriated muscle relaxant injection. British Journal of Psychiatry, 149, 210–215.Google Scholar
Cameron, L. & Woodruff, P. (1985) Cavernosal alpha blockade: a treatment for erectile impotence. British Journal of Psychiatry, 147, 107.Google Scholar
Charney, D. S., Heninger, G. R. & Sternberg, D. E. (1982) Assessment of alplu2adrenergic autoregulator function in humans: effects of oral yohimbine. Life Sciences, 30, 2033–2041.Google Scholar
Charney, D. S., Heninger, G. R., & Redmond, D. E. Jr (1983) Yohimbine induced anxiety and increased noradrenergic function in humans: effects of diazepam and clonidine. Life Sciences, 33, 19–29.Google Scholar
Cleeves, L. & Findley, L. J. (1987) Bromocriptine induced impotence in Parkinson's disease. British Medical Journal, 295, 367–368.CrossRefGoogle ScholarPubMed
Cole, M. (1985) Sex therapy – a critical appraisal. British Journal of Psychiatry, 147, 337–351.Google Scholar
Collins, G. F. & Kinder, B. N. (1984) Adjustment following surgical implantation of a penile prosthesis: a critical overview. Journal of Sex and Marital Therapy, 10, 255–271.Google Scholar
Costentin, J., Dubue, I. & Protais, P. (1983) Behavioural data suggesting the plurality of central dopamine receptors. In CNS Receptors – From Molecular Pharmacology to Behaviour (eds Mangel, P. & Defeudis, F. V.). New York: Raven Press.Google Scholar
De Amicis, L. A., Goldberg, D. C., Lopiccolo, J., et al (1985) Clinical follow-up of couples treated for sexual dysfunction. Archives of Sexual Behaviour, 14, 467–489.Google Scholar
Fabbri, A., Jannini, E. A., Gnessi, L., et al (1989) Endorphine in male impotence: evidence for naltrexone stimulation of erectile activity in patient therapy. Psychoneuroendocrinology, 14, 103–111.CrossRefGoogle ScholarPubMed
Gee, W. F., McRoberts, J. W., Raney, J. O., et al (1974) The impotent patient: surgical treatment with penile prosthesis and psychiatric evaluation. Journal of Urology, 111, 41–43.Google Scholar
Gerstenberger, D. L., Osbourne, D. & Furlow, W. L. (1979) Inflatable penile prosthesis: follow-up study of patient-partner satisfaction. Urology, 14, 583–587.Google Scholar
Gessa, G. L., Paglietti, E. & Pellegrini-Quarantotti, B. (1979) Induction of copulatory behaviour in sexually inactive rats by naloxone. Science, 204, 203–205.Google Scholar
Girdley, F. M., Bruskewitz, R. C., Feyzi, J., et al (1988) Intracavernous self-injection for impotence: a long-term therapeutic option? Experience in 78 patients. Journal of Urology, 140, 972–974.Google Scholar
Goldstein, J. A. (1986) Erectile function and naltrexone. Annals of Internal Medicine, 105, 799.Google Scholar
Goldstein, A. & Hansteen, R. W. (1977) Evidence against involvement of endorphin in sexual arousal and orgasm in man. Archives of General Psychiatry, 34, 1179–1180.Google Scholar
Gregoire, A. (1990) Self-injection treatment for impotence. British Medical Journal, 300, 357.Google Scholar
Hauri, D. (1986) A new operative technique in vasculogenic erectile impotence. World Journal of Urology, 4, 237–249.Google Scholar
Holmgren, B., Urba-Holmgren, R., Trucios, N., et al (1985) Association of spontaneous and dopaminergic-induced yawning and penile erections in rat. Pharmacology, Biochemistry and Behaviour, 11, 31–35.Google Scholar
Ishii, N., Watanabe, H., Irisawa, C., et al (1989) Intracavernous injection of prostaglandin E1 for the treatment of erectile impotence. Journal of Urology, 141, 323–325.Google Scholar
Journal of Urology (1981) Editorial comment, 126, 175.Google Scholar
Kaufman, J. J., Boxer, R. J., Boxer, B., et al (1981) Physical and psychological results of penile prosthesis: a statistical survey. Journal of Urology, 126, 173–175.Google Scholar
Kebabian, J. W. & Calne, D. B. (1979) Multiple receptors for dopamine. Nature, 577, 93–96.Google Scholar
Kiely, E. A., Ignotus, P. & Williams, G. (1987a) Penile function following intracavernosal injection of vasoactive agents or saline. British Journal of Urology, 59, 473–476.Google Scholar
Kiely, E. A., Williams, G. & Goldie, L. (1987b) Assessment of the immediate and long-term effects of pharmacologically induced penile erections in the treatment of psychogenic and organic impotence. British Journal of Urology, 59, 164–169.Google Scholar
Kramarsky-Binkhorst, S. (1978) Female partner perception of small carrion implant. Urology, 12, 545.Google Scholar
Lakin, M. M., Montague, D. K., Vanderbrug Medendorp, S., et al (1990) Intracavernous injection therapy: analysis of results and complications. Journal of Urology, 143, 1138–1141.CrossRefGoogle Scholar
Lal, S., Ackman, D., Thavundayil, J. N., et al (1984) Effect of apomorphine, a dopamine receptor agonist, on penile tumescence in normal subjects. Neuro-Psychopharmacological and Biological Psychiatry, 8, 695–699.Google Scholar
Lal, S., Labyea, E., Thavundayil, J. K., et al (1987) Apomorphine induced penile tumescence in impotent patients – preliminary findings. Neuro-Psychopharmacological and Biological Psychiatry, 11, 535–542.Google ScholarPubMed
Lal, S., Tesfaye, Y., Thavundayil, J. K., et al (1989) Apomorphine: clinical studies on erectile impotence and yawning. Neuro-Psychopharmacological and Biological Psychiatry, 13, 329–339.Google Scholar
Legros, J. J., Chiodera, P., Mormont, C., et al (1980) A psychoneuroendocrinological study of sexual impotence in patients with abnormal reaction to a glucose tolerance test. Advances in Biological Psychiatry, 5, 117–124.Google Scholar
Levine, S. B., Althof, S. E., Turner, L. A., et al (1989) Side effects of self-administration of intracavernous papaverine and phetolamine for the treatment of impotence. Journal of Urology, 141, 54–57.Google Scholar
Lewis, R. W., Puyau, F. A., & Bell, D. P. (1986) Another surgical approach for vasculogenic impotence. Journal of Urology, 136, 1210–1212.Google Scholar
LoPiccolo, J. & Stock, W. (1986) Treatment of sexual dysfunction. Journal of Consulting Clinical Psychology, 54, 158–167.Google Scholar
Lue, T. F. (1988) Treatment of venogenic impotence. In Contemporary Management of Impotence and Infertility (eds Tanagho, E. A., Lue, T. F. & McClure, R. D.). Baltimore: Williams & Wilkins.Google Scholar
Lue, T. F. & McAninch, J. W. (1988) Priapism. In Contemporary Management of Impotence and Infertility (eds Tanagho, E. A., Lue, T. F. & McClure, R. D.). Baltimore: Williams & Wilkins.Google Scholar
Lydston, G. F. (1908) The surgical treatment of impotency. American Journal of Clinical Medicine, 15, 71–73.Google Scholar
Martindale (1989) Naltrexone hydrochloride. The Extra Pharmacopea (29th edn), pp. 486–487. London: Pharmaceutical Press.Google Scholar
Masters, W. E. & Johnson, V. E. (1970) Human Sexual Inadequacy. Boston: Little Brown & Co.Google Scholar
Mintz, J., O'Hare, K., O'Brien, C. P., et al (1974) Sexual problems with heroin addicts. Archives of General Psychiatry, 31, 700–703.Google Scholar
Morales, A., Condra, M., Owen, J. A., et al (1988) Oral and transcutaneous pharmacological agents for the treatment of impotence. In Contemporary Management of Impotence and Infertility (eds. Tanagho, E. A., Lue, T. F. & McClure, R. D.). Baltimore: Williams & Wilkins.Google Scholar
Moul, J. W. & McLeod, D. G. (1986) Experience with the AMS 600 maleable penile prosthesis. Journal of Urology, 135, 929–931.Google Scholar
Myers, B. & Baum, M. J. (1979) Facilitation by opiate antagonists of sexual performance in the male rat. Biochemical Behaviour, 10, 615–618.Google Scholar
Nadig, P. W., Catesby-Ware, J. & Blumoff, R. (1986) Noninvasive device to produce and maintain an erection-like state. Urology, 11, 126–131.Google Scholar
Padma-Nathan, H. & Goldstein, I. (1988) Arterial reconstruction. In Contemporary Management of Impotence and Infertility (eds Tanagho, E. A., Lue, T. F. & McClure, R. D.). Baltimore: Williams & Wilkins.Google Scholar
Price, L. H., Charney, D. S., & Heninger, G. R. (1984) Three cases of manic symptoms following yohimbine administration. American Journal of Psychiatry, 141, 1267–1268.Google Scholar
Reid, K., Morales, A., Harris, C., et al (1987) Double-blind trial of yohimbine in treatment of psychogenic impotence. Lancet, i, 421–423.Google Scholar
Reynolds, B. S. (1977) Psychological treatment models and outcome results for erectile dysfunction: a critical review. Psychological Bulletin, 84, 1218–1238.Google Scholar
Riley, A. J. (1990) Erection-assisting devices. British Journal of Sexual Medicine, 17, 175–177.Google Scholar
Riley, A. J., Goodman, R. E., Kellett, J. M., et al (1989) Double-blind trial of yohimbine hydrochloride in the treatment of erection inadequacy. Sexual and Marital Therapy, 4, 17–26.Google Scholar
Schlatter, E. K. E. & Lal, S. (1972) Treatment of alcoholism using Dent's oral apomorphine method. Quarterly Journal of Studies on Alcohol, 33, 430–436.CrossRefGoogle ScholarPubMed
Schramek, P., Dorninger, R., Waldhauser, M., et al (1990) Prostaglandin E1 in erectile dysfunction. British Journal of Urology, 65, 68–71.Google Scholar
Scott, F. B., Byrd, G. J. & Karacan, I. (1979) Erectile impotence treated with an implantable inflatable prosthesis: five years of clinical experience. Journal of the American Medical Association, 241, 2609–2612.Google Scholar
Sidi, A. A., Cameron, J. S., Duffy, L. M., et al (1986) Intracavernous drug-induced erections in the management of male erectile dysfunction: experience with 100 patients. Journal of Urology, 135, 704–706.Google Scholar
Sidi, A. A., Reddy, P. A. & Chen, K. K. (1988) Patient acceptance of and satisfaction with vasoactive intracavernous pharmacotherapy for impotence. Journal of Urology, 140, 293–294.Google Scholar
Smith, A. D. (1981) Causes and classification of impotence. Urology Clinics of North America, 8, 79–89.Google Scholar
Sotile, W. M. (1979) The penile prosthesis: a review. Journal of Sexual and Marital Therapy, 5, 90–102.Google Scholar
Spycher, M. A., Hauri, D. (1986) The ultrastructure of erectile tissue in priapism. Journal of Urology, 135, 142–147.Google Scholar
Stackl, W., Hasun, R. & Marberger, M. (1988) Intracavernous injection of prostaglandin E1 in impotent men. Journal of Urology, 140, 66.Google Scholar
Steege, J. F., Stout, A. L. & Carsen, C. C. (1986) Patient satisfaction in Scot and Small carrion penile implant recipients: a study of 52 patients. Archives of Sexual Behaviour, 15, 393–399.Google Scholar
Strauss, B. (1950) Impotence from the psychiatric standpoint. British Medical Journal, i, 697–704.Google Scholar
Susset, J. G., Tessier, C. D., Wincze, J., et al (1989) Effect of yohimbine hydrochloride on erectile impotence: a double-blind study. Journal of Urology, 141, 1360–1363.Google Scholar
Talley, J. D. & Crawley, I. S. (1985) Transdermal nitrate, penile erection and spousal headache. Annals of International Medicine, 103, 804.Google Scholar
Thorner, M. O., McNeilly, A. S., Hagan, C., et al (1974) Long-term treatment of galactorrhoea and hypogonadism with bromocriptine. British Medical Journal, ii, 419–422.Google Scholar
ViRAg, R. (1982) Intracavernous injection of papaverine for erectile failure. Lancet, ii, 928.Google Scholar
Wagner, G. & Green, R. (1981) Impotence. New York: Plenum.Google Scholar
Waiters, G. R., Keogh, E. J., Earle, C. M., et al (1988) Experience in the management of erectile dysfunction using the intracavernosal self-injection of vasoactive drugs. Journal of Urology, 140, 1417–1419.Google Scholar
Wespes, E. & Schulman, C. C. (1985) Venous leakage: surgical treatment of a curable cause of impotence. Journal of Urology, 133, 796–798.Google Scholar
Wespes, E. & Schulman, C. C. (1988) Systemic complication of intracavernous papaverine injection in patients with venous leakage. Urology, 31, 114–115.Google Scholar
Wiles, P. G. (1988) Successful non-invasive management of erectile impotence in diabetic men. British Medical Journal, 296, 161–162.Google Scholar
Williams, G., Mulcahy, M. J. & Kiely, E. A. (1987) Impotence: treatment by autoinjection of vasoactive drugs. British Medical Journal, 295, 595–596.Google Scholar
Williams, G., Mulcahy, M. J., Hartnell, G., et al (1988) Diagnosis and treatment of venous leakage: a curable cause of impotence. British Journal of Urology, 61, 151–155.Google Scholar
Wright, J., Pbrreault, R. & Mathieu, M. (1977) The treatment of sexual dysfunction – a review. Archives of General Psychiatry, 34, 881–890.Google Scholar
Zorgniotti, A. W. & Lefleur, R. S. (1985) Auto-injection of the corpus cavernosum with a vasoactive drug combination for vasculogenic impotence. Journal of Urology, 133, 39–41.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.