ERECTILE DYSFUNCTION – DISEASE-ASSOCIATED MECHANISMS AND NOVEL INSIGHTS INTO THERAPY Edited by Kenia Pedrosa Nunes Erectile Dysfunction – Disease-Associated Mechanisms and Novel Insights into Therapy Edited by Kenia Pedrosa Nunes Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Romana Vukelic Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published February, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Erectile Dysfunction – Disease-Associated Mechanisms and Novel Insights into Therapy, Edited by Kenia Pedrosa Nunes p. cm. ISBN 978-953-51-0199-4 Contents Preface IX Part 1 An Introduction of ED 1 Chapter 1 Mechanisms in Erectile Function and Dysfunction: An Overview 3 Kenia Pedrosa Nunes and R. Clinton Webb Chapter 2 Erectile Dysfunction Etiological Factors 23 Rafaela Rosalba de Mendonça, Fernando Korkes and João Paulo Zambon Chapter 3 Erectile Dysfunction and Quality of Life 35 Quek Kia Fatt Part 2 Diseases-Associated ED 47 Chapter 4 The Role Erectile Dysfunction Plays in Cardiovascular Diseases 49 Sandra Crestani, Kenia Pedrosa Nunes, Maria Consuelo Andrade Marques, José Eduardo Da Silva Santos and R. Clinton Webb Chapter 5 Erectile Dysfunction: A Chronic Complication of the Diabetes Mellitus 69 Eulises Díaz-Díaz, Mario Cárdenas León, Nesty Olivares Arzuaga, Carlos M. Timossi, Rita Angélica Gómez Díaz, Carlos Aguilar Salinas and Fernando Larrea Chapter 6 Premature Ejaculation Re-Visited: Definition and Contemporary Management Approaches 97 Tariq F. Al-Shaiji Chapter 7 Erectile Dysfunction in Paraplegic Males 127 Charalampos Konstantinidis VI Contents Part 3 ED Treatment Options and Perspectives 143 Chapter 8 Current Perspectives on Pharmacotherapy Treatments for Erectile Dysfunction 145 Jason E. Davis, Kenia Pedrosa Nunes, Inger Stallmann-Jorgensen and R. Clinton Webb Chapter 9 Surgical Treatment of Erectile Dysfunction 161 Faruk Kucukdurmaz and Ates Kadioglu Chapter 10 Gene and Stem Cell Therapy in Erectile Dysfunction 185 Trevor Hardigan, R. Clinton Webb and Kenia Pedrosa Nunes Chapter 11 The Assessment of Atherosclerosis in Erectile Dysfunction Subjects Using Photoplethysmography 195 Yousef Kamel Qawqzeh, Mamun Ibne Reaz and Mohd Aluadin Mohd Ali Preface I am delighted to bring you the Erectile Dysfunction (ED) book. Organizing this book was an enlightening experience and an amazing adventure in science. Considering the breadth and depth of information available in the continuously expanding field of ED, this book provides information ranging from the basic mechanism of erectile function and dysfunction to updates regarding most discussed topics in ED nowadays, such as association between ED and cardiovascular diseases. Although ED disorder has been described for more than 1,000 years, the molecular basis and mechanisms of ED have yet to be completely understood. Over the last four decades, elucidation of the macroscopic structures of the erectile system ushered in a new era of therapeutic options for erectile disorders. Later, new insights into erectile neurotransmission, essentially the nitric oxide (NO) pathway, resulted in rational alternatives as a treatment. Nowadays, advances in gene discovery and intensive research regarding different mechanisms that could lead to ED have increased the working knowledge of the pathways involved in this condition. However, many questions still need to be elucidated. This book contains chapters written by widely acknowledged experts, each of which provides a unique synthesis of information on emergent aspects of ED. All chapters take into account not only new perspectives on ED but also recent extensions of basic knowledge that presage directions for further research. The approach in this book has been to not only describe the recent popular aspects of ED, such as basic mechanism updates, etiologic factors and pharmacotherapy, but also disease-associated ED and some future perspectives in this field. ED is a widespread problem affecting many men across all age groups and it is more than a serious quality of life problem for sexually active men. The prevalence of ED is very high and is expected to rise considerably over the next 25 years, affecting more than 300 million men by 2025. ED is a multifactorial pathology and has recently been observed as a condition that may predict cardiovascular disease, making the knowledge in this area extremely important to prevent future diseases. Finally, to you, our readers, even though this book is a small overview of ED field, I hope that it provides enough useful and updated information that you will consider joining us in studying this condition. In addition, for readers who are not physicians, I wish that basic information as well as a scientific overview about research in ED can be acquired from this work. X Preface I would like to thank Dr R. Clinton Webb, Professor and Chairperson of the Physiology Department at Georgia Health Sciences University, for his help and advice in the preparation of this edition. Many thanks are also due to Dr Maria Elena De Lima and Dr Romulo Leite for introducing me to the scientific research world. Special thanks to my co-workers, as well as to my parents, Feliciano (in memoriam) and Conceição, who have always been behind the scenes supporting me. It would not be fitting for me to conclude this preface without a major acknowledgment to my beloved husband, Russell Bruhn. My husband’s journalistic experience in reading and revising many parts of this book was an indispensable aid in accomplishing this work. As it is inevitable when preparing a text, in addition to my own experience, I have called upon the help and advice of many others as I have in ten years or since I started research in this field. Thus, I’m deeply grateful to all the people who made this book possible. Comments on this edition will be welcome. Kenia Pedrosa Nunes Georgia Health Sciences University, Augusta, Georgia USA . ERECTILE DYSFUNCTION – DISEASE-ASSOCIATED MECHANISMS AND NOVEL INSIGHTS INTO THERAPY Edited by Kenia Pedrosa Nunes Erectile Dysfunction. orders@intechweb.org Erectile Dysfunction – Disease-Associated Mechanisms and Novel Insights into Therapy, Edited by Kenia Pedrosa Nunes p. cm. ISBN