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A detailed medical and psychosexual history and a thorough physical examination are the most important steps in the differential diagnosis of sexual dysfunction. Interviewing the partner, if available, is very helpful…

Other causes may affect one or more of the factors controlling the erectile mechanism. Because of the lack of scientific studies, however, their precise pathogenetic relationship remains speculative.

A. Drugs
Many…

The anatomic mechanism of penile erection was discovered in the 1980s by electron microscopy of corrosion penile casts made in the flaccid state and during erection (_{Fournier et al, 1987; Banya et al,…}

In the Massachusetts Male Aging Study, a community-based survey of men between 40 and 70 years of age, 52% of respondents reported some degree of ED: 17% mild, 25% moderate, and 10% complete.…

Male sexual dysfunction, denoting the inability to achieve a satisfactory sexual relationship, may involve inadequacy of erection or problems with emission, ejaculation, or orgasm.

Erectile dysfunction (impotence) is the inability to obtain or maintain…

The tunica of the corpora cavernosa is a bilayered structure with multiple sublayers. The inner circular bundles support and contain the cavernous tissue. From this inner layer radiate intracavernosal pillars that…

Innervation of the Penis

The autonomic spinal erection center is located in the intermediolateral nuclei of the spinal cord at levels S₂-S₄ and T₁₂-L₂. Nerve fibers from the thoracolumbar (sympathetic) and sacral (parasympathetic)…

During sexual stimulation, NO released from nerve ending and endothelium diffuses into the trabecular and arterial smooth-muscle cells to activate guanylyl cyclase, which catalyzes the formation of second messenger cyclic guanosine monophosphate…

Androgens are essential for male sexual maturity. Testosterone regulates gonadotropin secretion and muscle development; dihydrotestosterone mediates all other aspects of male sexual maturation, including hair growth, acne, male pattern baldness, and spermatogenesis. In…

by Tom F. Lue, MD

A better understanding of male sexual dysfunction has been made possible by innovative laboratory and clinical research in the mechanism, neurophysiology, and pharmacology of penile erection. Erectile…

A new survey has found that a significant number of young men have used erectile dysfunction, (ED), medications such as Viagra often in conjunction with other recreational drugs, and…

According to a Sydney scientist a hormone-based contraceptive for men has the ability to reverse its effect just four months after stopping its use.

Dr. Peter Liu of the Los Angeles Biomedical…

A new study indicates a high prevalence of erectile dysfunction (ED) and evidence of recreational use of erectile dysfunction medications (EDM) among adolescents and young…

About three-fourths of middle-aged and older women are sexually active and two-thirds of them are at least somewhat satisfied, according to a new study. Black women are more satisfied with…

Spermatogenesis is a complex process by which primitive, totipotent stem cells divide to either renew themselves or produce daughter cells that become spermatozoa. These processes occur within the seminiferous tubules of the…

Introduction
Infertility is defined as the inability to conceive after 1 year of unprotected sexual intercourse. Infertility affects approximately 15% of couples. Roughly 40% of cases involve a male contribution or factor, 40% involve…

If neither surgery nor medical therapy is appropriate for male infertility treatment, assisted reproductive techniques can be used to achieve a pregnancy.

In at least 25% of infertile men, no identifiable cause can be attributed to the problem. Because the pathophysiology is ill-defined, this is termed idiopathic infertility. There is a second group…

Specific Therapy

Specific therapy seeks to reverse known pathophysiologic effects to improve fertility. For the most part, they are cost-effective treatments.

A. Pyospermia
The presence of elevated numbers of leukocytes in…

An undescended testis occurs in 0.8% of male infants at 1 year of age. Spontaneous descent into the scrotum is unlikely after 1 year. Although the most important reason for…

A complete failure of emission and ejaculation occurs most commonly from spinal cord injury (10,000 cases/ year in the United States) and as a result of deep pelvic or retroperitoneal…

For over 20 years, transurethral resection of the ejaculatory ducts (TURED) has been used to relieve pain due to ejaculatory duct obstruction. More recently, it has become obvious…