Hemodynamic Aspects Penile erection and detumescence are primari ly controlled by hemodynamic events. Increased arterial inflow appears to be of primary importance; the contribution of increased venous resistance to the production of penile erection remains controversial. Furthermore, our understanding of precise anatomic details ( including “shunts”) and the neural control of vascular events i...

Penile erections are usually classified as arising from "reflexogenic" or "psychogenic" causes. In practice this dichotomy has translated, somewhat circularly, to a distinction between spinal vs. supraspinal mediation, pelvic vs. hypogastric neural mediation, and perineal somesthetic stimulation vs. stimulation of receptors innervated by the cranial nerves. Evidence for differential regulation ...

AIM To investigate how erectile dysfunction (ED) medications affect morning erection in patients with ED and how they respond to the return of morning erection. METHODS This study was conducted in 120 patients who experienced successful intercourse with either tadalafil or sildenafil. Using a random face-to-face interview and a questionnaire (about the quality and number of days getting morni...

OBJECTIVE Penile erection following epidural anesthesia is an infrequent occurrence of unclear etioogy. It is very troublesome to perform the procedure during penile erection and attempting it leads to various complications. Three such cases are reported herein. The literature on the pathophysiology and management of intraoperative penile erection is discussed. METHODS Eighteen hundred patien...

In contrast to the spinal control of erection, relatively little is known about the brain control. In the present review, we have outlined the role of brain structures involved in penile erection and provided a synopsis on the brain circuit of erection. Findings from both animal and human studies are discussed. Evidence suggests that the most important structures are the frontal lobe, cingulate...

Nitric oxide (NO) generated by neuronal NO synthase (nNOS) initiates penile erection, but has not been thought to participate in the sustained erection required for normal sexual performance. We now show that cAMP-dependent phosphorylation of nNOS mediates erectile physiology, including sustained erection. nNOS is phosphorylated by cAMP-dependent protein kinase (PKA) at serine(S)1412. Electrica...

OBJECTIVE The ENDURANCE study evaluated the efficacy of vardenafil, a phosphodiesterase type 5 (PDE5) inhibitor, in men with erectile dysfunction (ED), by measuring the duration of erection leading to successful intercourse using a stopwatch as the assessment instrument. METHODS This was a randomised, multicentre, double-blind, placebo-controlled, crossover study consisting of a 4-week treatm...

background: kallmann syndrome (kal s) is an isolated form of hypogonadotrophic hypogonadism in combination with a defect in smell sensation. depending on the genetic form of the disease, a number of non-reproductive, non-olfactory abnormalities may also be existent. in the present report, we describe a male with kal s associated with hearing loss, and the successful treatment of his sexual and ...

The cholinergic neurons in the laterodorsal tegmental nucleus (LDT) play a crucial role in the regulation of rapid eye movement (REM) sleep. Because penile erection occurs during REM sleep, the involvement of the LDT in penile erection was examined in unanesthetized head-restrained rats. To detect penile erection, corpus spongiosum of the penis (CSP) pressure was measured through a telemetric d...

Purpose To evaluate in Japanese patients their sexual function after robot-assisted radical prostatectomy (RARP) and to investigate the influence of the multinerve-sparing (NS) grade on their sexual function. Methods In total, 225 patients were reviewed with localized prostate cancer who underwent RARP at the authors' institution. They underwent RARP >3 months ago, without pre- and posthormon...