Diagnosis and Treatment of Erectile Disturbances: A Guide by R. Taylor Segraves

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By R. Taylor Segraves

This booklet is the results of a casual organization among the editors which extends again to 1974. in the beginning, it was once a tenuous alliance among physicians in particularly diverse clinical subspecialties-urology and psychiatry. because the alliance was once solid, subspecialty rivalries and distrust have been changed by means of a typical scientific curiosity within the prognosis and therapy of erectile difficulties. We fast turned conscious of the excessive incidence of such problems, how poorly ready we have been to make actual and re­ sponsible prognosis and cures, and the way advanced an etiol­ ogical analysis may perhaps end up to be. numerous organic and mental impacts undergo on sexual functionality, and in lots of medical contexts, analysis and remedy making plans consists of attention of advanced interactive var­ iables. the necessity for an multiplied multidisciplinary crew turned visible. The considered necessary wisdom base prolonged throughout too many subspecialty obstacles, and the required info used to be no longer on hand in a conve­ nient resource. As we all started gathering the data base, we turned conscious that this data should be of price to different physicians. The authors benefit from the luxurious of an educational environment within which distinctive services could be conveniently assembled. Such assets are frequently unavailable to the health professional in perform. therefore, it really is our desire that this article can function a multi forte group for the health practitioner in solo perform. R. TAYLOR SEGRAVES New Orleans, Louisiana HARRY W.

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Ls7-1s9 There has also been one case report of nocturnal enuresis caused by thioridazine. l60 Chlorpromazine. There have been two case reports l61 ,16Z of chlorpromazine causing ejaculatory inhibition. A controlled study163 of the erectile response to erotic stimuli found no effect of chlorpromazine administration on erections. However, this study utilized only 125 mg chlorpromazine, a dose much smaller than usually employed in clinical practice. 164-169. Chlorprofhixine. Ditman170 reported one case of absence ejaculation in the presence of normal erectile capacity in a patient on 300 mg of chlorprothixine.

38 With the exception of spironolactone, diuretics alone apparently rarely cause sexual disturbances,39-43 although there are case reports of impotence and decreased libido with these agents. Hogan and co-workers 44 at the Naval Medical Center in Oakland, CaliTable 1. 8 0 + + + + 0 20-35% 15% 20-67% 0 0 + + 0 + 35-92% 15% 41-92% • 0, No reported effect; +, reported effect. In clinical series of more than 20 patients, actual percentages with the side effect(s) are used, Where several reports are available for the same drug, figures from the largest series are utilized or the data are pooled, ERECTILE DYSFUNCTION AND PHARMACOLOGICAL AGENTS 29 fornia, gave an impotence questionnaire to 861 male patients receiving antihypertensive medication.

Hollifield and coworkers 103 at Vanderbilt University reported that sexual problems were nonexistent on propranolol doses of 160 mg/day. However, seven male patients received doses ranging from 480 to 960 mg/day, and two complained of impotence and three of decreased libido. This suggests that sexual side effects with propranolol may be dose-dependent. Other investigators have also reported dose-dependent sexual side effects. 99 Other beta blockers have received less study. Gavras and associates 95 reported that impotence was not associated with oxprenolot and Bathen97 reported that impotence while on propranolol disappeared when a patient was switched to atenolol.

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