Topic: Erectile Dysfunction

Testosterone Replacement and Focal Therapy

Mohit Khera, MD, MBA, MPH, reviews the literature surrounding the safety of testosterone replacement therapy (TRT) following prostate cancer treatment, including after brachytherapy, EBRT, and radical prostatectomy (RP). He also discusses the concept of bipolar androgen therapy (BAT) and the importance of TRT for erectile preservation post-RP.

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Clinical Care Pathway for Anejaculation

John Mulhall, MD, the chair of the committee for the American Urological Association (AUA) testosterone guidelines, summarizes indications regarding anejaculation. He explains the anatomical and physiological differences of retrograde ejaculation and failure of emission, and possible etiologies for these symptoms. Furthermore, he reviews the recommendations for diagnosis, management, and use of electroejaculation for semen retrieval.

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Men’s Health from the Heart

Tobias S. Kohler, MD, MPH, demonstrates the correlation between cardiac pathology and erectile function, other sexual function, testosterone levels, and lower urinary tract symptoms (LUTS). To illustrate this, he describes the methodology and results of his Cardio-Urologic Pathology/Prevalence Interplay Determination (CUPID) study. He also discusses ED risk factors, sex hormone binding globulin (SHBD), and the connection between testosterone levels and benign prostatic hyperplasia (BPH).

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Origins and Treatment of ED through Vascular Mechanisms

Tobias S. Kohler MD, MPH, discusses the corollary relationship between vascular disease and its treatment and erectile dysfunction (ED) and the literature supporting this relationship. He then reviews ED management approaches through a cardiovascular standpoint, including counseling patients on lifestyle modification and pudendal artery stenting.

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