Relevant pharmacology

Pharmacological induction of erection in impotent men can be brought about by intracavernosal injection of the potent smooth muscle-relaxing drug papaverine, or by mixtures of papaverine and the a-receptor blocker phentolamine, or by injection of prostaglandin El, which is also a powerful relaxant of the erectile smooth muscle. The use of phenoxybenzamine (another a-receptor blocker) has been largely discontinued, since although it can produce long-lasting erections, these are often painful and damaging. More recently oral ingestion of a specific phosphodiesterase-5 inhibitor (Viagra) has gained popularity by enhancing erections to psychogenic stimuli. This drug works by reducing breakdown of cGmP, the second messenger mediating the relaxant effects of NO.

Bladder outflow obstruction due to benign prostatic hyperplasia maybe treated with a-receptor blocking agents such as finasteride, since it is thought that activity in the smooth muscle cells in the stroma of the gland may contribute to the obstruction.

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