Abstract: . . .  2002;14 Suppl 1:S1721. 17. Yaman O, Yilmaz E, Bozlu M, et al. Alterations of intracorporeal structures in patients with erectile dysfunction. Urol Int 2003;71:87 90. 18. Richardson D, Vinik A. Etiology and treatment of erectile failure in diabetes mellitus. Curr Diab Rep 2002;2:5019. 186 Cheitlin JACC Vol. 43, No. 2, 2004 Editorial Comment January 21, 2004:1856  . . .
. . .  men treated for prostate cancer. J Urol 2001;165:4305. 14. Archer SL. Potassium channels and erectile dysfunction. Vascul Pharmacol 2002;38:6171. 15. Wespes E, Sattar AA, Golzarian J, et al. Corporeal veno-occlusive dysfunction: predominantly intracavernous muscular pathology. J Urol 1997;157:167880. 16. Wespes E. Smooth muscle pathology and erectile dysfunction. Int J Impot Res 2002;14 Suppl 1:S1721. 17. Yaman O, Yilmaz E, Bozlu . . .
. . .  al. Endothelium-dependent dilation in the systemic arteries of asymptomatic subjects relates to coronary risk factors and their interaction. J Am Coll Cardiol 1994; 24:146874. 13. Siegel T, Moul JW, Spevak M, et al. The development of erectile dysfunction in men treated for prostate cancer. J Urol 2001;165:4305. 14. Archer SL. Potassium channels and erectile dysfunction. Vascul Pharmacol 2002;38:6171. 15. Wespes E, Sattar AA, Golzarian . . .
. . .  were ruled out: lipoprotein (a), elevated homocys- teine, glucose intolerance, and insulin resistance were not examined. It is possible that the patients had risk factors predisposing them to atherosclerosis. Still, the earliest sign before any demonstrable vascular disease was the develop- ment of ED. There are etiologies of ED other than endothelial dys- function, such as damage to the penile autonomic innerva- tion as seen . . .
. . .  atherosclerosis. An interesting finding in this study is that both endothelial-dependent and endothelial-independent vaso- dilatation were abnormal in patients with ED. The impli- cation is that, in these ED patients without signs of early atherosclerosis, the problem is not only endothelial dysfunc- tion but also a problem with smooth muscle relaxation itself. A possible explanation for this finding is that with long- standing penile vascular . . .
. . .  EDITORIAL COMMENT Erectile Dysfunction: The Earliest Sign of Generalized Vascular Disease ?* Melvin D. Cheitlin, MD, FACC San Francisco, California Until sildenafil, the first effective oral agent for erectile dysfunction (ED), was introduced, only genitourinary . . .
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