By Mike Robertson
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Extra resources for Bulletproof knees
J Urol 1987; 137: 163–167. 25. Lue TF, Zeineh SJ, Schmidt RA, Tanagho EA. Neuroanatomy of penile erection: its relevance to iatrogenic impotence. J Urol 1984; 131: 273–280. 26. Walsh PC, Donker PJ. Impotence following radical prostatectomy: insight into etiology and prevention. J Urol 1982; 128: 492–497. 38 Rehman and Melman 27. Lepor H, Gregerman M, Crosby R, Mostoﬁ FK, Walsh PC. Precise localization of the autonomic nerves from the pelvic plexus to the corpora cavernosa: a detailed anatomical study of the adult male pelvis.
Up to 90% of it is metabolized in one passage through the lungs (nearly completely within two passes) and it is excreted through kidneys and liver. It has recently been postulated that an active metabolite of PGE1, now termed PGEO, has a longer half-life (1 h), is responsible for the majority of the clinical, as well as systemic, side effects (PGE1) when administered intracavernosal (139,140). , tactile stimuli → (spinothalamic tract) → thalamic VLN+ ILN) → (Somatic sensory) → Postcentral gyrus Pelvic and Cavernous N.
3–10-fold increases in intracellular cAMP levels have been documented in cultured human corporal smooth-muscle cells in response to activation of prostaglandin E1 (50). Cyclic nucleotide phosphodiesterase (PDEase) cleavage cAMP to AMP. Smooth-muscle relaxants, like papaverine, exert its effect through phosphodiesterase inhibition inducing the accumulation of either cAMP and/or cGMP depending on its selectivity (55). NO acts via guanylase cyclase, which produces cGMP. This pathway is activated by nitric oxide.