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Mark S. Litwin, MD, MPH

JAMA. 1999;281:495-496.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

For the specialty of urology, 1998 was the year of the penis. Last spring the field of urology was taken by storm with the Food and Drug Administration's (FDA's) approval of oral sildenafil citrate (Viagra) for the treatment of male erectile dysfunction. The identification of nitric oxide as a penile neurotransmitter¹ paved the way for sildenafil, a selective cyclic guanosine monophosphate (GMP)–specific phosphodiesterase inhibitor that increases cyclic GMP levels, thus enhancing the effect of nitric oxide in response to sexual stimulation. In the penis, the effect of sildenafil is to increase cavernosal smooth muscle dilation, a requisite component of erection. Coincidentally, 3 US researchers—Louis J. Ignarro, Robert F. Furchgott, and Ferid Murad—were awarded the 1998 Nobel Prize for elucidating the physiology of nitric oxide, the first gas discovered to act as a human signal molecule. In their sentinel article, Goldstein et al² described the results . . . [Full Text of this Article]

Author Affiliation: Department of Urology, University of California, Los Angeles.

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