R. S. Kirby, Culley C. Carson, and G. D. Webster; eds. 262 pages. Stoneham, Massachusetts: Butterworth-Heinemann; 1991. $115.00.

Nearly ten million men in the United States alone suffer from some degree of erectile dysfunction. The prevalence in diabetic men ranges from 35% to 75%. Clearly, this topic is important. In addition, our improved knowledge of the mechanisms of erection has allowed us to understand better the causes of failure. This in turn reflects the increased focus on basic physiology that urology as a whole is developing in its approach to understanding disease processes.

Numerous texts, monographs, and journal articles on erectile dysfunction are available. However, none deals with the subject in both the depth and breadth of this book. Make no mistake, this is not casual bedtime reading; it is an encyclopedia of current thought that requires constant and careful attention.

The topics progress logically, starting with a discussion of the neurologic, circulatory, pharmacologic, and endocrinologic factors relating to normal erection. Methods of patient evaluation, both clinical and investigatory, are presented in detail. Medical, surgical, and psychological modes of therapy are discussed, as are more specific topics such as the prevention of iatrogenic problems.

A minor drawback is that some of the material has been published previously. For example, the description of circulatory physiology is nearly identical to one by the same authors in Problems in Urology (1991). Other authors, however, have updated their previous work on the same subject (such as a discussion on external appliances). Most of the information, however, appears new and its value far outweighs the occasional duplication. In his foreword, Irwin Goldstein accurately states that "The book will not only be of use to practicing urologists, but also to those who wish to achieve an overview of the current and evolving concepts of penile erection, impotence diagnosis and management".