Twenty years of IJIR

Twenty years ago, the International Journal of Impotence Research (IJIR) launched as the first journal for sexual dysfunction. As IJIR's fifth Editor-in-Chief, it has been extremely rewarding to see the field of sexual medicine grow over this time as well. As the field has grown, so has the journal—since the journal's inception, IJIR's scope has developed and changed to include female sexual dysfunction, cardiology, endocrinology, neurology and psychology.

A very basic goal of the journal from the very beginning was to publish both basic science and clinical studies. To this end, we have fulfilled that goal and published several noteworthy important papers along the way. We published the classic epidemiologic study by Braun et al.¹ evaluating nearly 5000 men in Germany (the Cologne Male Survey). The data revealed striking results. The authors concluded that regular sexual activity is a normal finding in advanced age. Erectile dysfunction (ED) is a frequent disorder, contributing to dissatisfaction with sexual life in a considerable proportion of men and adequate diagnostic workup is essential to offer patients individually adapted treatment. These data shed light on a variety of sexual issues heretofore underappreciated and underreported.

The paper by Park et al.² investigated the physiology and pathophysiology of female sexual dysfunction. The authors developed an animal model of vaginal engorgement insufficiency and clitoral erectile insufficiency and found that vaginal engorgement and clitoral erection depended on the increased blood inflow. In addition, atherosclerosis was associated with vaginal engorgement insufficiency and clitoral erectile insufficiency.

Eleven years ago, the journal published one of the first studies to show a correlation between cardiac function and ED by Greenstein et al.³ The authors noted a statistically significant correlation between erectile function and the number of coronary vessels involved. Patients with one-vessel disease had more (P<0.04) and firmer erections (P<0.001) with fewer difficulties in achieving an erection (P<0.007) than men with two- or three-vessel disease.

IJIR also published the first IC351 (tadalafil) paper,⁴ and more recently a pivotal study of daily tadalafil dosing.⁵ Several of the earliest sildenafil^{6, 7} and vardenafil papers⁸ also have published in the Journal. And, the journal published the first information on the validated psychometric instrument, Structured Interview on Erectile Dysfunction,⁹ along with the IIEF-5¹⁰ and the validation of the Self-esteem and Relationship questionnaire.¹¹ IJIR has published the seminal work on PT-141 and phentolamine^{12, 13, 14} and was at the forefront of publishing data on penile injection therapy¹⁵ and on penile rehabilitation after a radical prostatectomy.^{16, 17}

Recently, IJIR published an important paper by Sesti et al.¹⁸ continuing the interest of the cardiovascular link to ED. The aim of the study was to determine, in an animal model, the effects of tadalafil on myocardial infarct size, hemodynamics and regional myocardial blood flow after myocardial ischemia and reperfusion. Another recent groundbreaking paper of significance is by Song et al.¹⁹ on the first human bone marrow-derived mesenchymal stem cells for possible cell therapy in patients suffering from ED. Wayman et al.²⁰ also published important data on PDE11 knockout mice and sperm physiology.

Other recent articles include Eaton et al.²¹ who provide significant epidemiologic data using a subcohort of almost 1000 men between the ages of 46–81 years. The authors concluded that the selected biomarkers for endothelial function, thrombosis and dyslipidemia, but not inflammation, are associated with the degree of ED in this cross-sectional analysis. And, Svartberg et al.²² provide important data on testosterone replacement in older men and concluded that testosterone treatment improved the body composition, but it did not reverse an unfavorable metabolic profile.

Following in the same tradition of excellence and in celebration of IJIR's 20th anniversary, we have created this special commemorative issue that presents five review articles from the notables in the field. We are honored and privileged to have my dear friend, Jacob Rajfer²³ who provides an indepth report of his discovery of NO, which is undoubtedly the most important scientific discovery in the field of male sexual medicine in the past 20 years. Dr Karl Montague, a pioneer in the field of penile prosthetics, and his colleague²⁴ provide a nice presentation of the past, present and future of penile prosthesis implantation. Tom Lue, an esteemed colleague and mentor, who has been involved in sexual medicine for over two decades, and his colleagues²⁵ have written a contemporary overview of Peyronie's disease. Robert Kloner²⁶, an outstanding research scientist, provides an authoritative review of the potential for ED to predict coronary disease. Finally, Rosemary Basson,²⁷ a luminary in female sexual dysfunction, presents an overview of the current uncertainties and future directions field's.

I remain absolutely confident that the next 20 years will continue to bring about important advances that not only elucidate fundamental mechanisms but also serve as the basis for the improved diagnosis and treatment. The most critical future developments in this field will be published in the pages of IJIR. And for that, I thank my distinguished and eminent editorial board/reviewers and the outstanding researchers who submit their papers to the journal—my reward is the opportunity to review and publish these contributions.

Happy 20th, IJIR.