ESSM Newsletter # 33

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3 ESSMToday
Prof. Meuleman is an internationally known fig-
ure and world-class leader in the field of Sexual
Medicine. He is an outstanding contributor to the
field of Sexual Medicine as a researcher, patient
advocate, educator, innovator and author. Having
you here it is a real pleasure and honor not only
for me but also for all ESSM Members.
JIMS: Prof. MEULEMAN could you make us
a brief journey throughout your professional
background?
Starting in 1986 as a resident in training for
urology my interest in male erectile dysfunction
was triggered by my trainer Dr. Karl Delaere, who
introduced a program of intracavernous self-
injection with papaverin into the urology clinic
in Heerlen, The Netherlands. In 1989, I moved
to the Radboud University Medical Center in Ni-
jmegen for my last year of training. There, Prof
Frans Debruyne gave me the opportunity to ex-
tent my clinical research into the pathofysiology
and diagnosis of erectile dysfunction, resulting in
the publication of my thesis “Recent progress in
the diagnosis of erectile dysfunction”, in which
I describe the methodology of penile duplex ul-
trasonography and cavernosometry in 1991.
What followed was the era of international ED-
research, fueled by the interest of pharmaceuti-
cal companies to develop an oral erectogenic
agent. This also led to the maturation of the In-
ternational Society of Impotence research and
corpus cavernosum revascularization founded in
1978 by the late Adrian Zorgniotti in New York.
The ED-hype culminated in 1998 with the launch
of Viagra, precisely at the time that I was host-
Interview with Prof. Meuleman
by Juan I. Martínez-Salamanca
ing the world meeting on impotence research
in Amsterdam. The meeting was attended by
more then 1800 participants. Under the guid-
ance of the late Mr Robert von Hinke Kessler
and with the aid of the financial benefits of the
meeting, the society was transformed into a pro-
fessional organization and was renamed in the
International Society of Sexual Medicine (ISSM).
I had the honor to serve ISSM as a treasurer for
6 years until 2006.
In the beginning of 2000 I realized that there
is more than male ED in the world of sexual
medicine and expanded my clinical and scien-
tific interest into the field of andrology including
reproductive medicine and men’s health.
Since 2005 I’m appointed at the VU University
Medical Center in Amsterdam as a professor of
andrological urology and program director of the
urology residency training program.
JIMS: During you dilated career, which has
led to the passage from “Andrology” to
“Sexual Medicine”, and what do you prefer
“Sexual Medicine” or “Men´s Health”?
As a young urologist I focused my research
completely on erectile dysfunction. Driven by
clinical practice – patients who consulted me –
I expanded my scientific interest and expertise
into the broader field of male reproduction, sex-
ual medicine and men’s health. In other words:
Andrology. Thus, sexual and reproductive health
meet each other in men’s health.
JIMS: What do you think the role of the urolo-
gist should be in the management of male in-
fertility? And what are our major challenges?
In The Netherlands, reproductive medicine is
organized in a multidisciplinary team consist-
ing of a gynecologist, urologist, embryologist,
endocrinologist, geneticist and ethesist. In other
words the urologist needs to be a teamplayer.
The urologist has a specific role in case of ana-
tomical or functional disorders of the male genital
tract and azoospermia.
As a major challenge I see the preservation and
transplantation of spermatogonial stemcells in
prepubertal boys with an oncological problem
who need chemotherapy.
JIMS: Prof. Meuleman, PDE-5 Inhibitors (Tada-
lafil) have been recently approved in U.S. for
patients with ED & LUTS, which do you con-
sider being the ultimate role of this drug in all
treatment options of this group of patients?
ED and LUTS are both symptoms of the uro-
genital aging process. For the short term PDE-5
inhibitors, especially the long-acting ones such
as tadalafil may be used for symptom relief.
Thus, PDE-5 inhibition may postpone further
deterioration of urogenital function, it can not
reverse the process of urogenitale aging. In
that respect I would put my money on life-style
modification programs especially in men – and
this is the majority – with co-morbidity such as
the metabolic syndrome.
JIMS: In the field of Peyronie’s Disease,
what do you think are the main challenges
to achieve?
Peyronie’s disease is a condition of the tunica
albuginea that is linked to aging and genetic fac-
tors. In most men it is associated not only with
localized plaques that cause deformity but also
with generalized fibrosis of the tunica leading
dr. Juan i. Martínez-Salamanca
Hospital Universitario Puerta de
Hierro-Majadahonda Universidad
Autónoma de Madrid
Department of Urology
EJh Meuleman Md, Phd
Professor of Andrological Urology
Suite 4F04
VU University Medical Center
De Boelelaan 1117
1081HV Amsterdam
The Netherlands