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Sample records for acitretin-associated erectile dysfunction

  1. Acitretin-associated erectile dysfunction: a case report

    Rossi, Marco; Pellegrino, Michele

    2009-01-01

    Introduction Two cases of impotence following a treatment with etretinate have been reported in the literature. Acitretin is the principal active metabolite of etretinate. We report a case of erectile dysfunction associated with the use of acitretin. Case presentation A 39-year-old Caucasian man referred his incapacity to reach and maintain a penile erection during a course of acitretin for the treatment of a severe form of psoriasis. Physical examination, laboratory findings and psychologica...

  2. Erectile Dysfunction (ED)

    ... age. Is erectile dysfunction just a part of old age? Erectile dysfunction doesn't have to be a ... episode of impotence Feeling stressed, including stress from work or family situations Being troubled by problems in ...

  3. Erectile dysfunction: management update

    Fazio, Luke; Brock, Gerald

    2004-01-01

    DRAMATIC ADVANCES IN THE MANAGEMENT of erectile dysfunction have occurred over the past decade. Oral therapy with vasoactive agents has emerged as first-line treatment and has transformed both the manner in which the public views erectile dysfunction and the way health care providers deliver care. Whereas an extensive investigation was previously common in the management of erectile dysfunction, recent treatment guidelines promote a more minimalist, goal-oriented approach. In this article, we...

  4. [Neurogenic erectile dysfunction].

    Ramos, Antonio Sánchez; Durán, Juan Antonio Godino; Oliviero, Antonio

    2010-10-01

    Neurogenic erectile dysfunction is a consequence of alterations in neural pathways, autonomic, somatic, the combination of both or brain components that induce erection. This review aims to explain the physiopathological mechanisms of the most frequent neurological alterations causing erectile dysfunction and sexual disorders. PMID:20978292

  5. The erectile dysfunction

    Johan Eduardo Ardila Jaimes

    2002-12-01

    Full Text Available The erectile dysfunction (ED is a high prevalence disorderassociated to psychological and mainly organic factors thatcan affect at men of any age. The increase of the knowledgeof the physiologic mechanisms of the masculine erection andthe development of new agents that improve the erectilefunction have generated great interest among the physicians,the men and their couples because these advances areextending the available options in the management of thisdisorder. In this article we revise the etiologic andphysiopathologic aspects, as well as the clinical focus andthe current management of the ED.

  6. [Erectile and Ejaculatory Dysfunction].

    Gross, Oliver; Sulser, Tullio; Eberli, Daniel

    2015-11-25

    The inability to achieve an erection of the penis sufficient for sexual activity is called erectile dysfunction (ED). In most cases, the diagnosis can be made by medical history. The prevalence of ED in men at the age of 65 has been reported to be up to 50%. Premature ejaculation has a prevalence, up to 20% and is the most frequent ejaculatory dysfunction. The etiology of ED can involve psychological, vascular, neurogenic, hormonal or urogenital pathologies. The main pathophysiological mechanisms of ED are vascular disorders such as diabetes mellitus and atherosclerosis. Because of the common pathophysiology, patients diagnosed with ED should have a diagnostic work-up for systemic vascular pathologies to prevent concomitant cardiac events. Treatment options include invasive and non-invasive procedures. PMID:26602851

  7. Diagnostic evaluation of erectile dysfunction.

    Miller, T A

    2000-01-01

    Erectile dysfunction, the persistent inability to attain or maintain penile erection sufficient for sexual intercourse, affects millions of men to various degrees. The majority of cases have an organic etiology, most commonly vascular disease that decreases blood flow into the penis. Regardless of the primary cause, erectile dysfunction can have a negative impact on self-esteem, quality of life and interpersonal relationships. The initial step in evaluation is a detailed medical and social history, including a review of medication use. Discussion with the patient's sexual partner may clarify exacerbating issues. The physical examination focuses on the cardiovascular, neurologic and urogenital systems. Laboratory tests are useful to screen for common etiologic factors and, when indicated, to identify hypogonadal syndromes. Appropriate evaluation of erectile dysfunction leads to accurate advice, management and referral of patients with erectile dysfunction. PMID:10643952

  8. Erectile dysfunction in patients with cardiovascular disease

    Ophuis, A.J.M. Oude; Nijeholt, A.A.B. Lycklama à

    2006-01-01

    Erectile dysfunction is a highly prevalent disease, especially in cardiovascular-compromised men. Many of the well-established risk factors for cardiovascular disease are also risk factors for erectile dysfunction. A correlation between erectile dysfunction and endothelial dysfunction is well established. It is postulated that erectile dysfunction with an arteriovascular aetiology can predate and be an indicator of potential coronary artery disease. In this paper we will attempt to increase a...

  9. Erectile dysfunction following intravitreal bevacizumab

    Yohendran Jayshan; Chauhan Devinder

    2010-01-01

    Despite initial concerns regarding systemic complications, the use of intravitreal antivascular endothelial growth factor (anti-VEGF) agents for ocular disease is rapidly expanding worldwide, in terms of both the number of patients injected and its indications. To our knowledge, there are no cases in the literature reporting erectile dysfunction following the use of intravitreal bevacizumab. We postulate an organic mechanism for impaired erectile function due to systemically absorbed intravit...

  10. Management of erectile dysfunction.

    Heidelbaugh, Joel J

    2010-02-01

    Erectile dysfunction (ED) is the most common sexual problem in men. The incidence increases with age and affects up to one third of men throughout their lives. It causes a substantial negative impact on intimate relationships, quality of life, and self-esteem. History and physical examination are sufficient to make a diagnosis of ED in most cases, because there is no preferred, first-line diagnostic test. Initial diagnostic workup should usually be limited to a fasting serum glucose level and lipid panel, thyroid-stimulating hormone test, and morning total testosterone level. First-line therapy for ED consists of lifestyle changes, modifying drug therapy that may cause ED, and pharmacotherapy with phosphodiesterase type 5 inhibitors. Obesity, sedentary lifestyle, and smoking greatly increase the risk of ED. Phosphodiesterase type 5 inhibitors are the most effective oral drugs for treatment of ED, including ED associated with diabetes mellitus, spinal cord injury, and antidepressants. Intraurethral and intracavernosal alprostadil, vacuum pump devices, and surgically implanted penile prostheses are alternative therapeutic options when phosphodiesterase type 5 inhibitors fail. Testosterone supplementation in men with hypogonadism improves ED and libido, but requires interval monitoring of hemoglobin, serum transaminase, and prostate-specific antigen levels because of an increased risk of prostate adenocarcinoma. Cognitive behavior therapy and therapy aimed at improving relationships may help to improve ED. Screening for cardiovascular risk factors should be considered in men with ED, because symptoms of ED present on average three years earlier than symptoms of coronary artery disease. Men with ED are at increased risk of coronary, cerebrovascular, and peripheral vascular diseases. PMID:20112889

  11. Lack of awareness of erectile dysfunction in many men with risk factors for erectile dysfunction

    Magee Michelle; Kaufman Joel; Shabsigh Ridwan; Creanga Dana; Russell David; Budhwani Meeta

    2010-01-01

    Abstract Background Men with erectile dysfunction often have concurrent medical conditions. Conversely, men with these conditions may also have underlying erectile dysfunction. The prevalence of unrecognized erectile dysfunction in men with comorbidities commonly associated with erectile dysfunction was determined in men invited to participate in a double-blind, randomized, placebo-controlled trial of sildenafil citrate. Methods Men ≥30 years old presenting with ≥1 erectile dysfunction risk f...

  12. What I Need to Know about Erectile Dysfunction

    ... URL Español What I need to know about Erectile Dysfunction Page Content On this page: What is erectile ... Nutrition Points to Remember Clinical Trials What is erectile dysfunction (ED)? Erectile dysfunction * is when you cannot get ...

  13. [Oral therapy of erectile dysfunction].

    Trummer, H

    2000-01-01

    Erectile disfunction (E. D.) is more common in older men but may affect younger men too. Diabetes mellitus, coronary heart disease and hypertension are often associated with E. D. The majority of the patients are treated medically for erectile dysfunction and, recently, oral therapy has become most important since Viagra has been approved. New phosphodiesterase blockers are in preclinical evaluation since then. Phentolamine and apomorphine will become available soon for the treatment of E. D. It is important to know about the etiology of E. D. as well as the mechanisms by which drugs may improve erection in order to decide which drug is appropriate for a particular patient. PMID:10746289

  14. Erectile dysfunction in haemodialysis patients

    There is a very high prevalence of Erectile Dysfunction (ED) in dialysis patients. There is no as such available data on ED and factors affecting it in our patients. Analytical, cross-sectional, hospital based study conducted from January to March 2008, Haemodialysis unit of Shalimar and Mayo Hospital, Lahore. All male patients of end stage renal disease (ESRD) on maintenance haemodialysis therapy, whose spouses are alive and able to perform intercourse, were included in the study. Patient with cognitive and communication deficits were excluded from study. International index of erectile function-5 (IIEF-5), adopted in Urdu was used for the determination of prevalence of erectile function. Categorization of erectile dysfunction was done as mild, moderate and severe. Demographic data were collected and certain laboratory parameters (haemoglobin, haematocrit, urea, HBsAg and Anti HCV) were sent. Total numbers of patient were fifty. Major cause of ESRD was diabetes mellitus 28 (56%). Most of the patients 33 (66%) have passed 10th grade or they were under 10th grade. Prevalence of ED was 86% with mean IIEF-5 score of 10.36+-7.13. Majority of patients 33 (64.7%) were suffering from severe degree of ED. Factors responsible for ED are diabetes mellitus, age more than 50 year, high pre dialysis urea and Anti HCV positive patients. In this study, smoking, duration of dialysis and monthly spending is not related with ED. Majority of the patients suffering from ESRD, on maintenance haemodialysis are having ED. None of the patients suffering from ED were taking any treatment for it. Haemodialysis does not improve sexual dysfunction. Major factors responsible for ED are diabetes mellitus, age more than 50 years, high pre dialysis urea and Anti HCV positive patients. (author)

  15. Imaging for evaluation of erectile dysfunction

    Penile erection is a complex phenomenon that includes coordinated intraaction of the nervous, arterial, venous, and sinusoidal systems. A defect in any of these systems may result in erectile dysfunction. Erectile dysfunction is defined as the consistent inability to generate or maintain an erection of sufficient rigidity for sexual intercourse. Although the introduction of sildenafil citrate made the information from imaging studies less critical in the management of the patients with erectile dysfunction, still the imaging studies such as Doppler US, penile arteriography, and cavemosonetry/cavemosography remain the major modalities in the evaluation of erectile dysfunction.

  16. Imaging for evaluation of erectile dysfunction

    Kim, Seung Hyup [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2001-03-15

    Penile erection is a complex phenomenon that includes coordinated intraaction of the nervous, arterial, venous, and sinusoidal systems. A defect in any of these systems may result in erectile dysfunction. Erectile dysfunction is defined as the consistent inability to generate or maintain an erection of sufficient rigidity for sexual intercourse. Although the introduction of sildenafil citrate made the information from imaging studies less critical in the management of the patients with erectile dysfunction, still the imaging studies such as Doppler US, penile arteriography, and cavemosonetry/cavemosography remain the major modalities in the evaluation of erectile dysfunction.

  17. Lack of awareness of erectile dysfunction in many men with risk factors for erectile dysfunction

    Magee Michelle

    2010-11-01

    Full Text Available Abstract Background Men with erectile dysfunction often have concurrent medical conditions. Conversely, men with these conditions may also have underlying erectile dysfunction. The prevalence of unrecognized erectile dysfunction in men with comorbidities commonly associated with erectile dysfunction was determined in men invited to participate in a double-blind, randomized, placebo-controlled trial of sildenafil citrate. Methods Men ≥30 years old presenting with ≥1 erectile dysfunction risk factor (controlled hypertension, hypercholesterolemia, smoking, metabolic syndrome, stable coronary artery disease, diabetes, depression, lower urinary tract symptoms, obesity [body mass index ≥30 kg/m2] or waist circumference ≥40 inches, and not previously diagnosed with erectile dysfunction were evaluated. The screening question, "Do you have erectile dysfunction?," with responses of "no," "yes," and "unsure," and the Erectile Function domain of the International Index of Erectile Function (IIEF-EF were administered. Results Of 1084 men screened, 1053 answered the screening question and also had IIEF-EF scores. IIEF-EF scores indicating erectile dysfunction occurred in 71% (744/1053, of whom 54% (399/744 had moderate or severe erectile dysfunction. Of 139 answering "yes," 526 answering "unsure," and 388 answering "no," 96%, 90%, and 36%, respectively, had some degree of erectile dysfunction. The mean±SD (range number of risk factors was 2.9 ± 1.7 (3-8 in the "yes" group, 3.2 ± 1.7 (3-9 in the "unsure" group, and 2.6 ± 1.5 (2-8 in the "no" group. Conclusion Although awareness of having erectile dysfunction was low, most men with risk factors had IIEF-EF scores indicating erectile dysfunction. Erectile dysfunction should be suspected and assessed in men with risk factors, regardless of their apparent level of awareness of erectile dysfunction. Trial registration ClinicalTrials.gov Identifier NCT00343200.

  18. "Viagra stories": challenging 'erectile dysfunction'.

    Potts, Annie; Grace, Victoria; Gavey, Nicola; Vares, Tiina

    2004-08-01

    Medical approaches to sexual difficulties prioritise the physical aspects of sexuality over other aspects, locating 'disorders' primarily in the anatomy, chemistry or physiology of the body. In accordance with this perspective on sexual matters, physicians look to physical interventions (for example, hormones, drugs, and surgery) to treat any 'abnormalities'. Following the discovery of popular--and profitabl-e-sexuopharmaceuticals such as sildenafil citrate (Viagra) for the treatment of erectile difficulties affecting men, the medical model has gained increasing influence in the domain of sexual health and well-being. However, while medical definitions of--and interventions related to--sexual difficulties are underpinned by an understanding of a 'universal' body (that is, an essential biological body that transcends culture and history), and by the categorisation of the normal and the pathological, the accounts of users of Viagra, and their sexual partners, do not necessarily support such understandings. In some cases, the experiences and perspectives of those affected by erectile difficulties directly challenge the reductionist model of sexuality and sexual experience espoused by medicine. In this paper, we report on a New Zealand study investigating the socio-cultural implications of Viagra, involving 33 men and 27 women discussing the impact of erectile difficulties and Viagra use within relationships. The diverse experiences of participants are discussed in relation to two key issues: the notion of 'sexual dysfunction' itself; and the idea of drugs such as Viagra acting as a 'quick fix' for sexual difficulties affecting men. We argue that the existence of a range of Viagra 'stories' disrupts a simplistic mechanistic portrayal of the male body, male sexuality and 'erectile disorder'. PMID:15144760

  19. Postprostatectomy Erectile Dysfunction: A Review.

    Capogrosso, Paolo; Salonia, Andrea; Briganti, Alberto; Montorsi, Francesco

    2016-08-01

    In the current era of the early diagnosis of prostate cancer (PCa) and the development of minimally invasive surgical techniques, erectile dysfunction (ED) represents an important issue, with up to 68% of patients who undergo radical prostatectomy (RP) complaining of postoperative erectile function (EF) impairment. In this context, it is crucial to comprehensively consider all factors possibly associated with the prevention of post-RP ED throughout the entire clinical management of PCa patients. A careful assessment of both oncological and functional baseline characteristics should be carried out for each patient preoperatively. Baseline EF, together with age and the overall burden of comorbidities, has been strongly associated with the chance of post-RP EF recovery. With this goal in mind, internationally validated psychometric instruments are preferable for ensuring proper baseline EF evaluations, and questionnaires should be administered at the proper time before surgery. Careful preoperative counselling is also required, both to respect the patient's wishes and to avoid false expectations regarding eventual recovery of baseline EF. The advent of robotic surgery has led to improvements in the knowledge of prostate surgical anatomy, as reflected by the formal redefinition of nerve-sparing techniques. Overall, comparative studies have shown significantly better EF outcomes for robotic RP than for open techniques, although data from prospective trials have not always been consistent. Preclinical data and several prospective randomized trials have demonstrated the value of treating patients with oral phosphodiesterase 5 inhibitors (PDE5is) after surgery, with the concomitant potential benefit of early re-oxygenation of the erectile tissue, which appears to be crucial for avoiding the eventual penile structural changes that are associated with postoperative neuropraxia and ultimately result in severe ED. For patients who do not properly respond to PDE5is, proper

  20. Psychogenic erectile dysfunction. Classification and management.

    Rosen, R C

    2001-05-01

    Psychogenic factors are involved alone or in combination with organic causes in a substantial number of cases of erectile dysfunction. Epidemiologic studies have implicated the role of depressed mood, loss of self-esteem, and other psychosocial stresses in the cause of erectile dysfunction. A new definition and classification of psychogenic erectile dysfunction has been proposed based on recent clinical and research findings. According to this new classification, psychogenic erectile dysfunction is categorized as generalized or situational type, with subcategories of each type proposed. Traditional treatment approaches for psychogenic erectile dysfunction have included anxiety reduction and desensitization procedures, cognitive-behavioral interventions, guided sexual stimulation techniques, and couples' or relationship counseling. Recently, these approaches increasingly have been combined with pharmacologic therapy such as sildenafil. Special situations have been identified in which combining psychosocial interventions with medical therapy is recommended. These situations include problems of sexual initiation, low sexual desire, other sexual dysfunctions, and significant couples' or relationship problems. More research is needed on the role of psychosocial interventions in the treatment of erectile dysfunction. PMID:11402580

  1. Erectile Dysfunction in Males on Hemodialysis

    Objective: The determine the frequency of erectile dysfunction in males on hemodialysis. Study Design: Descriptive study. Place and duration: Hemodialysis unit, Combined Military Hospital Kharian from October 2011 to April 2012. Patients and Methods: A total of 150 married male patients of end stage renal disease (ESRD) on hemodialysis were included in the study. Patients with cognitive and/or communication deficits and on hemodialysis for less than 06 months were excluded from the study. Erectile dysfunction (ED) was assessed using International Index of Erectile Function-5 (IIEF-5). Frequency of erectile dysfunction (ED) was analyzed using Statistical Package for Social Sciences (SPSS) version 17. Results: Mean age of the patients were 52.89 = 8.25 years. Mean duration of hemodialysis was 34 +- 9.62 months. The underlying etiology of end stage renal disease were diabetic nephropathy 69(46%), hypertensive nephropathy 51(34%), obstructive nephropathy 18(12%), glomerulonephritis 9(6%), autosomal polycystic kidney disease 3(2%). Mean IIEF-5 score was 13.29 +- 6.38. The frequency of erectile dysfunction was 74%. The majority of the patients, 73(48.7%) had moderate erectile dysfunction, while 24 (16%) had severe and 14 (9.3%) had mild erectile dysfunction. Out of total 150 patients enrolled, 39 (26%) patients had no erectile dysfunction. Conclusion: ED is a highly prevalent problem in men with ESRD. Physicians are urged to recognize the high prevalence of erection problems in men with ESRD and proactively question all patients regarding their sexual function. This will not only improve the recognition of this condition among these patients but also improve the quality of life after adequate treatment. (author)

  2. Erectile dysfunction in hemodialysis patients

    Imen Gorsane

    2016-01-01

    Full Text Available Erectile dysfunction (ED is a common problem seen among patients on hemodialysis (HD, but it is still a taboo subject in our country. The attention given to this sexual problem remained low, and the prevalence of ED among these patients has not been well characterized. We carried out this study in order to determine the prevalence and severity of ED in HD patients. We conducted a descriptive cross-sectional study in our HD unit in March 2013. ED was evaluated using the International Index Erection Function. Thirty patients with a mean age of 49.1 years were eligible for this study. The main causes of chronic kidney disease were hypertension (62.5% and diabetes (41.6%. The prevalence of ED was 80%, including 33.3% severe ED. Plasma levels of gonadotropins: luteinizing hormone (LH, follicule-stimulating hormone were in the standards except for one patient who had an elevated level of LH. Prolactin was elevated in four cases. ED was present in 8.4% of patients before the discovery of renal failure and in 91.6% of patients at the beginning of dialysis. For 19 patients (79.1%, the ED had increased during the dialysis sessions. A significant number of our HD patients presented with ED of varying degrees. Nephrologists should pay attention to the problem of ED in order to improve the quality of their life.

  3. Erectile dysfunction in patients with chronic renal failure

    Leonardo E. Messina; Joaquim A. Claro; Nardozza Archimedes; Enrico Andrade; Valdemar Ortiz; Miguel Srougi

    2007-01-01

    OBJECTIVE: Determine the prevalence of erectile dysfunction in patients undergoing hemodialysis MATERIALS AND METHODS: This cross-sectional study was carried out to determine the prevalence of erectile dysfunction in a population of 58 patients in hemodialysis program. Erectile dysfunction was assessed by using the International Index of Erectile Function (IIEF). Information on demographic data, renal failure, comorbidities, laboratory tests and search for medical treatment for erectile dysfu...

  4. Tadalafil therapy for erectile dysfunction following prostatectomy.

    Kadıoğlu, Ateş; Ortaç, Mazhar; Dinçer, Murat; Brock, Gerald

    2015-06-01

    Erectile dysfunction is a major complication affecting the quality of life of patients and partners after radical prostatectomy. Evolving evidence suggests that early penile rehabilitation may provide better erectile function after surgery. Phosphodiesterase type 5 (PDE-5) inhibitors are routinely considered a first-line treatment option in most algorithms for penile rehabilitation owing to their efficacy, ease of use, wide availability and minimal morbidity. Tadalafil is a long-acting, potent PDE-5 inhibitor for erectile dysfunction, with demonstrated effect in animal studies at preserving penile smooth muscle content and prevention of fibrosis of cavernosal tissue. This article evaluates the existing literature on tadalafil and critically analyzes its impact on erectile function following radical prostatectomy. PMID:26161145

  5. Hormonal evaluation in erectile dysfunction

    Selahattin Çalışkan

    2012-03-01

    Full Text Available Objective: Erectile dysfunction (ED is defined as the inability to achieve and maintain an erection sufficient to permit satisfactory sexual intercourse. In this study, we evaluated the relationship between ED and hormonal abnormalities. Material and methods: We evaluated 178 patients between the ages of 25 and 85 years old. Medical histories and details were collected, and the IIEF question test was completed by all patients. After the basic evaluation, serum total testosterone, thyroid stimulating hormone (TSH, prolactin, follicle stimulating hormone (FSH and luteinizing hormone (LH levels were measured.Results: The mean age of the patients and IIEF scores were 50.5±12.3 and 12.8±6.13, respectively. The mean testosterone, prolactin, TSH, LH and FSH were 426±152 ng/dL, 15.8±45.6 ng/mL, 1.56±1.2 micro IU/mL, 5.5±4.3 m IU/mL and 7.7±6.9 m IU/mL, respectively. Two patients had abnormal TSH levels, and 27 patients had abnormal LH levels. Abnormal FSH levels were detected in 6 patients. Eight patients had abnormal testosterone levels, and twenty had abnormal prolactin levels.Conclusion: ED is an illness that affects older men, and multiple factors cause this illness. Hormonal abnormalities are one of these factors that can be corrected. When appropriate, hormone levels should be measured and treated in patients who present with ED.

  6. Hidden Risks of Erectile Dysfunction "Treatments" Sold Online

    ... mail Consumer Updates RSS Feed Hidden Risks of Erectile Dysfunction "Treatments" Sold Online Printer-friendly PDF (297 KB) ... Men looking online for "dietary supplements" to treat erectile dysfunction (ED) or enhance their sexual performance should beware: ...

  7. Case Report: Persistent erectile dysfunction in a man with prolactinoma

    Badal, Justin; Ramasamy, Ranjith; Hakky, Tariq; Chandrashekar, Aravind; Lipshultz, Larry; Smith, Ryan; Hsiao, Wayland; Bennett, Nelson

    2015-01-01

    Erectile dysfunction has been explored as a condition secondary to elevated prolactin; however, the mechanisms by which elevated prolactin levels cause erectile dysfunction have not yet been clearly established. We here present a patient with a history of prolactinoma who suffered from persistent erectile dysfunction despite testosterone supplementation and pharmacological and surgical treatment for the prolactinoma.  Patients who have had both prolactinemia and erectile dysfunction have been...

  8. Management of erectile dysfunction in hypertension: Tips and tricks

    Viigimaa, Margus; Vlachopoulos, Charalambos; Lazaridis, Antonios; Doumas, Michael

    2014-01-01

    Arterial hypertension is a major risk factor for cardiovascular disease and affects approximately one third of the adult population worldwide. The vascular origin of erectile dysfunction is now widely accepted in the vast majority of cases. Erectile dysfunction is frequently encountered in patients with arterial hypertension and greatly affects their quality of life of hypertensive patients and their sexual partners. Therefore, the management of erectile dysfunction in hypertensive patients i...

  9. [TREATMENT OF ERECTILE DYSFUNCTION FOLLOWING TRANSVESICAL PROSTATECTOMY].

    Motin, P I; Andrjuhin, M I; Pul'bere, S A; Alekseev, O Ju; Agaev, N K

    2015-01-01

    This study examines the efficacy and safety of phosphodiesterase type 5 (PDE-5) inhibitors in treating erectile dysfunction after transvesical prostatectomy. The study involved 63 men aged 55 to 68 years, divided into two groups--29 and 34 patients, respectively. Patients in group 1 received 50 mg of sildenafil citrate (Ereksezil®) on a daily basis, in group 2--100 mg of sildenafil citrate (Ereksezil®) on demand. Postoperative visits were scheduled at the stage of screening, then after a month of treatment and on day 14 after treatment completion (3 visits altogether). Changes of patients' complaints according to IIEF-15 questionnaire showed a significant improvement in erectile function and its components of sexual life satisfaction in both groups of patients, but more significantly with regular medication intake, which has a positive impact on patients' quality of life. At the same time, treatment by PDE-5 inhibitors did not affect the maximum urinary flow rate and residual urine volume. Given the high incidence of the postoperative erectile dysfunction, postoperative administration of PDE-5 inhibitors is relevant and promising. PMID:26665774

  10. Novel therapeutic targets for erectile dysfunction.

    Williams, Steve K; Melman, Arnold

    2012-01-01

    Erectile dysfunction (ED) is a neurovascular phenomenon modulated by hormonal, local biochemical, and biomechanical/structural factors of the penis. The success of the orally active phosphodiesterase inhibitors for the treatment of ED has boosted research activities into the physiology of the erectile mechanism. Peripheral intracellular signal transduction in the penis as well as central brain and spinal cord pathways controlling penile erection have been investigated and are now better understood. The results of this ongoing research have provided the basis for the development and introduction of several novel therapeutic modalities into the management of ED. Many novel pharmacotherapeutic approaches under development including the use of melanocortins and Rho-kinase inhibitors as well as the introduction of gene therapy and tissue engineering have demonstrated efficacy in animal as well as early human trials. This review describes the major new and evolving pharmacological advances in the field of oral pharmacotherapy for the treatment of male ED. PMID:22154078

  11. Can low-intensity extracorporeal shockwave therapy improve erectile dysfunction?

    Olsen, Anne B; Persiani, Marie; Boie, Sidsel;

    2015-01-01

    OBJECTIVE: The aim of this study was to investigate whether low-intensity extracorporeal shockwave therapy (LI-ESWT) can be used as a treatment for men with erectile dysfunction of organic origin. MATERIALS AND METHODS: This prospective, randomized, blinded, placebo-controlled study included 112 ...... needed. KEYWORDS: Erectile dysfunction; extracorporeal shockwave; penis...

  12. Cognitive-Behavioral Erectile Dysfunction Treatment for Gay Men

    Hart, Trevor A.; Schwartz, Danielle R.

    2010-01-01

    The purpose of the present paper is to assist cognitive-behavioral therapists who are treating erectile dysfunction among gay men. Little information is available to cognitive-behavioral therapists about the psychological and social effects of erectile dysfunction in this population, or how to incorporate the concerns of gay men with erectile…

  13. Management of erectile dysfunction in hypertension:Tips and tricks

    Margus; Viigimaa; Charalambos; Vlachopoulos; Antonios; Lazaridis; Michael; Doumas

    2014-01-01

    Arterial hypertension is a major risk factor for cardiovascular disease and affects approximately one third of the adult population worldwide. The vascular origin of erectile dysfunction is now widely accepted in the vast majority of cases. Erectile dysfunction is frequently encountered in patients with arterial hypertension and greatly affects their quality of life of hypertensive patients and their sexual partners. Therefore, the management of erectile dysfunction in hypertensive patients is of paramount importance. Unfortunately, erectile dysfunction remains under-reported, under-recognized, and under-treated in hypertensive patients, mainly due to the lack of familiarity with this clinical entity by treating physicians. This review aims to discuss the more frequent problems in the management of hypertensive patients with erectile dysfunction and propose ways to overcome these problems in everyday clinical practice.

  14. Pure Obstructive Sleep Apnea Syndrome and Erectile Dysfunction

    Cenk Gürbüz

    2011-11-01

    Full Text Available Objective: The aim of this study is to investigate the existence of erectile dysfunction in patients with obstructive sleep apnea syndrome (OSAS in which the other possible causes of erectile dysfunction were eliminated.Material and Methods: The study group consisted of 24 patients diagnosed as OSAS with polysomnographic evaluation, and 15 non-apneic controls (mean age; 41.0±8.8 and 42.3±7.9 year respectively whose comorbidities which might be associated with erectile dysfunction were excluded. Daytime sleepiness was evaluated by Epworth Sleepiness Scale (ESS and measurement of erectile function was performed by International Index of Erectile Function.Results: The rate of erectile dysfunction in OSAS and control groups were 54.2% and 33.3% respectively (p=0.204. The difference between mean erectile function scores of patient and control groups was non-significant (26.1±4.5 and 26.3±4.3 respectively, p=0.900. There was no correlation between erectile function scores and apnea hypnoea index (r=-0.140; p=0.395.Conclusion: Findings obtained from this study suggest that the high incidence of erectile dysfunction reported in OSAS patients seems to be related with concomitant comorbidities such as diabetes, atherosclerosis and neuroendocrine disorders rather than sleep apnea.

  15. Stem cell-based therapy for erectile dysfunction

    WU Jian-hong; XIA Shu-jie

    2011-01-01

    Objective To review the effect of stem cells in erectile dysfunction as well as their application to the therapy of erectile dysfunction.Data sources The data used in the present article were mainly from PubMed with relevant English articles published from 1974 to 2011.The search terms were "stem cells" and "erectile dysfunction".Study selection Articles regarding the role of stem cells in erectile dysfunction and their application to the therapy of erectile dysfunction were selected.Results Stem cells hold great promise for regenerative medicine because of their ability to self-renew and to differentiate into various cell types.Meanwhile,in preclinical experiments,therapeutic gene-modified stem cells have been approved to offer a novel strategy for cell therapy and gene therapy of erectile dysfunction.Conclusion The transplantation of stem cells has the potential to provide cell types capable of restoring normal function after injury or degradation inerectile dysfunction.However,a series of problems,such as the safety of stem cells transplantation,their application in cell therapy and gene therapy of erectile dysfunction need further investigation.

  16. Animal model of high cholesterol atherosclerotic erectile dysfunction and mechanism of atherosclerotic erectile dysfunction

    Guo-ShengYang; Zhao-DianChen; Hong-JuWang

    2004-01-01

    Aim: To establish the animal model of atherosclerotic erectile dysfunction (ED) induced by high cholesterol diet and explore the mechanism of atherosclerotic ED. Methods: Thirty male rabbits were divided at random into two groups: the normal diet (ND)group (n=10) and the high cholesterol (HCH) group fed with 1.5% cholesterol diet (n=20). Serum total cholesterol, plaque areas of the ascending aorta,

  17. Pure Obstructive Sleep Apnea Syndrome and Erectile Dysfunction

    Cenk Gürbüz; Hacer Kuzu Okur; Selamettin Demir; Salih Ordu; Turhan Caşkurlu

    2011-01-01

    Objective: The aim of this study is to investigate the existence of erectile dysfunction in patients with obstructive sleep apnea syndrome (OSAS) in which the other possible causes of erectile dysfunction were eliminated.Material and Methods: The study group consisted of 24 patients diagnosed as OSAS with polysomnographic evaluation, and 15 non-apneic controls (mean age; 41.0±8.8 and 42.3±7.9 year respectively) whose comorbidities which might be associated with erectile dysfunction were exclu...

  18. AB230. Calpain inhibition improves diabetic erectile dysfunction in rats

    Li, Hao; Wang, Tao; Liu, Jihong

    2016-01-01

    Objective Diabetic erectile dysfunction is an intractable disease which results from both vascular and nervous dysfunction in penis. Calpain mediates the vascular dysfunction during hyperglycemia and is involved in some neurodegenerative diseases. This study was designed to investigate the role of calpain inhibition in improving diabetic erectile dysfunction in rats. Methods Type 1 diabetes was induced by intraperitoneal injection of streptozotocin at the dose of 60 mg/kg in rats. After 2 months, diabetic erectile dysfunction was confirmed by apomorphine test. Then the animals were divided into three groups: (I) nondiabetic control groups, (II) diabetic rats + vehicle and (III) diabetic rats + MDL28170. Two weeks later the erectile function was measured by electrical stimulation of the cavernous nerve and the ratio between intracavernosal pressure (ICP) and mean systemic arterial blood pressure (MAP) at the peak of erectile response was calculated. After that penis tissue was harvested. Calpain activity in corpus cavernosum was measured by western blot. Neuronal nitric oxide synthase (nNOS) and endothelial nitric oxide synthase (eNOS) were observed by immunohistochemistry and western blot. The endothelial content in the cavernosum was measured by immunohistochemistry. Results The calpain activity was increased in diabetic rats and inhibited by MDL28170. The erectile function was improved by MDL28170 treatment. The expression of nNOS and eNOS, as well as the content of endothelium in corpus cavernosum were also increased by inhibition of calpain. Conclusions Calpain activation may play a role in the erectile dysfunction of diabetic rats. Inhibition of calpain could improve diabetic erectile dysfunction by increasing expression of nNOS and eNOS in the corpus cavernosum. This could be a novel therapeutic target to protect the erectile function in diabetic patient.

  19. Erectile dysfunction and type 2 diabetes mellitus in northern Pakistan

    Objective: To determine the frequency of erectile dysfunction in married male Type-2 diabetic patients. Methods: The cross-sectional observational study was carried out at the Endocrinology, Diabetes and Metabolic Diseases Unit Hayatabad Medical Complex, Peshawar, from July 2011 to Apr 2012, comprising 217 male married Type-2 diabetic patients. Serum samples were assayed for blood glucose, lipid profile and glycated haemoglobin A1c. Body mass index and waist-to-hip ratio was calculated. Erectile dysfunction was assessed by Sexual Health Inventory for Men questionnaire. SPSS 18 was used for statistical analysis. Results: A total of 217 patients were initially interviewed. The mean age was 43.1+-8.160 years. The frequency of drectile dysfunction increased with age, duration of patients and increased body mass index. Overall, 6 (2.8%) patients had no erectile dysfunction, 37 (17.1%) had mild, 82 (37.8%) mild to moderate; 47 (21.7%) moderate; and 45 (20.7%) severe. Higher HbA1c levels and atherogenic dyslipidaemia were associated with erectile dysfunction. Conclusion: Poor glycaemic control was associated with increased erectile dysfunction risk. Duration of diabetes, older age, increased body mass index are associated with increased incidence of the condition in patients with diabetes. Intensive lifestyle changes in the beginning can add to the better management of Type-2 diabetes and prevention of erectile dysfunction. (author)

  20. Beware When Buying "All Natural" Erectile Dysfunction Products

    Full Text Available ... Protect Yourself Health Fraud Beware When Buying "All Natural" Erectile Dysfunction Products Share Tweet Linkedin Pin it ... Compliance Federal, State & Local Officials Consumers Health Professionals Science & Research Industry Scroll back to top Popular Content ...

  1. Beware When Buying "All Natural" Erectile Dysfunction Products

    Full Text Available ... Fraud Beware When Buying "All Natural" Erectile Dysfunction Products Share Tweet Linkedin Pin it More sharing options ... About FDA Contact FDA Browse by Product Area Product Areas back Food Drugs Medical Devices Radiation-Emitting ...

  2. Beware When Buying "All Natural" Erectile Dysfunction Products

    Full Text Available HHS U.S. Department of Health and Human Services FDA U.S. Food and Drug Administration Protecting and Promoting ... Fraud Beware When Buying "All Natural" Erectile Dysfunction Products Share ...

  3. Beware When Buying "All Natural" Erectile Dysfunction Products

    Full Text Available ... For Consumers Home For Consumers Protect Yourself Health Fraud Beware When Buying "All Natural" Erectile Dysfunction Products ... Linkedin Pin it Email Print More in Health Fraud For Consumers For Educators Warning Letters - Health Fraud ...

  4. Molecular mechanisms associated with diabetic endothelial-erectile dysfunction.

    Castela, Ângela; Costa, Carla

    2016-05-01

    Erectile dysfunction (ED) is a common complication of diabetes, affecting up to 75% of all diabetic men. Although the aetiology of diabetic ED is multifactorial, endothelial dysfunction is recognized as a mainstay in the pathophysiology of the disease. Endothelial dysfunction is induced by the detrimental actions of high glucose levels and increased oxidative stress on endothelial cells that make up the vascular lining. Besides directly injuring the endothelium, diabetes might also hamper vascular repair mechanisms of angiogenesis and vasculogenesis. These states exacerbate and maintain endothelial dysfunction, impairing vasorelaxation events and cavernosal blood perfusion, which are crucial for normal erectile function. PMID:26878803

  5. A new therapeutic approach for erectile dysfunction: Low intensity shockwaves

    García-Perdomo, Herney Andrés

    2015-07-01

    Full Text Available Erectile dysfunction is the inability to achieve or sustain a penile erection for vaginal penetration and satisfactory sexual performance. It is the second most frequent problem of sexual dysfunction in men, after premature ejaculation, with an approximate prevalence rate of 30%. Most cases of erectile dysfunction have an organic origin, mostly vascular diseases, but it is also associated with psychological, neurological, and hormonal factors, or with structural alterations of the penis. Therapy with 5-phosphodiesterase inhibitors has been clinically effective, but some patients do not respond to it. Lowintensity shock waves may improve penile vascularity and blood flow, leading to better erections, and improvement of the quality of sexual performance. In this review several studies are included that show the effectiveness of this treatment for erectile dysfunction.

  6. Proposed therapeutic proceedings for erectile dysfunction. Cognitive-behavioral approach.

    Oettingen, Justyna

    2014-06-01

    Full Text Available Current treatment methods of sexual problems are short-term and problem-oriented, therefore it is recommended to treat sexual dysfunctions with cognitive-behavioral approach (CBT. This paper is a compilation of available therapeutic methods, which were here integrated by the author into a ready-to-use erectile dysfunction therapeutic protocol.

  7. Pathophysiology of Erectile Dysfunction - an Organisation/Activation Concept

    Kula K; Kula W; Slowikowska-Hilczer J

    2005-01-01

    Erection supposes a process regulated by hormonal and neuro-vascular mechanisms on both cerebral and peripheral levels. The current understanding of erectile function and dysfunction (ED) does not provide, however, a coherent model that accounts for the integration of sex hormones action and neuro-vascular mechanisms. Herein we suggest a model that involves organising and activating roles of sex steroids and neurovascular mechanisms in the regulation of erectile response. The organising rol...

  8. Physiotherapy of chronic prostatitis complicated with erectile dysfunction

    I. A. Kolmatsui; L. V. Barabash; S. V. Alaitseva; O. V. Dostovalova; O. Ye. Golosova

    2016-01-01

    Multimodality physiotherapy of chronic prostatitis complicated with erectile dysfunction, consisting of: EHF-puncture, sine-wave -pelotherapy of the penis zone, remedial gymnastics, iodic-bromine baths, and digital prostate massage was developed. Administration of the medical technology leaded up to reduction of inflammation in pelvic minor organs, improvement in penis microcirculation, and improvement in autonomic nervous systems state, enhancement of erectile function and improvement of qua...

  9. Cialis (Tadalafil) Does Not Prevent Erectile Dysfunction in Prostate Cancer Patients

    ... Prostate Cancer Study: Cialis (Tadalafil) Does Not Prevent Erectile Dysfunction in Prostate Cancer Patients Article date: April 4, ... that Cialis (tadalafil) does not help men avoid erectile dysfunction after radiation therapy for prostate cancer . Erection problems ...

  10. Cardiovascular drugs and erectile dysfunction - a symmetry analysis

    Rasmussen, Lotte; Hallas, Jesper; Madsen, Kenneth Grønkjaer; Pottegård, Anton

    2015-01-01

    AIM: Erectile dysfunction is a common problem among patients with cardiovascular diseases and the influence of cardiovascular drugs is much debated. The aim of this study was to evaluate the short term potential for different cardiovascular drugs to affect the risk of being prescribed a drug...... against erectile dysfunction. METHODS: We employed a symmetry analysis design and included all Danish male individuals born before 1950 who filled their first ever prescription for a cardiovascular drug and a 5-phosphodiesterase inhibitor within a 6 month interval during 2002-2012. If the cardiovascular...... drug induces erectile dysfunction, this would manifest as a non-symmetrical distribution of subjects being prescribed the cardiovascular drug first vs. persons following the opposite pattern. Furthermore, we calculated the number of patients needed to treat for one additional patient to be treated for...

  11. Erectile dysfunction in methadone maintenance patients: a cross sectional study in northern iran.

    Seyed Hamzeh Hosseini; Ali Isapour; Mehrdad Tavakoli; Mehrdad Taghipour; Meysam Rasuli

    2013-01-01

    Objective Erectile dysfunction affects quality of life and is a common dysfunction in drug abusers. The aim of this study was to evaluate the frequency of erectile dysfunction in drug abusers on methadone maintenance therapy to reduce this drug side effect in the future studies. Methods This cross-sectional study was conducted with two hundred addicted individuals on methadone maintenance therapy. Erectile dysfunction was surveyed using the International Index of Erectile Function (IIEF). Fin...

  12. Sonographic evaluation of penile in patients with erectile dysfunction

    A review of the current state of knowledge is made on sonographic evaluation of penile in patients with erectile dysfunction. This sonography is developed with high resolution ultrasound on gray scale, combined with color Doppler ultrasonography; which the arteries of penile are examined before and during the erection. The penile ultrasonography has meant an important tool in the evaluation of specific patients who have submitted erectile dysfunction, particularly, in those with record of trauma and history of Peyronie's disease. In addition, through a sonographic evaluation has permitted to prove manifestations of the pathophysiological phenomena of the patient in order to establish their classification and guide their treatment

  13. Evaluation of Erectile Dysfunction in Spinal Cord Injured Patients

    Berrin Gündüz; Salih Baran; Belgin Erhan; Ayşe Nur Bardak; Feride Savaş

    2010-01-01

    Objective: Spinal cord injuries affect sexual function and cause problems in erection, ejaculation, orgasm and fertility; erectile dysfunction is the most important one. The aim of this study is to evaluate the erectile dysfunction seen after spinal cord injury.Materials and Method: Sixty male patients with spinal cord injury, 20 above the level of T10, 20 between T11 and L2, 20 with conus/cauda equina lesions were included in this study. The patients were evaluated according to the American ...

  14. The erectile dysfunction as a cardiovascular risk factor

    Nathan Artom

    2014-12-01

    Full Text Available Erectile dysfunction (ED, defined as the inability of the subject of the male gender to achieve and/or maintain an erection sufficient to permit satisfactory sexual intercourse, is a source of great discomfort for patients in everyday life. This condition has a high prevalence in the general population, although frequently underestimated in clinical practice. The purpose of this article is to review the epidemiology, the pathophysiology and the clinical features of this disease, emphasizing the importance of erectile dysfunction as an indicator of silent atherosclerotic disease.

  15. Hypogonadism and erectile dysfunction: an overview

    Nilgun Gurbuz; Elnur Mammadov; Mustafa Faruk Usta

    2008-01-01

    In humans androgen decline is presented as a clinical picture which includes decreased sexual interest, diminished erectile capasity, delayed or absent orgasms and reduced sexual pleasure. Additionally, changes in mood, diminished well being, fatigue, depression and irritability are also associated with androgen insufficiency. The critical role of androgens on the development, growth, and maintanence of the penis has been widely accepted. Although, the exact effect of androgens on erectile physiology still remains undetermined, recent experimental studies have broaden our understanding about the relationship between androgens and erectile function. Preclinical studies showed that androgen deprivation leads to penile tissue atrophy and alterations in the nerve structures of the penis. Furthermore,androgen deprivation caused to accumulation of fat containing cells and decreased protein expression of endothelial and neuronal nitric oxide synthases (eNOS and nNOS), and phosphodiesterase type-5 (PDE-5), which play crucial role in normal erectile physiology. On the light of the recent literature, we aimed to present the direct effect of androgens on the structures, development and maintanence of penile tissue and erectile physiology as well. Furhermore,according to the clinical studies we conclude the aetiology, pathophysiology, prevalance, diagnosis and treatment options of hypogonadism in aging men.

  16. Incontinence and Erectile Dysfunction Following Radical Prostatectomy: A Review

    Gerasimos Alivizatos

    2005-01-01

    Full Text Available Radical prostatectomy remains the treatment of choice for localized prostate cancer in age-appropriate and health-appropriate men. Although cancer control is the most important aspect of a radical prostatectomy, minimization of postoperative morbidity, especially urinary incontinence and erectile dysfunction, is becoming a greater concern. We reviewed recent data available on Medline regarding the incidence, pathophysiology, evaluation, and treatment of incontinence and sexual dysfunction after radical prostatectomy. Health-related quality of life issues have been specifically addressed. Although low incidences of incontinence and erectile dysfunction after radical prostatectomy have been reported in the hands of experienced surgeons, the literature review revealed a great variety, with incontinence rates ranging from 0.3–65.6% and potency rates ranging from 11–87%. Several factors contribute to this wide difference, the most important being the application of a meticulous surgical technique. General and cancer-specific health-related quality of life is not being affected after radical prostatectomy. The incidence of incontinence and erectile dysfunction is higher after radical prostatectomy when compared to the incidence observed when other therapies for localized prostate cancer are applied. However, the majority of the patients undergoing radical prostatectomy would vote for the operation again. Today, avoidance of major complications after radical prostatectomy depends mostly on a high-quality surgical technique. When incontinence or erectile dysfunction persists after radical prostatectomy, the majority of the treated patients can be managed effectively by various methods.

  17. Erectile dysfunction in healthy subjects predicts reduced coronary flow velocity reserve.

    Borgquist, Rasmus; Gudmundsson, Petri; Winter, Reidar; Nilsson, Peter; Willenheimer, Ronnie

    2006-01-01

    Background: Erectile dysfunction is associated with, and may be the first sign of coronary artery disease. We aimed to assess whether men with erectile dysfunction but without cardiovascular disease have reduced coronary flow reserve, as a sign of early coronary atherosclerosis. Methods: We investigated 12 men aged 68-73 years with erectile dysfunction, and 12 age-matched controls. Erectile function was evaluated using the validated IIEF-5 questionnaire. A score <= 18 (of 25) was defined a...

  18. Endothelial Dysfunction, Erectile Dysfunction and Phosphodiesterase 5 Inhibitors. An Update of the Current Data and Future Perspectives

    Angelis Konstantinopoulos; Konstantinos Giannitsas; Spiros Raptis; Petros Perimenis

    2007-01-01

    Endothelial dysfunction is a pathological entity that multiply affects the health status. Erectile dysfunction is being recognized as a condition that is strongly interrelated with endothelial dysfunction, being a vascular event itself. Oral pharmacotherapy for erectile dysfunction has provided us with a new armamentarium on this condition. Phosphodiesterase 5 inhibitors have been investigated and proved useful in clinical practice for erectile dysfunction but in addition to this, the results...

  19. Megalourethra as a rare cause for erectile dysfunction

    Robert Pallas, MD, Bch

    2015-01-01

    Full Text Available MRI findings of megalourethra have not previously been reported. We present a case of an adult presenting with lifelong erectile dysfunction secondary to poor development of the corpus spongiosum and corpora cavernosa. The pathogenesis, typical presentation, and treatment of megalourethra, as well as the use of modern imaging techniques to aid in the diagnosis and treatment of this disease are discussed.

  20. Erectile dysfunction: Principles of radiological clarification and treatment

    Diagnosis of erectile dysfunction is performed by means of Doppler sonography, cavernosography and cavernosometry, as well as by angiographic methods. Interventional radiological treatment methods are, arterially, vasodilatation or vasorecanalisation, and, as far as the venous approach is concerned, percutaneous venous occlusion. The article reviews the diagnostic and therapeutic radiological methods. (orig.)

  1. Erectile Dysfunction ia a common problem in Interstitial Lung Disease

    Fløe, Andreas; Hilberg, Ole; Wijsenbeek, Marlies;

    Rationale : The relationship between erectile dysfunction (ED) and chronic diseases, most notably diabetes and atherosclerosis, is well established. Previous studies have shown a relationship between COPD and ED. The pathogenesis is not clearly established, but studies have shown a correlation be...

  2. RISK FACTORS OF THE ERECTILE DYSFUNCTION IN THE PATIENTS WITH CARDIOVASCULAR DISEASES

    E. V. Minakov

    2016-01-01

    Full Text Available Aim. To study erectile dysfunction prevalence among out-patients with arterial hypertension (HT and/or coronary heart disease (CHD as well as to study risk factors of erectile dysfunction.Material and methods. The anonymous poll was carried out among 103 male patients with HT and/or CHD. General information about patient, medical history, treatment was analyzed. All patients were examined by cardiologists. Erectile function was assessed with The International Index Erectile Function (IIEF questionnaire.Results. 86 (84% questionnaires were returned. 62 (72% patients from 86 responding had erectile dysfunction. Age, blood pressure level, abdominal obesity, beta-blocker therapy and chronic heart failure affected erectile function.Conclusion. The erectile dysfunction was common disorder among male patients with HT and/or CHD. Early erectile dysfunction diagnosis, prevention and therapy are necessary to provide high level of compliance in patients with cardiovascular diseases.

  3. Cardiometabolic Risk Factors in Patients with Erectile Dysfunction

    Serhat Tanik

    2014-01-01

    Full Text Available Introduction. There is an increasing interest in the association between erectile dysfunction (ED and cardiovascular risk factor. Epicardial adipose tissue (EAT is associated with insulin resistance, increased cardiometabolic risk, and coronary artery disease. Our aim was to investigate relationships between epicardial fat thickness (EFT as a cardiometabolic risk factor and erectile dysfunction. Method. We selected 30 erectile dysfunction patients without comorbidities and 30 healthy individuals. IIEF-5 score was applied to all patients, and IIEF-5 score below 22 was considered as erectile dysfunction. EFT was measured by echocardiography. Results. Body mass index (BMI was higher in ED patients than those without ED (28.19 ± 4.45 kg/m2 versus 23.84±2.36 kg/m2, P = 0.001, resp.. Waist circumstance (WC was higher in ED patients than those without ED (106.60±5.90 versus 87.86 ± 14.51, P = 0.001, resp.. EFT was higher in ED patients compared to non-ED patients (0.49 ± 0.09 cm versus 0.45 ± 0.03 cm, P = 0.016, resp.. There was positive correlation among BMI, WC, and EFT. There was negative correlation between EFT and IIEF-5 score (r : -0.632, P = 0.001. Conclusion. EAT, BMI, and WC as cardiometabolic risk factors were higher in erectile dysfunction patients.

  4. Rise of herbal and traditional medicine in erectile dysfunction management.

    Ho, Christopher C K; Tan, Hui Meng

    2011-12-01

    Herbal medicine long has been used in the management of sexual dysfunction, including erectile dysfunction. Many patients have attested to the efficacy of this treatment. However, is it evidence-based medicine? Studies have been done on animal models, mainly in the laboratory. However, randomized controlled trials on humans are scarce. The only herbal medications that have been studied for erectile dysfunction are Panax ginseng, Butea superba, Epimedium herbs (icariin), Tribulus terrestris, Securidaca longipedunculata, Piper guineense, and yohimbine. Of these, only Panax ginseng, B. superb, and yohimbine have published studies done on humans. Unfortunately, these published trials on humans were not robust. Many herbal therapies appear to have potential benefits, and similarly, the health risks of various phytotherapeutic compounds need to be elucidated. Properly designed human trials should be worked out and encouraged to determine the efficacy and safety of potential phytotherapies. PMID:21948222

  5. AB162. Is it feasible to apply a new concept of erectile dysfunction syndrome (EDS) in clinical practice?

    Chen, Jun; Zhang, Bin; Wen, Jiaming

    2014-01-01

    How to understand the erectile function? How to define erectile dysfunction? In general, erectile function is evaluated by the quality of penile erection. If penis shows good erection, we think erectile function is normal. Otherwise, erectile dysfunction occurs. This concept is reflected in the definition of erectile dysfunction (ED). ED is defined as the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance. From the definition of ED, it...

  6. Impact of renal transplantation on erectile dysfunction due to chronic renal failure in male patients

    Erectile dysfunction can be defined as the persistent inability of man to achieve penile erection and maintain it sufficient for satisfactory coitus. The objectives of this study were to find out the impact of successful renal transplantation on the degree and frequency of erectile dysfunction. Thirty patients of end stage renal disease that were on regular haemodialysis and candidates of renal transplantation of age range 20-55 years were included in the study after getting informed consent. Erectile functions were assessed by history, examination, investigations and international index of erectile function (IIEF) before and 3 and 6 months after renal transplantation, other information regarding disease and patient were collected in the performa. Out of thirty patients 14 (46.6%) patients had sever erectile dysfunction while 16 (53.3%) patients had moderate erectile dysfunction in the pre renal transplantation period. After three months of renal transplantation 15 (50%) had severe erectile dysfunction, 6 (20%) patients moderate erectile dysfunction and 9 (30%) patients mild erectile dysfunction. After six months 11 (36.6%), 10 (33.3%) and 8 (26.6%) patients had severe, moderate and mild erectile dysfunction respectively. There was improvement in 40%, no change in 53.3% and deterioration in 6.6% patients in the erectile functions after getting renal transplantation for end stage renal disease. (author)

  7. Does pelvic injury trigger erectile dysfunction in men?

    H.Hüseyin Ceylan; Ersin Kuyucu; Remzi Erdem; G(o)khan Polat; Ferit Y(i)lmaz; Bilal Gümü(s); Mehmet Erdil

    2015-01-01

    Purpose:Pelvic ring fractures constitute 3%-8% of all fractures of the skeletal system and are generally related with high energy trauma.Sexual dysfunction following pelvic fracture has a high incidence,and affects the male patients both physically and psychologically.In this study,we aimed to investigate the impact and frequencies of comorbidities such as erectile dysfunction (ED) with adverse sociocultural and psychological consequences for the patient who had a pelvic ring fracture.Methods:This study included 26 men who corresponded to the inclusion criteria and agreed to participate our study.Results:According to fracture types,most of our cases were Tile type A1 and type A2.Severe and moderate ED were detected in 46.1% (12/26) of these patients via the International Index of Erectile Function-5 questionnaire.Conclusion:ED develops following pelvic fractures,especially in Tile type B and C pelvic fractures.

  8. Testosterone replacement therapy: should it be performed in erectile dysfunction?

    Celik, Orcun; Yücel, Selcuk

    2013-09-01

    The classical etiology of erectile dysfunction (ED) comprises aging and vascular, neurogenic, psychological and hormonal components. Recent studies have shown that ED can be the forerunner of serious cardiovascular disturbances. It has also been reported that peripheral neuropathy and microvascular injuries caused by pathophysiological changes in patients with diabetes and obesity lead to ED in a significant number of such cases. These patients develop clinically significant ED and comprise a significant portion of the patient group which do not respond to PDE-5 inhibitors. Testosterone has been shown to increase the expression of PDE-5. This function of testosterone supports its effect on the regulation of erection and increasing the sexual libido. In view of the complexity of ED, as well as the effect of testosterone on erection, it is concluded that PDE-5 inhibitors in combination with testosterone replacement would be a better therapy alternative in the management of erectile dysfunction in hypogonadal patients. PMID:24350081

  9. A Quality Analysis of Randomized Controlled Trials about Erectile Dysfunction

    Chung, Jae Hoon; Lee, Jeong Woo; Jo, Jung Ki; Kim, Kyu Shik; Lee, Seung Wook

    2013-01-01

    Purpose A low quality clinical trial could produce errors, and these errors could, in turn, distort the results of the clinical trial. To avoid applying distorted results of trials clinically, a quality analysis of clinical trials is needed. Materials and Methods We selected randomized controlled trials (RCTs) about erectile dysfunction (ED) conducted in Korea using Medline and KoreaMed. Quality assessment of selected RCTs was performed using three assessment tools (Jadad scales, van Tulder s...

  10. Combination therapy for erectile dysfunction: an update review

    Dhir, Rohit R; Lin, Hao-Cheng; Canfield, Steven E.; Wang, Run

    2011-01-01

    The introduction of oral phosphodiesterase-5 inhibitors (PDE5Is) in the late 1990s and early 2000s revolutionized the field of sexual medicine and PDE5Is are currently first-line monotherapy for erectile dysfunction (ED). However, a significant proportion of patients with complex ED will be therapeutic non-responders to PDE5I monotherapy. Combination therapy has recently been adopted for more refractory cases of ED, but a critical evaluation of current combination therapies is lacking. A thor...

  11. Obesity and Erectile Dysfunction: Is Androgen Deficiency the Common Link?

    Feeley, Robert J.; Traish, Abdulmaged M.

    2009-01-01

    Obesity is associated with increased risk of erectile dysfunction (ED); however, the underlying causes of ED in obese individuals remain poorly defined. The aim of this review is to discuss the evidence available on the relationship between obesity and ED. A search of published studies in PubMed from 1970 through 2009 was conducted, and relevant articles were evaluated and discussed.Visceral obesity is a public health threat, and is associated with increased risk of diabetes, vascular disease...

  12. Lifestyle modifications and erectile dysfunction:what can be expected?

    Maria Ida Maiorino; Giuseppe Bellastella; Katherine Esposito

    2015-01-01

    Erectile dysfunction (ED) is a common medical disorder whose prevalence is increasing worldwide. Modifiable risk factors for ED include smoking, lack of physical activity, wrong diets, overweight or obesity, metabolic syndrome, and excessive alcohol consumption. Quite interestingly, all these metabolic conditions are strongly associated with a pro‑inflammatory state that results in endothelial dysfunction by decreasing the availability of nitric oxide (NO), which is the driving force of the blood genital flow. Lifestyle and nutrition have been recognized as central factors influencing both vascular NO production, testosterone levels, and erectile function. Moreover, it has also been suggested that lifestyle habits that decrease low‑grade clinical inflammation may have a role in the improvement of erectile function. In clinical trials, lifestyle modifications were effective in ameliorating ED or restoring absent ED in people with obesity or metabolic syndrome. Therefore, promotion of healthful lifestyles would yield great benefits in reducing the burden of sexual dysfunction. Efforts, in order to implement educative strategies for healthy lifestyle, should be addressed.

  13. Evaluation of the erectile dysfunction of vascular origin by means of the ultrasound Doppler Duplex

    We studied 20 patients with erectile dysfunction of vascular origin and 10 patients with psychological erectile dysfunction with Doppler ultrasound before and after injection of intra cavernous vasoactive substances. We observed that psychological erectile dysfunction, is characterized by normal vascular velocities in cavernous arteries (control group). In patients with vascular aetiology we obtained abnormal registrations that differentiated arterial from venous pathology. There was a significant difference in the diameter of the cavernous artery and the systolic flow after the injection of vasoactive substances

  14. Physician attitudes and behaviour regarding erectile dysfunction in at-risk patients from a rural community

    Perttula, E.

    1999-01-01

    Erectile dysfunction affects many men in the United States. A 34% prevalence is estimated among male family practice patients. It is associated with a loss of self-image, self-confidence, and even chronic anger. Several risk factors increases the risk of erectile dysfunction. Prevalence is increased by 20-40% in patients with diabetes, hypertension, and those over 65 years old. While erectile dysfunction is generally acknowledged as an important health problem, misconceptions remain as to the...

  15. Erectile dysfunction among diabetic patients in Saudi Arabia: A hospital-based primary care study

    Yousef A Al-Turki

    2007-01-01

    Conclusions: Complete (severe and partial erectile dysfunction was quite common among adult diabetic patients in a hospital-based primary care setting in Saudi Arabia. It is important for primary care physicians to diagnose erectile dysfunction in diabetic patients, and to counsel them early, as most patients are hesitant to discuss their concern during a consultation. Further studies are recommended to evaluate the effect of other risk factors on erectile dysfunction in diabetic patients.

  16. Effect of sildenafil in cavernous arteries of patients with erectile dysfunction

    Joaquim A. Claro; Sérgio F Ximenes; Archimedes Nardozza Jr.; Enrico Andrade; Leonardo Messina; Miguel Srougi

    2003-01-01

    INTRODUCTION: Sildenafil citrate is a type 5 phosphodiesterase inhibitor, which has demonstrated excellent results in the treatment of erectile dysfunction. The effect of sildenafil citrate in the cavernous arteries of patients with erectile dysfunction has not been established yet. The objective of this study was to assess the effect of sildenafil citrate in the cavernous arteries of patients with erectile dysfunction, following an intracavernous injection of alprostadil. MATERIALS AND METHO...

  17. Dynamic cavernosography. The radiological diagnosis of venous causes of erectile dysfunction and of abnormalities of the erectile tissues

    Porst, H.; Ahlen, H. van; Leipner, N.; Koester, O.

    1986-07-01

    In 30 to 50% erectile dysfunctions are due to vascular disorders. Roughly a third of these vasculogenic disturbances is based on venous disorders. These venous-induced erectile failures may be objectivated and radiologically located via dynamic cavernosography, combined with a simultaneous recording of a cavernous pressure profile. Based on over 130 examinations it was possible to provide both an exact description of the normal venous drainage in normal potent men and to give a good idea of the different venous leakages in patients complaining of erectile dysfunctions. Congenital and acquired penile deviations along with Peyronie's disease may also be appropriate for dynamic cavernosography.

  18. Prevention of erectile dysfunction after radiotherapy for prostate cancer

    Izak Faiena

    2014-12-01

    Full Text Available With increasing scrutiny of prostate cancer (PCa diagnosis and treatment, much attention has been given to the morbidity caused by radical prostatectomy (RP and/or radiotherapy (RT. One of the most common side-effects of either treatment is erectile dysfunction (ED. [1] Approximately, 40% of patients will experience ED after RT for PCa. The post-RT ED causes significant patient dissatisfaction with cancer treatment as well as decrease in patient and partner psychosocial function. [2] To address this issue in patients undergoing RT, Pisansky et al. [3] conducted a prospective, randomized, double-blinded, placebo-controlled trial to assess the efficacy of a phosphodiesterase enzyme-5 inhibitor (PDE5i, tadalafil, as a preventive measure for patients undergoing RT for PCa and found no difference in erectile function between the control and treatment groups.

  19. Hypogonadism and erectile dysfunction as harbingers of systemic disease

    2016-01-01

    Prescription sales of Testosterone and erectile aids such as phosphodiesterase-5 inhibitors are at an all-time high, underscoring the importance of hypogonadism (HG) and erectile dysfunction (ED) to men’s health. The effect of these debilitating conditions has a major impact on the quality of men’s lives. Some risk factors for HG or ED including aging, obesity, smoking, and a sedentary lifestyle. Notably, these are the same risk factors for several other medical co-morbidities that contribute to significant morbidity and mortality in men. HG and ED often co-exist with cardiovascular disease, diabetes, and osteoporosis. This review will explore these three co-morbidities that overlap with HG and ED, and will provide a review of their relationship with each other.

  20. Understanding and Managing Erectile Dysfunction in Patients Treated for Cancer.

    Annam, Kiran; Voznesensky, Maria; Kreder, Karl J

    2016-04-01

    Cancer can cause sexual adverse effects by direct and indirect pathways. It can involve sexual organs, indirectly affect body image, or cause fatigue or depression with subsequent effects on libido. Erectile dysfunction (ED), the inability to obtain or maintain an erection firm enough for sexual intercourse, can also result from adverse effects of cancer treatment, such as fatigue, pain, or anxiety about therapy. In addition, depressed feelings about having cancer can affect sexuality, causing a range of signs and symptoms that can lead to ED. Chemotherapy, hormone therapy, surgery, and radiation can all cause sexual adverse effects. Additional factors that play a role include patient age and degree of ED before starting cancer treatment. In this article, we discuss how chemotherapy, hormone therapy, surgery, and radiation affect erectile function as well as possible treatment options for ED. PMID:27072383

  1. Hypogonadism and erectile dysfunction as harbingers of systemic disease.

    Chiles, Kelly A

    2016-04-01

    Prescription sales of Testosterone and erectile aids such as phosphodiesterase-5 inhibitors are at an all-time high, underscoring the importance of hypogonadism (HG) and erectile dysfunction (ED) to men's health. The effect of these debilitating conditions has a major impact on the quality of men's lives. Some risk factors for HG or ED including aging, obesity, smoking, and a sedentary lifestyle. Notably, these are the same risk factors for several other medical co-morbidities that contribute to significant morbidity and mortality in men. HG and ED often co-exist with cardiovascular disease, diabetes, and osteoporosis. This review will explore these three co-morbidities that overlap with HG and ED, and will provide a review of their relationship with each other. PMID:27141446

  2. Paget's disease of the skull causing hyperprolactinemia and erectile dysfunction: a case report

    Hepherd Rachel; Jennings Paul E

    2008-01-01

    Abstract Introduction Hyperprolactinemia is an uncommon cause of erectile dysfunction in men. Paget's disease of the skull is a relatively common disease. This case proposes a rare example of a causative link between the two and how treatment of the Paget's disease with bisphosphonates helped the patient regain erectile function. Case presentation A 67-year-old man with Paget's disease of the skull presented with prostatitis, erectile dysfunction, and hyperprolactinemia. Radio-isotope scannin...

  3. Associated factors and prevalence of erectile dysfunction in hemodialysis patients

    Marcio Rodrigues Costa

    2014-01-01

    Full Text Available Purpose: The proposal of this study was to determine the prevalence and the associated factors of erectile dysfunction (ED among hemodialysis (HD patients. Materials and Methods: This was a cross-sectional study based on data collected from HD male patients. Clinical, demographic and laboratory data of all patients were collected in three HD clinics from December 2010 to June 2011. Patients answered questions of erectile function domain from International Index of Erectile Function. Data were evaluated by descriptive analysis and by univariate (ULRA and multivariate logistic regression analysis (MLRA. Results: Three hundred and five patients participated of the study. The prevalence of ED was 68.19%. ED was associated with diabetes (DM, benign prostatic hyperplasia, glomerulonephritis as cause of chronic renal failure (CRF, smoking habits, lower creatinine levels (ULRA, use of calcium channel blocker (MLRA, aging, lower education level, alcohol consumption, DM (as cause of CRF and coronary insufficiency (ULRA and MLRA. Conclusions: ED was highly prevalent in the HD men. It was independently associated with aging, current use of alcohol, long alcohol use (even for those who do not drink more, lower education level, diabetes as cause of CRF, coronary insufficiency and use of channel blockers calcium.

  4. Leriche Syndrome Presenting as Depression with Erectile Dysfunction

    Gautam, Priyanka; Saha, Rashmita

    2016-01-01

    Leriche syndrome results from thrombotic occlusion of the abdominal aorta immediately above the site of its bifurcation. Impotence in leriche syndrome is caused due to proximal obstruction, commonly involving isolated common iliac, internal iliac, internal pudendal or dorsalis penis artery. The symptoms of Leriche syndrome include intermittent and bilateral claudication, pallor, coldness and fatigue in lower extremities. Data regarding psychiatric morbidity in Leriche syndrome is unavailable. We hereby report the case of Leriche syndrome, presenting to psychiatry outpatient department with depressive disorder and erectile dysfunction (ED) with focus on dilemmas faced in the diagnosis and management in psychiatry.

  5. The role of penile prosthetic surgery in the modern management of erectile dysfunction

    Jain, S.; Bhojwani, A; Terry, T

    2000-01-01

    The management of erectile dysfunction looks set to be revolutionised with the introduction of effective oral therapies. There will remain, however, some men who do not respond to conservative measures. This article reviews the important role of penile prosthetic surgery as a treatment option in these patients.


Keywords: penile prosthesis; erectile dysfunction

  6. Erectile dysfunction in methadone maintenance patients: a cross sectional study in northern iran.

    Seyed Hamzeh Hosseini

    2013-12-01

    Full Text Available Erectile dysfunction affects quality of life and is a common dysfunction in drug abusers. The aim of this study was to evaluate the frequency of erectile dysfunction in drug abusers on methadone maintenance therapy to reduce this drug side effect in the future studies.This cross-sectional study was conducted with two hundred addicted individuals on methadone maintenance therapy. Erectile dysfunction was surveyed using the International Index of Erectile Function (IIEF. Finally, all data were collected and analyzed by descriptive statistics such as measures of variability and central tendency and Chi-squared (χ(2 test using SPSS Version18.0 software.The amount of the total frequency of erectile dysfunction was pointed 30 or less among the two hundred patients and included the moderate and severe cases. In this study, the number of patients with erectile dysfunction was fifty three (26.5%.The frequency of erectile dysfunction in our study was approximately 1.5 times of prevalence of the public (16.1%. In this study, all the factors related to sexual function such as erectile function, libido, orgasm, and sexual pleasure showed a decline among drug abusers.

  7. Oestrogen-androgen crosstalk in the pathophysiology of erectile dysfunction

    BSrilatha; PGAdaikan

    2003-01-01

    Ageing in man is associated with a decline in testosterone following changes in the hypothalamo-pituitary-testicular axis. This may offset the physiologic equilibrium between oestrogen and androgen and at some point when the ratio of free testosterone to oestradiol reaches a critical level, the oestrogenic gonadotropin suppressive effect predominates with decreased release of FSH and LH. Adding to this endocrinal complexity is the continued peripheral conversion to oestradiol through aromatisation. Although the androgen deficiency is not the sole cause for impotence in the elderly, there is a gradual decrease in nocturnal penile tumescence (NPT) and spontaneous morning erections with ageing. Despite the age related increase in oestrogen levels, the information on the pathophysiological role of the "female hormone" in erectile dysfunction has been scanty. Together with our identification of oestrogen receptors within the penile cavernosum, we have delineated dysfunctional changes on male erection mediated by oestradiol.These findings parallel the recent concerns over environmental oestrogens on fertility declines in young men. Oestrogenic activity is also present in plants and thereby in human diet. These phytoestrogens are structurally and functionally similar to oestradiol and more potent than the environmental oestrogenic chemicals such as organochlorine and phenolic compounds. Thus in the light of growing concerns of possible compromising effects on sexuality by endogenous and environmental oestrogens, we are faced with the scientific need to delineate their role on the mechanism of male erectile pathway in health and disease for clinical correlates and prognostics.

  8. Erectile dysfunction and central obesity: an Italian perspective

    Giovanni Corona

    2014-08-01

    Full Text Available Erectile dysfunction (ED is a frequent complication of obesity. The aim of this review is to critically analyze the framework of obesity and ED, dissecting the connections between the two pathological entities. Current clinical evidence shows that obesity, and in particular central obesity, is associated with both arteriogenic ED and reduced testosterone (T levels. It is conceivable that obesity-associated hypogonadism and increased cardiovascular risk might partially justify the higher prevalence of ED in overweight and obese individuals. Conversely, the psychological disturbances related to obesity do not seem to play a major role in the pathogenesis of obesity-related ED. However, both clinical and preclinical data show that the association between ED and visceral fat accumulation is independent from known obesity-associated comorbidities. Therefore, how visceral fat could impair penile microcirculation still remains unknown. This point is particularly relevant since central obesity in ED subjects categorizes individuals at high cardiovascular risk, especially in the youngest ones. The presence of ED in obese subjects might help healthcare professionals in convincing them to initiate a virtuous cycle, where the correction of sexual dysfunction will be the reward for improved lifestyle behavior. Unsatisfying sexual activity represents a meaningful, straightforward motivation for consulting healthcare professionals, who, in turn, should take advantage of the opportunity to encourage obese patients to treat, besides ED, the underlying unfavorable conditions, thus not only restoring erectile function, but also overall health.

  9. Epidemiology of erectile dysfunction in hemodialysis patients using IIEF questionnaire

    Leila Malekmakan

    2011-01-01

    Full Text Available Erectile dysfunction (ED is defined as the inability to attain or maintain an erec-tion sufficient for satisfactory sexual performance. This cross-sectional study was conducted on pa-tients on hemodialysis (HD in Shiraz, Iran, using the International Index of Erectile Dysfunction questionnaire for determination of the frequency and severity of ED in these patients. We used the Chi-square, Mann-Whitney, Kruskal-Wallis and Pearson′s correlation coefficient tests for statis-tical analysis. A total of 73 patients were enrolled into this study. The mean score of ED was 10.3 ± 6.3 (total score 25. The prevalence of ED of various degrees was 87.7%. There was a signi-ficant correlation between different degrees of ED and age (P = 0.002; it was significantly higher in patients older than 50 years (P = 0.005. Also, ED was more common in patients whose Kt/V was <1.2 (P = 0.04. Our study suggests that ED is a major health concern in patients on HD. Improvement of ED may improve their quality of life. Our results can give the basic data for future research in this field.

  10. Elucidating the etiology of erectile dysfunction after definitive therapy for prostatic cancer

    Purpose: To determine the etiology of treatment-induced erectile dysfunction among patients who underwent surgery or radiotherapy for prostatic cancer. Methods and Materials: Ninety-eight patients were evaluated for erectile dysfunction after definitive therapy for prostate cancer with Duplex ultrasonography before and after intracorporal prostaglandin injection. Patients were classified as having arteriogenic, cavernosal, mixed (arteriogenic/cavernosal), or neurogenic impotence based upon the results of the Duplex studies. Results: Among patients who underwent radical prostatectomy (RP), 31 (52%) had cavernosal dysfunction, 19 (32%) had arteriogenic dysfunction, 3 (5%) were classified as mixed, and 7 (12%) as neurogenic dysfunction. Among patients treated with radiotherapy (RT), 24 (63%) had arteriogenic dysfunction, 12 (32%) had cavernosal dysfunction, 1 (2.5%) were classified as mixed, and 1 (2.5%) as neurogenic dysfunction. A multivariate analysis identified prior RT as the only predictor of an arteriogenic etiology (p < 0.001) and prior RP as the only predictor of a cavernosal etiology (p < 0.04) for erectile dysfunction among these patients. In the RP and RT groups, the median erectile responses were 70 and 65%, respectively. Arterial peak flows <25 cc/min predicted for a suboptimal erectile response with intracavernosal prostaglandin injections. Among 47 patients with arterial peak flows <25 cc/min, 21 (55%) had erectile responses of <70%, while for 51 patients with arterial peak flows ≥25 cc/min, 31 (39%) had erectile responses of <70% (p < 0.039). Conclusions: While the etiology of erectile dysfunction after definitive therapy for prostatic cancer is likely a multifactorial phenomenon, these data suggest that the predominant etiology among patients who undergo RT is arteriogenic and among patients who undergo RP is veno-occlussive/cavernosal pathology. This information may have implications for the design of more effective therapies to address erectile

  11. TESTOCAP: A HERBAL SOLUTION FOR ERECTILE DYSFUNCTION AND PREMATURE EJACULATION

    Satender Tanwar* and Shailaja SV

    2015-03-01

    Full Text Available Sexual activity is a vital principle of human living that connects the desire, energy and pleasure of the body to a knowledge of human intimacy, for the sake of erotic love, intimate friendship, human mating and procreation. Sexuality is the capacity to have erotic experiences and responses. According to Masters and Johnson, the human sexual response cycle consists of four phases: excitement, plateau, orgasm, and resolution. The World Health Organization's International Classifications of Diseases defines sexual problems as "various ways in which an individual is unable to participate in a sexual relationship as he or she would wish". There are four major categories of sexual problems: desire disorders, arousal disorders, orgasmic disorders, and sexual pain disorders. Sexual arousal disorder in men, erectile dysfunction. Erectile dysfunction (ED or impotence is sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual activity.Orgasmic disorders In men, premature ejaculation Premature ejaculation (PE occurs when a man experiences orgasm and expels semen soon after sexual activity and with minimal penile stimulation. Sexuality has been explained in the Ayurveda classics in detail along with the various disorders related to desire, arousal, orgasmic and sexual pain disorders. The various formulations have been explained in classics to relieve these disorders and help the man to enjoy their sexual life.Considering these issues the need of hour this conceptual study has been carried out to help, support and provide enhanced sexual life with readily available pure botanicals which are time tested evidenced based and 100% safe and effective.

  12. Pathophysiology of Erectile Dysfunction - an Organisation/Activation Concept

    Kula K

    2005-01-01

    Full Text Available Erection supposes a process regulated by hormonal and neuro-vascular mechanisms on both cerebral and peripheral levels. The current understanding of erectile function and dysfunction (ED does not provide, however, a coherent model that accounts for the integration of sex hormones action and neuro-vascular mechanisms. Herein we suggest a model that involves organising and activating roles of sex steroids and neurovascular mechanisms in the regulation of erectile response. The organising role of hormones initiates during fetal life when androgens evoke both organogenesis of a penis and morphogenesis of a male type structure of sexually dimorphic brain regions (SDBR responsible for male sexual behavior. Due to androgen-stimulation, penile growth proceeds in early childhood, is accelerated at puberty and ceases thereafter despite high androgen levels. Similarly, masculinisation of SDBR may extend to the adulthood but these structures may not be susceptible to hormonal manipulations thereafter. The activating component of erection appears also on both cerebral and peripheral levels. Since puberty male type of androgen/estrogen balance may simultaneously activate cerebral sympathetic tone responsible for sexual drive (libido and parasympathetic tone responsible for erectile response on spinal cord level. On periphery the neuro-vascular activation of erection is present since fetal life and not dependent on libido. ED, the inability to achieve and maintain the erection to penetrate the vagina, may be of developmental origin as a primary failure or may derivate from organic or psychogenic diseases as secondary failure. As primary, ED may result from the lack or insufficient organising role of sex hormones on penile and behavioral levels, androgen-treatment will be necessary. In turn, secondary ED is more frequent, may result predominantly from the disturbances in the neuro-vascular erection activating mechanisms, and is less responsive to androgen-treatment.

  13. Mechanistic link between erectile dysfunction and systemic endothelial dysfunction in type 2 diabetic rats.

    Musicki, B; Hannan, J L; Lagoda, G; Bivalacqua, T J; Burnett, A L

    2016-09-01

    Men with type 2 diabetes mellitus (T2DM) and erectile dysfunction (ED) have greater risk of cardiovascular events than T2DM men without ED, suggesting ED as a predictor of cardiovascular events in diabetic men. However, molecular mechanisms underlying endothelial dysfunction in the diabetic penis explaining these clinical observations are not known. We evaluated whether the temporal relationship between ED and endothelial dysfunction in the systemic vasculature in T2DM involves earlier redox imbalance and endothelial nitric oxidase synthase (eNOS) dysfunction in the penis than in the systemic vasculature, such as the carotid artery. Rats were rendered T2DM by high-fat diet for 2 weeks, followed by an injection with low-dose streptozotocin. After 3 weeks, erectile function (intracavernosal pressure) was measured and penes and carotid arteries were collected for molecular analyses of eNOS uncoupling, protein S-glutathionylation, oxidative stress (4-hydroxy-2-nonenal, 4-HNE), protein expression of NADPH oxidase subunit gp91(phox) , endothelium-dependent vasodilation in the carotid artery, and non-adrenergic, non-cholinergic (NANC)-mediated cavernosal relaxation. Erectile response to electrical stimulation of the cavernous nerve and NANC-mediated cavernosal relaxation was decreased (p early in T2DM in the penis, but not in the carotid artery. These molecular changes contribute to T2DM ED, while vascular function in the systemic vasculature remains preserved. PMID:27153512

  14. Do lifestyle changes work for improving erectile dysfunction?

    Kaya Horasanli; Ugur Boylu; Muammer Kendirci; Cengiz Miroglu

    2008-01-01

    The main cause of erectile dysfunction (ED) is organic in nature, with vascular etiologies being the most common risk factors. Although there have been sufficient data on the relationship between ED and several well-recognized risk factors, including aging, coronary artery disease, atherosclerosis, diabetes mellitus, dyslipidemia, high blood pressure,and pelvic surgeries, little attention has been paid by the urologists to the role of lifestyle factors in ED. However,accumulating data from basic science and clinical studies have determined a link between the occurrence of ED and a number of lifestyle factors, such as smoking, obesity, alcohol consumption, and lack of physical activity. The application of findings from animal and human studies to the clinical practice regarding the modification of lifestyle factors could help improving ED as well as reducing the risks of developing cardiovascular diseases. This communication addresses the impact of lifestyle factors on erectile function and the potential benefits of modifying these factors to improve ED in respect to the current evidence.

  15. Erectile dysfunction: A review and herbs used for its treatment

    Ashwin Saxena

    2012-01-01

    Full Text Available Erectile dysfunction (ED or male impotence is defined as the inability to have or sustain an erection long enough to have a meaningful sexual intercourse. ED tends to occur gradually until the night time or early morning erections cease altogether or are so flaccid that successful intercourse does not occur. Sexual health is an important determinant of quality of life. Today, millions of men, young and old, suffer from ED due to high levels of synthetic hormones (known as Xenoestrogens in our diet/environment; nutritionally imbalanced diet resulting from poor quality of produces; and extremely low levels of testosterone. To overcome the problem of sexual (or ED various natural aphrodisiac potentials are preferred. The present review discusses about aphrodisiac potential of plants, its biological source, common name, part used and references, which are helpful for researchers to develop new aphrodisiac formulations.

  16. Pharmacogenetics of erectile dysfunction: navigating into uncharted waters.

    Lacchini, Riccardo; Tanus-Santos, Jose E

    2014-08-01

    Sildenafil and other PDE-5 inhibitors have revolutionized erectile dysfunction (ED) treatment. However, a significant number of patients do not respond or present adverse reactions to these drugs. While genetic polymorphisms may underlie this phenomenon, very little research has been undertaken in this research field. Most of the current knowledge is based on sildenafil, thus almost completely ignoring other important pharmacological therapies. Currently, the most promising genes with pharmacogenetic implications in ED are related to the nitric oxide and cGMP pathway, although other genes are likely to affect the responsiveness to treatment of ED. Nevertheless, the small number of studies available opens the possibility of further exploring other genes and phenotypes related to ED. This article provides a comprehensive overview of the genes being tested for their pharmacogenetic relevance in the therapy of ED. PMID:25303302

  17. The treatment of erectile dysfunction in patients with neurogenic disease.

    Shridharani, Anand N; Brant, William O

    2016-02-01

    Erectile dysfunction (ED) related to compromise of the nervous system is an increasingly common occurrence. This may be due to the multifactorial nature of ED, the myriad of disorders affecting the neurotransmission of erectogenic signals, and improved awareness and diagnosis of ED. Nevertheless, neurogenic ED remains poorly understood and characterized. Disease related factors such as depression, decreased physical and mental function, the burden of chronic illness, and loss of independence may preclude sexual intimacy and lead to ED as well. The amount of data regarding treatment options in subpopulations of differing neurologic disorders remains scarce except for men with spinal cord injury. The treatment options including phosphodiesterase inhibitors, intracavernosal or intraurethral vasoactive agents, vacuum erection devices (VED) and penile prosthetic implantation remain constant. This review discusses the options in specific neurologic conditions, and briefly provides insight into new and future developments that may reshape the management of neurogenic ED. PMID:26904415

  18. The Old Made New: Natural Compounds against Erectile Dysfunction.

    Pavan, Valeria; Mucignat-Caretta, Carla; Redaelli, Marco; Ribaudo, Giovanni; Zagotto, Giuseppe

    2015-09-01

    The interest toward sex-related diseases keeps growing through the years. In this review, we focus our attention on erectile dysfunction (ED), a condition that caught much attention especially after the introduction on the market of phosphodiesterase 5 inhibitors such as the well-known sildenafil. Here, we briefly describe both the etiology of ED and the available treatments, examining then extensively some natural derivatives that, coming from traditional medicine, could represent promising starting points for the development of alternative remedies. In fact, herbal remedies from several parts of the world have been traditionally known for long, and were recently reconsidered and are now being studied to demonstrate their eventual potential in the treatment of ED. Among the various examples reported in the literature and reviewed here, plants and extracts containing polyphenols—especially a class of compounds called kraussianones—appear to be particularly effective and promising against ED. PMID:25974223

  19. Erectile dysfunction and the cardiovascular patient: endothelial dysfunction is the common denominator

    Solomon, H; Man, J W; Jackson, G.

    2003-01-01

    Erectile dysfunction (ED) is a common condition and studies predict that it will become even more common in the future. There is increasing evidence to suggest that it is predominantly a vascular disease and may even be a marker for occult cardiovascular disease. The common pathological process is at the level of the endothelium, and cardiovascular risk factor control may be the key to preventing ED. Many men with established cardiovascular disease have ED. Specific guidelines for the managem...

  20. Prolactinoma in a Diabetic Dialysis Patient with Erectile Dysfunction: A Difficult Differential Diagnosis

    Piccoli, Giorgina B.; Bermont, Francesca; Magnano, Andrea; Soragna, Giorgio; Terzolo, Massimo

    2006-01-01

    Dialysis patients often suffer from erectile dysfunction. The prevalence of this symptom in the context of dialysis is as high as 90%. Diabetes, diffuse vascular disease and pharmacological therapy are attendant causes of this condition, severely impairing the quality of life. Due to the high frequency of erectile dysfunction in uremic patients, minimalist diagnostic approaches are often used. Nevertheless, a careful differential diagnosis is also warranted in well dialyzed patients to identi...

  1. Polycythemia vera revealed via a bladder tumor in a patient with erectile dysfunction: a case report

    Bouchikhi, Ahmed-Amine; Tazi, Mohammed Fadl; Mellas, Soufiane; Amiroune, Driss; Elammari, Jalal Eddine; Khallouk, Abdelhak; El Fassi, Mohammed Jamal; Farih, Moulay Hassan

    2013-01-01

    Introduction Polycythemia vera is a polyglobular myeloproliferative syndrome related to the mutation of multipotent hemopoietic stem cells. This case report describes a patient whose bladder tumor was associated with polycythemia vera and erectile dysfunction. The association of bladder neoplasia with polycythemia vera and erectile dysfunction has not previously been reported in the literature. Case presentation A 40-year-old Moroccan man was followed up for a bladder tumor which manifested w...

  2. Systematic review of randomised controlled trials of sildenafil (Viagra) in the treatment of male erectile dysfunction.

    Burls, A.; Gold, L; Clark, W.

    2001-01-01

    BACKGROUND: Sildenafil (Viagra), a new oral drug for the treatment of erectile dysfunction, was licensed for use across Europe in 1998. AIM: To examine the effectiveness and safety of sildenafil as an oral treatment for erectile dysfunction. DESIGN OF STUDY: Systematic review and meta-analysis. SETTING: All published or unpublished randomised controlled trials comparing sildenafil with a placebo or alternative therapies. METHOD: Published studies were sought by computerised searches of electr...

  3. Erectile Dysfunction after Myocardial Infarction – Myth or a Real Problem?

    Ružić, Alen; Peršić, Viktor; Miletić, Bojan; Včev, Aleksandar; Mirat, Jure; Soldo, Ivan; Batinac, Tanja; Kovač, Tanja

    2007-01-01

    Erectile dysfunction is a common problem whose relation to cardiovascular diseases has scientifically been proved, but it has not been studied sufficiently in patients recovering from myocardial infarction. The objective of this study was to establish the frequency of erectile dysfunction in patients recovering from myocardial infarction. We examined 89 patients (aged 30 to 75 years) included in the program of cardiac rehabilitation after myocardial infarction. The results were co...

  4. Comparison between primary angioplasty and thrombolytic therapy on erectile dysfunction after acute ST elevation myocardial infarction

    Akdemir, Ramazan; Karakurt, Özlem; Orcan, Salih; Karakoyunlu, Nihat; Mucahit Balci, Mustafa; SAĞNAK, Levent; Ersoy, Hamit; Bulent Vatan, Mehmet; Kilic, Harun; Yeter, Ekrem

    2012-01-01

    Acute ST elevation myocardial infarction has high mortality and morbidity rates. The majority of patients with this condition face erectile dysfunction in addition to other health problems. In this study, we aimed to investigate the effects of two different reperfusion strategies, primary angioplasty and thrombolytic therapy, on the prevalence of erectile dysfunction after acute myocardial infarction. Of the 71 patients matching the selection criteria, 45 were treated with primary coronary an...

  5. Role of clinical neurophysiological tests in evaluation of erectile dysfunction in people with spinal cord disorders

    Ashraf V; Taly Arun Kumar; Sivaraman Nair K; Rao Shivaji; Sridhar

    2005-01-01

    BACKGROUND: While erectile dysfunction is frequent among people with disorders of the spinal cord, the role of various clinical neurophysiological tests in assessment is not clear. AIMS: To study the role of clinical neurophysiological investigations in assessing erectile dysfunction among men with spinal cord disorders. SETTING: National Institute of Mental Health and Neurosciences, India. DESIGN: Survey. MATERIALS AND METHODS: Subjects with a score of 21 or less on the International Index ...

  6. Impaired flow-mediated vasodilatation in Asian Indians with erectile dysfunction

    Bhatia, Tanuj; Kapoor, Aditya; Kumar, Jatinder; Sinha, Archana; Ranjan, Priyadarshi; Kumar, Sudeep; Garg, Naveen; Tewari, Satyendra; Srivastava, Aneesh; Kapoor, Rakesh; Goel, Pravin K.

    2013-01-01

    Endothelial dysfunction is the postulated link between coronary artery disease (CAD) and erectile dysfunction (ED). Brachial artery flow-mediated vasodilatation (FMD) is a non-invasive surrogate marker for endothelial function assessment. Despite Asian Indians representing a considerable global CAD burden, data on FMD and ED in these patients are lacking. Of the 225 patients undergoing coronary angiography, 72% had ED (assessed using the International Index of Erectile Function (IIEF-5) quest...

  7. AB156. Homocysteine and vitamin B12: risk factors for erectile dysfunction

    Lu, Zheng; Mo, Zengnan

    2014-01-01

    Background Increasing levels of homocysteine (Hcy) is associated with cardiovascular disease, and erectile dysfunction (ED) has close relation with cardiovascular disease, therefore, high homocysteine may be one of the risk factors of ED. During the metabolism of homocysteine, vitamin B12 plays an important role and could be the main factor in causing erectile dysfunction as well. Purpose To investigate the relationship between Hcy, vitamin B12 and ED in sample. Methods The study included 1,4...

  8. Sex hormones and erectile dysfunction in hemodialysis patients

    Objective: To determine the prevalence of Erectile Dysfunction (ED) in hemodialysis patients (HD) and to study the associated changes in sex hormones in these patients. Methodology: This is a hospital based cross sectional study conducted at hemodialysis units of Shalamar and Mayo Hospitals, Lahore from January to March 2008. All male patients with ESRD on maintenance (HD), whose spouses were alive and able to perform intercourse, were included in the study. Patients with cognitive and communication deficits were excluded from study. International index of erectile function-5(IIEF-5), adopted in Urdu was used for determination of prevalence of ED. Demographic data was collected and sex hormones (total testosterone, Dihydroepiandrosteronediones (DHEA), Follicle Stimulating Hormone (FSH), Leutinizing Hormone (LH) and serum Prolactin) were measured. Results: A total number of fifty patients were included in the study. The major cause of ESRD was diabetes mellitus 28 (56%). The prevalence of ED was 86% with a mean IIEF-5 score 10.36 + 7.13. The majority of patients, 33 (66%), were suffering from a severe degree of ED. The total testosterone level was low in 30 (60%) patients and DHEA were low normal in most of patients, 46 (92%). Compared to patients with non-ED, those with ED had a significantly lower DHEA (1.93 +- 0.73 vs 0.81 +- 0.11, p value = 0.007). Total testosterone and DHEA had a negative correlation with age and diabetes mellitus. FSH showed a variable response in these patients, it was low ( 9.74 mIU/ ml) in eight patients. LH was low ( 7.8 mIU/ml) in fifteen patients. FSH and LH showed a positive correlation with duration of dialysis. Prolactin level was low in 21(42%) patients. Total testosterone, FSH, LH and Prolactin had no association with ED. Conclusion: The majority of the patients suffering from ESRD, on maintenance HD had ED. DHEA was significantly lower in patients with ED, compared to those with no-ED. Total testosterone and DHEA had an inverse

  9. STUDY ON HEMODYNAMICS OF ERECTION IN DIABETIC ERECTILE DYSFUNCTION

    傅强; 姚德鸿; 蒋跃庆

    2004-01-01

    Objective To study the cavernosa hemodynamics in diabetic erectile dysfunction (ED).Methods 22 diabetic and 35 psychic ED patients were studied by intracavernosum injection of a mixture papaverine and phentolamine ( 30/ lmg ) to assess the hemodynamics changes of the corpus cavernosum by means of colour duplex ultrasonography. Results The average hemodynamics data of the diabetic ED patients vs that of the psychogenic ED patients in terms of peak fiow velocity ( PFV) : 20. 06 ± 7. 15cm/s vs 35.82 ±9.41cm/s, end diastolic velocity ( EDV) : 8.82 +0. 35cm/s vs 5. 51 ±0. 42cm/s,artery diameter (Ad): 0. 78 ±0. 25cm vs 1.01 ±0. 42cm,vein diameter (Vd): 1.05 ±0. 32mm vs 1.21 ±0. 45mm, resistance index(RI): 0. 72 ±0. 28 vs 0. 98 ±0.31 ,mean velocity of artery ( MV) :6. 71 ±0. 27cm/ s vs 10. 31 ±3. 32cm/s, dorsal deep vein fiow( DDVF) : 28. 81 ±6. 32cm/s vs 25. 74 ± 0.58cm/s. Stasticstical differences existed in PFV, Ad, RI and MV( P < 0. 01 ). The arterial wall is thick and rigid in diabetic ED patients. Conclusion Atheroscleorsis and veno-occlusive dysfunction of the corpus cavernosum are essential to the development of diabetic ED.

  10. Impact of prostate volume on erectile dysfunction and premature ejaculation.

    Lee, Jun Ho; Lee, Sung Won

    2016-06-01

    We evaluated the impact of total prostate volume (TPV) on the international index of erectile function-5 (IIEF) and the premature ejaculation diagnostic tool (PEDT). A cross-sectional study was conducted that included 8336 men who had participated in a health examination. PEDT, IIEF and transrectal ultrasonography were used. A full metabolic work-up and serum testosterone level checks were also performed. The median age of participants was 51.0 years. In total, 40.1% had IIEF scores ≤16. Additionally, 24.7% were classified as demonstrating premature ejaculation (PE) (PEDT > 10). The severity of erectile dysfunction (ED) significantly increased with the TPV (p trend < 0.001). After adjusting for potential confounding factors, the odds ratio (OR) for IIEF scores ≤ 16 significantly increased in the group with TPVs of 30-39 cm(3) and the group with TPVs ≥ 40 cm(3) compared with the group with TPVs ≤ 19 cm(3) (TPV 30-39 cm(3), OR: 1.204, 95% confidence interval: 1.034-1.403; TPV ≥ 40 cm(3), OR: 1.326: 95% confidence interval: 1.051-1.733) and this relationship was maintained after adjusting for propensity score (TPV ≥ 30 cm(3), OR: 1.138: 95% confidence interval: 1.012-1.280). However, neither PEDT nor PE was correlated with TPV. In conclusion, TPV is significantly and independently correlated with IIEF but not with PEDT. Future investigations should explore the temporal relationship between TPV and ED. PMID:27145693

  11. Help-seeking interval in erectile dysfunction: analysis of attitudes, beliefs, and factors affecting treatment-seeking interval in Turkish men with previously untreated erectile dysfunction.

    Gülpinar, Omer; Haliloğlu, Ahmet H; Abdulmajed, Mohamed Ismat; Bogga, Mehmet Salih; Yaman, Onder

    2012-01-01

    In this study, we report data on attitudes, beliefs, and factors affecting the help-seeking interval among Turkish men with erectile dysfunction to determine whether they are different from those previously published in the literature. Out of 279 Turkish men complaining of erectile dysfunction attending our clinic between December 2006 and March 2008 without the need for referral, 202 were interviewed from a standardized questionnaire covering demographic details, relationships, help-seeking intervals, and attitudes and beliefs. Eleven patients interrupted the questionnaire and only 191 individuals who had never sought medical help for their erectile dysfunction completed the study. The mean age of the study population was 50.1 (20-80) years. Overall, 93.7% of participants had engaged in sexual intercourse during the year preceding the interview. The mean help-seeking interval and the mean estimated time elapsed since last satisfactory sexual intercourse were 24.5 (1-360) and 10.5 (1-180) months, respectively. Patients with low household income and education level had a relatively longer help-seeking interval than the remaining sample. No statistical correlation was seen between treatment-seeking interval and patient age, duration of marriage or continued relationship, and presence of premature ejaculation. Main reasons for delayed consultation included embarrassment (n = 63, 33%) and thinking of erectile dysfunction as a natural process of aging (n = 51, 26.7%). To enable earlier diagnosis and management of erectile dysfunction, emphasis should be put into the provision of affordable health care and wide public education about erectile dysfunction as an entity requiring prompt medical consultation. PMID:22016350

  12. Total Testosterone Levels and the Effect of Sildenafil on Type 2 Diabetics with Erectile Dysfunction

    Nabeel Najib Fadhil Hadeed

    2014-01-01

    Full Text Available Objectives: Hypotestosteronemia has been reported in approximately half of type 2 diabetic men in general. This study aims to assess serum total testosterone levels in type 2 diabetics with erectile dysfunction and to correlate the degree of improvement between sildenafil citrate and testosterone levels. Methods: A cross sectional and prospective comparative interventional study was conducted at the Diabetic Clinic of Assalam Teaching Hospital in Mosul, during the period from January 1, 2009 through to December 31, 2011. The study enrolled 120 type 2 diabetic males with erectile dysfunction who were analyzed with regard to age, duration of diabetes, duration and severity of erectile dysfunction, serum total testosteron levels and the degree of response to sildenafil citrate in terms of testosterone levels. The data were statistically analyzed using the independent two-sample Student t test, χ2 test and Pearson correlation test. A p-value of <0.05 was considered statistically significant. Results: Thirty six percent of type 2 diabetic males with erectile dysfunction were found to have low serum testosterone levels. The hypotestosteronemic and normotestosteronemic subgroups were not significantly different in terms of mean age, duration of diabetes, reduction of libido, and reduction in erectile function. The rate and the degree of improvement of erection by sildenafil in the normo-and-hypotestosteronemic respondents were not significantly different, but the degree of improvement by sildenafil was significantly correlated to testosterone levels among the hypotestosteronemic group. Conclusion: Hypotestosteronemia was found in 36% of type 2 diabetic males with erectile dysfunction. The degree of improvement of erectile dysfunction by sildenafil was directly proportional to the serum testosterone levels among the hypotestosteronemic group. Therapeutic supplement with testosterone preparation in the hypotestosteronemic diabetics with erectile

  13. Erectile Dysfunction Severity as a Risk Marker for Cardiovascular Disease Hospitalisation and All-Cause Mortality: A Prospective Cohort Study

    Banks, Emily; Joshy, Grace; Abhayaratna, Walter P.; Kritharides, Leonard; Macdonald, Peter S; Korda, Rosemary J.; Chalmers, John P.

    2013-01-01

    Editors' Summary Background Erectile dysfunction is the medical term used when a man is unable to achieve or sustain an erection of his penis suitable for sexual intercourse. Although a sensitive topic that can cause much embarrassment and distress, erectile dysfunction is very common, with an estimated 40% of men over the age of 40 years experiencing frequent or occasional difficulties. The most common causes of erectile dysfunction are medications, chronic illnesses such as diabetes, and dr...

  14. Sympathetic skin response: a new test to diagnose erectile dysfunction

    Guang-You ZHU; Yan SHEN

    2001-01-01

    Electrophysiological monitoring of the activity of the penile sympathetic skin responses (PSSR) in healthy men and patients with erectile dysfunction (ED). Methods: PSSR were recorded from the skin of penis with disk electrodes at the time of electric stimulation of left median nerves. Results: PSSR were recorded from all the healthy men and almost all the patients. In healthy men the latency of P0, the latency of N1, the duration of N1 and the amplitude of N1 were 1249 ± 111 ms, 2239 ± 286 ms, 1832 ± 505 ms and 470 μV (median), respectively. In ED patients the latency of P0, the latency of N1, the duration of N1 and the amplitude of N1 were 1467 ± 183 ms ( P < 0.01), 2561±453 ms (P <0.05), 2560±861 ms (P <0.01) and 91 μV (P <0.01), respectively. The normal latency of P0 was less than 1471 ms. The normal amplitude of N1 was more than 235 μV. According to this normal value, of 20 patients 11 showed longer latency of P0, and 14 showed lower amplitude of N1 as compared with those of normal subjects.Conclusion: PSSR can be used as an electrophysiological method in assisting the diagnosis of ED.

  15. Organic causes of erectile dysfunction in men under 40.

    Ludwig, Wesley; Phillips, Michael

    2014-01-01

    There are a significant number of men under 40 who experience erectile dysfunction (ED). In the past, the vast majority of cases were thought to be psychogenic in nature. Studies have identified organic etiologies in 15-72% of men with ED under 40. Organic etiologies include vascular, neurogenic, Peyronie's disease (PD), medication side effects and endocrinologic sources. Vascular causes are commonly due to focal arterial occlusive disease. Young men with multiple sclerosis, epilepsy and trauma in close proximity to the spinal cord are at increased risk of ED. It is estimated that 8% of men with PD are under 40, with 21% of these individuals experiencing ED. Medications causing ED include antidepressants, NSAIDs and finasteride (Propecia), antiepileptics and neuroleptics. Hormonal sources are uncommon in the young population, however possible etiologies include Klinefelter's syndrome, congenital hypogonadotropic hypogonadism, and acquired hypogonadotropic hypogonadism. The workup of young men with ED should include a thorough history and physical examination. The significant prevalence of vascular etiologies of ED in young men should prompt consideration of nocturnal penile tumescence testing and penile Doppler ultrasound. Treatment options that may improve ED include exercise and oral PDE-5 inhibitors. PMID:24281298

  16. The dosimetry of brachytherapy-induced erectile dysfunction

    There is emerging evidence that brachytherapy-induced erectile dysfunction (ED) is technique-related and may be minimized by careful attention to source placement. Herein, we review the relationship between radiation doses to the prostate gland/surrounding structures and the development of brachytherapy-induced ED. The permanent prostate brachytherapy literature was reviewed using MEDLINE searches to ensure completeness. Although the site-specific structure associated with brachytherapy-induced ED remains unknown, there is an increasing body of data implicating the proximal penis. With day 0 CT-based dosimetry, the dose to 50% (D50) and 25% (D25) of the bulb of the penis should be maintained below 40% and 60% mPD, respectively, while the crura D50 should be maintained below 28% mPD to maximize post-brachytherapy potency. To date, there is no data to suggest that either radiation doses to the neurovascular bundles or choice of isotope is associated with brachytherapy-induced ED, while conflicting data has been reported regarding radiation dose to the prostate and the use of supplemental external beam radiation therapy. Although the etiology of brachytherapy-induced ED is likely multifactorial, the available data supports the proximal penis as an important site-specific structure. Refinements in implant technique, including preplanning and intraoperative seed placement, will result in lower radiation doses to the proximal penis with potential improvement in potency preservation

  17. White matter microstructural changes in psychogenic erectile dysfunction patients.

    Zhang, P; Liu, J; Li, G; Pan, J; Li, Z; Liu, Q; Qin, W; Dong, M; Sun, J; Huang, X; Wu, T; Chang, D

    2014-05-01

    Brain dysfunction in erectile dysfunction (ED) has been identified by multiple neuroimaging studies. A recent MRI study indicated grey matter alterations in ED patients. This study aims to investigate the microstructural changes of cerebral white matter (WM) in psychological ED patients and their possible correlations with clinical variables. Twenty-seven psychological ED patients and 27 healthy subjects (HS) were included and underwent a magnetic resonance (MR) diffusion tensor imaging (DTI) scan. The tract-based spatial statistics were employed to identify the WM structure alterations in psychological ED patients. The multiple DTI-derived indices' [fractional anisotropy (FA), axial diffusivity (AD) and mean diffusivity (MD)] correlations with the symptoms and their durations, respectively, were analysed. The IIEF-5, quality of erection questionnaire (QEQ) and the self-esteem and relationship (SEAR) questionnaire were used to assess the symptoms of psychological ED patients. Compared with HS, the psychological ED patients showed increased FA values, reduced MD values and reduced AD values in multiple WM tracts including the corpus callosum (genu, body and splenium), corticospinal tract, internal capsule, corona radiata, external capsule and superior longitudinal fasciculus (p < 0.05, threshold-free cluster enhancement corrected). Both of the IIEF scores and QEQ scores of ED patients showed a significantly negative correlation with the average FA values, and positive correlation with average AD values and MD values in the splenium of the corpus callosum (p < 0.05). The results provided preliminary evidence of WM microstructural changes in patients with psychological ED. The morphological alterations in the splenium of the corpus callosum were related to the symptom severity. PMID:24711250

  18. A comprehensive review of erectile dysfunction in men with diabetes.

    Kamenov, Z A

    2015-03-01

    Erectile dysfunction (ED) is more common in men with diabetes (DM). Dependent on the selected population, age, DM type and duration, the prevalence of diabetic ED (DED) varies from 32 to 90%. In 12-30% of men ED is the first sign of diabetes, diagnosed later. Today men with diabetes live longer than ever, and develop more late diabetic complications. Having in mind also the global ageing of the world population all this data suggests an increasing number of men with DED in the future. The main factors playing in the complex pathogenesis of DED are diabetic neuropathy (oxidative stress, polyol pathway, advanced glycation end-products, nerve growth factor deficiency, dysfunction of protein kinase C, tissue remodeling, etc.), macrovascular arterial disease (endothelial dysfunction, abnormal collagen deposition and smooth muscle degeneration, dyslipidemia, arterial hypertension, veno-occlusive dysfunction, etc.), hypogonadism, structural remodeling of the corporeal tissue, psychogenic components and adverse drug reactions. The diagnostic process is based on the results of questionnaires, neurological, vascular (Doppler) and other more rarely used investigations.Because of the complex pathogenesis of DED diabetic men represent a "difficult" treatment group. The difficulties are from the "beginning", because patients do not talk about their problem spontaneously, and doctors do not ask about it. The treatment of DED should be team work, preferably including also specialists in sexual medicine. Psychological support and counseling of the couple is necessary in most cases. The general measures include implementation of a healthier lifestyle, improved glycemic-, lipids-, and arterial pressure control, and careful re-evaluation of the concomitant medications. The specific treatment includes as first line therapy the inhibitors of phosphodiesterase type 5 (PDE-5) with lesser effectiveness compared to non-DM men. There are rare studies with selected diabetic populations and

  19. AB028. Current status of pharmacotherapy for erectile dysfunction

    Adaikan, P Ganesan

    2016-01-01

    The advent of phosphodiesterase type 5 (PDE5) inhibition as oral therapy has significantly revolutionized both clinical and basic research in the area of erectile dysfunction (ED). Much of this progress is due to a better understanding in the last three decades of the various pathophysiological and cellular mechanisms contributing to ED. Apart from the three available PDE5 inhibitors viz., sildenafil, tadalafil and vardenafil globally at the turn of this century, four other PDE inhibitors have joined the armament in recent time; these include avanafil, lodenafil, mirodenafil and udenafil. All seven PDE inhibitors are effective therapies for the treatment of ED in men. There is no significant difference among them with respect to efficacy, safety profile and tolerability. As such, good safety profiles have widened the horizon in patient choice, selectivity and efficacy. With the ease of oral administration and better patient compliance, other measures of the past, including intracavernosal injections and non-pharmacological treatments have been relegated to second-line therapy for most patients with ED. But, PDE inhibitors as first-line oral therapies are effective in about 75% of male patients diagnosed with ED. Intracavernous injection (IC) therapy with PGE1 (alprostadil) for about 10% patient-usage in general is a well-known effective and well tolerated treatment for men with ED. It is also recommended as a second line therapy for ED along with urethral and topical PGE1. Transurethral PGE1 is less effective compared to IC PGE1. Also the transurethral dosage options are 125 to 1,000 µg, while the IC dosage options are 5 to 40 µg. The topical PGE1 (300 µg in 100 mg of the cream) is also less effective compared to IC PGE1. Topical cream is not approved in many countries as yet. Other existing vasoactive agents such as papaverine, and alpha adrenergic blockers and their combinations and the ever increasing number of other agents in the pipeline including nitric

  20. Prospective survey of erectile dysfunction after external beam radiotherapy for prostate cancer

    We prospectively evaluated the effect of external beam radiotherapy on erectile function in patients with localized or locally advanced prostate cancer using the Japanese version of the International Index of Erectile Function (IIEF) survey. From 2000 to 2007, we identified 55 patients who underwent external beam radiotherapy at our institution for localized or locally advanced prostate cancer and could respond to the IIEF survey. The patients did not receive neo- and/or adjuvant hormone therapy and they were followed-up for at least 12 months after radiotherapy. Mean patient age was 69 years and the mean prostate specific antigen (PSA) level before radiotherapy was 24.9 ng/ml. First we evaluated the change of the erectile function domain score over time before and after radiotherapy. The population of severe erectile dysfunction (ED) increased while those with no or mild ED decreased after radiotherapy. The erectile function and intercourse satisfaction domain score of the IIEF declined significantly after radiotherapy, however, the orgasmic function, sexual desire, and overall satisfaction domain scores did not change after external beam radiation. Of the 34 patients who had erectile function at baseline, 10 patients could maintain erectile function 12 months after radiotherapy. Though there were no significant differences in clinical features between patients who could maintain erectile function and those who had worsening erectile function 12 months after radiotherapy, the sexual desire domain score before radiotherapy was significantly higher in patients who could maintain erectile function than their counterparts. Using the IIEF survey, external beam radiation was found to affect erectile function in patients with localized or locally advanced prostate cancer. (author)

  1. EPIDEMIOLOGY AND ETIOLOGICAL FACTORS OF ERECTILE DYSFUNCTION IN PATIENTS ON DIALYSIS AND AFTER RENAL TRANSPLANTATION

    E. A. Efremov

    2011-06-01

    Full Text Available Today the problem of better life quality of patients with end stage renal disease and after renal transplantation and their sexual adaptation is considered to be more impotent. The clinical part of the investigation is the obser- vation of 205 patients – men with terminal stage renal disease. Erectile dysfunction is represented in 91,4% (64 of patients getting haemodialysis, 92,3% (24 of patients getting peritoneal dialysis, 61,5% (67 of patients after renal transplantation. According to International Index of Erectile Function the mean score of erectile function is 16,7 ± 5,2 in haemodialysis patients, 19,46 ± 3,6 in peritoneal dialysis patients, 21,9 ± 5,6 in patients after renal transplantation. The analysis revealed great prevalence of erectile dysfunction and interest in improvement among the patients with end stage renal disease and after renal transplantation. 

  2. Paget's disease of the skull causing hyperprolactinemia and erectile dysfunction: a case report

    Hepherd Rachel

    2008-07-01

    Full Text Available Abstract Introduction Hyperprolactinemia is an uncommon cause of erectile dysfunction in men. Paget's disease of the skull is a relatively common disease. This case proposes a rare example of a causative link between the two and how treatment of the Paget's disease with bisphosphonates helped the patient regain erectile function. Case presentation A 67-year-old man with Paget's disease of the skull presented with prostatitis, erectile dysfunction, and hyperprolactinemia. Radio-isotope scanning showed increased vascularity around the sphenoid bone. Treatment with intravenous bisphosphonates improved the active Paget's disease as indicated by declining alkaline phosphatase levels and the patient's erectile function while serum prolactin levels became normal and serum testosterone levels remained unchanged. Conclusion It is possible that hyperprolactinemia is unrecognised in other patients with Paget's disease of the skull. Normalizing elevated prolactin levels by using bisphosphonates in treating Paget's disease appears to be more appropriate than traditional treatment for hyperprolactinemia.

  3. Penile erectile dysfunction after brachial plexus root avulsion injury in rats

    Fu, Guo; Qin, Bengang; Jiang, Li; Huang, Xijun; Lu, Qinsen; Zhang, Dechun; Liu, Xiaolin; Zhu, Jiakai; Zheng, Jianwen; Li, Xuejia; Gu, Liqiang

    2014-01-01

    Our previous studies have demonstrated that some male patients suffering from brachial plexus injury, particularly brachial plexus root avulsion, show erectile dysfunction to varying degrees. However, the underlying mechanism remains poorly understood. In this study, we evaluated the erectile function after establishing brachial plexus root avulsion models with or without spinal cord injury in rats. After these models were established, we administered apomorphine (via a subcutaneous injection...

  4. Help-seeking behavior for erectile dysfunction: A clinic-based survey in China

    Kai Zhang; Wei Yu; Zhan-Ju He; Jie Jin

    2013-01-01

    The behavior of Chinese patients seeking help for erectile dysfunction (ED) has not been described in detail. This was an observational study conducted using an outpatient clinic-based questionnaire survey of ED patients. From 2008 to 2009, physicians in 10 medical centers in China enrolled 2693 men (aged 25-70 years) diagnosed with ED. The diagnosis was based on the International Index of Erectile Function 5 (IIEF-5) Questionnaire. The men completed a survey that asked questions about demogr...

  5. Joint keynote presentation – “Erectile dysfunction in Neurological Disorders”

    Treacy, C.L.; Steggall, M.J.

    2013-01-01

    The nature and severity of a man’s neurological condition may have a profound effect on erectile function and this warrants careful consideration in relation to providing supportive treatment options that are effective, safe and acceptable for the individual and his partner. Neurological disorders contribute to erectile dysfunction (ED) in a number of different ways and may occur as a direct result of impairment in the central nervous system, the peripheral nervous system, or a combination of...

  6. Stem cells: novel players in the treatment of erectile dysfunction

    Haiyang Zhang; Maarten Albersen; XunboJin; Guiting Lin

    2012-01-01

    Stem cells are defined by their capacity for both self-renewal and directed differentiation; thus,they represent great promise for regenerative medicine.Historically,stem cells have been categorized as either embryonic stem cells (ESCs) or adult stem cells (ASCs).It was previously believed that only ESCs hold the ability to differentiate into any cell type,whereas ASCs have the capacity to give rise only to cells of a given germ layer.More recently,however,numerous studies demonstrated the ability of ASCs to differentiate into cell types beyond their tissue origin.The aim of this review was to summarize contemporary evidence regarding stem cell availability,differentiation,and more specifically,the potential of these cells in the diagnosis and treatment of erectile dysfunction (ED) in both animal models and human research.We performed a search on PubMed for articles related to definition,Iocalisation and circulation of stem cells as well as the application of stem cells in both diagnosis and treatment of ED.Strong evidence supports the concept that stem cell therapy is potentially the next therapeutic approach for ED.To date,a large spectrum of stem cells,including bone marrow mesenchymal stem cells,adipose tissue-derived stem cells and muscle-derived stem cells,have been investigated for neural,vascular,endothelial or smooth muscle regeneration in animal models for ED.In addition,several subtypes of ASCs are localized in the penis,and circulating endogenous stem cells can be employed to predict the outcome of ED and ED-related cardiovascular diseases.

  7. Should patients with erectile dysfunction be evaluated for cardiovascular disease?

    Kenneth A Ewane; Hao-Cheng Lin; Run Wang

    2012-01-01

    The landmark Massachusetts Male Ageing Study shed new light on the prevalence of erectile dysfunction (ED) and drew attention to ED as a disease of ageing.Over the years,ED has been linked to the development of cardiovascular disease (CVD) in some patients.There is clear evidence that ED and CVD share and have a similar risk factor profile.CVD is one of the most recognizable causes of mortality and early detection coupled with prevention of mortality from CVD has been the prime interest of many researchers.Consequently,there has been a multidisciplinary curiosity regarding the proposal to use ED as a marker for future CVD.In fact,there have been several proposals to use ED as a screening tool for future CVD.We performed a comprehensive search of two main databases-PubMed and Cochrane Library using a combination of keywords such as acute myocardial infarction,coronary artery disease (CAD) and ED.Journal articles from January 2000 to June 2011 were reviewed.We included all articles discussing the relationship between ED and CVD in the English language.All the relevant randomized controlled trials,cohort and retrospective studies,and review articles were included in our overall analysis in an attempt to answer the question whether all patients with ED should be clinically evaluated for CVD.The results showed a link between ED and the development of future CVD in some patients,but ED was not shown to be an independent risk predictor that is any better than the traditional Framingham risk factors.Screening for CVD may,however,be rewarding in younger oatients with severe ED and in patients with concurrent CVD risk factors.

  8. [Viagra: oral therapy of male erectile dysfunction I].

    Malizia, E

    1998-01-01

    Sildenafil, the active component of Viagra was synthetized in 1992-3 and registered for sale in US and subsequently in Europe in 1998, on the basis of positive results of numerous preclinical and clinical studies. In the first part of this review, male sexual impotence (recently named erectile disfunction) is defined and its history and epidemiology is reported. The anatomy, physiology and biochemistry of erectile disfunction and the cycle of male sexual response are also discussed. PMID:10052251

  9. Methylphenidate for the treatment of erectile dysfunction induced by long acting injectable paliperidone palmitate: a case report

    ng chong guan; koh ong hui; jesjeet singh gill

    2013-01-01

    Erectile dysfunction is one of the common sexual adverse effects encountered in male patients treated with antipsychotics. It is associated with prolactin secretion secondary to dopamine antagonism by the antipsychotics. Methylphenidate is a psychostimulant that inhibits the reuptake of dopamine. In this case, we report a 42 year old schizophrenic male, who developed erectile dysfunction after administration of a long acting injectable antipsychotic, namely paliperidone palmitate. The erectil...

  10. Exercise prevents Western diet-associated erectile dysfunction and coronary artery endothelial dysfunction: response to acute apocynin and sepiapterin treatment

    La Favor, Justin D.; Anderson, Ethan J.; Dawkins, Jillian T.; Hickner, Robert C.

    2013-01-01

    The aim of this study was to investigate aerobic exercise training as a means to prevent erectile dysfunction (ED) and coronary artery disease (CAD) development associated with inactivity and diet-induced obesity. Male Sprague-Dawley rats were fed a Western diet (WD) or a control diet (CD) for 12 wk. Subgroups within each diet remained sedentary (Sed) or participated in aerobic interval treadmill running throughout the dietary intervention. Erectile function was evaluated under anesthesia by measuring the mean arterial pressure and intracavernosal pressure in response to electrical field stimulation of the cavernosal nerve, in the absence or presence of either apocynin, an NADPH oxidase inhibitor, or sepiapterin, a tetrahydrobiopterin precursor. Coronary artery endothelial function (CAEF) was evaluated ex vivo with cumulative doses of ACh applied to preconstricted segments of the left anterior descending coronary artery. CAEF was assessed in the absence or presence of apocynin or sepiapterin. Erectile function (P erectile function (P Erectile function (P erectile function in WD-Sed. These data demonstrate that a chronic WD induces impairment in erectile function and CAEF that are commonly partially reversible by apocynin, whereas sepiapterin treatment exerted differential functional effects between the two vascular beds. Furthermore, exercise training may be a practical means of preventing diet-induced ED and CAD development. PMID:23761637

  11. [An evidence-based approach to writing reviews as illustrated by treatment of erectile dysfunction].

    Apolikhin, O P; Abdullin, I I

    2005-01-01

    Reviews integrate the data from original sources of information on the given topic. The quality of the review of literature depends on the quality of initial information. The development of evidence-based medicine demands higher standards from clinical trials. The authors analyse available information on the treatment of erectile dysfunction basing on standard international requirements for clinical trials. A checking list is available for standardization of clinical assessment. The data obtained is ranged by the degree of statistical significance. Basing on the evidence-based approach, the conclusion on efficacy of the following modern drugs in the treatment of erectile dysfunction are made: sildenafil, iochimbin, prostaglandin E1 and tadalafil. The conclusion on efficacy of the other drugs against erectile dysfunction is impossible in view of methodological drawbacks of the trials. PMID:16281837

  12. Frequency of autonomic neuropathy in patients with erectile dysfunction in diabetes mellitus

    Background: Among diabetic patients autonomic neuropathy (AN) is one of the most frequent complications. This affects peripheral nervous system and thus results into erectile dysfunction (ED). The main objectives of the study were to determine the frequency of autonomic neuropathy (AN) in diabetic patients with ED and to find out the associated risk factors. Method: In this descriptive case series, a total 200 consecutive patients of Diabetes Mellitus with erectile dysfunction attended the Department of Endocrinology and Metabolism (DEM), Services Hospital Lahore during three months (from June to August 2013), were included. For assessing erectile dysfunction (ED) and autonomic neuropathy (AN) International Index of Erectile Function (IIEF) and Composite Autonomic Scoring System (CASS) were used respectively. Other factors impacting the autonomic functions in diabetes like duration of diabetes, age of patient, body mass index (BMI), and glycaemic control (HbAlc), hypertension and smoking status were recorded. Results: Average age of the patients was 57.58±9.53 years (95 percentage C.I. 55.54-59.63). Frequency of autonomic neuropathy (AN) in ED patients was 86 (43 percentage). Duration of diabetes Mellitus and BMI were statistically significantly different among patients with severe, moderate and mild autonomic neuropathy. Conclusions: Autonomic neuropathy was very frequent in diabetic patients with erectile dysfunction. The associated risk factors are duration of disease and body mass index. (author)

  13. Case Report: Persistent erectile dysfunction in a man with prolactinoma [v1; ref status: indexed, http://f1000r.es/4qj

    Justin Badal; Ranjith Ramasamy; Tariq Hakky; Aravind Chandrashekar; Larry Lipshultz

    2015-01-01

    Erectile dysfunction has been explored as a condition secondary to elevated prolactin; however, the mechanisms by which elevated prolactin levels cause erectile dysfunction have not yet been clearly established. We here present a patient with a history of prolactinoma who suffered from persistent erectile dysfunction despite testosterone supplementation and pharmacological and surgical treatment for the prolactinoma.  Patients who have had both prolactinemia and erectile dysfunction have been...

  14. Nuclear medicine imaging technique in the erectile dysfunction evaluation: a mini-review

    Camila Godinho Ribeiro; Regina Moura; Rosane de Figueiredo Neves; Jean Pierre Spinosa; Mario Bernardo-Filho

    2007-01-01

    Functional imaging with positron emission tomography and single photon emission computed tomography is capable of visualizing subtle changes in physiological function in vivo. Erectile dysfunction(ED) diminishes quality of life for affected men and their partners. Identification of neural substrates may provide information regarding the pathophysiology of types of sexual dysfunction originating in the brain. The aim of this work is to verify the approaches of the nuclear medicine techniques i...

  15. Modifying Risk Factors in the Management of Erectile Dysfunction: A Review.

    DeLay, Kenneth J; Haney, Nora; Hellstrom, Wayne Jg

    2016-08-01

    Erectile dysfunction (ED) is prevalent among men and its presence is often an indicator of systemic disease. Risk factors for ED include cardiovascular disease, hypertension, diabetes mellitus (DM), tobacco use, hyperlipidemia, hypogonadism, lower urinary tract symptoms, metabolic syndrome, and depression. Addressing the modifiable risk factors frequently improves a patient's overall health and increases lifespan. The literature suggests that smoking cessation, treatment of hyperlipidemia, and increasing physical activity will improve erectile function in many patients. How the treatment of DM, depression, and hypogonadism impacts erectile function is less clear. Clinicians need to be aware that certain antihypertensive agents can adversely impact erectile function. The treatment of men with ED needs to address the underlying risk factors to ameliorate the disease process. PMID:27574592

  16. Low-intensity extracorporeal shockwave therapy in the treatment of postprostatectomy erectile dysfunction: a pilot study

    Frey, Anders; Sønksen, Jens; Fode, Mikkel

    OBJECTIVE: The objective was to investigate the effect and feasibility of low-intensity extracorporeal shockwave therapy (LI-ESWT) as a treatment for erectile dysfunction (ED) after bilateral nerve-sparing radical prostatectomy (RP). MATERIALS AND METHODS: Patients who had undergone robot...

  17. Psychology's Role in the Assessment of Erectile Dysfunction: Historical Precedents, Current Knowledge, and Methods.

    Ackerman, Mark D.; Carey, Michael P.

    1995-01-01

    Describes the role of the psychologist in the evaluation of erectile dysfunction. Reviews current diagnostic criteria and provides a historical overview of the topic. Summarizes current epidemiologic knowledge, including data on prevalence and research on cognitive, affective, dydactic, and lifestyle etiologic risk factors. Discusses assessment…

  18. Erectile dysfunction: Principles of radiological clarification and treatment. Erektile Dysfunktion: Prinzipien der radiologischen Abklaerung und Therapie

    Schild, H.; Mueller, S.C. (Mainz Univ. (Germany, F.R.). Inst. fuer Klinische Strahlenkunde Mainz Univ. (Germany, F.R.). Urologische Klinik und Poliklinik)

    1991-01-01

    Diagnosis of erectile dysfunction is performed by means of Doppler sonography, cavernosography and cavernosometry, as well as by angiographic methods. Interventional radiological treatment methods are, arterially, vasodilatation or vasorecanalisation, and, as far as the venous approach is concerned, percutaneous venous occlusion. The article reviews the diagnostic and therapeutic radiological methods. (orig.).

  19. The Association Between Female Sexual Dysfunction and the Husband's Erectile Dysfunction: Evidence from Married Couples in Hong Kong.

    Zhang, Huiping; Fan, Susan; Yip, Paul

    2016-04-01

    Little is known about the association between the sexual functioning of each partner in a heterosexual married couple. By using a community-based survey of Hong Kong Chinese couples in 2012, this study attempted to examine the relation between female sexual dysfunction and their husbands' erectile dysfunction. Among the 1,518 female and 1,059 male respondents, 944 sexually active couples were eligible for the analysis, with mean age of 39.3 ± 6.8 years (range = 21-50) for the wives and 43.6 ± 8.6 years (range = 18-80) for the husbands. Of the wives, 27.0% reported at least one form of female sexual dysfunction and 5.0% of the husbands reported erectile dysfunction. After adjusting for the female's age and other risk factors, the total and domain scores of female sexual dysfunction were not associated with her husband's erectile dysfunction except for physical pain during sexual intercourse. Therefore, whether to screen the partner's sexual function depends on the age of the female clients. PMID:25514566

  20. AB171. Targeting Ninjurin-1 for future therapy of erectile dysfunction

    Yin, Guo Nan; Ryu, Ji-Kan; Suh, Jun-Kyu

    2014-01-01

    Penile erection is a neurovascular phenomenon, and erectile dysfunction (ED) is caused mainly by vascular risk factors or diseases, neurologic abnormalities, and hormonal disturbances. Men with diabetic ED often have severe endothelial dysfunction and peripheral nerve damage, which result in poor response to oral phosphodiesterase-5 inhibitors. Nerve injury-induced protein 1 (Ninjurin 1, Ninj 1) is known to be involved in neuroinflammatory processes and to be related to vascular regression du...

  1. AB05. Targeting Ninjurin-1 for future therapy of erectile dysfunction

    Suh, Jun Kyu

    2014-01-01

    Penile erection is a neurovascular phenomenon, and erectile dysfunction (ED) is caused mainly by vascular risk factors or diseases, neurologic abnormalities, and hormonal disturbances. Men with diabetic ED often have severe endothelial dysfunction and peripheral nerve damage, which result in poor response to oral phosphodiesterase-5 inhibitors. Nerve injury-induced protein 1 (Ninjurin 1, Ninj 1) is known to be involved in neuroinflammatory processes and to be related to vascular regression du...

  2. Erectile dysfunction and heart failure: the role of phosphodiesterase type 5 inhibitors

    Al-Ameri, H; Kloner, R. A.

    2009-01-01

    The phosphodiesterase type 5 (PDE-5) inhibitors are effective in treating erectile dysfunction (ED). ED and heart failure (HF) share similar risk factors, and commonly present together. This association has led to questions ranging from the safety and efficacy of PDE-5 inhibitors in HF patients to a possible role for this class of medication to treat HF patients with or without ED. In addition to endothelial dysfunction, there are causes of ED specific to patients with HF including low exerci...

  3. How Serious Is Erectile Dysfunction in Men's Lives? Comparative Data From Korean Adults

    Ji, Yoon Seob; Choi, Ji Woong; Ko, Young Hwii; Song, Phil Hyun; Jung, Hee Chang; Moon, Ki Hak

    2013-01-01

    Purpose Whereas sexual function has long been assumed to be an important component of adult men's lives, the impact of sexual dysfunction has not been estimated in parallel to other modern disease entities. We compared the seriousness of erectile dysfunction (ED) with that of other diseases by use of self-administered questionnaires. Materials and Methods Between January 2012 and July 2012, 434 healthy male volunteers (group 1) and 263 ED patients (group 2) were enrolled. The questionnaire co...

  4. Brain Networks during Free Viewing of Complex Erotic Movie: New Insights on Psychogenic Erectile Dysfunction

    Cera, Nicoletta; Di Pierro, Ezio Domenico; Ferretti, Antonio; Tartaro, Armando; Romani, Gian Luca; Perrucci, Mauro Gianni

    2014-01-01

    Psychogenic erectile dysfunction (ED) is defined as a male sexual dysfunction characterized by a persistent or recurrent inability to attain adequate penile erection due predominantly or exclusively to psychological or interpersonal factors. Previous fMRI studies were based on the common occurrence in the male sexual behaviour represented by the sexual arousal and penile erection related to viewing of erotic movies. However, there is no experimental evidence of altered brain networks in psych...

  5. [Oral drug therapy options in the treatment of erectile dysfunction].

    Hrgović, Z; Hrgović, I; Thaci, D

    1998-01-01

    The erectile disfunction (ED) represent a disease where diagnostic and therapy are maial standardized. However in the pharmacological there exists a lot of administer justice and legal-insurent problems because there are to few registered medicines. In respect towards the new revolutionary development in the therapy of erectile disfunction, the injectionary therapy of the corpus cavernous loses it is permanent place. Without questions the modilities of the new oral therapy with sildenafil will replace many patients using the "injectionary therapy", concerving psychogenic, neurogenic and soft disturbance into bloodvint during the erection. Simply, it must be said, that there are no further results in the oral therapy, because of the short time research regarding sildenofil. Therefore it is not know what kind of side effects would resulting inffens of sildenafil. After taking one tablet the effects could be expected after half on hour. According to literature recent success with the new therapy in about 90%. PMID:9769638

  6. Erectile dysfunction following treatment with low-dose brachytherapy for prostate cancer

    Of 260 prostate cancer patients, 26% had potency before brachytherapy when defined as an sexual health inventory for men (SHIM) score of ≥12. Three years after brachytherapy, 44% patients had preserved erectile function (EF-pts) and 56% were erectile dysfunction (ED-pts). Between ED-pts and EF-pts, we compared the doses delivered to the penile bulb or neurovascular bundle using a dose-volume histogram obtained from brachytherapy postplan and patients' characteristics. The mean age and prostate volume of ED-pts were significantly higher than those of EF-pts. No difference was observed in the respective doses between the 2 groups.(author)

  7. [Patient with testosterone deficit syndrome and erectile dysfunction non-responder to PDE-5 inhibitors].

    Rodríguez-Izquierdo, Marta; Martínez-Salamanca, Juan I; Moncada, Ignacio; Linares Espinós, Estefanía; del Portillo, Luis; Areche, Jennifer; Carballido, Joaquín

    2013-09-01

    Androgens play an essential role in the corporo-venous occlusive mechanism that provokes erection. Accordingly to various studies based on animal models,testosterone deficit syndrome causes an endothelial disorder in the corpora cavernosa with diminished secretion of NO, alteration of penile smooth muscle and tunica albuginea structure, and increase of the number of adipocytes within the erectile tissue, which favors fibrosis and impairs erection. All these alterations are reversible with the exogenous administration of androgens. There are not enough studies to get definitive conclusions about androgen supply improving erectile dysfunction in patients with hypogonadism. Studies have been published in which seems that exogenous testosterone could be useful in the treatment of this type of patients. Nevertheless,in most published randomized double blind studies comparing with placebo, testosterone supply does not provide greater benefit on erectile dysfunction than PDE-5 Inhibitors exclusively. All studies coincide in the need to optimize the treatment with PDE-5 Inhibitors since they do have proven to be effective for the treatment of erectile dysfunction in patients with testosterone deficit syndrome. PMID:24047632

  8. Nuclear medicine imaging technique in the erectile dysfunction evaluation: a mini-review

    Functional imaging with positron emission tomography and single photon emission computed tomography is capable of visualizing subtle changes in physiological function in vivo. Erectile dysfunction (ED) diminishes quality of life for affected men and their partners. Identification of neural substrates may provide information regarding the pathophysiology of types of sexual dysfunction originating in the brain. The aim of this work is to verify the approaches of the nuclear medicine techniques in the evaluation of the erectile function/dysfunction. A search using the words ED and nuclear medicine, ED and scintigraphy, ED and SPECT and ED and PET was done in the PubMed. The number of citations in each subject was determined. Neuroimaging techniques offer insight into brain regions involved in sexual arousal and inhibition. To tackle problems such as hyposexual disorders or ED caused by brain disorders, it is crucial to understand how the human brain controls sexual arousal and penile erection. (author)

  9. Nuclear medicine imaging technique in the erectile dysfunction evaluation: a mini-review

    Ribeiro, Camila Godinho; Moura, Regina; Neves, Rosane de Figueiredo [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Inst. de Biologia Roberto Alcantara Gomes. Lab. de Radiofarmacia Experimental]. E-mail: cacagr@yahoo.com.br; Spinosa, Jean Pierre [Hopital de Zone, Morges (Switzerland). Dept. of Gynecology and Obstetrics; Bernardo-Filho, Mario [Instituto Nacional do Cancer, Rio de Janeiro, RJ (Brazil). Coordenadoria de Pesquisa

    2007-09-15

    Functional imaging with positron emission tomography and single photon emission computed tomography is capable of visualizing subtle changes in physiological function in vivo. Erectile dysfunction (ED) diminishes quality of life for affected men and their partners. Identification of neural substrates may provide information regarding the pathophysiology of types of sexual dysfunction originating in the brain. The aim of this work is to verify the approaches of the nuclear medicine techniques in the evaluation of the erectile function/dysfunction. A search using the words ED and nuclear medicine, ED and scintigraphy, ED and SPECT and ED and PET was done in the PubMed. The number of citations in each subject was determined. Neuroimaging techniques offer insight into brain regions involved in sexual arousal and inhibition. To tackle problems such as hyposexual disorders or ED caused by brain disorders, it is crucial to understand how the human brain controls sexual arousal and penile erection. (author)

  10. Evaluation of transurethral application of alprostadil for erectile dysfunction in Indonesians

    WimpieI.Pangkahila

    2000-01-01

    Aim: To evaluate the efficacy and safety of transurethral application of alprostadil (MUSE.) for the treatment of erectile dysfunction in Indonesians. Methods: Twenty erectile dysfunction patients aged between 32 - 74 years old were recruited in this study. The inclusion criteria were as follows: 1 ) adult males 18 years or older with a subjective complaint or erectile dysfunction, 2) to provide written informed consent, 3) to agree not to use other forms of treatment for erectile dysfunction, 4) fulfill the screening laboratory values. Part 1, eligible patients were titrated in the clinic starting with a dose of 250 μg and proceed in a stepwise manner to 500μg and 1000μg on separate clinic visits until they identified a dose that produced a satisfactory response. The interval between each in-clinic titration was 2-3 days. Each in-clinic titration dose was evaluated at 15 min intervals over a one hour period for erection assessment, blood pressure and pulse. Part 2, patients used MUSE at home for three months at the dose identified during the inclinic titration. Monthly interim visits were required for patient follow-up and drug distribution. At the end of the study, patients had another laboratory (except testosterone, only assayed in screening procedure) and physical examination. Results: The etiology of erectile dysfunction was psychological in 5 patients and organic in 15 patients. The 65% of the patients achieved the erection scale of 4 or 5 either in the clinic or at home, 10% achieved the scale of 4 at home, but not in the clinic, and 25 % only achieved the scale of 2 or 3 with the highest dose of 1000μg either in the clinic or at home. No significant differences were found in biochemical examination before and after the study. The 60 % of the patients who achieved erection scale 4 or 5 continued to use MUSE until the end of the study, while 40 % of them complained of pain at the time of MUSE application, during erection and/or during intercourse. They

  11. Analysis of polysomnographic findings of men with obstructive sleep apnea syndrome who have erectile dysfunction and effects of nasal CPAP theraphy on the erectile dysfunction

    Mustafa Acar

    2014-01-01

    Full Text Available Objective: We aimed to investigate the relationship between polysomnographic (PSG findings and sexual functions of men with erectile dysfunction (ED caused by obstructive sleep apnea (OSA syndrome. and point out the alteration in the sexual functions after continous positive airway pressure (CPAP theraphy. Materials and Methods: Patients referred to Yunus Emre State Hospital sleep laboratory between May 2013 and October 2013 with a complaints of snoring and apnea during sleep and have apnea hypopnea index (AHI>15 were the subjects of this prospective clinical study. All patients were asked to fill IIEF (International Index of Erectile Function test before and after 12 weeks of CPAP theraphy. Results: As well as total IIEF-15 scores, each score of five questions (erectile function, orgasmic function, sexual desire, intercourse satisfaction, overall satisfaction were significantly increased after nasal CPAP therapy (p0.05. Twenty-one (84 and 10 (40 patients had ED before and after CPAP treatment respectively and the changing was statistically significant (p=0.003. The correlation analysis was revealed no significant relation between the IIEF-15 (total five item scores and PSG findings. Conclusion: Our findings revealed that CPAP therapy improves ED of men with OSAS. Although ED is not a mortal complaint, it has remarkable impact on mens life and might be improved after CPAP theraphy.

  12. Penile erectile dysfunction after brachial plexus root avulsion injury in rats

    Guo Fu; Xuejia Li; Liqiang Gu; Bengang Qin; Li Jiang; Xijun Huang; Qinsen Lu; Dechun Zhang; Xiaolin Liu; Jiakai Zhu; Jianwen Zheng

    2014-01-01

    Our previous studies have demonstrated that some male patients suffering from brachial plexus injury, particularly brachial plexus root avulsion, show erectile dysfunction to varying degrees. However, the underlying mechanism remains poorly understood. In this study, we evaluated the erectile function after establishing brachial plexus root avulsion models with or without spinal cord injury in rats. After these models were established, we administered apomorphine (via a sub-cutaneous injection in the neck) to observe changes in erectile function. Rats subjected to simple brachial plexus root avulsion or those subjected to brachial plexus root avulsion combined with spinal cord injury had signiifcantly fewer erections than those subjected to the sham operation. Expression of neuronal nitric oxide synthase did not change in brachial plexus root avulsion rats. However, neuronal nitric oxide synthase expression was signiifcantly decreased in brachial plexus root avulsion + spinal cord injury rats. These ifndings suggest that a decrease in neuronal nitric oxide synthase expression in the penis may play a role in erectile dysfunction caused by the combi-nation of brachial plexus root avulsion and spinal cord injury.

  13. Effects of Aerobic Exercise in the Management of Erectile Dysfunction: A Meta Analysis Study on Randomized Controlled Trials

    Lamina, Sikiru; Agbanusi, EC; Nwacha, Richard C

    2011-01-01

    Background Penile erection is a hemodynamic process involving increased arterial inflow and restricted venous outflow, coordinated with corpus cavernosum and penile arterial smooth muscle relaxation. Any problem in this mechanism results in Erectile Dysfunction and its etiology is generally multifactorial. This study is aimed at determining the objective outcome of aerobic training in the management of Erectile Dysfunction of arterogenic origin using Meta analysis. Methods Relevant publicatio...

  14. Crude ethanolic leaf extracts of Citropsis articulata: a potential phytomedicine for treatment of male erectile dysfunction associated with testosterone deficiency

    Patrick Vudriko; Martin K. Baru; John Kateregga; Ndukui, James G

    2014-01-01

    Background: Erectile dysfunction is the inability to sustain erection of the penis firm enough for sexual intercourse in males. Citropsis articulata is used locally by communities in Uganda for the management of erectile dysfunction. The current study evaluated the effect of ethanolic leaf extract of C. articulata on the serum level of testosterone and mounting frequency in Male albino rats. Methods: The study animals were divided into four groups and the extract groups dosed daily orally ...

  15. Penile prosthesis implant for erectile dysfunction: A new minimally invasive infrapubic surgical technique

    Gabriele Antonini

    2016-01-01

    Full Text Available Erectile dysfunction, the most common male sexual disorder after premature ejaculation, with its important impact on man and partner’s sexuality and quality of life is a persistent inability to obtain and maintain an erection sufficient to permit satisfactory sexual performance. Non-surgical treatments with controversial results are usually applyed before surgical treatment that has reached high levels of satisfaction. We describe a new surgical technique to implant three-pieces penile prosthesis in patients suffering from erectile dysfunction (ED not responding to conventional medical therapy or reporting side effects with such a therapy. Implantation of an inflatable prosthesis, for treatment of ED, is a safe and efficacious approach with high satisfaction reported by patients and partners. Surgical technique should be minimally invasive and latest technology equipment should be implanted in order to decrease common complications and to obtain a better aesthetic result.

  16. Penile prosthesis implant for erectile dysfunction: A new minimally invasive infrapubic surgical technique.

    Antonini, Gabriele; Busetto, Gian Maria; De Berardinis, Ettore; Giovannone, Riccardo; Vicini, Patrizio; Gentile, Vincenzo; Perito, Paul E

    2015-12-01

    Erectile dysfunction, the most common male sexual disorder after premature ejaculation, with its important impact on man and partner's sexuality and quality of life is a persistent inability to obtain and maintain an erection sufficient to permit satisfactory sexual performance. Non-surgical treatments with controversial results are usually applyed before surgical treatment that has reached high levels of satisfaction. We describe a new surgical technique to implant three-pieces penile prosthesis in patients suffering from erectile dysfunction (ED) not responding to conventional medical therapy or reporting side effects with such a therapy. Implantation of an inflatable prosthesis, for treatment of ED, is a safe and efficacious approach with high satisfaction reported by patients and partners. Surgical technique should be minimally invasive and latest technology equipment should be implanted in order to decrease common complications and to obtain a better aesthetic result. PMID:26766806

  17. Erectile dysfunction as rare side effect in the simultaneous intrathecal application of morphine and clonidine.

    Koman, Gershom; Alfieri, Alex; Rachingter, Jens; Strauss, Christian; Scheller, Christian

    2012-01-01

    We report on the case of a 52-year-old man who presented with a history of chronic neuropathic pain treated with intrathecal application of morphine for many years. In spite of significant dose escalation, considerable pain relief had not been achieved. Ziconotide had been tried but not only did it not provide pain relief, but it also caused severe side effects in this patient. A combination of morphine and clonidine was delivered by a programmable pump, slowly increasing the clonidine rate over several weeks. For ease of transition and minimization of hospitalization, which was a special concern to this patient, combining clonidine and morphine was chosen over monotherapy with hydromorphone, with both possibilities being described as equal alternatives in the literature. Considerable pain relief was achieved during week 2 at a clonidine dose of 0.040 mg/d, thereby decreasing the visual analog score (VAS) from 10 to 4. Yet, after developing erectile dysfunction and relative hypotension soon after beginning clonidine treatment, the patient decided not to continue with the combined application of morphine and clonidine. Treatment was therefore switched back to the former monotherapy with morphine. Thereafter, erectile dysfunction disappeared and blood pressure returned to habitual high levels. Although common in systemic application, erectile dysfunction caused by the intrathecal application of clonidine has not been described yet in the literature. In this patient, this rare side effect decisively impaired life quality, subjectively outweighing the considerable pain relief which could be achieved after formerly inefficacious treatment. Further and prospective investigation might be needed to estimate the connection of erectile dysfunction to intrathecal application of clonidine. PMID:22828698

  18. A new potential risk factor in patients with erectile dysfunction and premature ejaculation: folate deficiency

    Wen-Jie Yan; Nan Yu; Tai-Lang Yin; Yu-Jie Zou; Jing Yang

    2014-01-01

    We investigated serum folic acid (FA) levels in patients with erectile dysfunction (ED) and/or premature ejaculation (PE). Fasting serum samples were obtained from 42 patients with ED, 36 with PE, 25 ED patients with PE, and 30 healthy men; the mean intravaginal ejaculation latency time (IELT) was measured during a 4 weeks baseline period. Levels of sex hormones (follicle-stimulating hormone, luteinizing hormone, total testosterone), homocysteine (Hcys), and FA were measured using chemilumine...

  19. AB038. Prevalence and influential factors of erectile dysfunction in male renal transplant recipients

    Tian, Ye; Ji, Zheng-guo; Tang, Ya-Wang; Zhang, Lei; Lin, Jun; Sun, Wen; Guo, Hong-bo; Xie, Ze-Lin; Ao, Jian-Hua; Ma, Lin-Lin; Lv, Wen-Cheng; Du, Lin-Dong; Chen, Li-Sheng; Xu, Yuan-Cheng

    2015-01-01

    Objective To research the prevalence of erectile dysfunction (ED) and the influencial factors in male renal transplant recipients (RTR). Methods A cross-sectional survey was conducted in three renal transplantion centres. Structured questionnaires were administrated by trained interviewers to 824 male renal transplant patients, who had active sexual life in last 6 months. Results The complaints of ED was reported by 75.5% of the 809 RTR (age range, 19-75 y, mean 45±10 y), whose questionnaires...

  20. Phosphodiesterase type 5 inhibitors as a treatment for erectile dysfunction: Current information and new horizons

    Ferguson, James E.; Carson, Culley C

    2013-01-01

    Introduction Over the past 15 years, the discovery and development of oral medications that selectively inhibit the enzyme phosphodiesterase type 5 (PDE5) have revolutionised the treatment of erectile dysfunction (ED). Currently, three PDE5 inhibitors are widely available clinically, i.e., sildenafil, vardenafil and tadalafil. New PDE5 inhibitors, including avanafil and udenafil, are now in clinical use in a few countries, and other compounds are under development. Methods We describe the cur...

  1. Chronic Low Dosing of Phosphodiesterase Type 5 Inhibitor for Erectile Dysfunction

    Sung, Hyun Hwan; Lee, Sung Won

    2012-01-01

    Oral phosphodiesterase type 5 (PDE5) inhibitors have provided non-invasive, effective, and well-tolerated treatments for patients with erectile dysfunction (ED). However, many patients with ED are unresponsive to 'on-demand' PDE5 inhibitors. In addition, the lack of spontaneity and naturalness of the on-demand regimen could be a reason for decreased compliance with PDE5 inhibitors. Recently, tadalafil and udenafil were approved for low-dose daily administration for the treatment of ED. Since ...

  2. Tadalafil once daily in the management of erectile dysfunction: patient and partner perspectives

    Pierre Costa; Thierry Grivel; Naji Gehchan

    2009-01-01

    Pierre Costa1, Thierry Grivel2, Naji Gehchan31Service d’Urologie–Andrologie, Hôpital Caremeau, Nîmes, France; 2159, Avenue Sainte-Marguerite, Nice, France; 3Eli Lilly and Company, Lilly France – Medical Division, Suresnes, FranceAbstract: Erectile dysfunction (ED) is a prevalent condition that affects men and their partners. Significant improvements in the sexual lives of these couples have been achieved with the introduction of phosphodiester...

  3. Non-invasive management of primary phosphodiesterase type 5 inhibitor failure in patients with erectile dysfunction

    Lowe, Gregory; Bahnson, Robert

    2009-01-01

    Phosphodiesterase type 5 inhibitors (PDE5-i) have become first line therapy for the treatment of erectile dysfunction. Most initial prescriptions for PDE5-i are by primary care practitioners. Urologists must now routinely manage the patient who has failed initial therapy with PDE5-i. Lifestyle modifications can be of benefit to patients. Patient education and optimization of the PDE5-i can result in a successful response. Interestingly, there are reports of up to 60% salvage after changing th...

  4. Muslim Prayer Movements as an Alternative Therapy in the Treatment of Erectile Dysfunction: A Preliminary Study

    Ibrahim, Fatimah; Sian, Tee Chee; Shanggar, Kuppusamy; Razack, Azad Hassan

    2013-01-01

    [Purpose] Our objective was to assess the effect of salat and mimicking salat movements and postures on subjects with erectile dysfunction. [Methods] Ten volunteers were recruited in this study. Subjects who were Muslims (Group I) were asked to perform their daily salat and a new intervention of an additional 12 movement cycles of salat for three sessions a week. Non-Muslim subjects (Group II) were taught to mimic salat movements, and were asked to perform a total of 12 movement cycles withou...

  5. Oral drug treatments in patients with erectile dysfunction and multiple comorbidities: a retrospective observational study

    Zaman Huri, Hasniza; Lian Choo, Tee; Sulaiman, Che Zuraini; Mark, Raymond; Abdul Razack, Azad Hassan

    2014-01-01

    Objective To investigate factors associated with demographic/clinical characteristics and drug selection in patients with erectile dysfunction (ED). The prevalence of ED is increasing worldwide. Studies have shown that ED is associated with age, lifestyle and comorbidities. However, the factors associated with patient characteristics as well as drug selection are incompletely understood. Setting A tertiary medical centre in Kuala Lumpur, Malaysia. Participants A total of 219 patients (range 2...

  6. Post-prostatectomy erectile dysfunction: contemporary approaches from a US perspective

    Hamilton Z; Mirza M

    2014-01-01

    Zachary Hamilton,1 Moben Mirza,2 1Department of Urology, 2Division of Urologic Oncology, Department of Urology, University of Kansas, Kansas City, KS, USA Abstract: Success of cancer surgery often leads to life-changing side effects, and surgical treatment for malignant urologic disease often results in erectile dysfunction (ED). Patients that undergo surgical prostatectomy or cystoprostatectomy will often experience impairment of erections due to disruption of blood and nerve supply. Surgic...

  7. Penile prosthesis implant for erectile dysfunction: A new minimally invasive infrapubic surgical technique

    Gabriele Antonini; Gian Maria Busetto; Ettore De Berardinis; Riccardo Giovannone; Patrizio Vicini; Vincenzo Gentile; Paul E. Perito

    2016-01-01

    Erectile dysfunction, the most common male sexual disorder after premature ejaculation, with its important impact on man and partner’s sexuality and quality of life is a persistent inability to obtain and maintain an erection sufficient to permit satisfactory sexual performance. Non-surgical treatments with controversial results are usually applyed before surgical treatment that has reached high levels of satisfaction. We describe a new surgical technique to implant three-pieces penile prosth...

  8. AB006. Erectile dysfunction (ED) as a marker for cardiovascular diseases (CVD)

    Torres, Luiz Otavio

    2015-01-01

    In 1973 V. Michal, a vascular surgeon said “Erectile dysfunction (ED) is related to diseases of the vascular bed”. And this makes sense since ED and cardiovascular diseases (CVD) share many risk factors like aging, obesity, inactivity, smoking, depression, dyslipidemia, hypertension, diabetes/insuline resistance. These conditions may lead to an oxidative stress which ultimately can promote vasoconstriction, thrombosis, atherosclerosis and finally ED and CVD. One of the most accepted Idea is t...

  9. Bilateral Simultaneous Nonarteritic Anterior Ischemic Optic Neuropathy after Ingestion of Sildenafil for Erectile Dysfunction

    Anna Tarantini; Alessandra Faraoni; Francesca Menchini; Paolo Lanzetta

    2012-01-01

    Purpose. To describe a patient who developed bilateral, simultaneous nonarteritic anterior ischemic optic neuropathy (NAION) after ingestion of Sildenafil citrate (Viagra) for erectile dysfunction. Methods. Observational case report. Results. A 60-year-old diabetic man noted sudden decrease of vision in both eyes 16 hours after his third consecutive 50 mg daily Sildenafil ingestion. A diagnosis of bilateral NAION was made and he was treated for three days with methylprednisolone 1 g/d intrave...

  10. ATMAGUPTADI CHURNA AND PSYCHOTHERAPY IN THE TREATMENT OF MANASKLAIBYA (ERECTILE DYSFUNCTION)

    Amit Kumar Misra; K. H. H. V. S. S. Narasimha Murthy

    2011-01-01

    Impotence or Erectile Dysfunction is a very common and one of the most distressing ailment in men which reflects its negative stigmas in several forms of social decomposites. As stated in Ayurvedic texts that ‘Ahara, Nidra and Brahmacharya / Abrahmacharya’ are three basic sub pillars responsible for integrity of Arogya, which is the essential factor for achievement of ‘Purusharth-Chatushtayas’.A single blind clinical study was done in 40 patients selected from the OPD and IPD of Kayachikitsa,...

  11. Future prospects in the treatment of erectile dysfunction: focus on avanafil

    Alwaal A; Al-Mannie R; Carrier S

    2011-01-01

    Amjad Alwaal, Raed Al-Mannie, Serge Carrier Division of Urology, McGill University Health Centre, Montreal, Quebec, Canada Abstract: The treatment of erectile dysfunction (ED) has been revolutionized in the last 15 years with the introduction of type 5 phosphodiesterase (PDE5) inhibitors. Their efficacy, safety, and ease of administration have made them first-line treatment for ED. This article reviews the current therapies available for ED, and the new PDE5 inhibitors that are being investi...

  12. Correlation between penile cavernosal artery blood flow and retinal vascular findings in arteriogenic erectile dysfunction

    Emarah, Ahmed

    2010-01-01

    Ahmed M Emarah1, Shawky M El-Haggar2, Ihab A Osman2, Abdel Wahab S Khafagy21Departments of Ophthalmology, 2Andrology and Sexology, Cairo University Hospital, EgyptObjectives: Arteriogenic erectile dysfunction (ED) is a target organ disease of atherosclerosis, and therefore might be a predictor of systemic atherosclerosis. Being systemic, it might be possible to evaluate the extent of atherosclerosis from retinal vascular findings. We investigated the possible correlation between penile cavern...

  13. Effect of sildenafil in cavernous arteries of patients with erectile dysfunction

    Joaquim A Claro

    2003-08-01

    Full Text Available INTRODUCTION: Sildenafil citrate is a type 5 phosphodiesterase inhibitor, which has demonstrated excellent results in the treatment of erectile dysfunction. The effect of sildenafil citrate in the cavernous arteries of patients with erectile dysfunction has not been established yet. The objective of this study was to assess the effect of sildenafil citrate in the cavernous arteries of patients with erectile dysfunction, following an intracavernous injection of alprostadil. MATERIALS AND METHODS: 29 male patients, with mean age of 53.8 years (32 to 75 years, were prospectively evaluated. The mean time with complaint of erectile dysfunction was 50.5 months (6 to 168 months. Each patient was his own control. Patients underwent a measurement of peak systolic velocity before and after use of sildenafil citrate associated with 5 micrograms of alprostadil, through ultrasonic velocitometry Knoll/MIDUS® system. In the interval between measurements, approximately 15 days, patients used 3 tablets of sildenafil at home with their partners. RESULTS: Using only 5 mcg of alprostadil, average peak systolic velocity was 23.9 cm/s, and when associated to 50 mg of sildenafil it was 24.8 cm/s. Despite the increase in the flow rate caused by sildenafil, the difference was not statistically significant, Zcalculated = - 0.695 NS (Wilcoxon test. Twenty one of the 29 patients (72.4% showed global improvement in sexual performance with the use of sildenafil citrate at home. There was not a statistically significant correlation between the global response to sildenafil citrate and the increase in the peak systolic velocity. CONCLUSION: We concluded that, even though the use of 50 mg of sildenafil citrate associated with 5 mcg of alprostadil provides an increase in the peak systolic velocity of the cavernous arteries, there was no statistic difference in relation to alprostadil alone. There was no correlation between the global response to sildenafil and the increase in

  14. Olfactory and erectile dysfunction association in smoking and non-smoking men.

    Özmen, Süay; Dülger, Seyhan; Çoban, Soner; Özmen, Ömer Afşın; Güzelsoy, Muhammed; Dikiş, Özlem Şengören; Akdeniz, Önder

    2016-06-01

    The studies evaluating the effect of smoking on olfaction reveals opposite results. In vitro and animal studies and epidemiological evidence from volunteers and patients, demonstrated the association between olfaction and erectile functions. In smoking man the reduction of olfactory acuity could adversely affect sexuality. The aim of the present study was to investigate the relationship between erectile dysfunction (ED) and olfactory dysfunction (OD) by comparing a group of healthy adult men with a group of smoking adult men. This prospective study involved 62 volunteers, who were recruited and divided into two groups; one consisted of 35 smoking adult men, and the other included 27 healthy non-smoking men. All participants in both groups were examined in detail for any condition with the potential to cause OD. They all had a normal genitourinary system suffered from no circulatory diseases, diabetes mellitus, hypertension, coronary artery disease nor hyperlipidemia; they had no history of medication affecting genitourinary system. Butanol threshold test and sniffin' stick® (Burghart, Wedel; Germany) screening test was used to asses olfactory functions in both groups. Participants' sexual desire was assessed using an International Index of Erectile Function (IIEF-5) scale. The means of sniffin' sticks scores, butanol threshold scores and IIEF-5 scores were statistically higher in non-smoking group. Butanol threshold scores and sniffin' sticks scores are correlated statistically with IIEF-5 in non-smoking and smoking groups. This study found an association between olfaction and erectile function in smoking and non-smoking men. As far as we know this study is the third published study to show the relationship olfactory and erectile function. In the future studies electrophysiological olfactory methods could be used to confirm in large cohorts the results obtained by the psychophysical approach. PMID:27037193

  15. Sildenafil citrate (Viagra) for the treatment of erectile dysfunction in men with Parkinson's disease.

    Zesiewicz, T A; Helal, M; Hauser, R A

    2000-03-01

    Sildenafil citrate (Viagra) is a phosphodiesterase type V inhibitor used to treat erectile dysfunction. Ten men with idiopathic Parkinson's disease (PD) and erectile dysfunction were prescribed 50-100 mg sildenafil citrate to use in eight sexual encounters over a 2-month period. Patients underwent Unified Parkinson's Disease Rating Scale (UPDRS) evaluations and completed a Beck's Depression Inventory (BDI) and a Sexual Health Inventory-M version (SHI-M) at baseline and after 8 weeks. There was statistically significant improvement in total SHI-M scores (23.8 +/- 2.0 vs 16.6 +/- 2.8; p = 0.01), overall sexual satisfaction (p = 0.03), satisfaction with sexual desire (p = 0.04), ability to achieve erection (p = 0.02), ability to maintain erection (p = 0.03), and ability to reach orgasm (p = 0.04) with use of sildenafil citrate. UPDRS and BDI scores were not significantly changed. Side effects included headache in one patient during three sexual encounters. In this open-label study, sildenafil citrate significantly improved sexual function in men with PD and erectile dysfunction. PMID:10752581

  16. Viagra for temporary erectile dysfunction during treatments with assisted reproductive technologies.

    Tur-Kaspa, I; Segal, S; Moffa, F; Massobrio, M; Meltzer, S

    1999-07-01

    During treatments with assisted reproductive technologies (ART), some men may have difficulties in producing spermatozoa on demand at the time of insemination, either for intrauterine insemination (IUI) or for in-vitro fertilization (IVF). This situation imposes tremendous stress on the couple and may cause cancellation of the treatment. Here we describe, for the first time, the use of sildenafil citrate (ViagraTM) for temporary erectile dysfunction in couples undergoing ART. The first case was a man who could not produce spermatozoa for the first IVF treatment after an exhausting trial for 12 h, despite the fact that he never had problems in providing sperm samples during previous IUI cycles. Using Viagra enabled him to provide spermatozoa, but the delay in oocyte insemination resulted in no embryonic development. This prompted us to be more alert to this option and to suggest the use of Viagra to men who had a history of erectile dysfunction during previous ART cycles. In these cases, the use of Viagra was planned in advance and it successfully solved any unpredictable erectile dysfunction on the day of insemination. Such cases emphasize the need to think in advance of this potential use of Viagra during ART. PMID:10402389

  17. Case Report: Persistent erectile dysfunction in a man with prolactinoma [v1; ref status: indexed, http://f1000r.es/4qj

    Justin Badal

    2015-01-01

    Full Text Available Erectile dysfunction has been explored as a condition secondary to elevated prolactin; however, the mechanisms by which elevated prolactin levels cause erectile dysfunction have not yet been clearly established. We here present a patient with a history of prolactinoma who suffered from persistent erectile dysfunction despite testosterone supplementation and pharmacological and surgical treatment for the prolactinoma.  Patients who have had both prolactinemia and erectile dysfunction have been reported in the literature, but we find no report of a patient with persistent erectile dysfunction in the setting of testosterone supplementation and persistent hyperprolactinemia refractory to treatment. This case provides evidence supporting the idea that suppression of erectile function occurs in both the central and peripheral nervous systems independent of the hypothalamic-pituitary-gonadal axis.

  18. Efficacy and safety of sildenafil citrate in men with erectile dysfunction and stable coronary artery disease.

    DeBusk, Robert F; Pepine, Carl J; Glasser, Dale B; Shpilsky, Arkady; DeRiesthal, Herb; Sweeney, Michael

    2004-01-15

    This was a double-blind, placebo-controlled, flexible-dose study of the efficacy and safety of sildenafil in men with erectile dysfunction (ED) and clinically stable coronary artery disease (CAD). Patients were randomized to receive sildenafil or placebo for 12 weeks. Primary outcomes were questions 3 and 4 of the International Index of Erectile Function (IIEF). Secondary outcomes included the other IIEF questions and functional domains, the Life Satisfaction Checklist, the Erectile Dysfunction Inventory of Treatment Satisfaction, 2 global efficacy assessment questions, and intercourse success rate. By week 12, sildenafil-treated patients (n = 70) showed significant improvements on questions 3 and 4 compared with placebo-treated patients (n = 72; p <0.01). Larger percentages of sildenafil-treated patients reported improved erections (64%) and improved intercourse (65%) compared with placebo-treated patients (21% and 19%, respectively). Sildenafil-treated patients were highly satisfied with treatment and their sexual life compared with placebo-treated patients. Forty-seven percent of sildenafil- and 32% of placebo-treated patients experienced adverse events, including transient headache, hypertension, flushing, and dyspepsia. There were no serious drug-related cardiovascular effects. Thus, sildenafil is an effective and well-tolerated treatment for ED in men with CAD. Sildenafil was not associated with additional safety risks in this patient population. PMID:14715338

  19. EFFICACY ASSESSMENT OF KAEMPFERIA PARVIFLORA FOR THE MANAGEMENT OF ERECTILE DYSFUNCTION

    Panakaporn Wannanon

    2012-01-01

    Full Text Available Age-related decline in erectile function is a noted phenomenon worldwide. A variety of medicinal plants have been identified as having strong aphrodisiac properties along with the ability to improve erectile functioning. Kaempferia Parviflora (KP has famous as a Thai Viagra and use it to increase male impotency. However, there is limited scientific evidence regarding the efficacy of this herb on this issue in aging healthy men. This study therefore investigated the effect of KP extract administration on erectile response of male elderly volunteers. Total 45 male healthy elderly volunteers will be divided into 3 separated groups including placebo and the different doses of ethanolic extracts of KP (25 and 90 mg once daily at a period of 2 months. The erectile function tests including the response latency time to visual erotic stimuli, size and length of penis both in flaccid and erection states were assessed after single administration, 1 and 2 months of treatment. In order to investigate the possible underlying mechanism, we also determined the alteration of testosterone, FSH and LH concentrations. KP at a dose of 90 mg day-1 treated group exhibited a significant enhanced all parameters after 1 and 2 months of treatment. Moreover, the penile length at erection states and the response latency to sexual erotic stimuli appeared to be the parameters that showed significant changes during the delay period. Unfortunately, our study failed to show the significant changes on hormones concentration. Our study clearly demonstrates that KP is a potential resource for the development of nutraceutical compound against aged related male erectile dysfunction.

  20. Erectile Function and Dysfunction Following Low Flow Priapism: A comparison of Distal and Proximal Shunts

    Ali Tabibi, ,

    2010-09-01

    Full Text Available PURPOSE: To compare erectile function following low flow priapism in patients undergoing distal and proximal shunts. MATERIALS AND METHODS: From January 1995 to December 2005, we retrospectively studied 16 patients who presented to our medical center with refractory priapism. Of 16 patients, 5 underwent Winter shunt, while El-Ghorab procedure was performed for 7 patients and the remaining 4 underwent Grayhack shunt. Erectile function was assessed in a minimum follow-up of 2 years (range, 2 to 10 years using erectile dysfunction (ED intensity scale [Total score: 5 to 10 (severe ED; 11 to 15 (moderate ED; 16 to 20 (mild ED; and 21 to 25 (no ED]. RESULTS: The mean patients’ age was 40.62 ± 15.27 years. Mean duration of priapism was 51.12 ± 37.99 hours. Of 4 patients (25% who underwent proximal shunt (Grayhack procedure, 2 (50% were impotent, 1 had potency, and the other one achieved some penile erection with administration of oral sildenafil. Of 5 patients (31.25% who underwent Winter procedure, 1 died because of metastatic bladder cancer and of 4 remainders, 2 (50% had normal erectile function, but 1 patient suffered from recurrent priapism. Of 7 patients (43.75% who underwent El-Ghorab procedure, 1 was lost for follow-up and of remaining 6 patients, 2 (33.3% had normal erectile function and 4 (66.6% were impotent. No surgical complication was seen. Median lag time from priapism till surgery for patients with and without ED was 48 and 26 hours, respectively (P = .22. CONCLUSION: Grayhack shunt is a safe surgical procedure without any major complications and with lower ED rate. Grayhack shunt might be considered as treatment of choice for refractory low flow priapism.

  1. Clinical trial of Butea superba, an alternative herbal treatment for erectile dysfunction

    W.Cherdshewasart; N.Nimsakul

    2003-01-01

    Aim: To study the effect of Butea superba on erectile dysfunction (ED) in Thai males. Methods: A 3-month randomized double-blind clinical trial was carried out in volunteers with ED, aged 30 years-70 years, to evaluate the therapeutic effect of the crude preparation of Butea superba tubers on ED. Results: There was a significant upgrading in 4 of the 5 descriptive evaluations of the IIEF-5 questionnaire. Estimation of the sexual record indicated that 82.4 % of the patients exhibited noticeable improvement. Haematology and blood chemistry analysis revealed no apparent change. Conclusion: The plant preparation appears to improve the erectile function in ED patients without apparent toxicity. ( Asian J Andro12003 Sep; 5: 243-246)

  2. AB236. The effect of Xuanju compound capsule combined with bromocriptine on erectile dysfunction due to hyperprolactinemia

    Bian, Jun; Liu, Cundong; Sun, Xiangzhou; Deng, Chunhua; Huang, Yanping; Ye, Yunlin

    2016-01-01

    Objective To investigate the effect of Xuanju compound capsule combined with bromocriptine on erectile dysfunction due to hyperprolactinemia. Methods Forty-six patients with erectile dysfunction due to hyperprolactinemia were divided into a treatment group (n=23) and a control group (n=23), both treated by bromocriptine and the former given Xuanju compound capsule in addition. After treatment for 12 weeks, comparison were made in erectile function, serum prolactin level and serum testosterone in two groups. Results Compared with those before treatment, the erectile function after treatment was significantly improved in two groups (P0.05). Serum testosterone after treatment in treatment group was significantly higher than that in control group (Phyperprolactinemia, and the effect was better than bromocriptine.

  3. Correlation between life quality indices and a form of erectile dysfunction in young and middle-aged men

    D. Z. Vorobets

    2010-06-01

    Full Text Available The psychogenic erectile dysfunction (ED does not show strong correlation between domains of questionnaires SF-36 and IIEF. In conditions of ED caused by endothelial dysfunction the domains of general health, physical functioning, bodily pain and vitality strongly correlates with all domains rates of IIEF questionnaire except overall satisfaction. In conditions of erectile dysfunction caused by chronic pelvis pain the rates of IIEF correlate with domains of physical functioning, pain, vitality from SF-36. In conditions of premature ejaculation and ED accompaniment the rates of general health, pain intensity and vitality become worth and correlate with total score of IIEF, rates of sexual desire end intercourse satisfaction.

  4. The incidence of erectile dysfunction after pelvic fracture urethral injury: A systematic review and meta-analysis

    Blaschko, SD; Sanford, MT; Schlomer, BJ; Alwaal, A; Yang, G.; Villalta, JD; Wessells, H; McAninch, JW; Breyer, BN

    2014-01-01

    Background Pelvic fracture urethral injury (PFUI) is associated with a high risk of erectile dysfunction (ED). The effect of the type of posterior urethral disruption repair on erectile function has not been clearly established. We systematically reviewed and conducted a meta-analysis of the proportion of patients with ED at (i) baseline after pelvic fracture with PFUI, (ii) after immediate primary realignment, and (iii) after delayed urethroplasty. Methods Using search terms for primary real...

  5. The Possible Effects of Methadone Maintenance Therapy on Erectile Dysfunction in Male Addicts Visiting MMT Centers of Rasht

    Morteza Rahbar Taramsari

    2014-06-01

    Full Text Available Background: Methadone is considered a long-acting opioid agonist which is widely used in the treatment of drug addiction. It is believed that opioids can cause erectile dysfunction (ED by inhibiting gonadotropin and testosterone release. This study is aimed at defining the possible effects of conservative treatment with methadone on erectile dysfunction in the addicts. Methods: A total of 382 male addicts visiting methadone maintenance therapy (MMT centers in Rasht, Iran, during 2010 were enrolled in this study. International Index of Erectile Function (IIEF questionnaire and patients' profiles were the main means of collecting data on demographic information, methadone dose intake, and erectile function status before and after the two months of therapy with methadone. Erectile function status was defined by the total score from questions 1, 2, 3, 4, 5, and 15 of the questionnaire. The data was analyzed by X2, McNemer’s test, and paired t-test using SPSS software 18. Results: The mean age of patients was 37.6 ± 8.9 years (range: 18-72 years. Most of the patients were married (79.3% and they were citizens of Rasht (72.3%. The most frequent substances were opium (188 patients, 49.2% and crack (129 patients, 33.8%, respectively. Most of the patients received low dose methadone (286 patients, 74.9%. No significant relationship was indicated comparing the average scores of erectile function before and after taking methadone (18.53±6.978 vs. 19.03±5.819 (P=0.138. However, the severity of erectile dysfunction was significantly related to the methadone intake dose (P<0.001. Conclusion: Although MMT increases the frequency of erectile dysfunction, appropriate doses of methadone minimize this effect.

  6. Hyperhomocysteinaemia in rats is associated with erectile dysfunction by impairing endothelial nitric oxide synthase activity.

    Jiang, Weijun; Xiong, Lei; Bin Yang; Li, Weiwei; Zhang, Jing; Zhou, Qing; Wu, Qiuyue; Li, Tianfu; Zhang, Cui; Zhang, Mingchao; Xia, Xinyi

    2016-01-01

    To investigate the effect of hyperhomocysteinaemia (HHCy) on penile erectile function in a rat model, a methionine-rich diet was used in which erectile function, the reproductive system, and nitric oxide synthase were characterized. The intracavernous pressure, apomorphine experiments, measurement of oxidative stress, hematoxylin and eosin staining, immunohistochemistry analysis, reverse transcription-polymerase chain reactions and measurement of endothelial nitric oxide synthase activity were utilized. Our results showed that erections in the middle-dose, high-dose, and interference (INF) groups were significantly lower than the control (P < 0.05). INF group, being fed with vitamins B and folic acid, demonstrated markedly improved penile erections compared with the middle-dose group (P < 0.05). HHCy-induced eNOS and phospho-eNOS protein expression was reduced and the antioxidant effect was markedly impaired. The data of the present data provide evidence that HHCy is a vascular risk factor for erectile dysfunction by impairing cavernosa endothelial nitric oxide synthase activity. Intake of vitamins B can alleviate this abnormality. PMID:27221552

  7. A retrospective study of the relationship between biomarkers of atherosclerosis and erectile dysfunction in 988 men.

    Eaton, C B; Liu, Y L; Mittleman, M A; Miner, M; Glasser, D B; Rimm, E B

    2007-01-01

    Erectile dysfunction (ED) is associated with clinical atherosclerosis and several atherosclerotic risk factors including smoking, hypertension, dyslipidemia, diabetes mellitus, obesity and sedentary lifestyle. Clinical atherosclerosis is also associated with these same risk factors and with biomarkers of inflammation, thrombosis, endothelial cell activation. We evaluated the cross-sectional association between the degree of ED and levels of atherosclerotic biomarkers. A subcohort of 988 US male health professionals between the ages 46 and 81 years as part of an ongoing epidemiologic study had atherosclerotic biomarkers measured from blood collected in 1994-1995. These same men had in 2000, been retrospectively asked about erectile function in 1995 and in 2000. Biennial questionnaires since 1986 assessed medical conditions, medications, smoking, physical activity, body mass index, alcohol intake. The retrospective assessment of erectile function in 2000 for 1995 in these 988 men ranged from very good - 28.2%, good - 25.1%, fair - 19.2%, poor - 13.6%, to very poor - 13.9%. Men with poor to very poor erectile function compared to men with good and very good erectile function had 2.9 the odds of having elevated Factor VII levels (P=0.03), 1.9 times the odds of having elevated vascular cell adhesion molecule (P=0.13) and 2.0 times the odds of having elevated intracellular adhesion molecule (P=0.06) and 2.1 times the odds of having elevated total cholesterol/high-density lipoprotein ratio (P=0.02) comparing the top to bottom quintiles for each atherosclerotic biomarker after multivariate adjustment. Lipoprotein(a), homocysteine, interleukin-6 and tumor necrosis factor receptor, C-reactive protein and fibrinogen were not associated with the degree of erectile function after adjustment. We conclude that selected biomarkers for endothelial function, thrombosis and dyslipidemia but not inflammation are associated with the degree of ED in this cross-sectional analysis. Future

  8. Prevalence of erectile dysfunction in Colombia, Ecuador, and Venezuela: a population-based study (DENSA).

    Morillo, L E; Díaz, J; Estevez, E; Costa, A; Méndez, H; Dávila, H; Medero, N; Rodriguez, N; Chaves, M; Vinueza, R; Ortiz, J A; Glasser, D B

    2002-08-01

    The purpose of this study was to estimate the prevalence of erectile dysfunction (ED) in Colombia, Ecuador, and Venezuela. A 49-item questionnaire was completed by 1946 men aged 40 years and older. The age-adjusted combined prevalence of minimal, moderate, and complete ED for all three countries was 53.4%, with 19.8% of all men reporting moderate to complete ED. Age was the variable most strongly linked to ED; the prevalence of complete ED increased markedly in men older than 79 y of age (31.9%) and 70-79 y (17.2%) compared with men aged 40-49 y (disease. PMID:12161763

  9. Detecting internet activity for erectile dysfunction using search engine query data in the Republic of Ireland.

    Davis, Niall F

    2012-12-01

    What\\'s known on the subject? and What does the study add? Despite the increasing prevalence of erectile dysfunction (ED), there is reluctance among symptomatic patients to present to healthcare providers for appropriate advice and treatment. A number of Internet campaigns have been launched by the Irish healthcare media since 2007 aiming to provide easily accessible advice on ED. Novel online technologies appear to provide a useful tool for educating the general public on the symptoms of ED because there has been a significant increase in overall Internet search activity for this term since 2007.

  10. [The aging male: a global approach to late onset hypogonadism and erectile dysfunction].

    Vlamopoulos, Yannis; Jichlinski, Patrice; Tawadros, Thomas

    2014-12-01

    The concept of aging male is defined by an age in which might appear some clinical symptoms. These symptoms, including erectile dysfunction (ED), are sometimes similar to those met in the late onset hypogonadism. Simultaneously, cardiovascular diseases increase with age and are associated with ED. The diagnosis of ED, associated or not with late onset hypogonadism, is mostly clinical. Its management will include PDE-5 which are generally well tolerated. Early detection of late onset hypogonadism is recommended as testosterone substitution improves quality of life. Although testosterone substitution needs to be carefully monitored, there is no clear evidence of increased risk of prostate cancer or cardiovascular disease. PMID:25626250

  11. Does tadalafil prevent erectile dysfunction in patients undergoing radiation therapy for prostate cancer?

    Luca Incrocci

    2014-10-01

    Full Text Available A recently published paper addressed the interesting topic of prevention of erectile dysfunction (ED with tadalafil, a phosphodiesterase-type 5 inhibitor (PDE5i in patients undergoing radiation therapy for localized prostate cancer. [1] Tadalafil 5 mg or placebo was administered once-daily for 24 weeks in patients undergoing external-beam radiotherapy (EBRT or brachytherapy (BT for prostate cancer. This randomized trial did not show superior efficacy of the active drug compared with placebo 4-6 weeks after stopping the study drug. Furthermore, patients younger than 65 years did not respond significantly better than older patients.

  12. AB228. Research on the mechanism of androgen replacement therapy improving erectile dysfunction in castrated rats

    Cui, Kai; Li, Rui; WANG, Tao; Zhang, Yan; Wang, Shaogang; Rao, Ke; Liu, Jihong

    2016-01-01

    Objective To investigate the mechanism of androgen replacement therapy (ART) improving erectile dysfunction (ED) in castrated rats. Methods We randomly divided 40 8-week-old healthy male SD rats into 4 groups: group A was the control, and rats of the group B, C and D were castrated, then rats in the groups C and D were treated with different concentrations of testosterone undecanoate orally every day (C: 10 mg/kg, D: 20 mg/kg), while other groups with 0.9% NS instead. 8weeks’ treatment later,...

  13. Androgen Deficiency and Erectile Dysfunction in Patients with Type 2 Diabetes

    Entesar O.A. El Saghier; Shebl, Salah E; Olfat A. Fawzy; Ihab M. Eltayeb; Lamya M.A. Bekhet; Abdelnasser Gharib

    2015-01-01

    BACKGROUND The association between type 2 diabetes mellitus (T2DM) and low total serum testosterone (LST) has been identified in several cross-sectional studies. OBJECTIVES To assess the prevalence of androgen deficiency and erectile dysfunction (ED) and their relation to glycemic control within a sample of Egyptian men with T2DM. RESEARCH DESIGN AND METHODS A cross-sectional study including 70 men having T2DM. Their ages ranged from 30 to 50 years. They were evaluated for symptoms of androge...

  14. Acute effect of phosphodiesterase type 5 inhibitor on serum oxidative status and prolidase activities in men with erectile dysfunction

    Murat Savas

    2010-01-01

    Full Text Available OBJECTIVES: To investigate the acute effect of phosphodiesterase type 5 (PDE5 inhibitor on erectile dysfunction by evaluating serum oxidative status and prolidase activity. METHODS: Serum samples of 36 patients with erectile dysfunction and 30 control cases were analyzed for total antioxidant status, total oxidant status, and prolidase activity, before and after the administration of tadalafil citrate. RESULTS: Before and after tadalafil citrate administration, serum total antioxidant status, total oxidant status, and prolidase were 1.1+0.0 vs. 1.6 + 0.0 umol H2O2 Eq/L, 10.3+1.1 vs. 6.9 + 1.2 umol H2O2 Eq/L, and 236.4+19.5 vs. 228.2 + 19.2 U/L, respectively (p<0.0001 for all. CONCLUSIONS: Evaluation of serum oxidative status and prolidase activity confirmed the beneficial acute effects of PDE5 inhibitor in patients with erectile dysfunction.

  15. Medical management of erectile dysfunction in aging males: is it too late to treat?

    Kai Zhang

    2014-02-01

    Full Text Available Erectile dysfunction (ED is a common disorder among aging males. However, most aging males refuse to seek medical help and believe that ED is an irreversible event in the aging process. The purpose of this study was to describe the current medical management of ED in aging males and to examine whether it is too late to treat this disorder in these elderly men. From 2007 to 2008, 4507 patients diagnosed with ED were gathered from 46 centers in China; 4241 completed the study, 3837 of whom were treated with sildenafil. The 3837 patients were divided into five groups based on age (group A: 20-30 years; group B: 31-40 years; group C: 41-50 years; group D: 51-60 years; and group E: >60 years. After comparing pre- and posttreatment International Index of Erectile Function-Erectile Function domain (IIEF-EF questionnaires, Erection Hardness Scale (EHS, and IIEF Q13 ("How satisfied have you been with your overall sex life?", we discovered that the aging males had worse erectile function, erection hardness, and sexual satisfaction than the younger males (P < 0.001. After treatment, the improvement rates in the IIEF-EF, EHS, and IIEF Q13 scores were 107.0%, 83.1%, and 116.5%, respectively. The magnitude of these changes demonstrated significant differences among groups (P < 0.001. Accordingly, aging males are likely to benefit more from medical treatment. We propose that aging males should be informed that age is not a limiting factor for medical ED management, and it is never too late to treat.

  16. Impact of the association between elevated oestradiol and low testosterone levels on erectile dysfunction severity

    Ahmed I El-Sakka

    2013-01-01

    Our aim was to assess the impact of the association between elevated oestradiol (E2) and low testosterone (T) levels on erectile dysfunction (ED) severity.A total of 614 male patients with ED and a normal or low T level in association with normal or elevated E2 levels were enrolled.Patients underwent routine laboratory investigations in addition to measurements of total T,total E2,follicle-stimulating hormone (FSH),luteinizing hormone (LH) and prolactin.We compared the responses to the erectile function domain,Q3 (achieving erection) and Q4 (maintaining erection) of the International Index for Erectile Function (IIEF) score in patients with the following:normal T and E2 levels; low T level; low T level and elevated E2 level; and elevated E2 level.Of the patients included,449 (73.1%) had normal T and E2 levels,110 (17.9%) had a low T level,36 (5.9%) had a low T level and an elevated E2 level,and 19 (3.1%) had an elevated E2 level.Increased ED severity was significantly associated with low T levels,elevated E2 levels,and both a low T level and an elevated E2 level.Additionally,the mean values of the EF-domain,Q3 and Q4 were significantly lower in patients with both a low T level and an elevated E2 level compared to patients with any condition alone.In conclusion,a low T level had the primary effect on erectile function; however,a concomitantly elevated E2 level had an additive impairment effect.

  17. Erectile dysfunction among men attending surgical outpatients Department in a Tertiary Hospital in South-Western Nigeria

    Augustine O Takure

    2016-01-01

    Full Text Available Background: Erectile dysfunction is becoming a public health issue with high incidences reported in community studies. Objective: To evaluate the characteristics and outcome of treatment in men with erectile dysfunction in a tertiary center in Ibadan southwestern Nigeria. Methods: Data of men with erectile dysfunction was retrieved between July 2004 and June 2014 and analyzed using SPSS version 16 statistical software. Results: Eighty-nine men with erectile dysfunction were managed which constituted 2% of all urological cases seen during the study period. Their median and mean ages were 39 years and 39.6 ± 1.2SD (range 19-76 years. The peak age incidence at 30-44 years was 41.6% and reduced with increasing age after 65 years to 4.5%. The etiologies were psychogenic in 55%, organic in 27%, idiopathic in 17% and 1% was familial. 67.5%, 31.5% and 3.4% were married, single and separated respectively. Seventy percent neither smoked cigarette nor drank alcohol, 21.3% drank alcohol and 9% took both alcohol and smoked cigarette. Seventy seven and half percent of men presented within 5 years of their symptom. The treatments offered were PDE type 5 inhibitors alone or in combination with psychotherapy or modification of medications. The outcome of these treatments ranged from 89% to 91% success rate. Conclusion: The number of men with erectile dysfunction managed in the tertiary hospital is very low though the outcome of treatment is within acceptable range. Increase public enlightenment may encourage increase hospital patronage and access to the available treatments for erectile dysfunction.

  18. Our experience in the diagnostic and the treatment of the traumatical erectile dysfunction. Advantages of the digital substraction angiography and cavernosography

    The erectile dysfunction is a problem with underlined mediocosocial significance. In this aspect we report our experience in diagnostics and treatment of traumatic vessels - caused erectile dysfunction. Patients are treated by a diagnostic program, which we made on the basis of our experience from the whole group of vessel - caused erectile dysfunction. We have tested and cured 6 patients with traumatic erectile dysfunction. In all the patients we found erectile dysfunction of type 'venous leak', which was diagnosed by digital subtraction cavernosography, which was suggested by the authors. The way of diagnostic research for application of digital subtraction cavernosography is characterized or pelvic angiography independance of the coordinated venous and arterial traumatic laesions such are found in 2 of the patients. The method for surgical treatment is suggested and the long - lasting effect by the treatment is defined by the authors. (orig.)

  19. Indication, methods and results of selective arteriography of the A. iliaca interna in case of erectile dysfunction

    Baehren, W.; Gall, H.; Scherb, W.; Thon, W.

    1988-01-01

    Erectile dysfunction very frequently can be traced back to the real cause by means of angiography. Selective angiography is the method of choice in cases where other causes of circulatory disturbance have already been excluded, and non-invasive tests are expected to yield information of relevance to therapy. The qualitatively best angiographic results are obtained by examination under peridural anesthesia and by intracavitary injection of vaso-active substances. Selective arteriography is indicated in cases of primary or post-traumatic erectile dysfunction. It is a prerequisite of surgery for revascularisation of the pudendal-penile vascular bed.

  20. Indication, methods and results of selective arteriography of the A. iliaca interna in case of erectile dysfunction

    Erectile dysfunction very frequently can be traced back to the real cause by means of angiography. Selective angiography is the method of choice in cases where other causes of circulatory disturbance have already been excluded, and non-invasive tests are expected to yield information of relevance to therapy. The qualitatively best angiographic results are obtained by examination under peridural anesthesia and by intracavitary injection of vaso-active substances. Selective arteriography is indicated in cases of primary or post-traumatic erectile dysfunction. It is a prerequisite of surgery for revascularisation of the pudendal-penile vascular bed. (orig./MG)

  1. Radioisotope penile plethysmography: Technique for evaluating corpora cavernosal blood flow during early tumescence in patients with erectile dysfunction

    Radioisotope penile plethysmography is a new adaptation of technetium-labeled red blood cell imaging. It is designed to assess penile corpora cavernosal blood flow during early tumescence in patients with erectile dysfunction. Peak corporal flow rates and volume changes in the penis were analyzed and compared with arterial integrity (arteriography) and venous-sinusoidal competence (cavernosometry). Peak corporal flow rates correlated most accurately with arterial integrity (r =.01). No significant correlation was identified with venous leakage variables (r =.01) The significant correlation of peak corporal flow and arteriography suggests that radioisotope penile plethysmography may assist in the evaluation of arterial inflow disorders in patients with erectile dysfunction

  2. A new potential risk factor in patients with erectile dysfunction and premature ejaculation: folate deficiency

    Wen-Jie Yan

    2014-12-01

    Full Text Available We investigated serum folic acid (FA levels in patients with erectile dysfunction (ED and/or premature ejaculation (PE. Fasting serum samples were obtained from 42 patients with ED, 36 with PE, 25 ED patients with PE, and 30 healthy men; the mean intravaginal ejaculation latency time (IELT was measured during a 4 weeks baseline period. Levels of sex hormones (follicle-stimulating hormone, luteinizing hormone, total testosterone, homocysteine (Hcys, and FA were measured using chemiluminescent immunoassays. The sexual functions of PE patients and normal control men were evaluated using the Chinese Index of Premature Ejaculation (CIPE. The abridged International Index of Erectile Function-5 (IIEF-5 questionnaire was used to gauge erectile quality for ED patients and for normal controls. Serum FA concentrations were lower in ED (7.61 ± 3.97 ng ml -1, PE (9.37 ± 3.40 ng ml -1, and ED/PE (8.84 ± 4.28 ng ml -1 patients than in healthy men (12.23 ± 5.76 ng ml -1 , P 0.05. There were positive correlations between serum FA concentrations and CIPE scores (r = 0.530, P < 0.01, IIEF-5 scores (r = 0.589, P < 0.01, and IELT (r = 0.445, P < 0.01; negative correlations with Hcys concentrations (r = −0.487, P < 0.01 were found in all participants. These findings showed a strong relationship between serum FA levels and sexual dysfunction, possibly due to an effect of FA on the metabolism of nitric oxide, Hcys, and 5-hydroxytryptamine.

  3. Distal corpus cavernosum fibrosis and erectile dysfunction secondary to non-ischaemic priapism.

    Zacharakis, Evangelos; Ralph, David J; Walkden, Miles; Muneer, Asif

    2015-09-01

    Non-ischaemic priapism is a rare type of priapism and is associated with penile or perineal trauma. The absence of ischaemia should theoretically prevent smooth muscle necrosis and corporal fibrosis which occurs in ischaemic priapism. The aim of this study was to first report a patient series with non-ischaemic priapism that developed distal corpus cavernosum fibrosis and erectile dysfunction. Over a 5 year period, a cohort of 6 patients diagnosed with non-ischaemic priapism presented to a single centre. The diagnosis was based on a clinical history, penile examination with confirmation using a combination of cavernosal blood gas analysis, colour duplex ultrasonography of the penis and angiography. Patients were followed up in clinic at regular intervals with clinical examination and repeat imaging. Following a median follow up of 4 weeks (range 2-12) the patients reported either the development of erectile dysfunction with distal penile flaccidity. Five patients required the use of PDE-5 inhibitors to achieve full tumescence. The remaining patient eventually underwent insertion of a penile prosthesis due to the failure of pharmacotherapies. Based on these findings we suggest that superselective embolisation of non-ischaemic priapism cases occasionally should be performed after a shorter period of conservative treatment. PMID:26428655

  4. Distal corpus cavernosum fibrosis and erectile dysfunction secondary to non-ischaemic priapism

    Evangelos Zacharakis

    2015-09-01

    Full Text Available Non-ischaemic priapism is a rare type of priapism and is associated with penile or perineal trauma. The absence of ischaemia should theoretically prevent smooth muscle necrosis and corporal fibrosis which occurs in ischaemic priapism. The aim of this study was to first report a patient series with non-ischaemic priapism that developed distal corpus cavernosum fibrosis and erectile dysfunction. Over a 5 year period, a cohort of 6 patients diagnosed with non-ischaemic priapism presented to a single centre. The diagnosis was based on a clinical history, penile examination with confirmation using a combination of cavernosal blood gas analysis, colour duplex ultrasonography of the penis and angiography. Patients were followed up in clinic at regular intervals with clinical examination and repeat imaging. Following a median follow up of 4 weeks (range 2-12 the patients reported either the development of erectile dysfunction with distal penile flaccidity. Five patients required the use of PDE-5 inhibitors to achieve full tumescence. The remaining patient eventually underwent insertion of a penile prosthesis due to the failure of pharmacotherapies. Based on these findings we suggest that superselective embolisation of non-ischaemic priapism cases occasionally should be performed after a shorter period of conservative treatment.

  5. Vardenafil for the treatment of erectile dysfunction: an overview of the clinical evidence

    Antonio Martín Morales

    2009-12-01

    Full Text Available Antonio Martín Morales1, Vincenzo Mirone2, John Dean3, Pierre Costa41Department of Urology, Hospital Carlos Haya, Malaga, Spain; 2Department of Urology, University Federico II, Naples, Italy; 3St. Peter’s Sexual Medicine, The London Clinic, London, UK; 4Center Hospitalier Caremeau, Nîmes, FranceAbstract: Many men with erectile dysfunction (ED also have associated underlying cardiovascular and metabolic conditions, for which they are likely to be taking medication. Therefore, cardiovascular safety and potential drug interactions are two of the major concerns when using PDE-5 inhibitors in these patients. The PDE-5 inhibitor, vardenafil, is characterized by a rapid onset of action, increased duration of erection, high rates of first-dose success and reliable efficacy that can be maintained with continued use. In both clinical trials and real-life observational studies, vardenafil has demonstrated a favorable efficacy and safety profile in men with ED, including those with associated underlying conditions such as diabetes, hypertension and dyslipidemia. Importantly, the concomitant use of medication for these conditions is not associated with any noteworthy changes in the efficacy and safety of vardenafil. The evidence presented in this review supports the use of vardenafil as a first-line treatment for men with ED, including those with underlying conditions.Keywords: vardenafil, erectile dysfunction, efficacy, safety, underlying conditions

  6. Sildenafil improves quality of life in men with heart failure and erectile dysfunction.

    Freitas, D; Athanazio, R; Almeida, D; Dantas, N; Reis, F

    2006-01-01

    Patients with congestive heart failure (CHF) have specific factors that enhance the risk for erectile dysfunction (ED), such as low cardiac output and the use of drugs with vasodilator effect. ED can negatively affect interpersonal relationships and self-esteem, with significant impact on the quality of life. We hypothesized that the improvement of the sexual dysfunction would enhance the quality of life of individuals with systolic heart failure. This is a prospective study of 12 male CHF patients using a fixed dose of sildenafil during 1 month. Patients were included if they had left ventricular ejection fraction lower than 40% documented by echocardiography and International Index of Erectile Function (IIEF) score lower than 21. The effect of sildenafil in quality of life was evaluated by the Minnesota questionnaire. Improvement in ED was assessed using the IIEF. The mean IIEF5 score was 9.6 (+/-3.8) before the use of sildenafil and 19.3 (+/-4.3) after sildenafil (P = 0.0001). The mean Minnesota score was 28.75 (+/-21) before treatment and 12.75 (+/-10.1) after the intervention (P = 0.012). In conclusion, the sexual function improvement provided by sildenafil enhances quality of life in individuals with systolic heart failure. PMID:16121207

  7. Correlation between penile cavernosal artery blood flow and retinal vascular findings in arteriogenic erectile dysfunction

    Ahmed M Emarah

    2010-09-01

    Full Text Available Ahmed M Emarah1, Shawky M El-Haggar2, Ihab A Osman2, Abdel Wahab S Khafagy21Departments of Ophthalmology, 2Andrology and Sexology, Cairo University Hospital, EgyptObjectives: Arteriogenic erectile dysfunction (ED is a target organ disease of atherosclerosis, and therefore might be a predictor of systemic atherosclerosis. Being systemic, it might be possible to evaluate the extent of atherosclerosis from retinal vascular findings. We investigated the possible correlation between penile cavernosal artery blood flow and retinal vascular findings in patients with arteriogenic ED.Patients and methods: Sixty patients with ED were divided according to the peak systolic velocity (PSV in their penile cavernosal arteries into two groups; Group A included 30 patients with PSV less than 25 cm/sec, and Group B included 30 patients with PSV more than 35 cm/sec. Blood flow in the penile cavernosal artery was measured with color Doppler ultrasonography. All patients were assessed by ocular fundus examination under amydriatic conditions to evaluate retinal vascular atherosclerotic changes using Hyman’s classification.Results: Evidence of retinal vascular atherosclerotic changes was found in 19 patients (63.3% in Group A and in 10 patients (33.3% in Group B.Conclusions: Our study confirms the possibility of predicting penile arterial vascular status in patients with ED from their retinal vascular findings by using amydriatic simple, practical funduscopy.Keywords: erectile dysfunction, atherosclerosis, retinal vascular atherosclerosis

  8. Influence of sexual performance anxiety on Erectile Dysfunction%性操作焦虑对阴茎勃起障碍的影响研究

    刘明矾

    2002-01-01

    Objective: To understand psychological factors involved in erectile dysfunction. Methods: The erectile dysfunction rating scale (EDRS), State-trait anxiety inventory (STAI), and sexual psychological questionnaire (self-designed) were administered to 74 cases (30 psychogenic ED patients and 44 normal control objects).Results: High levels of sexual performance anxiety were found to affect patients' self-evaluation and coping responses. Sexual performance anxiety, deficient sexual sensitivity and poor communication techniques were the major contributing factors of psychogenic erectile dysfunction.Conclusion: Sexual performance anxiety constitutes a significant factor of erective dysfunction.

  9. Erectile Dysfunction

    ... campuses in Maryland and Arizona Research Resources Protocols, repositories, mouse models, plasmids, and more Technology Advancement & Transfer ... through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, ...

  10. Erectile Dysfunction

    ... Maryland and Arizona Research Resources Protocols, repositories, mouse models, plasmids, and more Technology Advancement & Transfer Material transfer ... including research advances, research coordination, and health information Jobs at NIDDK How to ... for unusual characteristics of the penis itself, which could suggest the ...

  11. Efficacies of Papaverine and Sildenafil in the Treatment of Erectile Dysfunction in Early-Stage Paraplegic Men

    Yildiz, Necmettin; Gokkaya, Nilufer Kutay Ordu; Koseoglu, Fusun; Gokkaya, Serkan; Comert, Didem

    2011-01-01

    The aim of the study was to determine which vasoactive agent was more efficacious for erectile dysfunction (ED), intracavernosal papaverine or oral sildenafil, in paraplegic men within the first year after injury by using a penile color Doppler ultrasound as a quantitative imaging method and to determine the association between responses to these…

  12. Effects of Omega-3 Fatty Acids on Erectile Dysfunction in a Rat Model of Atherosclerosis-induced Chronic Pelvic Ischemia.

    Shim, Ji Sung; Kim, Dae Hee; Bae, Jae Hyun; Moon, Du Geon

    2016-04-01

    The aim of this study was to investigate whether the omega-3 fatty acids help to improve erectile function in an atherosclerosis-induced erectile dysfunction rat model. A total of 20 male Sprague-Dawley rats at age 8 weeks were divided into three groups: Control group (n = 6, untreated sham operated rats), Pathologic group (n = 7, untreated rats with chronic pelvic ischemia [CPI]), and Treatment group (n = 7, CPI rats treated with omega-3 fatty acids). For the in vivo study, electrical stimulation of the cavernosal nerve was performed and erectile function was measured in all groups. Immunohistochemical antibody staining was performed for transforming growth factor beta-1 (TGF-β1), endothelial nitric oxide synthase (eNOS), and hypoxia inducible factor 1-alpha (HIF-1α). In vivo measurement of erectile function in the Pathologic group showed significantly lower values than those in the Control group, whereas the Treatment group showed significantly improved values in comparison with those in the Pathologic group. The results of western blot analysis revealed that systemically administered omega-3 fatty acids ameliorated the cavernosal molecular environment. Our study suggests that omega-3 fatty acids improve intracavernosal pressure and have a beneficial role against pathophysiological consequences such as fibrosis or hypoxic damage on a CPI rat model, which represents a structural erectile dysfunction model. PMID:27051243

  13. Erectile dysfunction as a manifestation of urogenital autonomic neuropathy in patients with type 1 diabetes: epidemiology, classification, pathophysiology, diagnosis and treatment options

    Gagik Radikovich Galstyan

    2014-05-01

    Full Text Available Sexual dysfunction characterized by a significant decline in the quality of life of patients and leading to infertility and problems in social life is diagnosed in more than 40% of patients with diabetes mellitus (DM.Erectile dysfunction is the most common sexual disorder in DM patients. The article describes epidemiology, classification, pathophysiology, diagnostic and treatment of erectile dysfunction in T1DM patients.

  14. Modulation of soluble guanylate cyclase for the treatment of erectile dysfunction.

    Lasker, George F; Pankey, Edward A; Kadowitz, Philip J

    2013-07-01

    Nitric oxide (NO) is the principal mediator of penile erection, and PDE-5 inhibitors are the first-line agents used to treat erectile dysfunction (ED). When NO formation or bioavailability is decreased by oxidative stress and PDE-5 inhibitors are no longer effective, a new class of agents called soluble guanylate cyclase (sGC) stimulators like BAY 41-8543 will induce erection. sGC stimulators bind to the normally reduced, NO-sensitive form of sGC to increase cGMP formation and promote erection. The sGC stimulators produce normal erectile responses when NO formation is inhibited and the nerves innervating the corpora cavernosa are damaged. However, with severe oxidative stress, the heme iron on sGC can be oxidized, rendering the enzyme unresponsive to NO or sGC stimulators. In this pathophysiological situation, another newly developed class of agents called sGC activators can increase the catalytic activity of the oxidized enzyme, increase cGMP formation, and promote erection. The use of newer agents that stimulate or activate sGC to promote erection and treat ED is discussed in this brief review article. PMID:23817801

  15. Prevalence of erectile dysfunction in a cohort of Italian hypertensive subjects.

    Artom, Nathan; Pinna, Giuliano; Musso, Natale R; Orlandini, Francesco; Malasoma, Paolo; Uccelli, Massimiliano; Artom, Alberto; Rabbia, Franco; Pascale, Claudio; Lantieri, Francesca; Pende, Aldo

    2016-01-01

    The aim of this study was to evaluate the prevalence of erectile dysfunction (ED) in a cohort of Italian hypertensive men and the association with clinical and biochemical data. The study involved 270 consecutive hypertensive subjects aged 40-70 years evaluated in Italian Hypertension Centers of six hospitals from Liguria and Piedmont. ED was assessed through the self-administered questionnaire of the International Index of Erectile Function. Clinical history with ongoing drug treatment, various clinical parameters, biochemical data and evidence about the presence of subclinical target organ damage was collected. Twenty-seven subjects refused to answer the questionnaire (10%). Among the 243 remained subjects, 123 presented ED (50.6%). ED was highly related to age, systolic blood pressure, pulse pressure, smoking status, statin therapy and kidney function. The addition of a thiazide diuretic to an inhibitor of the renin-angiotensin system significantly increased the prevalence of ED. The prevalence of ED increased in relation with the number of hypotensive drug classes taken by the patients. ED was highly prevalent in this cohort of Italian hypertensive subjects and was associated with other cardiovascular risk factors, such as age, smoking status and kidney function. The role of ED as an early marker of cardiovascular disease is discussed. PMID:26418513

  16. Erectile dysfunction in primary care: prevalence and patient characteristics. The ENIGMA study.

    de Boer, B J; Bots, M L; Lycklama a Nijeholt, A A B; Moors, J P C; Pieters, H M; Verheij, Th J M

    2004-08-01

    The availability of adequate treatment for erectile dysfunction (ED) triggers studies into the prevalence of ED in the general population. Yet, previous studies showed different prevalence estimates partly due to differences in patient selection, in (unclear) definitions of ED and in assessment. ENIGMA has been designed to study the prevalence of ED in the general population of The Netherlands, using the WHO definition with a description of the way of assessment. In all, 5721 mail surveys were sent to all men, aged 18 y and older in 12 general practices in The Netherlands. A total of 5601 were included in the study and 2117 (38%) were completed. A total of 38% of the men reported to have ever had some kind of erectile problem. The prevalence of ED was 17% (6% mild, 4% moderate and 7% complete). Age, diabetes, cardiovascular diseases, penile disorders, irradiation in the pelvic region, relational problems, fear for failure, surmenage, medication use and regular consumption of alcohol were independently related to ED. Men with ED were less content with their (sexual) life and had less confidence in sexual performance. Presence of ED was negatively related to affected happiness in life. ED is commonly found in men and is related to age, medication, comorbidity and lifestyle factors. Men with ED perceive a lower quality of (sex)life. Doctors should be aware of the presence of ED and its consequences in patients. PMID:14961062

  17. Erectile dysfunction patients are more satisfied with penile prosthesis implantation compared with tadalafil and intracavernosal injection treatments.

    Kucuk, E V; Tahra, A; Bindayi, A; Onol, F F

    2016-09-01

    There are various treatment modalities for erectile dysfunction with different success and satisfaction rates. We aim to compare patient satisfaction with tadalafil, intracavernosal injection, and penile prosthesis implantation in patients with erectile dysfunction. The records of 3448 men with erectile dysfunction were evaluated retrospectively. A total of 356 men with organic erectile dysfunction were enrolled into this study. Of these patients, 132 (37%) received tadalafil 20 mg twice a week for 12 weeks, 106 (30%) patients received tadalafil 5 mg once-daily for 12 weeks, 96 (27%) patients used intracavernosal injection therapy (Bi-mix; papaverine and phentolamine). Moreover, 22 patients underwent penile prosthesis implantation. Patient and partner satisfaction were assessed with International Index of Erectile Function (IIEF) and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire. Patients' mean age was 52.4 ± 25.76 (32-71). The etiology of erectile dysfunction was chronic systemic diseases in 133 (44%) and radical prostatectomy in 121 patients (40%). The mean IIEF-5 scores improvement after the treatment was higher in penile prosthesis implantation group (12.4 ± 1.3) compared with tadalafil 5 mg (6.7 ± 1.5) (p prosthesis implantation group (78.2 ± 11.3) compared with intracavernosal injection (60.3 ± 6.3), tadalafil 5 mg (72.5 ± 4.5), and tadalafil 20 mg 70.7 ± 3.4 groups (p prosthesis implantation group, 50.2 ± 1.5 in intracavernosal injection group, 62.9 ± 7.8 in tadalafil 5 mg, and 61.3 ± 5.3 in tadalafil 20 mg group (p prosthesis implantation seem to be more satisfied compared with tadalafil treatment and intracavernosal injection. Future clinical trials are warranted to confirm our results. PMID:27368423

  18. Can low-intensity extracorporeal shockwave therapy improve erectile dysfunction? A prospective, randomized, double-blind, placebo-controlled study

    Olsen, Anne Buchhave; Persiani, Marie; Boie, Sidsel; Lund, Lars

    2015-01-01

    included 112 men unable to have intercourse either with or without medication. Erectile dysfunction was assessed at screening and 5, 12 and 24 weeks after treatment. Assessment was performed by interview and using the Erection Hardness Scale (EHS) and the International Index of Erectile Function (IIEF-15...... group). RESULTS: Twenty-nine men (57%, active group) were able to obtain an erection after treatment and to have sexual intercourse without the use of medication. In the placebo group, only five men (9%) showed similar results (p = 0.0001). The EHS after 5 weeks showed that men in the active group...

  19. Erectile Dysfunction, Vascular Risk, and Cognitive Performance in Late Middle Age

    Moore, Caitlin S.; Grant, Michael D.; Zink, Tyler A.; Panizzon, Matthew S.; Franz, Carol E.; Logue, Mark W.; Hauger, Richard L.; Kremen, William S.; Lyons, Michael J.

    2016-01-01

    Vascular disease is the most common etiology of erectile dysfunction (ED). Men with ED are at a 65% increased relative risk of developing coronary heart disease and a 43% increased risk of stroke within 10 years. Vascular disease is associated with cognitive impairment; ED—an overt manifestation of vascular dysfunction—could also signal early compromised cognition. We sought to determine whether cognitive differences existed between men with ED and healthy peers. Our sample consisted of 651 men (ages 51–60 years) from the Vietnam Era Twin Study of Aging. ED was associated with poorer cognitive performance, particularly on attention–executive–psychomotor speed tasks. ED remained significantly associated with cognition after inclusion of other cardiovascular risk factors (including hypertension, high cholesterol, body mass index, and smoking). These findings underscore the importance of further study of ED as a predictor of cognitive and cardiovascular health. PMID:24660805

  20. Premature Ejaculation and Erectile Dysfunction%早泄与勃起功能障碍

    郑新民; 杨琨

    2010-01-01

    @@ 早泄(premature ejaculation,PE)和勃起功能障碍(erectile dysfunction,ED)是成年男性中最常见的性功能障碍性疾病.其中PE的发病率为25%~40%,ED的总发病率约为40%~52%[1].两者之间在病因、发病机制、诊断及治疗等方面有共同之处,近年来随着对男性勃起机制认识的加深和新的治疗手段的出现,PE和ED的诊疗有了较大的进展.

  1. PHOSPHODIESTERASE-5 INHIBITORS USE IN PATIENTS WITH ERECTILE DYSFUNCTION AND CARDIOVASCULAR DISEASE IN CLINICAL PRACTICE

    M. N. Mamedov

    2016-01-01

    Full Text Available About 150 million men worldwide and about 50% of men aged 40-88 y.o. in outpatient practice suffer from erectile dysfunction (ED. There is a linear relation between the age and ED rate. The main reason of ED in the majority of men (about 80% of patients is cardiovascular diseases (atherosclerosis, hypertension, diabetes mellitus, as well as certain risk factors (smoking, alcohol abuse, physical inactivity etc.. The problem of ED in cardiac outpatients and modern pharmacotherapy is discussed. The phosphodiesterase-5 (PDE5 inhibitors increase the relaxing effect of nitric oxide and increase cyclic GMP levels during sexual arousal. It results in increase of cavernosum blood flow, contributing to the physiological erection. Three PDE5 inhibitors (sildenafil, tadalafil, vardenafil are used in clinical practice nowadays.

  2. Bilateral Simultaneous Nonarteritic Anterior Ischemic Optic Neuropathy after Ingestion of Sildenafil for Erectile Dysfunction

    Tarantini, Anna; Faraoni, Alessandra; Menchini, Francesca; Lanzetta, Paolo

    2012-01-01

    Purpose. To describe a patient who developed bilateral, simultaneous nonarteritic anterior ischemic optic neuropathy (NAION) after ingestion of Sildenafil citrate (Viagra) for erectile dysfunction. Methods. Observational case report. Results. A 60-year-old diabetic man noted sudden decrease of vision in both eyes 16 hours after his third consecutive 50 mg daily Sildenafil ingestion. A diagnosis of bilateral NAION was made and he was treated for three days with methylprednisolone 1 g/d intravenously, followed by oral prednisone 75 mg/d. Final visual acuity was 20/50 right eye (OD) and 20/20 left eye (OS). He had preexisting diabetes. Conclusion. This is the first reported case of simultaneous bilateral NAION occurred in a diabetic patient early after Sildenafil intake. Patients with predisposing conditions such as diabetes have to be warned against the use of PDE inhibitors. PMID:22481954

  3. Mirodenafil for the treatment of erectile dysfunction: a systematic review of the literature.

    Park, Hyun Jun; Moon, Kyung Hyun; Lee, Seung Wook; Lee, Won Ki; Kam, Sung Chul; Lee, Jun Ho; Park, Nam Cheol

    2014-04-01

    Phosphodiesterase type 5 (PDE5) inhibitors are the most commonly used treatment for erectile dysfunction (ED). Since the launch of sildenafil, several drugs-including mirodenafil, sildenafil citrate (sildenafil), tadalafil, vardenafil HCL (vardenafil), udenafil, and avanafil-have become available. Mirodenafil is a newly developed pyrrolopyrimidinone compound, which is a potent, reversible, and selective oral PDE5 inhibitor. Mirodenafil was launched in Korea in 2007, and an orally disintegrating film of mirodenafil was developed in 2011 for benefitting patients having difficulty in swallowing tablets. This study aimed to review the pharmacokinetic characteristic profile of mirodenafil and report evidence on its efficacy in the case of ED. In addition, we reviewed randomized controlled studies of mirodenafil's daily administration and efficacy for lower urinary tract symptoms. PMID:24872948

  4. Pudendal Nerve and Internal Pudendal Artery Damage May Contribute to Radiation-Induced Erectile Dysfunction

    Purpose/Objectives: Erectile dysfunction is common after radiation therapy for prostate cancer; yet, the etiopathology of radiation-induced erectile dysfunction (RI-ED) remains poorly understood. A novel animal model was developed to study RI-ED, wherein stereotactic body radiation therapy (SBRT) was used to irradiate the prostate, neurovascular bundles (NVB), and penile bulb (PB) of dogs. The purpose was to describe vascular and neurogenic injuries after the irradiation of only the NVB or the PB, and after irradiation of all 3 sites (prostate, NVB, and PB) with varying doses of radiation. Methods and Materials: Dogs were treated with 50, 40, or 30 Gy to the prostate, NVB, and PB, or 50 Gy to either the NVB or the PB, by 5-fraction SBRT. Electrophysiologic studies of the pudendal nerve and bulbospongiosus muscles and ultrasound studies of pelvic perfusion were performed before and after SBRT. The results of these bioassays were correlated with histopathologic changes. Results: SBRT caused slowing of the systolic rise time, which corresponded to decreased arterial patency. Alterations in the response of the internal pudendal artery to vasoactive drugs were observed, wherein SBRT caused a paradoxical response to papaverine, slowing the systolic rise time after 40 and 50 Gy; these changes appeared to have some dose dependency. The neurofilament content of penile nerves was also decreased at high doses and was more profound when the PB was irradiated than when the NVB was irradiated. These findings are coincident with slowing of motor nerve conduction velocities in the pudendal nerve after SBRT. Conclusions: This is the first report in which prostatic irradiation was shown to cause morphologic arterial damage that was coincident with altered internal pudendal arterial tone, and in which decreased motor function in the pudendal nerve was attributed to axonal degeneration and loss. Further investigation of the role played by damage to these structures in RI-ED is

  5. Pudendal Nerve and Internal Pudendal Artery Damage May Contribute to Radiation-Induced Erectile Dysfunction

    Nolan, Michael W., E-mail: mwnolan@ncsu.edu [Department of Clinical Sciences, and Center for Comparative Medicine and Translational Research, North Carolina State University, Raleigh, North Carolina (United States); Department of Environmental and Radiologic Health Sciences, Colorado State University, Fort Collins, Colorado (United States); Marolf, Angela J. [Department of Environmental and Radiologic Health Sciences, Colorado State University, Fort Collins, Colorado (United States); Ehrhart, E.J. [Department of Microbiology, Immunology and Pathology, Colorado State University, Fort Collins, Colorado (United States); Rao, Sangeeta [Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado (United States); Kraft, Susan L. [Department of Environmental and Radiologic Health Sciences, Colorado State University, Fort Collins, Colorado (United States); Engel, Stephanie [Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado (United States); Yoshikawa, Hiroto; Golden, Anne E. [Department of Environmental and Radiologic Health Sciences, Colorado State University, Fort Collins, Colorado (United States); Wasserman, Todd H. [Department of Radiation Oncology, Washington University, St. Louis, Missouri (United States); LaRue, Susan M. [Department of Environmental and Radiologic Health Sciences, Colorado State University, Fort Collins, Colorado (United States)

    2015-03-15

    Purpose/Objectives: Erectile dysfunction is common after radiation therapy for prostate cancer; yet, the etiopathology of radiation-induced erectile dysfunction (RI-ED) remains poorly understood. A novel animal model was developed to study RI-ED, wherein stereotactic body radiation therapy (SBRT) was used to irradiate the prostate, neurovascular bundles (NVB), and penile bulb (PB) of dogs. The purpose was to describe vascular and neurogenic injuries after the irradiation of only the NVB or the PB, and after irradiation of all 3 sites (prostate, NVB, and PB) with varying doses of radiation. Methods and Materials: Dogs were treated with 50, 40, or 30 Gy to the prostate, NVB, and PB, or 50 Gy to either the NVB or the PB, by 5-fraction SBRT. Electrophysiologic studies of the pudendal nerve and bulbospongiosus muscles and ultrasound studies of pelvic perfusion were performed before and after SBRT. The results of these bioassays were correlated with histopathologic changes. Results: SBRT caused slowing of the systolic rise time, which corresponded to decreased arterial patency. Alterations in the response of the internal pudendal artery to vasoactive drugs were observed, wherein SBRT caused a paradoxical response to papaverine, slowing the systolic rise time after 40 and 50 Gy; these changes appeared to have some dose dependency. The neurofilament content of penile nerves was also decreased at high doses and was more profound when the PB was irradiated than when the NVB was irradiated. These findings are coincident with slowing of motor nerve conduction velocities in the pudendal nerve after SBRT. Conclusions: This is the first report in which prostatic irradiation was shown to cause morphologic arterial damage that was coincident with altered internal pudendal arterial tone, and in which decreased motor function in the pudendal nerve was attributed to axonal degeneration and loss. Further investigation of the role played by damage to these structures in RI-ED is

  6. Prostaglandin E1 versus sex therapy in the management of psychogenic erectile dysfunction.

    Baum, N; Randrup, E; Junot, D; Hass, S

    2000-06-01

    The treatment for psychogenic erectile dysfunction has been previously managed by non-medical methods consisting of counseling with a psychiatrist, psychologist or sex therapist. The success rate for treatment with counseling has not been uniformly successful. This paper compares the treatment of psychogenic erectile dysfunction using standard sex therapy and self-injection therapy using low-dose PGE1. Fifty men with psychogenic impotence were divided into two groups: standard sex therapy for twelve weeks or treatment using low-dose (2.5 - 5.0 microg) of PGE1. The results showed that men treated with low-dose PGE1 had a 47% improvement of obtaining an unaided erection compared to 58% improvement rate with sex therapy. 69% of patients in the PGE1 group were satisfied with their treatment compared to 75% receiving sex therapy. The frequency of intercourse reported in patient diaries for the two groups was similar (20.5 per month for PGE1 vs 20.0 per month for sex therapy. The reported duration of erection by patients receiving PGE1 therapy was longer than that reported by those receiving sex therapy (35 min vs 10 min). The comparison of the cost of treatment of the two treatment groups reveals that the sex therapy is approximately 25% more expensive than the PGE1 treatment. This pilot study demonstrates that the efficacy of PGE1 was numerically, though not statistically, less than sex therapy in the treatment of psychogenic impotence. The cost per positive outcome with PGE1 treatment is lower than that of sex therapy treatment making PGE1 more cost-effective. PMID:11045914

  7. Effects of tissue-cultured mountain ginseng (Panax ginseng CA Meyer) extract on male patients with erectile dysfunction

    Tae-Hwan Kim; Seung Hyun Jeon; Eun-Joo Hahn; Kee-Yoeup Paek; Jong Kwan Park; Nae Young Youn; Hyung-Lae Lee

    2009-01-01

    Korean ginseng and mountain ginseng (Panax ginseng CA Meyer) are important traditional herbal plants whose ginsenosides are generally accepted as serving to improve sexual functions, such as penile erection. We investigated the effects of tissue-cultured mountain ginseng extract (TMGE) on male patients with erectile dysfunction (ED). A double-blind, placebo-controlled study was conducted with 143 patients experiencing ED. Over the course of 8 weeks, one group took 1 000 mg of TMGE twice a day, and the other group took 1 000 mg of placebo twice a day. The effects of the TMGE and the placebo were analyzed using the Korean version of the International Index of Erectile Function (IIEF) questionnaire. A total of 86 patients completed 8 weeks of treatment. The scores on the five domains of the IIEF after medication were significantly higher than the baseline scores in the group treated with TMGE (P0.05). Erectile function and overall satisfaction scores after medication were significantly higher in the TMGE group than in the placebo group (P<0.05). Erectile function of patients in the TMGE-treated group significantly improved, suggesting that TMGE could be utilized for improving erectile function in male patients.

  8. To ED or not to ED--is erectile dysfunction in obstructive sleep apnea related to endothelial dysfunction?

    Hoyos, Camilla M; Melehan, Kerri L; Phillips, Craig L; Grunstein, Ronald R; Liu, Peter Y

    2015-04-01

    Both obstructive sleep apnea (OSA) and erectile dysfunction (ErectD) are highly prevalent and largely under diagnosed medical conditions. These disorders often co-exist, with about half of the male OSA population having ErectD and vice versa. OSA is strongly associated with an increased risk of cardiovascular mortality while ErectD has been proposed as a phenotypic marker of cardiovascular disease. This implies that the two conditions may be linked by a common pathophysiological mechanism. In this review we provide evidence supporting the hypothesis that endothelial dysfunction (EndoD) may be the common pathophysiological mechanism linking OSA with both ErectD and cardiovascular complications. EndoD is one of the earliest markers of cardiovascular disease and substantial evidence suggests that OSA independently causes EndoD. There is also strong evidence that causally links EndoD with organic ErectD. Further research should be directed at determining the value of simultaneously assessing both ErectD and OSA in patients presenting with symptoms of either condition. In both ErectD and OSA clinics, identifying both conditions could improve overall cardiovascular risk stratification whilst treatment of OSA could reduce both ErectD and cardiovascular risk. PMID:24813467

  9. AB095. Increased expression of TMEM16A/Ano1 chloride channel associated with diabetic erectile dysfunction

    Ruan, Yajun; Chen, Yingwei; Li, Mingchao; Wang, Tao; Yang, Jun; Rao, Ke; Wang, Shaogang; Yang, Weimin; Liu, Jihong; Ye, Zhangqun

    2016-01-01

    Objective To investigate the presence, location and functional role of TMEM16A/anotamin-1 (Ano1) calcium-activated chloride channel (CaCC) in the penile of rats with diabetic erectile dysfunction. Methods Eight-week-old male Sprague-Dawley (SD) rats were administrated streptozotocin (diabetic) or citrate buffer (control) randomly. Erectile function was measured by cavernous nerve electrostimulation at 12th week after diabetes was induced. The effect of Ano1 specific inhibitor—T16Ainh-A01 on intracavernous pressure (ICP) was evaluated. Then the penile tissues were harvested for molecular exploration. Real-time PCR and Western Blotting were used to assess the expression of Ano1 in penile tissues. Immunofluorescent labelling of penile tissue allowed localization of Ano1. Cavernous smooth muscle cell (CSMC) was cultured in high glucose medium. The change of Ano1 was measured using Western Blotting. The proliferation of CSMC was evaluated by cell counting kit-8 (CCK-8). Results Erectile function was impaired in diabetic rats. The expression of Ano1 was increased in rats with diabetic erectile dysfunction at mRNA and protein levels. Immunofluorescent labelling revealed the presence of Ano1 mainly in cavernous smooth muscle cells. The inhibition of Ano1 increased the ICP of DED rats. High glucose in vitro enhanced the proliferation of CSMC and the expression level of Ano1. Conclusions Ano1 is expressed in rat penile tissue and is increased with diabetes mellitus. The inhibition of Ano1 increased the ICP of DED rats. The alerted Ano1 may be associated with diabetic erectile dysfunction. It is a potential therapy target for ED in the future.

  10. Nuclear medicine imaging technique in the erectile dysfunction evaluation: a mini-review

    Camila Godinho Ribeiro

    2007-09-01

    Full Text Available Functional imaging with positron emission tomography and single photon emission computed tomography is capable of visualizing subtle changes in physiological function in vivo. Erectile dysfunction(ED diminishes quality of life for affected men and their partners. Identification of neural substrates may provide information regarding the pathophysiology of types of sexual dysfunction originating in the brain. The aim of this work is to verify the approaches of the nuclear medicine techniques in the evaluation of the erectile function/disfunction. A search using the words ED and nuclear medicine, ED and scintigraphy, ED and spect and ED and pet was done in the PubMed. The number of citations in each subject was determined. Neuroimaging techniques offer insight into brain regions involved in sexual arousal and inhibition. To tackle problems such as hyposexual disorders or ED caused by brain disorders, it is crucial to understand how the human brain controls sexual arousal and penile erection.Imagens functionais, como o positron emission tomography e o single photon emission computed tomography são capazes de identificar súbitas alterações fisiológicas in vivo. A disfunção er��til diminui a qualidade de vida do casal. A identificação de substratos neurais pode esclarecer a fisiopatologia dos diferentes tipos de disfunções sexuais originadas no cérebro. O objetivo deste trabalho é verificar a abordagem das técnicas da medicina nuclear na avaliação da função/disfunção erétil. Uma pesquisa utilizando as palavras disfunção erétil e medicina nuclear, disfunção erétil e cintigrafia, disfunção erétil e SPECT e disfunção erétil e PET foi realizada no PubMed. O número de citações em cada palavra estudada foi determinado. Técnicas de neuroimagem permitem a avaliação das regiões cerebrais durante o estímulo ou inibição sexual. Para resolver alterações como disfunções hipossexuais ou disfunção erétil causada

  11. Trends in the Rate of Self-Report and Diagnosis of Erectile Dysfunction in the United States 1990-1998: Was the Introduction of Sildenafil an Influencing Factor?

    Tracy L. Skaer; Sclar, David A.; Robison, Linda M.; Richard S. Galin

    2001-01-01

    Objective: To present the pattern of self-report and diagnosis of erectile dysfunction in the US over the time period 1990 through 1998 and examine whether the introduction of sildenafil in March 1998 influenced these findings. Study design and methods: Retrospective database analysis. Data from the National Ambulatory Medical Care Survey (NAMCS) for the years 1990 through 1998 were used. Data from office-based physician-patient encounters for which either a complaint of erectile dysfunction ...

  12. AB228. Research on the mechanism of androgen replacement therapy improving erectile dysfunction in castrated rats

    Cui, Kai; Li, Rui; Wang, Tao; Zhang, Yan; Wang, Shaogang; Rao, Ke; Liu, Jihong

    2016-01-01

    Objective To investigate the mechanism of androgen replacement therapy (ART) improving erectile dysfunction (ED) in castrated rats. Methods We randomly divided 40 8-week-old healthy male SD rats into 4 groups: group A was the control, and rats of the group B, C and D were castrated, then rats in the groups C and D were treated with different concentrations of testosterone undecanoate orally every day (C: 10 mg/kg, D: 20 mg/kg), while other groups with 0.9% NS instead. 8weeks’ treatment later, we determined the level of serum testosterone and assessed the erectile function of rats. Western blot, immunohistochemistry were performed to detect the level of target proteins. Results (I) The level of serum testosterone and erectile function (Max ICP/MAP): group Bwas significantly lower than group A, C and D, and group D was higher compared with group C; (II) effect of castration and ART on endothelial cells and androgen receptor (AR)/vascular endothelial growth factor (VEGF)/cyclin A pathway: the expression of CD31, vWF and AR/VEGF/cyclin A in group B were lower than group A, C and D, and group D was higher compared with group C; (III) effect of castration and ART on corpus cavernosum smooth muscle cells (CCSMCs) and TGF-β/S1P2/RhoA/ROCK pathway: the expression of α-sma in group B were lower than group A, C and D, and group D was higher compared with group C; while the expression of TGF-β/S1P2/RhoA/ROCK1 were higher in group B than group A, C and D, and group D was lower compared with group C. Conclusions ART can improve ED in castrated rats through promoting the proliferation of corpus cavernosum endothelial cells by activating AR/VEGF/cyclin A pathway; decreasing the contraction of CCSMCs and corporal fibrosis by inhibiting TGF-β/S1P2/RhoA/ROCK pathway, which provides reference for revealing the mechanism of ART treating ED associated late-onset hypogonadism.

  13. [The treatment of erectile dysfunction: what are the objectives and the methods?].

    Bondil, P; Blachère, P

    1998-02-01

    Despite considerable progress, the treatment of erectile insufficiency is often difficult due to its usually multifactorial aetiology and to the fact that the 3 components of a satisfying sex life are: 1) Sufficient penile rigidity with no other associated sexual dysfunction, 2) an adapted mental state, 3) a loving relationship with the partner. All of these parameters must be taken into account to ensure a lasting success, hence the need for a global approach rather than an approach localized to the organ. Consequently, there is not one, but several treatments which must be adapted to each case. The rarity of easily curable aetiologies explains the very widespread use of symptomatic treatments and the primordial place of clinical assessment. A consensus has currently been reached concerning: a) give the patient objective information, an essential prerequisite for the choice and success of treatment, b) start by proposing minimally invasive medical treatments, c) emphasize the value of a multidisciplinary approach in the case of failure, d) recognize the fact that achievement of a rigid penis is not necessarily synonymous with cure. In practice, two situations can be distinguished: 1) in the presence of predominantly psychogenic disorders, sex therapy and/or sexual advice can be used in all patients, either alone or in combination with drug treatments and/or a vacuum device (especially in the case of failure of either of these treatments), 2) in the presence of predominantly organic abnormalities which are not easily curable drug treatments and/or vacuum must be proposed first, but sexological management is always useful in these so-called "organic" patients. Prosthetic surgery, the only approach with demonstrated efficacy, is only indicated following failure of medical treatment, after rigorous selection. The release onto the market, in the near future, of promising new oral or intraurethral drugs used "on request" will certainly modify the treatment hierarchy

  14. A review of the efficacy and safety of mirodenafil in the management of erectile dysfunction.

    Cho, Min Chul; Paick, Jae-Seung

    2016-04-01

    Erectile dysfunction (ED) is a common disorder that can jeopardize quality of life and the partnership of patients and their sexual partners. The advent of oral phosphodiesterase type 5 inhibitors (PDE5Is) has revolutionized a treatment for ED, and they are recognized as the first-line therapy for ED, regardless of its etiology. Mirodenafil, a second-generation PDE5I, has biochemical profiles such as high affinity for PDE5 and high selectivity for PDE5 over other PDE isoforms, compared to other existing PDE5Is such as sildenafil, vardenafil and tadalafil. Available evidence has suggested that doses of 50 and 100 mg mirodenafil effectively improve ED [with improvements in the erectile function domain of the International Index of Erectile Function (IIEF-EF) scores, positive responses to questions 2 of the Sexual Encounter Profiles (SEP2) and questions 3 of the Sexual Encounter Profiles (SEP3): 7.6-11.6 points, 27.72-38.98% and 44.20-67.33%, respectively] in a broad range of patient populations with ED of a variety of underlying etiologies, severities and ages, without any serious treatment-related adverse effects. In the treatment of diabetic ED, a traditionally difficult-to-treat population, 100 mg mirodenafil has been reported to offer favorable efficacy (with improvements in the IIEF-EF scores, and positive responses to the SEP2 and the SEP3: 9.3 points, 36.1% and 61.8%, respectively) and tolerability (mild adverse effects of less than 19.6%), which are comparable with results from clinical studies on other PDE5Is. Mirodenafil appears to be effective, safe and well tolerated in men with both ED and hypertension or lower urinary tract symptoms (LUTS)/benign prostatic hyperplasia (BPH) who are taking concomitant antihypertensive medications or α1-blockers. Furthermore, recent evidence has indicated that mirodenafil may be a potential option for chronic dosing in the treatment of ED despite its short half-life (T 1/2). Most of the available clinical studies have

  15. Stem Cell Therapy for Diabetic Erectile Dysfunction in Rats: A Meta-Analysis.

    Mingchao Li

    Full Text Available Stem cell therapy is a novel method for the treatment of diabetic erectile dysfunction (ED. Many relative animal studies have been done to evaluate the efficacy of this therapy in rats.This meta-analysis was performed to compare the efficacy of different stem cell therapies, to evaluate the influential factors and to determine the optimal stem cell therapeutic strategy for diabetic ED.We searched the studies analyzing the efficacy of stem cell therapy for diabetic ED in rats published before September 30, 2015 in PubMed, Web of Science and EBSCO. A random effects meta-analysis was conducted to assess the outcomes of stem cell therapy. Subgroup analysis was also performed by separating these studies based on their different characteristics. Changes in the ratio of intracavernous pressure (ICP to mean arterial pressure (MAP and in the structure of the cavernous body were compared.10 studies with 302 rats were enrolled in this meta-analysis. Pooled analysis of these studies showed a beneficial effect of stem cell therapy in improving erectile function of diabetic rats (SMD 4.03, 95% CI = 3.22 to 4.84, P< 0.001. In the stem cell therapy group, both the smooth muscle and endothelium content were much more than those in control group. There was also significant increase in the expression of endothelial nitric oxide synthase (eNOS and neuronal nitric oxide synthase (nNOS, the ratio of smooth muscle to collagen, as well as the secretion of vascular endothelial growth factor (VEGF. Besides, apoptotic cells were reduced by stem cell treatment. The subgroup analysis indicated that modified stem cells were more effective than those without modification.Our results confirmed that stem cell therapy could apparently improve the erectile function of diabetic rats. Some specific modification, especially the gene modification with growth factors, could improve the efficacy of stem cell therapy. Stem cell therapy has potential to be an effective therapeutic

  16. Stem Cell Therapy for Diabetic Erectile Dysfunction in Rats: A Meta-Analysis

    Li, Mingchao; Li, Hao; Ruan, Yajun; Wang, Tao; Liu, Jihong

    2016-01-01

    Introduction Stem cell therapy is a novel method for the treatment of diabetic erectile dysfunction (ED). Many relative animal studies have been done to evaluate the efficacy of this therapy in rats. Aims This meta-analysis was performed to compare the efficacy of different stem cell therapies, to evaluate the influential factors and to determine the optimal stem cell therapeutic strategy for diabetic ED. Methods We searched the studies analyzing the efficacy of stem cell therapy for diabetic ED in rats published before September 30, 2015 in PubMed, Web of Science and EBSCO. A random effects meta-analysis was conducted to assess the outcomes of stem cell therapy. Subgroup analysis was also performed by separating these studies based on their different characteristics. Changes in the ratio of intracavernous pressure (ICP) to mean arterial pressure (MAP) and in the structure of the cavernous body were compared. Results 10 studies with 302 rats were enrolled in this meta-analysis. Pooled analysis of these studies showed a beneficial effect of stem cell therapy in improving erectile function of diabetic rats (SMD 4.03, 95% CI = 3.22 to 4.84, P< 0.001). In the stem cell therapy group, both the smooth muscle and endothelium content were much more than those in control group. There was also significant increase in the expression of endothelial nitric oxide synthase (eNOS) and neuronal nitric oxide synthase (nNOS), the ratio of smooth muscle to collagen, as well as the secretion of vascular endothelial growth factor (VEGF). Besides, apoptotic cells were reduced by stem cell treatment. The subgroup analysis indicated that modified stem cells were more effective than those without modification. Conclusions Our results confirmed that stem cell therapy could apparently improve the erectile function of diabetic rats. Some specific modification, especially the gene modification with growth factors, could improve the efficacy of stem cell therapy. Stem cell therapy has potential

  17. Progesterone reduces erectile dysfunction in sleep-deprived spontaneously hypertensive rats

    Tufik Sergio

    2007-03-01

    Full Text Available Abstract Background Paradoxical sleep deprivation (PSD associated with cocaine has been shown to enhance genital reflexes (penile erection-PE and ejaculation-EJ in Wistar rats. Since hypertension predisposes males to erectile dysfunction, the aim of the present study was to investigate the effects of PSD on genital reflexes in the spontaneously hypertensive rat (SHR compared to the Wistar strain. We also extended our study to examine how PSD affect steroid hormone concentrations involved in genital events in both experimental models. Methods The first experiment investigated the effects of PSD on genital reflexes of Wistar and SHR rats challenged by saline and cocaine (n = 10/group. To further examine the impact of the PSD on concentrations of sexual hormones, we performed a hormonal analysis of testosterone and progesterone in the Wistar and in SHR strains. Since after PSD progesterone concentrations decreased in the SHR compared to the Wistar PSD group we extended our study by investigating whether progesterone (25 mg/kg or 50 mg/kg or testosterone (0.5 mg/kg or 1.0 mg/kg administration during PSD would have a facilitator effect on the occurrence of genital reflexes in this hypertensive strain. Results A 4-day period of PSD induced PE in 50% of the Wistar rats against 10% for the SHR. These genital reflexes was potentiated by cocaine in Wistar rats whereas this scenario did not promote significant enhancement in PE and EJ in hypertensive rats, and the percentage of SHR displaying genital reflexes still figured significantly lower than that of the Wistar strain. As for hormone concentrations, both sleep-deprived Wistar and SHR showed lower testosterone concentrations than their respective controls. Sleep deprivation promoted an increase in concentrations of progesterone in Wistar rats, whereas no significant alterations were found after PSD in the SHR strain, which did not present enhancement in erectile responses. In order to explore the role

  18. AB233. PDE5-Is for erectile dysfunction in patients with multiple sclerosis

    Yang, Xingliang; Yuan, Jiuhong

    2016-01-01

    Objective Male patients with multiple sclerosis commonly suffered sexual dysfunction. Phosphodiesterase five inhibitors are efficacious and widely used for erectile dysfunction in general population and even post-TURPT patients. However, whether PDE5-Is is effective for MS-associated ED is still unclear. Methods PubMed, ISI Web of Science and Google Scholar were searched and relevant studies were evaluated for the efficacy and safety of PDE5-Is on MS-associated ED. Results Sildenafil and tadalafil were used for the treatment of MS-associated ED in reported trials. In Safarinejad trial, sildenafil was slightly better than placebo regarding improved erections, successful penetration and successful sexual attempts. For side-effects, patients in sildenafil group showed significantly high proportion and the main AE was headache. In Fowler and Lombardi trials, sildenafil and tadalafil were used for treatment of MS-associated ED respectively. Both trials showed that PDE5-Is could improve erection or quality of life for patients and his partners. Although adverse events reported in two trials, no patient discontinued because of AEs. Conclusions PDE5-Is seems to be an effective for those MS-associated ED patients. However, the detail mechanism and long-term efficacy is still unknown.

  19. [Erectile dysfunction and quality of life in patients with chronic renal failure].

    Bellinghieri, G; Santoro, D; Satta, E; Savica, V

    2008-01-01

    Erectile dysfunction (ED) is associated with a reduced quality of life; it represents a risk factor for the development of depression. ED may induce depression, loss of self-esteem, poor self-image, anxiety, and tension in the relationship with the partner. These emotional disturbances can create physical conditions that lead to increased difficulty in achieving an erection. Depression can deprive a person of the ability to experience many of life's pleasures. It not only affects the mind but also the body--often in unexpected ways. As a result, many men who have been diagnosed with depression find themselves suffering from another condition: ED. Sexual dysfunction is a big problem also in patients with chronic renal failure and seriously affects their quality of life. About 40% of men on dialysis suffer from ED. Many uremic patients have additional symptoms including reduction of libido and a decreased frequency of sexual intercourse. With the start of dialysis some of these symptoms may improve, without, however, returning to normal. PMID:19048573

  20. Effect of tadalafil on erectile dysfunction in male patients with diabetes mellitus

    Popović Srđan

    2007-01-01

    Full Text Available Background/Aim. During the first 10 years over 50% of diabetes patients develop erectile dysfunction (ED. It is more severe and resistant to therapy than in male patients with normal glucoregulation. The purpose of this pilot study was to estimate the tadalafil (Cialis efficacy and safety in male patients with diabetes mellitus (DM, together with moderate to severe ED. Methods. The study included 30 male patients with diagnozed type 1 or type 2 DM together with ED. ED was estimated through the International Index of Erectile Function (IIEF-6, Sexual Encounter Profile (SEP questionnaire and prostaglandin test, at the beginning of the research and three months after the 20 mg tadalafil therapy initiation, once a week (on Fridays. Glycosylated haemoglobin in blood (HbA1c values were also monitored. According to the ED severity (IIEF values at the beginning of the therapy the patients were divided into 2 groups. The previous experience with sildenafil citrate (Viagra and prostaglandin E1 intracavernous therapy was recorded. Results. Tadalafil significantly improved ED (p < 0.001 for 7.40 points of the IIEF score, i.e. for 58% and 60% towards SEP2 and SEP3 questionnaire, respectively. Compared to the previous ED therapy subjectively better tadalafil experience was recorded. Each group experienced a significant improvement in IIEF score (p < 0.001, more significantly in the group 2 (8.26±1.49 points compared with the medium improvement in the group 1 (6.27±1.35 points. After three months HbA1c values decreased for 2.26±1.62 (p < 0.001. Conclusion. Tadalafil is an effective tool for treating ED in diabetes patients. In some situations tadalafil application could replace prostaglandin test. The sexual sphere motivation leads to the improvement of glucoregulation in DM patients. .

  1. Effect of Nerve-Sparing Radical Prostatectomy on Urinary Continence in Patients With Preoperative Erectile Dysfunction

    2016-01-01

    Purpose: We aimed to assess whether nerve-sparing radical prostatectomy (nsRP) is associated with improved recovery of urinary continence compared to non–nerve-sparing radical prostatectomy (nnsRP) in patients with localized prostate cancer and preoperative erectile dysfunction. Methods: A total of 360 patients with organ-confined prostate cancer and an International Index of Erectile Function score of less than 17 were treated with nsRP or nnsRP in Seoul St. Mary’s Hospital. Patients who received neoadjuvant or adjuvant androgen deprivation therapy or had a history of prostate-related surgery were excluded. Recovery of urinary continence was assessed at 0, 1, 3, 6, and 12 months. Postoperative recovery of continence was defined as zero pad usage. The association between nerve-sparing status and urinary continence was assessed by using univariate and multivariate Cox regression analyses after controlling for known predictive factors. Results: Urinary continence recovered in 279 patients (77.5%) within the mean follow-up period of 22.5 months (range, 6–123 months). Recovery of urinary continence was reported in 74.6% and 86.4% of patients after nnsRP and nsRP, respectively, at 12 months (P=0.022). All groups had comparable perioperative criteria and had no significant preoperative morbidities. Age, American Society of Anesthesiologists score, and nerve-sparing status were significantly associated with recovery of urinary continence on univariate analysis. On multivariate analysis, age (hazard ratio [HR], 1.254; 95% confidence interval [CI], 1.002–1.478; P=0.026) and nerve-sparing status (HR, 0.713; 95% CI, 0.548–0.929; P=0.012) were independently associated with recovery of urinary continence. Conclusions: nsRP, as compared to nnsRP, improves recovery rates of urinary incontinence and decreases surgical morbidity without compromising pathologic outcomes. PMID:27032560

  2. The relationship between platelet-lymphocyte ratio and severity of erectile dysfunction.

    Akbas, Alpaslan; Gulpınar, Murat Tolga; Sancak, Eyüp Burak; Gunes, Mustafa; Ucar, Murat; Altok, Muammer; Umul, Mehmet

    2016-02-01

    The prognostic importance of platelet-lymphocyte ratio (PLR) is already known for various artery diseases. In this study, the relationship between PLR and severity of erectile dysfunction (ED) is examined in patients with impotence. The data from patients suffering from erection problems was screened retrospectively. Detailed medical history, age, International Index of Erectile Function-5 (IIEF-5) scores, fasting blood glucose, lipid, whole blood count, and hormone profile values were examined. Patients with no ED were selected as the control group. All men answered the IIEF-5 questions and were then classified according to their scores. Patients were determined to have severe ED (scores 5-7), moderate ED (scores 8-16), or mild ED (scores 17-21). An IIEF-5 score greater than 21 was accepted for the control group. The PLR values from both patient and control groups were evaluated. Demographic data were similar in both groups. Mean PLR value was 104 in control and 118 in the patient group (p < 0.001). PLR value increased depending on the severity of ED. Mean PLR values were 108 in mild, 116 in moderate, and 130 in severe ED groups. Compared with the control group, this value was statistically significant for patients with moderate and severe ED (p = 0.04 and p < 0.001). PLR showed weak negative but significant correlation with IIEF-5 scores (r = -0.27 and p < 0.001). The PLR value was found to be higher in patients with ED. PLR value may be related to ED and its severity in patients with impotence. PMID:26944328

  3. Help-seeking behavior for erectile dysfunction: a clinic-based survey in China

    Kai Zhang

    2014-02-01

    Full Text Available The behavior of Chinese patients seeking help for erectile dysfunction (ED has not been described in detail. This was an observational study conducted using an outpatient clinic-based questionnaire survey of ED patients. From 2008 to 2009, physicians in 10 medical centers in China enrolled 2693 men (aged 25-70 years diagnosed with ED. The diagnosis was based on the International Index of Erectile Function 5 (IIEF-5 Questionnaire. The men completed a survey that asked questions about demographics, marital status, education level and household income as well as help-seeking behavior and awareness of medical therapy. The mean age of the 2693 men was 43.4 ± 5.3 years; 73% were <50-years-old and 49% had a high household income. The mean time between noticing ED and taking the first treatment was 4.3 ± 2.1 months. Of the 2577 respondents, physicians (54% and the internet (52% were most frequently consulted sources for information about ED. Young ED patients preferred using the internet and older patients preferred consulting with physicians. Western medicine (19% and traditional Chinese medicine (16% were most frequently used for treatment. Young ED patients preferred to first search the internet for information, whereas older patients first asked physicians for help. Side effects of treatment were the greatest concern, especially for older patients. Physicians and the internet are frequently consulted for ED information and therapy. On the basis of these survey results, we believe that physicians in China should enhance health education about ED, especially via the internet.

  4. Diagnostic relevance of gadolinium-enhanced sequential MR imaging of the penis in patients with erectile dysfunctions

    This paper reports on a new functional approach, used to investigate the dynamic contrast enhancement of the penis. The inflow of Gd-DTPA in penile tissue was observed at 10-second intervals during two-dimensional FLASH MR imaging. Two dimensional FLASH gradient-echo sequences were applied in a coronal orientation through the most anterior part of the symphysis. Twelve to 15 minutes after intracavernosal injection of 20 μg of prostaglandin E1 or 25 mg of papaverine, enhancement of signal intensity in the corpora cavernosa was determined every 10 seconds for 3.5 minutes. One additional late image was obtained 10 minutes after injection. Seventy-five investigations were performed in 56 patients with proved organic erectile dysfunction. Calculated time-related Gd-DTPA uptake and intracavernosal distribution depend closely on etiology. Well-defined functional inflow patterns give hints as to the pathophysiologic cause of erectile dysfunction

  5. Advances in the treatment of erectile dysfunction: what’s new and upcoming? [version 1; referees: 2 approved

    Chintan K. Patel

    2016-03-01

    Full Text Available Erectile dysfunction adversely affects up to 20% of all men and is the most commonly treated sexual disorder. The public health implications of this condition are significant and represent a challenge for our healthcare system. The physiological pathways responsible for erections have been extensively studied, and much advancement has been made since the introduction of phosphodiesterase 5 inhibitors. Newer agents, such as dopaminergic and melanocortin receptor agonists, which target central erectogenic pathways, are under investigation. Newer formulations and delivery methods of existing medications such as alprostadil will also be introduced in the near future. Furthermore, low-intensity shockwave lithotripsy and stem cell regenerative techniques are innovative approaches to the treatment of erectile dysfunction.

  6. Erectile dysfunction severity as a risk marker for cardiovascular disease hospitalisation and all-cause mortality: a prospective cohort study.

    Emily Banks

    Full Text Available BACKGROUND: Erectile dysfunction is an emerging risk marker for future cardiovascular disease (CVD events; however, evidence on dose response and specific CVD outcomes is limited. This study investigates the relationship between severity of erectile dysfunction and specific CVD outcomes. METHODS AND FINDINGS: We conducted a prospective population-based Australian study (the 45 and Up Study linking questionnaire data from 2006-2009 with hospitalisation and death data to 30 June and 31 Dec 2010 respectively for 95,038 men aged ≥45 y. Cox proportional hazards models were used to examine the relationship of reported severity of erectile dysfunction to all-cause mortality and first CVD-related hospitalisation since baseline in men with and without previous CVD, adjusting for age, smoking, alcohol consumption, marital status, income, education, physical activity, body mass index, diabetes, and hypertension and/or hypercholesterolaemia treatment. There were 7,855 incident admissions for CVD and 2,304 deaths during follow-up (mean time from recruitment, 2.2 y for CVD admission and 2.8 y for mortality. Risks of CVD and death increased steadily with severity of erectile dysfunction. Among men without previous CVD, those with severe versus no erectile dysfunction had significantly increased risks of ischaemic heart disease (adjusted relative risk [RR] = 1.60, 95% CI 1.31-1.95, heart failure (8.00, 2.64-24.2, peripheral vascular disease (1.92, 1.12-3.29, "other" CVD (1.26, 1.05-1.51, all CVD combined (1.35, 1.19-1.53, and all-cause mortality (1.93, 1.52-2.44. For men with previous CVD, corresponding RRs (95% CI were 1.70 (1.46-1.98, 4.40 (2.64-7.33, 2.46 (1.63-3.70, 1.40 (1.21-1.63, 1.64 (1.48-1.81, and 2.37 (1.87-3.01, respectively. Among men without previous CVD, RRs of more specific CVDs increased significantly with severe versus no erectile dysfunction, including acute myocardial infarction (1.66, 1.22-2.26, atrioventricular and left bundle branch

  7. PDE-5 inhibitors in monotherapy versus combination therapy in a sample of 1200 patients with erectile dysfunction

    Luis Labairu-Huerta; Bárbara Padilla-Fernández; José Luis Arrondo-Arrondo; Lauro Sebastián Valverde-Martínez; Agustín Martín-Rodríguez; Juan Miguel Silva-Abuín; María Begoña García-Cenador; José Antonio Mirón-Canelo; María Fernanda Lorenzo-Gómez

    2015-01-01

    Objectives: To compare the effectiveness in the treatment of erectile dysfunction when using PDE-5 inhibitors (PDE5i), alprostadil (PG-E1) and testosterone (TES) in monotherapy or combination therapy. Material and Methods: Observational multicentre retrospective study of men diagnosed and treated for ED between January 2008 and January 2014. Age, social and employment situation, pathological medical history, risk factors, usual treatments, IIEF-5 at the first consultation and at first and eac...

  8. Effects of tissue-cultured mountain ginseng (Panax ginseng CA Meyer) extract on male patients with erectile dysfunction

    Kim, Tae-Hwan; Jeon, Seung Hyun; Hahn, Eun-Joo; Paek, Kee-Yoeup; Park, Jong Kwan; Youn, Nae Young; Lee, Hyung-Lae

    2009-01-01

    Korean ginseng and mountain ginseng (Panax ginseng CA Meyer) are important traditional herbal plants whose ginsenosides are generally accepted as serving to improve sexual functions, such as penile erection. We investigated the effects of tissue-cultured mountain ginseng extract (TMGE) on male patients with erectile dysfunction (ED). A double-blind, placebo-controlled study was conducted with 143 patients experiencing ED. Over the course of 8 weeks, one group took 1 000 mg of TMGE twice a day...

  9. Is there a relationship between the severity of erectile dysfunction and the comorbidity profile in men with late onset hypogonadism?

    Yassin, Aksam A.; Nettleship, Joanne E.; Almehmadi, Yousef; Yassin, Dany-Jan; El Douaihy, Youssef; Saad, Farid

    2015-01-01

    Objective To determine whether the severity of erectile dysfunction (ED) in a man diagnosed with late-onset hypogonadism (LOH) gives information about his metabolic syndrome state, as patients with LOH often have sexual symptoms and associated cardiovascular and metabolic comorbidities, but the role of ED in predicting the prevalence of comorbid disease in men with low levels of testosterone is currently unknown. Patients and methods Men (130) diagnosed with LOH and fulfilling the criteria of...

  10. Clinical study on erectile dysfunction in diabetic and non-diabetic subjects and its management with Ficus relegiosa Linn.

    Virani, Nilesh V.; Chandola, H. M.; Vyas, S. N.; D. B. JADEJA

    2010-01-01

    Healthy sexual functioning plays an essential role in maintaining the harmony and happiness in marital life. It provides a media to express love, which is the base for all sorts of creative activities. The absence of this function hampers the marital relationship, leading to frustration and, sometimes, ending in divorce, and causes inadequacy in performing the routine duties. In this study, 53 patients having diabetes mellitus were surveyed to find out the incidence of erectile dysfunction (E...

  11. Efficacy of Avanafil 15 Minutes after Dosing in Men with Erectile Dysfunction: A Randomized, Double-Blind, Placebo Controlled Study

    Emre Bakırcıoğlu

    2015-01-01

    Phosphodiesterase type 5 (PDE 5) inhibitors are currently first-line medical treatment for erectile dysfunction (ED). PDE 5 inhibitors are differentiated by safety-tolerability profiles and efficacy considerations, such as time to onset and duration of action. The choice of PDE 5 inhibitors in a man with ED is generally based on quality of life factors such as patient and partner satisfaction as well as efficacy and safety. In this randomized, double-blind, placebo controlled study, a total o...

  12. An Evidence-Based Evaluation of Health Information on Erectile Dysfunction From 10 Nationwide Daily Newspapers in Korea

    Hah, Yoon Soo; Lee, Joo Yong; Lim, Sey Kiat; Cho, Kang Su; Choi, Young Deuk

    2013-01-01

    Purpose A rapid growth in the socioeconomic status of Koreans has triggered an unprecedented explosion of health information for the general population. Despite its obvious benefits, this increase in information could also result in potentially harmful effects for both consumers and professionals who do not use it appropriately. Thus, this study was conducted to evaluate the quality and accuracy of health information on erectile dysfunction from 10 nationwide daily newspapers. Materials and M...

  13. Switching from Nitrate Therapy to Ranolazine in Patients with Coronary Artery Disease Receiving Phosphodiesterase Type-5 Inhibitors for Erectile Dysfunction

    Udeoji, Dioma U; Ernst R. Schwarz

    2014-01-01

    Coronary artery disease (CAD) and erectile dysfunction (ED) frequently coexist. The introduction of phosphodiesterase type-5 (PDE-5) inhibitors has revolutionized medical management of organic ED; however, in patients with angina pectoris, a common symptom of CAD, coadministration of PDE-5 inhibitors and nitrates has been implicated in CAD-related deaths following sexual activity. The mechanism of action of PDE-5 inhibitors results in a potential cumulative drop in blood pressure (BP); thus, ...

  14. Nonalcoholic steatohepatitis as a novel player in metabolic syndrome-induced erectile dysfunction: an experimental study in the rabbit.

    Vignozzi L; Filippi S; Comeglio P; Cellai I; Sarchielli E; Morelli A; Rastrelli G; Maneschi E; Galli A; Vannelli GB; Saad F; Mannucci E; Adorini L; Maggi M.

    2014-01-01

    A pathogenic link between erectile dysfunction (ED) and metabolic syndrome (MetS) is now well established. Nonalcoholic steatohepatitis (NASH), the hepatic hallmark of MetS, is regarded as an active player in the pathogenesis of MetS-associated cardiovascular disease (CVD). This study was aimed at valuating the relationship between MetS-induced NASH and penile dysfunction. We used a non-genomic, high fat diet (HFD)-induced, rabbit model of MetS, and treated HFD rabbits with testosterone (T...

  15. The application of color Doppler flow imaging in the diagnosis and therapeutic effect evaluation of erectile dysfunction

    Xu-Jun Xuan

    2016-01-01

    Full Text Available We aim to investigate the correlations between hemodynamic parameters, penile rigidity grading, and the therapeutic effects of phosphodiesterase type 5 inhibitors using color Doppler flow imaging after intracavernosal injection in patients with erectile dysfunction. This study involved 164 patients. After intracavernosal injection with a mixture of papaverine (60 mg, prostaglandin E 1 (10 mg, and lidocaine (2%, 0.5-1 ml, the penile vessels were assessed using color Doppler flow imaging. Penile rigidity was classified based on the Erection Hardness Score system as Grades 4, 3, 2 or 1 (corresponding to Schramek Grades V to II. Then, the patients were given oral sildenafil (50-100 mg and scored according to the International Index of Erectile Function (IIEF-5 questionnaire. The number of patients with penile rigidities of Schramek Grades II to V was 14, 18, 21, and 111, respectively. The IIEF-5 score was positively correlated with the refilling index of the penile cavernosal artery (r = 0.79, P< 0.05, the peak systolic velocity (r = 0.45, P< 0.05, and penile rigidity (r = 0.75, P< 0.05, and was negatively correlated with the end diastolic velocity (r = −0.74, P< 0.05. For patients with erectile dysfunction, both the IIEF-5 score after sildenafil administration, which is correlated with penile rigidity, and the hemodynamic parameters detected using color Doppler flow imaging may predict the effects of phosphodiesterase type 5 inhibitor treatment and could provide a reasonable model for the targeted-treatment of erectile dysfunction.

  16. Recruiting endogenous stem cells: a novel therapeutic approach for erectile dysfunction

    Zhong-Cheng Xin

    2016-01-01

    Full Text Available Transplanted stem cells (SCs, owing to their regenerative capacity, represent one of the most promising methods to restore erectile dysfunction (ED. However, insufficient source, invasive procedures, ethical and regulatory issues hamper their use in clinical applications. The endogenous SCs/progenitor cells resident in organ and tissues play critical roles for organogenesis during development and for tissue homeostasis in adulthood. Even without any therapeutic intervention, human body has a robust self-healing capability to repair the damaged tissues or organs. Therefore, SCs-for-ED therapy should not be limited to a supply-side approach. The resident endogenous SCs existing in patients could also be a potential target for ED therapy. The aim of this review was to summarize contemporary evidence regarding: (1 SC niche and SC biological features in vitro; (2 localization and mobilization of endogenous SCs; (3 existing evidence of penile endogenous SCs and their possible mode of mobilization. We performed a search on PubMed for articles related to these aspects in a wide range of basic studies. Together, numerous evidences hold the promise that endogenous SCs would be a novel therapeutic approach for the therapy of ED.

  17. New oral agents for erectile dysfunction: what is changing in our practice?

    Antonio Aversa; Andrea Fabbri

    2001-01-01

    Erectile dysfunction (ED) is a highly prevalent disorder affecting an estimated 152 million men worldwide and is associated with a variety of behavioral risk factors, such as cigarette smoking and excessive alcohol consumption, as well as numerous age-related medical conditions, notably type-2 diabetes mellitus and cardiovascular disease. A rational step-wise approach which includes comprehensive medical and sexual history, a focused physical examination and essential laboratory tests such as fasting glucose, lipid profile and testosterone assay is to be preferred. Current diagnostic work-up does not recommend any of the specialized tests which were previously considered mandatory-i. e. penile pharmacotesting, Duplex ultrasound and nocturnal penile tumescence. Hormonal replacement therapy is appropriate only in the hypogonadal male with ED. Prior to direct intervention, the physician should consider altering modifiable risk factors or causes, although frequently insufficient to reverse ED completely. When indicated, oral therapy with new molecules (phosphodiesterase inhibitors or apomorphine) is the first-line treatment for the majority of patients because of potential benefits and lack of invasiveness.

  18. Prevalence of erectile dysfunction and associated factors among men without concomitant diseases: a population study.

    Nicolosi, A; Glasser, D B; Moreira, E D; Villa, M

    2003-08-01

    We interviewed a population sample of 2412 men aged 40-70 y in Brazil, Italy, Japan and Malaysia about medical history, lifestyle habits and sexual behavior. Men were classified as having moderate or complete erectile dysfunction (ED) if they reported to be sometimes or never able to achieve and maintain an erection satisfactory for sexual intercourse, respectively. There were 1335 men with no diagnosis of cardiovascular or prostate diseases, diabetes, ulcer or depression, nor taking hormones. The prevalence of ED was 16.1%. ED was associated with age (the risk increased 8% per y), moderate (odds ratio (OR)=2.2) or severe (OR=4.9) lower urinary tract symptoms and smoking (OR=2.3 for >30 cigarettes/day). It was inversely associated with physical activity (OR=0.5) and higher educational levels. Between the ages of 40 and 70 y, almost one in six 'healthy' men is affected by ED. Further research should look at preclinical disease stages and genetic factors. PMID:12934052

  19. Prevalence and correlates of erectile dysfunction in Salvador, northeastern Brazil: a population-based study.

    Moreira, E D; Lisboa Lôbo, C F; Villa, M; Nicolosi, A; Glasser, D B

    2002-08-01

    Our objectives were to determine the prevalence of erectile dysfunction (ED) in Brazil and to explore potential sociodemographic, medical, and lifestyle correlates. A cross-sectional, population-based, household survey was conducted in Salvador, Bahia, Brazil. Cluster samples of representative households were randomly selected for interviews. Of 654 eligible subjects, 602 (92%) participated. A structured questionnaire was administered by trained interviewers. ED was categorized as 'none', 'mild', 'moderate', or 'severe' according to the ability to 'attain and/or maintain an erection satisfactory for sexual intercourse'. All data were obtained by self-report. The age-adjusted prevalence of ED was 39.5% (minimal 25.1%, moderate 13.1%, severe 1.3%). Prevalence and severity increased with age. Having never been married, diabetes, depression, or prostate disease and current depressive or lower urinary tract symptoms were significantly (P<0.05) associated with increased prevalence. Medical, sociodemographic, and lifestyle variables associated with ED may alert physicians to patients at risk for ED and offer insight to its etiology. PMID:12161762

  20. The mineralocorticoid receptor in endothelial physiology and disease: novel concepts in the understanding of erectile dysfunction.

    Caprio, Massimiliano; Mammi, Caterina; Jaffe, Iris Z; Zennaro, Maria-Christina; Aversa, Antonio; Mendelsohn, Michael E; Fabbri, Andrea; Rosano, Giuseppe M C

    2008-01-01

    Aldosterone is a steroid hormone that controls blood pressure by binding to the mineralocorticoid receptor (MR), a ligand-activated transcription factor, and regulating genes that play a role in salt and water homeostasis in the kidney. Dysregulation of the mineralocorticoid system reveals its crucial role in various human diseases including hypertension, atherosclerosis, cardiac failure, mineralocorticoid resistance, and disorders of the nervous system. Recently, experimental animal models of mineralocorticoid/salt-induced hypertension and atherosclerosis have revealed an epithelial, pro-inflammatory role for MR activation. Extensive investigation has begun to elucidate the mechanisms underlying the vascular effects of MR activation which involve its direct role in cardiomyocytes, vascular smooth muscle cells, and endothelial cells. More specifically, in patients with cardiovascular risk factors and disease, including diabetes, hypertension, and/or congestive heart failure, an excess of MR activation has been shown to have a negative impact on endothelial function hence disrupting the physiological balance between vasoconstriction and vasodilation. Such a mechanism may play a role in the pathogenesis of erectile dysfunction (ED), a condition that occurs frequently in patients with increased cardiovascular risk and involves endothelial dysregulation of vascular relaxation. The aim of this review is to summarize the latest concepts in MR signaling, with particular attention to the endothelium, and to discuss the potential benefits of tissue-selective MR blockade in treating subsets of ED patients, such as those with congestive heart failure and hypertension, in which the MR system may be over activated. PMID:19128227

  1. Malaysian cultural differences in knowledge, attitudes and practices related to erectile dysfunction: focus group discussions.

    Low, W Y; Wong, Y L; Zulkifli, S N; Tan, H M

    2002-12-01

    This qualitative study aimed to examine cultural differences in knowledge, attitudes and practices related to erectile dysfunction (ED) utilizing focus group discussion. Six focus groups consisting of 66 men, 45-70-y-old were conducted-two Malay groups (n=18), two Chinese groups (n=25) and two Indian groups (n=23). Participants were purposely recruited from the general public on a voluntary basis with informed consent. Transcripts were analyzed using qualitative data analysis software ATLASti. The Malay and Chinese traditional remedies for preventing or treating ED are commonly recognized among all races. Many have a negative perception of someone with ED. Malay and Chinese men tended to blame their wife for their problem and thought that the problem might lead to extra-marital affairs, unlike the Indian men who attributed their condition to fate. Malays would prefer traditional medicine for the problem. The Chinese felt they would be more comfortable with a male doctor whilst this is not so with the Malays or Indians. Almost all prefer the doctor to initiate discussion on sexual issues related to their medical condition. There is a need for doctors to consider cultural perspectives in a multicultural society as a lack of understanding of this often contributes to an inadequate consultation. PMID:12494275

  2. Radiation therapy for prostate cancer and erectile (dys)function: The role of imaging

    Incrocci, Luca [Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam (Netherlands). Dept. of Radiation Oncology

    2005-10-01

    Incidence of erectile dysfunction (ED) after radiotherapy reported in the literature varies from 7 to 72% after external-beam radiotherapy to 5-51% after brachytherapy. Most of these studies are retrospective, the definition of ED is variable and sexual functioning is frequently assessed by asking only one question. Already in the 1980's it was suggested that post-radiation ED was attributable to vascular damage. The most reliable method to assess vasculogenic ED is the use of the Doppler ultrasound. More recently, many studies have assessed the relationship between radiation dose and volume of the penile bulb and post-radiation ED, though the outcome is controversial. The penile structures and the neurovascular bundles are best seen on magnetic resonance imaging (MRI). Therefore the use of a computer tomography scan/MRI image fusion can result in reducing the planning target volume and consequently the radiation dose to the penile bulb and bodies. If radiation induces vascular damage that causes ED, any means of reducing the dose to the pelvic vascular structures would likely decrease ED, therefore new radiation techniques such as the intensity modulated radiation therapy or the implant of fiducial markers can help decrease the margins and therefore ED.

  3. Radiation therapy for prostate cancer and erectile (dys)function: The role of imaging

    Incidence of erectile dysfunction (ED) after radiotherapy reported in the literature varies from 7 to 72% after external-beam radiotherapy to 5-51% after brachytherapy. Most of these studies are retrospective, the definition of ED is variable and sexual functioning is frequently assessed by asking only one question. Already in the 1980's it was suggested that post-radiation ED was attributable to vascular damage. The most reliable method to assess vasculogenic ED is the use of the Doppler ultrasound. More recently, many studies have assessed the relationship between radiation dose and volume of the penile bulb and post-radiation ED, though the outcome is controversial. The penile structures and the neurovascular bundles are best seen on magnetic resonance imaging (MRI). Therefore the use of a computer tomography scan/MRI image fusion can result in reducing the planning target volume and consequently the radiation dose to the penile bulb and bodies. If radiation induces vascular damage that causes ED, any means of reducing the dose to the pelvic vascular structures would likely decrease ED, therefore new radiation techniques such as the intensity modulated radiation therapy or the implant of fiducial markers can help decrease the margins and therefore ED

  4. Chronic Rhinosinusitis Associated with Erectile Dysfunction: A Population-Based Study.

    Tai, Shu-Yu; Wang, Ling-Feng; Tai, Chih-Feng; Huang, Yu-Ting; Chien, Chen-Yu

    2016-01-01

    Few studies have investigated the relationship between chronic rhinosinusitis (CRS) and erectile dysfunction (ED). This case-control study aimed to investigate the association between CRS and the risk of ED in a large national sample. Tapping Taiwan's National Health Insurance Research Database, we identified people 30 years or older with a new primary diagnosis of CRS between 1996 and 2007. The cases were compared with sex- and age-matched controls. We identified 14 039 cases and recruited 140 387 matched controls. Both groups were followed up in the same database until the end of 2007 for instances of ED. Of those with CRS, 294 (2.1%) developed ED during a mean (SD) follow-up of 3.20 (2.33) years, while 1 661 (1.2%) of the matched controls developed ED, mean follow up 2.97 (2.39) years. Cox regression analyses were performed adjusting for sex, age, insurance premium, residence, hypertension, hyperlipidemia, diabetes, obesity, coronary heart disease, chronic kidney disease, chronic obstructive pulmonary disease, asthma, allergic rhinitis, arrhythmia, ischemic stroke, intracerebral hemorrhage, and medications. CRS was revealed to be an independent predictor of ED in the fully adjusted model (HR = 1.51; 95% CI = 1.33-1.73; P < 0.0001). PMID:27578370

  5. Effects of Microdesmis keayana alkaloids on vascular parameters of erectile dysfunction.

    Zamblé, Alexis; Martin-Nizard, Françoise; Sahpaz, Sevser; Reynaert, Marie-Line; Staels, Bart; Bordet, Régis; Duriez, Patrick; Gressier, Bernard; Bailleul, François

    2009-06-01

    Microdesmis keayana (Pandaceae) is an African tropical plant whose roots are used in traditional medicine for erection impairment but the compounds responsible for its action are unknown. Two major alkaloids recently isolated from the roots of M. keayana, keayanidine B and keayanine, were tested for vasorelaxing properties using isolated rat aortic rings precontracted by phenylephrine to confirm its traditional use. Influence of the alkaloids on the endothelial production of endothelial nitric oxide synthase (eNOS) was measured by quantitative polymerase chain reaction (QPCR) analysis. Scavenging activities were assessed versus 1,1-diphenyl-2-picrylhydrazyle (DPPH) and reactive oxygen species (ROS) such as superoxide anion (O(2)(*-) and hydrogen peroxide (H(2)O(2)) in cell-free and cellular systems. The results showed that keayanidine B and keayanine had significant vasorelaxing properties. This effect could be due to their strong antioxidant activity versus O(2)(*-) and H(2)O(2) and to their stimulation of eNOS mRNA expression. Therefore these alkaloids could indirectly stimulate NO production in the vascular bed and would explain the traditional use of M. keayana in erectile dysfunction. PMID:19107738

  6. Hip Fracture in People with Erectile Dysfunction: A Nationwide Population-Based Cohort Study

    Wu, Chieh-Hsin; Tung, Yi-Ching; Lin, Tzu-Kang; Chai, Chee-Yin; Su, Yu-Feng; Tsai, Tai-Hsin; Tsai, Cheng-Yu; Lu, Ying-Yi; Lin, Chih-Lung

    2016-01-01

    The aims of this study were to investigate the risk of hip fracture and contributing factors in patients with erectile dysfunction(ED). This population-based study was performed using the Taiwan National Health Insurance Research Database. The analysis included4636 patients aged ≥ 40 years who had been diagnosed with ED (International Classification of Diseases, Ninth Revision, Clinical Modification codes 302.72, 607.84) during 1996–2010. The control group included 18,544 randomly selected age-matched patients without ED (1:4 ratio). The association between ED and hip fracture risk was estimated using a Cox proportional hazard regression model. During the follow-up period, 59 (1.27%) patients in the ED group and 140 (0.75%) patients in the non-ED group developed hip fracture. After adjusting for covariates, the overall incidence of hip fracture was 3.74-times higher in the ED group than in the non-ED group (2.03 vs. 0.50 per 1000 person-years, respectively). The difference in the overall incidence of hip fracture was largest during the 3-year follow-up period (hazard ratio = 7.85; 95% confidence interval = 2.94–20.96; P <0.0001). To the best of our knowledge, this nationwide population-based study is the first to investigate the relationship between ED and subsequent hip fracture in an Asian population. The results showed that ED patients had a higher risk of developing hip fracture. Patients with ED, particularly those aged 40–59 years, should undergo bone mineral density examinations as early as possible and should take measures to reduce the risk of falls. PMID:27078254

  7. Brain networks during free viewing of complex erotic movie: new insights on psychogenic erectile dysfunction.

    Cera, Nicoletta; Di Pierro, Ezio Domenico; Ferretti, Antonio; Tartaro, Armando; Romani, Gian Luca; Perrucci, Mauro Gianni

    2014-01-01

    Psychogenic erectile dysfunction (ED) is defined as a male sexual dysfunction characterized by a persistent or recurrent inability to attain adequate penile erection due predominantly or exclusively to psychological or interpersonal factors. Previous fMRI studies were based on the common occurrence in the male sexual behaviour represented by the sexual arousal and penile erection related to viewing of erotic movies. However, there is no experimental evidence of altered brain networks in psychogenic ED patients (EDp). Some studies showed that fMRI activity collected during non sexual movie viewing can be analyzed in a reliable manner with independent component analysis (ICA) and that the resulting brain networks are consistent with previous resting state neuroimaging studies. In the present study, we investigated the modification of the brain networks in EDp compared to healthy controls (HC), using whole-brain fMRI during free viewing of an erotic video clip. Sixteen EDp and nineteen HC were recruited after RigiScan evaluation, psychiatric, and general medical evaluations. The performed ICA showed that visual network (VN), default-mode network (DMN), fronto-parietal network (FPN) and salience network (SN) were spatially consistent across EDp and HC. However, between-group differences in functional connectivity were observed in the DMN and in the SN. In the DMN, EDp showed decreased connectivity values in the inferior parietal lobes, posterior cingulate cortex and medial prefrontal cortex, whereas in the SN decreased and increased connectivity was observed in the right insula and in the anterior cingulate cortex respectively. The decreased levels of intrinsic functional connectivity principally involved the subsystem of DMN relevant for the self relevant mental simulation that concerns remembering of past experiences, thinking to the future and conceiving the viewpoint of the other's actions. Moreover, the between group differences in the SN nodes suggested a

  8. Brain networks during free viewing of complex erotic movie: new insights on psychogenic erectile dysfunction.

    Nicoletta Cera

    Full Text Available Psychogenic erectile dysfunction (ED is defined as a male sexual dysfunction characterized by a persistent or recurrent inability to attain adequate penile erection due predominantly or exclusively to psychological or interpersonal factors. Previous fMRI studies were based on the common occurrence in the male sexual behaviour represented by the sexual arousal and penile erection related to viewing of erotic movies. However, there is no experimental evidence of altered brain networks in psychogenic ED patients (EDp. Some studies showed that fMRI activity collected during non sexual movie viewing can be analyzed in a reliable manner with independent component analysis (ICA and that the resulting brain networks are consistent with previous resting state neuroimaging studies. In the present study, we investigated the modification of the brain networks in EDp compared to healthy controls (HC, using whole-brain fMRI during free viewing of an erotic video clip. Sixteen EDp and nineteen HC were recruited after RigiScan evaluation, psychiatric, and general medical evaluations. The performed ICA showed that visual network (VN, default-mode network (DMN, fronto-parietal network (FPN and salience network (SN were spatially consistent across EDp and HC. However, between-group differences in functional connectivity were observed in the DMN and in the SN. In the DMN, EDp showed decreased connectivity values in the inferior parietal lobes, posterior cingulate cortex and medial prefrontal cortex, whereas in the SN decreased and increased connectivity was observed in the right insula and in the anterior cingulate cortex respectively. The decreased levels of intrinsic functional connectivity principally involved the subsystem of DMN relevant for the self relevant mental simulation that concerns remembering of past experiences, thinking to the future and conceiving the viewpoint of the other's actions. Moreover, the between group differences in the SN nodes

  9. Inverse correlation between testosterone and ventricle ejection fraction, hemodynamics and exercise capacity in heart failure patients with erectile dysfunction

    Edimar A. Bocchi

    2008-06-01

    Full Text Available BACKGROUND: Neurohormonal activation and abnormalities in growth hormone and testosterone concentrations have been reported in heart failure (HF. Erectile dysfunction(ED is common in these patients and contributes to a low quality of life. No data are known regarding the correlation between testosterone and hemodynamics, exercise capacity and cardiac function in HF patients with ED, a marker of endothelial dysfunction. The aim of this study was to correlate testosterone levels with cardiac function, hemodynamic and exercise capacity in HF patients with ED. MATERIALS AND METHODS: Fifteen HF patients underwent a six-minute treadmill cardiopulmonary walking test (6'CWT and, ten minutes later, a maximum cardiopulmonary exercise test. Also, testosterone and other hormones were determined at rest. RESULTS: Among hemodynamic variables only diastolic blood pressure on 6'CWT was correlated with testosterone levels(r =- 0.66, p = 0.007. The variables on exercise tests, VE/VCO2 slope and oxygen consumption did not show any correlation, except the distance at 6'CWT (r = 0.50, p = 0,047. Right and left ventricle ejection fraction showed inverse correlation with testosterone (r =- 0.55, p = 0.03 and r =- 0.69, p = 0.004 respectively. CONCLUSION: Testosterone levels correlated directly with distance at six-minute cardiopulmonary walk test and inversely with diastolic blood pressure, right and left ventricle ejection fraction in heart failure patients with erectile dysfunction. Further elucidation of mechanisms as regards testosterone action in these patients is warranted.

  10. Erectile dysfunction after prostate three-dimensional conformal radiation therapy. Correlation with the dose to the penile bulb

    Magli, A.; Ceschia, T.; Titone, F.; Parisi, G.; Fongione, S. [University Hospital Udine (Italy). Dept. of Radiation Oncology; Giangreco, M. [Udine Univ. (Italy). Hygiene and Epidemiology Inst.; Crespi, M.; Negri, A. [University Hospital Udine (Italy). Dept. of Medical Physics; De Giorgi, G. [University Hospital Udine (Italy). Dept. of Urology

    2012-11-15

    Purpose: Erectile dysfunction is associated with all the common treatment options for prostate cancer. The aim of this research was to evaluate the relationship between erectile function and radiation dose to the penile bulb (PB) and other proximal penile structures in men receiving conformal radiotherapy (CRT) without hormonal therapy (HT) for prostate cancer, whose sexual function was known before treatment. Patients and methods: The study included 19 patients treated with 3D-CRT for localized prostate cancer at our department, who were self-reported to be potent before treatment, had not received HT, and had complete follow-up data available. Our evaluation was based on the International Index of Erectile Function (IIEF-5). Dose-volume histograms (DVHs) were used to evaluate the dose to the PB. Statistical analysis was performed with an unconditional logistic regression model. Results: All patients reported change in potency after radiation. Eight patients (42%) remained potent but showed a decrease of 1 or 2 levels of potency, as defined by the IIEF-5 questionnaire (reduced potency group), while 11 patients (58%) reported a change of higher levels and revealed a severe erectile dysfunction after 2 years (impotence group). Multivariate analysis of morphological and dosimetric variables yielded significance for the mean dose (p = 0.05 with an odds ratio of 1.14 and 95% CI 1-1.30). Patients receiving a mean dose of less than 50 Gy to the PB appear to have a much greater likelihood of maintaining potency. Conclusion: Our data suggest a possible existence of a dose-volume correlation between the dose applied to the PB and radiation-induced impotence. (orig.)

  11. Erectile dysfunction after prostate three-dimensional conformal radiation therapy. Correlation with the dose to the penile bulb

    Purpose: Erectile dysfunction is associated with all the common treatment options for prostate cancer. The aim of this research was to evaluate the relationship between erectile function and radiation dose to the penile bulb (PB) and other proximal penile structures in men receiving conformal radiotherapy (CRT) without hormonal therapy (HT) for prostate cancer, whose sexual function was known before treatment. Patients and methods: The study included 19 patients treated with 3D-CRT for localized prostate cancer at our department, who were self-reported to be potent before treatment, had not received HT, and had complete follow-up data available. Our evaluation was based on the International Index of Erectile Function (IIEF-5). Dose-volume histograms (DVHs) were used to evaluate the dose to the PB. Statistical analysis was performed with an unconditional logistic regression model. Results: All patients reported change in potency after radiation. Eight patients (42%) remained potent but showed a decrease of 1 or 2 levels of potency, as defined by the IIEF-5 questionnaire (reduced potency group), while 11 patients (58%) reported a change of higher levels and revealed a severe erectile dysfunction after 2 years (impotence group). Multivariate analysis of morphological and dosimetric variables yielded significance for the mean dose (p = 0.05 with an odds ratio of 1.14 and 95% CI 1-1.30). Patients receiving a mean dose of less than 50 Gy to the PB appear to have a much greater likelihood of maintaining potency. Conclusion: Our data suggest a possible existence of a dose-volume correlation between the dose applied to the PB and radiation-induced impotence. (orig.)

  12. A Multicenter, Randomized, Open-Labeled, Parallel Group Trial of Sildenafil in Alcohol-Associated Erectile Dysfunction: The Impact on Psychosocial Outcomes

    Alexander Grinshpoon; Ira Radomislensky; Lev Averbuch; Alexander M. Ponizovsky

    2009-01-01

    To examine the effect of sildenafil on erectile dysfunction (ED) and psychosocial outcomes in alcohol-dependent (AD) men, 108 men with these diagnoses were randomly assigned to either take sildenafil (50 mg) as add-on to standard treatment for AD, or the same treatment without sildenafil, for 12 weeks. Only 50 patients in sildenafil group and 51 in control group twice completed the International Index of Erectile Function (IIEF) and a battery of self-report questionnaires. IIEF scores and psy...

  13. Erectile dysfunction and cardiovascular events in diabetic men: a meta-analysis of observational studies.

    Tomohide Yamada

    Full Text Available BACKGROUND: Several studies have shown that erectile dysfunction (ED influences the risk of cardiovascular events (CV events. However, a meta-analysis of the overall risk of CV events associated with ED in patients with diabetes has not been performed. METHODOLOGY/PRINCIPAL FINDINGS: We searched MEDLINE and the Cochrane Library for pertinent articles (including references published between 1951 and April 22, 2012. English language reports of original observational cohort studies and cross-sectional studies were included. Pooled effect estimates were obtained by random effects meta-analysis. A total of 3,791 CV events were reported in 3 cohort studies and 9 cross-sectional studies (covering 22,586 subjects. Across the cohort studies, the overall odds ratio (OR of diabetic men with ED versus those without ED was 1.74 (95% confidence interval [CI]: 1.34-2.27; P0.05. Moreover, meta-regression analysis found no relationship between the method used to assess ED (questionnaire or interview, mean age, mean hemoglobin A(1c, mean body mass index, or mean duration of diabetes and the risk of CV events or CHD. In the cross-sectional studies, the OR of diabetic men with ED versus those without ED was 3.39 (95% CI: 2.58-4.44; P<0.001 for CV events (N = 9, 3.43 (95% CI: 2.46-4.77; P<0.001 for CHD (N = 7, and 2.63 (95% CI: 1.41-4.91; P = 0.002 for peripheral vascular disease (N = 5. CONCLUSION/SIGNIFICANCE: ED was associated with an increased risk of CV events in diabetic patients. Prevention and early detection of cardiovascular disease are important in the management of diabetes, especially in view of the rapid increase in its prevalence.

  14. Avanaifl for male erectile dysfunction:a systematic review and meta-analysis

    Yuan-Shan Cui; Nan Li; Huan-Tao Zong; Hui-Lei Yan; Yong Zhang

    2014-01-01

    Avanaifl, a potent new selective phosphodiesterase type 5 (PDE5) inhibitor, has been developed for the treatment of erectile dysfunction (ED). We carried out a systematic review and meta-analysis to assess the efifcacy and safety of this drug for the treatment of ED. A literature review was performed to identify all published randomized, double-blind, placebo-controlled trials of avanaifl for the treatment of ED. The search included the following databases:MEDLINE, EMBASE and the Cochrane Controlled Trials Register. The reference lists of the retrieved studies were also investigated. Four publications, involving a total of 1381 patients, were used in the analysis, including four randomized controlled trials (RCTs) that compared avanaifl with a placebo. Among the co-primary efifcacy end points indicating that avanaifl 100 mg was more effective than a placebo were successful vaginal penetration (SEP2) (the odds ratio (OR)=5.06, 95%conifdence interval (CI)=3.29-7.78, P<0.00001) and successful intercourse (SEP3) (OR=3.99, 95%CI=2.80-5.67, P<0.00001). Men randomized to receive avanaifl were less likely than those receiving the placebo to drop out due to an adverse event (AE) (OR = 1.48, 95% CI = 0.54-4.08, P= 0.44). Speciifc AEs with avanaifl included headache and lfushing, which were signiifcantly less likely to occur with placebo. This meta-analysis indicates that avanaifl 100 or 200 mg is an effective and well-tolerated treatment for ED. Compared with avanaifl 100 mg, patients who take avanaifl 200 mg are more likely to experience headaches.

  15. Role of Caffeine Intake on Erectile Dysfunction in US Men: Results from NHANES 2001-2004.

    David S Lopez

    Full Text Available Caffeine is consumed by more than 85% of adults and little is known about its role on erectile dysfunction (ED in population-based studies. We investigated the association of caffeine intake and caffeinated beverages with ED, and whether these associations vary among comorbidities for ED.Data were analyzed for 3724 men (≥20 years old who participated in the National Health and Nutrition Examination Survey (NHANES. ED was assessed by a single question during a self-paced, computer-assisted self-interview. We analyzed 24-h dietary recall data to estimate caffeine intake (mg/day. Multivariable logistic regression analyses using appropriate sampling weights were conducted.We found that men in the 3rd (85-170 mg/day and 4th (171-303 mg/day quintiles of caffeine intake were less likely to report ED compared to men in the lowest 1st quintile (0-7 mg/day [OR: 0.58; 95% CI, 0.37-0.89; and OR: 0.61; 95% CI, 0.38-0.97, respectively], but no evidence for a trend. Similarly, among overweight/obese and hypertensive men, there was an inverse association between higher quintiles of caffeine intake and ED compared to men in the lowest 1st quintile, P≤0.05 for each quintile. However, only among men without diabetes we found a similar inverse association (Ptrend = 0.01.Caffeine intake reduced the odds of prevalent ED, especially an intake equivalent to approximately 2-3 daily cups of coffee (170-375 mg/day. This reduction was also observed among overweight/obese and hypertensive, but not among diabetic men. Yet, these associations are warranted to be investigated in prospective studies.

  16. A once-daily dose of tadalafil for erectile dysfunction: compliance and efficacy

    Samuel L Washington III

    2010-08-01

    Full Text Available Samuel L Washington III1, Alan W Shindel21School of Medicine, University of California at San Francisco, San Francisco, California, USA; 2Department of Urology, University of California at San Francisco, San Francisco, California, USAAbstract: Selective phosphodiesterase type 5 inhibitors (PDE5Is have revolutionized the ­treatment of erectile dysfunction (ED in men. As an on-demand treatment, PDE5Is have excellent efficacy and safety in the treatment of ED due to a broad spectrum of etiologies. Nevertheless, these drugs do have side-effect profiles that are troublesome to some patients, eg, headache, dyspepsia, myalgia, etc. Furthermore, many patients and their partners dislike the necessity of on-demand treatment for ED, citing a desire for greater spontaneity with sexual interactions. In 2008, approximately 10 years after the release of the first commercially available PDE5I, a paradigm shift in the management of ED occurred with the approval of once-daily dose of tadalafil by the US Food and Drug Administration for the management of ED. The prolonged half-life of tadalafil lends itself well to this dosing regimen and conveys the advantage of separating medication from sexual interactions; lower dose therapy also carries the theoretical benefit of lower incidence of side effects. In this study, we review the current state of the art with respect to this new management strategy for ED, highlighting published reports of the efficacy and tolerability of the daily dose tadalafil regimen.Keywords: PDE5 inhibitor, on-demand therapy, side effects, daily dosing

  17. EFFICACY ASSESSMENT OF KAEMPFERIA PARVIFLORA FOR THE MANAGEMENT OF ERECTILE DYSFUNCTION

    Panakaporn Wannanon; Jintanaporn Wattanathorn; Terdthai Tong-Un; Prasert Pangphukiew; Supaporn Muchimapura; Bungorn Sripanidkulchai; Wathita Phachonpai

    2012-01-01

    Age-related decline in erectile function is a noted phenomenon worldwide. A variety of medicinal plants have been identified as having strong aphrodisiac properties along with the ability to improve erectile functioning. Kaempferia Parviflora (KP) has famous as a Thai Viagra and use it to increase male impotency. However, there is limited scientific evidence regarding the efficacy of this herb on this issue in aging healthy men. This study therefore investigated the effect of KP extract admin...

  18. Anatomical evaluation of penile venous system by CT cavernosography in patients with erectile dysfunction and venous leakage

    P Famili

    2012-11-01

    Full Text Available Background: Erectile dysfunction is an important problem in men and an organic cause is found in about 50% of cases. When a vasculogenic etiology is suspected, imaging assessments are of great help. Cavernosography is traditionally recognized as an imaging modality for evaluation of venous leakage in men with impotency. We employed CT cavernosography as a novel technique for demonstrating penile venous anatomy and leaking veins.Methods: In the present case series study, we recruited 45 patients with erectile dysfunction by convenient sampling at Hazrat Rasoul Akram Hospital in Tehran, Iran, during one year (1390. The patients had previously been diagnosed with venous incompetency by Doppler study. After intracavernosal injection of prostaglandin E1, we injected sterile normal saline into the corpora cavernosa to achieve penile erection. Later, we injected contrast media into the corpus cavernosum, which was followed by CT scan of the penis and pelvic area to show the venous anatomy and leakage sites.Results: The mean age of the patients was 35.8±8.9 years. 36 (80% patients had venous leakage in crural veins, 27 (60% in cavernosal veins, 27 (60% in circumflex veins, 24 (52.3% in urethral veins, 21 (46.7% in deep dorsal vein, 3 (6.7% in para-arterial veins and 3 (6.7% in corpus spongiosum. Conclusion: The results of this study show the high prevalence of venous leakage in patients referring for erectile dysfunction. Moreover, CT cavernosography was shown to be a useful method for evaluating penile venous system and its related leakage sites which are important for surgical planning.

  19. Buttock Claudication and Erectile Dysfunction After Internal Iliac Artery Embolization in Patients Prior to Endovascular Aortic Aneurysm Repair

    Coil embolization of the internal iliac artery (IIA) is used to extend the application of endovascular aneurysm repair (EVAR) in cases of challenging iliac anatomy. Pelvic ischemia is a complication of the technique, but reports vary as to the rate and severity. This study reports our experience with IIA embolization and compares the results to those of other published series. The vascular unit database of the Leicester Royal Infirmary was used to identify patients who had undergone IIA coil embolization prior to EVAR. Data were collected from hospital case notes and by telephone interviews. Thirty-eight patients were identified; 29 of these were contactable by telephone. A literature search was performed for other studies of IIA embolization and the results were pooled. In this series buttock claudication occurred in 55% (16 of 29 patients) overall: in 52% of unilateral embolizations (11 of 21) and 63% of bilateral embolizations (5 of 8). New erectile dysfunction occurred in 46% (6 of 13 patients) overall: in 38% of unilateral embolizations (3 of 8) and 60% of bilateral embolizations (3 of 5). The literature review identified 18 relevant studies. The results were pooled with our results, to give 634 patients in total. Buttock claudication occurred in 28% overall (178 of 634 patients): in 31% of unilateral embolizations (99 of 322) and 35% of bilateral embolizations (34 of 98) (p = 0.46, Fisher's exact test). New erectile dysfunction occurred in 17% overall (27 of 159 patients): in 17% of unilateral embolizations (16 of 97) and 24% of bilateral embolizations (9 of 38) (p = 0.33). We conclude that buttock claudication and erectile dysfunction are frequent complications of IIA embolization and patients should be counseled accordingly.

  20. Predictive value of peak systolic velocity of cavernous artery in diagnosis of arterial insufficiency in erectile dysfunction

    Seyyed Morteza Bagheri

    2013-10-01

    Full Text Available Background: Arterial insufficiency is a well-recognized etiology of erectile dysfunction. Moreover, nowadays it is appreciated that it can herald silent coronary artery disease in involved patients. However color Doppler study of penis with intracavernosal injection (ICI of Papaverin, as a helpful diagnostic study, is somehow time consuming and technically demanding, as a result, radiologists are reluctant to accomplish. Hence, in a search for more plausible parameters, we were determined to validate PSV in flaccid state for predicting possible arterial insufficiency in patients. Methods: In a cross sectional study to evaluate diagnostic tests, accomplished in Hasheminejad Urology center in Tehran throughout 2011, we studied 59 patients with the complaint of erectile dysfunction. They were referred to our ultrasound clinics by urologists in order to undergo color Doppler study of penis by ICI of Papaverin. They were studied comprehensively before and after injection. Primary and secondary diagnostic criteria of arterial disease in color Doppler and consequently the physiologic event of full erection were designated as gold standard diagnostic considerations. The resulted data were matched and analyzed with SPSS software. Results: Fifty nine patients underwent the study, with the mean age of 45.6 ± 13.1 (24 to 74 year old. Twenty two cases revealed normal study (non-organic causes as 37.3%, 29 were classified as venous leakage, and eight of them demonstrate arterial insufficiency in the study. A flaccid state PSV of 10.5 cm/s as cut off had a sensitivity of 93.8%, specifity of 91.3% and negative predictive value of 93.8% to predict arterial disease. Conclusion: A flaccid state PSV of 10.5 has a suitable statistical value to proclaim arterial insufficiency in cavernosal arteries in patients with erectile dysfunction as a complaint.

  1. Assessment of the autonomic nervous system is an appropriate biological marker for the well-being in erectile dysfunction

    Tolga Dogru; Orhan Murat Kocak; Nurper Erberk-Ozen; Murat Basar

    2008-01-01

    Aim: To investigate whether the autonomic nervous system (ANS) components are suitable biological markers for representing well-being in patients with erectile dysfunction (ED). Methods: The present study included 74 male patients who had applied for check-ups in the cardiology outpatient clinic at Kirikkale University (Kirikkale, Turkey) and who had been diagnosed as having hyperlipidemia. Of these patients, 26 had an additional diagnosis of ED and made up the patient group. The remaining 48 patients formed the control group. Well-being was assessed with short- form 36 (SF-36). The International Index of Erectile Function (IIEF) was used as a measure of libido and erectile function. Quantitative assessment of the ANS was made based on the analysis of heart rate variability by means of 24-h holter monitorization. Results: Comparisons between the ED and control groups showed significant differences only in energy scale of SF-36. The ED group also had significantly higher values of sympathetic activity. Except for the general health score of SF-36, which was found to be correlated with parasympathetic activity only in ED group, there were similar correlation patterns within the groups. Although well-being and sympathetic activity were corre- lated negatively, parasympathetic activity and well-being were correlated positively. Conclusion: Quantitative as- sessment of the ANS by heart rate variability analysis might be a suitable marker for well-being of patients with ED. (Asian J Androl 2008 Jul; 10: 643-650)

  2. Erectile dysfunction after radiotherapy for prostate cancer and radiation dose to the penile structures: A critical review

    Erectile dysfunction (ED) is a common sequela after external beam radiotherapy and brachytherapy for prostate cancer. There are several structures in the vicinity of the prostate that are critical to erectile function and that receive a substantial radiation dose: neurovascular bundles (NVBs), internal pudendal arteries (IPAs), accessory pudendal arteries, corpora cavernosa and the penile bulb. Most reports analyzing the correlation between radiation dose to these structures and radiation-induced ED are limited by the small number of patients analyzed in each study. So far, there is no evidence for a role of the NVBs in radiation-induced ED. There are no reports on the IPAs, based on reduced arterial flow in the penis. Several studies show contradicting results on the corpora cavernosa, which house the erectile tissue required for erection. There are contradicting reports on the penile bulb, although studies with more patients tend not to find any correlation. Sparing of the penile bulb to improve potency-preservation is not sufficiently supported by the current literature. If sparing of the penile bulb is achieved by reducing the margin for the apex, an oncological risk is taken, while it is uncertain whether this will improve potency-preservation

  3. The pericyte as a cellular regulator of penile erection and a novel therapeutic target for erectile dysfunction

    Yin, Guo Nan; Das, Nando Dulal; Choi, Min Ji; Song, Kang-Moon; Kwon, Mi-Hye; Ock, Jiyeon; Limanjaya, Anita; Ghatak, Kalyan; Kim, Woo Jean; Hyun, Jae Seog; Koh, Gou Young; Ryu, Ji-Kan; Suh, Jun-Kyu

    2015-01-01

    Pericytes are known to play critical roles in vascular development and homeostasis. However, the distribution of cavernous pericytes and their roles in penile erection is unclear. Herein we report that the pericytes are abundantly distributed in microvessels of the subtunical area and dorsal nerve bundle of mice, followed by dorsal vein and cavernous sinusoids. We further confirmed the presence of pericytes in human corpus cavernosum tissue and successfully isolated pericytes from mouse penis. Cavernous pericyte contents from diabetic mice and tube formation of cultured pericytes in high glucose condition were greatly reduced compared with those in normal conditions. Suppression of pericyte function with anti-PDGFR-β blocking antibody deteriorated erectile function and tube formation in vivo and in vitro diabetic condition. In contrast, enhanced pericyte function with HGF protein restored cavernous pericyte content in diabetic mice, and significantly decreased cavernous permeability in diabetic mice and in pericytes-endothelial cell co-culture system, which induced significant recovery of erectile function. Overall, these findings showed the presence and distribution of pericytes in the penis of normal or pathologic condition and documented their role in the regulation of cavernous permeability and penile erection, which ultimately explore novel therapeutics of erectile dysfunction targeting pericyte function. PMID:26044953

  4. The effect of male erectile dysfunction on the psychosocial, relationship, and sexual characteristics of heterosexual women in the United States.

    Cameron, Ann; Tomlin, Molly

    2007-01-01

    Using Internet-based survey data, this study compared the demographic, psychosocial, relationship, and sexual characteristics of three groups of U.S. women: (a) women whose partners had erectile dysfunction (ED) and were taking medication to treat ED; (b) women whose partners had ED in the previous 3 months and were not taking medication to treat ED; and (c) a control group of women whose partners did not have ED. Results indicate that women are affected by their partners' ED and that ED treatment benefits women's sexual self-efficacy, communication about sexual issues, and sexual and relationship satisfaction. PMID:17365514

  5. Incidence rate of prostate cancer in men treated for erectile dysfunction with phosphodiesterase type 5 inhibitors: retrospective analysis

    Chavez, Anthony H; Scott Coffield, K; Hasan Rajab, M; Jo, Chanhee

    2013-01-01

    The purpose of this study was to determine the incidence rate of prostate cancer among men with erectile dysfunction (ED) treated with phosphodiesterase type 5 inhibitors (PDE-5i) over a 7-year period vs. men with ED of the same age and with similar risk factors who were not treated with PDE-5i. In a retrospective review of electronic medical records and billing databases between the years 2000 and 2006, men with ED between the ages of 50 and 69 years and no history of prostate cancer prior t...

  6. Regulating Direct-to-Consumer Drug Information: A Case Study of Eli Lilly's Canadian 40over40 Erectile Dysfunction Campaign.

    Pipon, Jean-Christophe Bélisle; Williams-Jones, Bryn

    2015-05-01

    Like most jurisdictions, Canada prohibits direct-to-consumer advertising (DTCA) of prescribed drugs. However, direct-to-consumer information (DTCI) is permitted, allowing companies to inform the public about medical conditions. An analysis of Eli Lilly's 40over40 promotion campaign for erectile dysfunction (ED), which included a quiz on ED, shows that DTCI, like DTCA, can be an effective means of drug familiarization. The pharmaceutical industry is "playing by the rules" currently in effect in Canada. Regulators should thus seriously consider whether existing rules permitting DTCI actually meet stated objectives of protecting the public from marketing campaigns (i.e., DTCA) that may deliver misleading information. PMID:26142356

  7. Color Doppler flow imaging diagnosis and treatment selection for erectile dysfunction

    XUAN Xu-jun; ZHANG Cai-xia; HUANG Jian; Rong Lu; SUN Peng; LIU Hai-nan

    2011-01-01

    Background Targeted therapy for erectile dysfunction (ED) involves fewer screening tests and provides a variety of treatment choices for patients.Although the advantage of targeted therapy in diagnosis and therapy for ED has been recognized,the rational mode for oriented ED therapy has not been established.This study aimed to investigate targeted diagnosis and therapy for ED.Methods A total of 198 patients with ED were included in the study.After intracavernosal vasoactive agent injection was given,color Doppler flow imaging was performed and penile rigidity was classified as Schramek grade 5 (10 minutes duration),grade 4 (10 minutes duration),grade 3 and grade 2,defining four patient groups as group Ⅴ (143 cases),group Ⅳ (23 cases),group Ⅲ (18 cases),and group Ⅱ (14 cases).Appropriate and acceptable treatment was recommended to patients according to erection grade.Results In 198 patients with ED,the peak systolic velocity,end diastolic velocity,and resistance index in the cavemosal artery and dorsal artery and the flow velocity in the deep dorsal vein were not significantly different before injection (P >0.05).After injection,peak systolic velocity,end diastolic velocity,and resistance index in the cavernosal artery were different among the four groups (P<0.05).Between each two groups,the difference in resistance index was significant (P <0.05).The statistical differences in other indexes were not significant (P >0.05).Selective targeted therapy based on erection grade by color Doppler flow imaging improved the clinical satisfaction rate to 91.91% (182/198).Conclusions Based on the routine diagnosis of ED,blood flow indexes in the cavernosal artery are measured by color Doppler flow imaging following minimally invasive intercavernosal injection,which is combined with the Schramek grade of erection.The most appropriate and acceptable treatment is recommended according to the different groups,which improves the clinical satisfaction of treatment for

  8. Treatment with CB2 Agonist JWH-133 Reduces Histological Features Associated with Erectile Dysfunction in Hypercholesterolemic Mice

    Rodrigo Araujo Fraga-Silva

    2013-01-01

    Full Text Available Hypercholesterolemia is one of the most important risk factors for erectile dysfunction, mostly due to the impairment of oxidative stress and endothelial function in the penis. The cannabinoid system might regulate peripheral mechanisms of sexual function; however, its role is still poorly understood. We investigated the effects of CB2 activation on oxidative stress and fibrosis within the corpus cavernosum of hypercholesterolemic mice. Apolipoprotein-E-knockout mice were fed with a western-type diet for 11 weeks and treated with JWH-133 (selective CB2 agonist or vehicle during the last 3 weeks. CB2 receptor expression, total collagen content, and reactive oxygen species (ROS production within the penis were assessed. In vitro corpus cavernosum strips preparation was performed to evaluate the nitric oxide (NO bioavailability. CB2 protein expression was shown in cavernosal endothelial and smooth muscle cells of wild type and hypercholesterolemic mice. Treatment with JWH-133 reduced ROS production and NADPH-oxidase expression in hypercholesterolemic mice penis. Furthermore, JWH-133 increased endothelial NO synthase expression in the corpus cavernosum and augmented NO bioavailability. The decrease in oxidative stress levels was accompanied with a reduction in corpus cavernosum collagen content. In summary, CB2 activation decreased histological features, which were associated with erectile dysfunction in hypercholesterolemic mice.

  9. Penile prosthesis implantation and tunica albuginea incision without grafting in the treatment of Peyronie's disease with erectile dysfunction

    Miroslav L Djordjevic; Vladimir Kojovic

    2013-01-01

    We evaluated penile prosthesis implantation with tunica albuginea-relaxing incisions without grafting in the treatment of Peyronie's disease associated with erectile dysfunction.Between April 2005 and June 2011,62 patients underwent surgery due to severe Peyronie's disease associated with erectile dysfunction.Malleable and inflatable penile prostheses ware inserted in 49 and 13 cases,respectively.Penile prostheses were inserted into the corpora cavemosa using the standard ventral approach.After lifting the neurevascular bundle,the tunica albuginea was incised and opened at the plaque region to correct the deformities and to lengthen the penis.Subsequently,the wide neurovascular bundle was replaced,and all incisions of the tunica albuginea were covered to prevent corporal grafting.In the median follow-up of 35 months (range 14-82 months),the penis was completely straightened in 59 (95%) patients.Numbness of the glans,which the patients found initially upsetting,decreased or disappeared spontaneously 3-6 months later.Penile prosthesis implantation with tunica albuginea incisions is a viable alternative in the treatment of Peyronie's disease because the extensive dissection of the neurovascular bundle allows a good approach to the plaque and provides excellent covering of the incised tunica albuginea witheut additional grafting.

  10. Patient preference and satisfaction in erectile dysfunction therapy: a comparison of the three phosphodiesterase-5 inhibitors sildenafil, vardenafil and tadalafil

    Amr Abdel Raheem

    2009-04-01

    Full Text Available Amr Abdel Raheem1, Philip Kell21St. Peter’s Andrology Department, The Institute of Urology, London, and Cairo University, Egypt; 2St. Peter’s Andrology Department, The Institute of Urology, London, UKAbstract: Erectile dysfunction (ED is a problem that may affect up to 52% of men between the ages of 40 and 70. It can be distressing because of its negative effect on self-esteem, quality of life, and interpersonal relationships. Oral phosphodiesterase-5 inhibitors (PDE5 inhibitors are now the first choice of treatment in ED. The availability of three (sildenafil citrate, tadalafil, and vardenafil well tolerated and effective oral PDE5 inhibitors gives treatment options for men with ED. Although the mechanism of action is the same for the three drugs, they differ in their pharmacokinetics. Several preference studies were conducted between the three PDE5 inhibitors but they were not free from bias. Because of the lack of overwhelming reliable data showing that one PDE5 inhibitor is superior to another, current opinion is that the individual patient should have the opportunity to test all three drugs and then select the one that best suits him and his partner.Keywords: erectile dysfunction, PDE5 inhibitors, patient preference

  11. A comparison of radiation dose to the neurovascular bundles in men with and without prostate brachytherapy-induced erectile dysfunction

    Purpose: The etiology of erectile dysfunction after definitive local therapy for carcinoma of the prostate gland represents a multifactorial phenomenon including neurogenic compromise, venous insufficiency, local trauma, and psychogenic causes. It has been suggested that impotence after prostate brachytherapy is a consequence of excessive radiation dose to the neurovascular bundles (NVB). Herein we evaluate the potential relationship between radiation dose to the NVB and the development of erectile dysfunction following prostate brachytherapy. Methods and Materials: The radiation dose to the NVB was evaluated for 33 patients who developed erectile dysfunction (ED) following brachytherapy plus 21 additional patients who were potent before and subsequent to brachytherapy. Of the 54 patient study group, the median follow up was 37 months, and 25 patients were managed with 125I as a monotherapeutic approach and 29 received 103Pd as a boost following 45 Gy of external beam radiation therapy. Radiographic localization of the NVB was performed via a two-dimensional geometric model that placed 3-NVB calculation points on the left and right posterolateral side of each 5-mm CT slice. Parameters evaluated included dose-surface histograms, dose parameters via point doses on each slice, the magnitude of the dose in relationship to the distance from the base, and the relationship between NVB radiation dose in patients with and without ED, patient response to sildenafil and case sequence number. Results: In terms of percent prescribed minimum peripheral dose (% mPD), there was no significant difference in mean neurovascular bundle dose between potent and impotent patients, between the isotopes (125I or 103Pd), mono- or boost therapy, or side of the prostate for which the overall average was 217% ± 55% of mPD. There was also no significant dosimetric difference in terms of response to sildenafil based on a multivariate analysis which included % mPD and various dose thresholds and

  12. Sildenafil citrate (Viagra) and erectile dysfunction following external beam radiotherapy for prostate cancer: a randomized, double-blind, placebo-controlled, cross-over study

    Purpose: To determine the efficacy of sildenafil citrate (Viagra) in patients with erectile dysfunction after three-dimensional conformal external beam radiotherapy (3D-CRT) for prostate cancer. Methods and Materials: 406 patients with complaints of erectile dysfunction and who completed radiation at least 6 months before the study were approached by mail. 3D-CRT had been delivered (mean dose 68 Gy). Sixty patients were included and entered a double-blind, placebo-controlled, cross-over study lasting 12 weeks. They received during 2 weeks 50 mg of sildenafil or placebo; at Week 2 the dose was increased to 100 mg in case of unsatisfactory erectile response. At Week 6, patients crossed over to the alternative treatment. Data were collected using the International Index of Erectile Function (IIEF) questionnaire, and side effects were recorded. Results: Mean age was 68 years. All patients completed the study. For most questions of the IIEF questionnaire there was a significant increase in mean scores from baseline with sildenafil, but not with placebo. Ninety percent of the patients needed a dose adjustment to 100 mg sildenafil. Side effects were mild or moderate. Conclusion: Sildenafil is well tolerated and effective in improving erectile function of patients with ED after 3D-CRT for prostate cancer

  13. Erectile Dysfunction in Type 2 Diabetic Men: Relationship to Exercise Fitness and Cardiovascular Risk Factors in the Look AHEAD Trial

    Rosen, Raymond C.; Wing, Rena R.; Schneider, Stephen; Wadden, Thomas A.; Foster, Gary D.; West, Delia Smith; Kitabchi, Abbas E.; Brancati, Frederick L.; Maschak-Carey, Barbara J.; Bahnson, Judy L.; Lewis, Cora E.; Gendrano, Isaias N.

    2016-01-01

    Introduction Determinants of erectile dysfunction in diabetic men have not been adequately investigated as potential mediators of change. Aim To determine the prevalence and correlates of erectile dysfunction (ED) in overweight men with type 2 diabetes in the multicenter, Look AHEAD trial (Action for Health in Diabetes). Main Outcome Measures International Index of Erectile Function (IIEF), self-reported use of phosphodiesterase type 5 inhibitors, laboratory measures of adiposity, cardiometabolic parameters, and exercise fitness. Methods Male participants aged 45–75 in the Look AHEAD trial in a committed relationship were recruited for an ongoing study of sexual function and diabetes. Eligible participants completed the IIEF questionnaire and provided updated information on use of medical treatments for sexual dysfunction. Baseline sexual function results for participants in the male ancillary study are reported here; intervention data and results for female participants are presented elsewhere. Results A total of 373 eligible male participants completed all sexual function questionnaires, of whom 263 (68.7%) were sexually active at the time of the study. Almost half (49.8%) of the men reported mild or moderate degrees of ED, and 24.8% had complete ED. Among sexually active participants, 42.6% had sought medical help for their problem, and 39.7% reported use of ED medications. ED was significantly associated with age (odds ratio [OR] = 1.05; confidence interval [CI]: 1.01–1.10) baseline HbA1c (OR = 1.31; CI: 1.05–1.63), hypertension history (OR = 2.41; CI: 1.34–4.36), and metabolic syndrome (OR = 3.05, CI: 1.31–7.11). Of note, cardiorespiratory fitness was found to be protective of ED in a multivariable analysis (OR = 0.61; P < 0.001). Conclusions ED is prevalent in this sample of obese, type 2 diabetic men in the Look AHEAD study. Cardiovascular risk factors were highly associated with ED in this population, and cardiorespiratory fitness was protective

  14. Alga Ecklonia bicyclis, Tribulus terrestris, and Glucosamine Oligosaccharide Improve Erectile Function, Sexual Quality of Life, and Ejaculation Function in Patients with Moderate Mild-Moderate Erectile Dysfunction: A Prospective, Randomized, Placebo-Controlled, Single-Blinded Study

    Salvatore Sansalone; Rosario Leonardi; Gabriele Antonini; Antonio Vitarelli; Giuseppe Vespasiani; Dragoslav Basic; Giuseppe Morgia; Sebastiano Cimino; Giorgio Ivan Russo

    2014-01-01

    We aimed to evaluate the efficacy of oral therapy with alga Ecklonia bicyclis, Tribulus terrestris, and glucosamine oligosaccharide (Tradamix TX1000) in patients with erectile dysfunction (ED) at 3 months of follow-up. From January 2013 to September 2013, 177 patients diagnosed with mild-moderate ED (IIEF-EF < 26) were enrolled in this multicenter, single-blinded, placebo-controlled study and randomized in Group A (Tradamix, n = 87) and Group B (placebo, n = 90). Penile color Doppler ultrasou...

  15. Gene expression profile comparison in the penile tissue of diabetes and cavernous nerve injury-induced erectile dysfunction rat model

    Kam, Sung Chul; Lee, Sang Hoon; Jeon, Ju Hong; So, Insuk; Chae, Mee Ree; Park, Jong Kwan

    2016-01-01

    Purpose To investigate the effects of cavernous nerve injury (CNI) on gene expression profiles in the cavernosal tissue of a CNI-induced erectile dysfunction (ED) model and to provide a basis for future investigations to discover potential target genes for ED treatment. Materials and Methods Young adult rats were divided randomly into 2 groups: sham operation and bilateral CN resection. At 12 weeks after CNI we measured erectile responses and performed microarray experiments and gene set enrichment analysis to reveal gene signatures that were enriched in the CNI-induced ED model. Alterations in gene signatures were compared with those in the diabetes-induced ED model. The diabetic-induced ED data is taken from GSE2457. Results The mean ratio of intracavernosal pressure/blood pressure for the CNI group (0.54±0.4 cmH2O) was significantly lower than that in the sham operation group (0.73±0.8 cmH2O, p<0.05). Supervised and unsupervised clustering analysis showed that the diabetes- and CNI-induced ED cavernous tissues had different gene expression profiles from normal cavernous tissues. We identified 46 genes that were upregulated and 77 genes that were downregulated in both the CNI- and diabetes-induced ED models. Conclusions Our genome-wide and computational studies provide the groundwork for understanding complex mechanisms and molecular signature changes in ED. PMID:27437539

  16. Our experience in the diagnostic and the treatment of the traumatical erectile dysfunction. Advantages of the digital substraction angiography and cavernosography

    Velkova, K.; Chopov, A.

    1994-12-31

    The erectile dysfunction is a problem with underlined mediocosocial significance. In this aspect we report our experience in diagnostics and treatment of traumatic vessels - caused erectile dysfunction. Patients are treated by a diagnostic program, which we made on the basis of our experience from the whole group of vessel - caused erectile dysfunction. We have tested and cured 6 patients with traumatic erectile dysfunction. In all the patients we found erectile dysfunction of type `venous leak`, which was diagnosed by digital subtraction cavernosography, which was suggested by the authors. The way of diagnostic research for application of digital subtraction cavernosography is characterized or pelvic angiography independance of the coordinated venous and arterial traumatic laesions such are found in 2 of the patients. The method for surgical treatment is suggested and the long - lasting effect by the treatment is defined by the authors. (orig.) [Deutsch] Die erektile Dysfunktion ist ein Problem mit sozial-medizinischer Signifikanz. In diesem Zusammenhang berichten wir ueber unsere Erfahrungen in der Diagnose und Behandlung der erektilen Dysfunktion auf der Grundlage traumatischer Gefaessverletzungen. Die Patienten werden entsprechend einem diagnostischen Vorgehen behandelt, das sich aus unseren Erfahrungen mit Erkrankungen aus dem Formenkreis der vaskulaer bedingten erektilen Dysfunktionen ergeben hat. Wir untersuchten und behandelten 6 Patienten mit traumatisch bedingter erektiler Dysfunktion. Bei allen Patienten fanden wir eine erektile Dysfunktion vom Typ der `venoesen Leckage`, die mittels digitaler Subtraktionskavernographie diagnostiziert wurde, eine Methode, die von uns entwickelt wurde. Die Methode der digitalen Subtraktionskavernographie beruht unabhaengig von der traumatischen Laesion auf der pelvinen Angiographie. Die chirurgische Behandlung wird vorgeschlagen und die Langzeitergebnisse der Behandlungen werden vorgestellt. (orig.)

  17. Switching from nitrate therapy to ranolazine in patients with coronary artery disease receiving phosphodiesterase type-5 inhibitors for erectile dysfunction.

    Udeoji, Dioma U; Schwarz, Ernst R

    2014-01-01

    Coronary artery disease (CAD) and erectile dysfunction (ED) frequently coexist. The introduction of phosphodiesterase type-5 (PDE-5) inhibitors has revolutionized medical management of organic ED; however, in patients with angina pectoris, a common symptom of CAD, coadministration of PDE-5 inhibitors and nitrates has been implicated in CAD-related deaths following sexual activity. The mechanism of action of PDE-5 inhibitors results in a potential cumulative drop in blood pressure (BP); thus, these agents are contraindicated in patients receiving nitrates. Beta-blockers and calcium channel antagonists are considered the mainstays of antianginal therapy, but may not be tolerated by all patients. Ranolazine is an antianginal agent that produces minimal reductions in heart rate and BP. Here we report three cases of men with CAD, chronic angina, and concomitant ED. We describe our treatment approach in these patients, using ranolazine as a potential substitute to nitrate therapy. PMID:25452706

  18. The devil is in the details: an analysis of the subtleties between phosphodiesterase inhibitors for erectile dysfunction

    Smith-Harrison, L.I.; Patel, Abhishek

    2016-01-01

    Erectile dysfunction (ED) is a common sexual disorder with numerous etiologies involving multiple organ systems that leads to significant distress and decreased quality of life for the affected men. Fortunately, there are several modalities and interventions for treating ED. Oral medications, intra-urethral compounds, intracorporeal injections, vacuum-assist devices and surgically implanted prostheses are all part of the treatment algorithm. One of the first-lines and certainly the most widely used options for treating ED is the family of oral phosphodiesterase type 5 inhibitors (PDE5I). The introduction of these medications in the late 1990s revolutionized the field of sexual medicine. Currently there are no guidelines and minimal literature to help providers choose among drugs in this class. This review will address differences in efficacy and side effects between various members of the oral selective phosphodiesterase-5 inhibitor class of drugs.

  19. Prevalence, correlates, attitude and treatment seeking of erectile dysfunction among type 2 diabetic Chinese men attending primary care outpatient clinics

    Wai Hon Lo; Sau Nga Fu; Carlos King Ho Wong; Ee San Chen

    2014-01-01

    To investigate the prevalence, correlates, attitude and treatment seeking behavior of erectile dysfunction(ED) in type2 diabetes mellitus (T2DM) patients in the primary care setting, a multi‑center cross‑sectional survey using a structured anonymous self‑administered questionnaire was performed in 10 general outpatient clinics. Of the 603 subjects(91% response rate), the prevalence of ED men, as deifned by the International Index of Erectile Function, was 79.1%. Most subjects had mild ED(28.9%), followed by mild‑to‑moderate ED(27.9%), then moderate ED(13.4%) and severe ED(9%). Nearly 55% of those with ED did not consider themselves as having ED. Less than 10% of them had ever sought medical treatment, although 76.1% of them wished to receive management from doctor(s) should they be diagnosed with ED. They considered the most important management from doctors to be clinical assessment(41.7%), followed by management of potential underlying cause(37.8%), referral to specialist(27.5%), education(23.9%), prescription of phosphodiesterase type5 inhibitors(16.9%) and referral to counseling service(6.7%). The prevalence of ED was strongly associated with subjects who thought they had ED(odds ratio(OR)= 90.49(20.00–409.48, P<0.001)) and were from the older age group(OR=1.043(1.011–1.076,P=0.008)). In conclusion, ED is highly prevalent among T2DM men. The majority of them wanted management from doctors should they have ED, but only a minority would actually voice out the request. Screening of ED among T2DM men using structural questionnaire allowed the diagnosis of more than half of the ED cases, which otherwise would have gone undiagnosed.

  20. AB096. Taurine supplementation improves erectile function in rats with streptozotocin-induced type 1 diabetes via amelioration of penile fibrosis and endothelial dysfunction

    Ruan, Yajun; Li, Mingchao; Wang, Tao; Yang, Jun; Rao, Ke; Wang, Shaogang; Yang, Weimin; Liu, Jihong; Ye, Zhangqun

    2016-01-01

    Objective For patients with diabetes, erectile dysfunction (ED) is common and greatly affects quality of life. However, these patients often exhibit a poor response to first-line oral phosphodiesterase type 5 inhibitors. The aim of this study was to investigate whether taurine, a sulfur-containing amino acid, affects diabetic ED (DED). Methods Type 1 diabetes mellitus was induced in male rats using streptozotocin. After 12 weeks, an apomorphine test was conducted to confirm DED. Only rats with DED were administered taurine or vehicle for four weeks. Age-matched nondiabetic rats were administered saline intraperitoneally for four weeks. Erectile function was evaluated by electrical stimulation of the cavernous nerve. Histologic and molecular alterations of the corpus cavernosum also were analyzed. Results Erectile function was significantly reduced in the diabetic rats compared with in the nondiabetic rats, and was ameliorated in the diabetic rats treated with taurine. The corpus cavernosum of the rats with DED exhibited severe fibrosis and decreased smooth muscle content. Deposition of extracellular matrix proteins was increased in the diabetic rats, while expression of endothelial nitric oxide synthase/cyclic guanosine monophosphate/nitric oxide pathway–related proteins was reduced. Taurine supplementation restored erectile response as well as histologic and molecular alterations. Conclusions Taurine supplementation improves erectile function in rats with DED probably by potential antifibrotic activity. This finding provides evidence for a potential new therapy for DED.

  1. Clinical assessment of a supplement of Pycnogenol® and L-arginine in Japanese patients with mild to moderate erectile dysfunction.

    Aoki, Hiromitsu; Nagao, Junji; Ueda, Taro; Strong, Jeffry M; Schonlau, Frank; Yu-Jing, Song; Lu, Yan; Horie, Shigeo

    2012-02-01

    A double-blind parallel group comparison design clinical study was conducted in Japanese patients with mild to moderate erectile dysfunction to investigate the efficacy of a supplement containing Pycnogenol® and L-arginine. Subjects were instructed to take a supplement (Pycnogenol® 60 mg/day, L-arginine 690 mg/day and aspartic acid 552 mg/day) or an identical placebo for 8 weeks, and the results were assessed using the five-item erectile domain (IIEF-5) of the International Index of Erectile Function. Additionally, blood biochemistry, urinalysis and salivary testosterone were measured. Eight weeks of supplement intake improved the total score of the IIEF-5. In particular, a marked improvement was observed in 'hardness of erection' and 'satisfaction with sexual intercourse'. A decrease in blood pressure, aspartate transaminase and γ-glutamyl transpeptidase (γ-GTP), and a slight increase in salivary testosterone were observed in the supplement group. No adverse reactions were observed during the study period. In conclusion, Pycnogenol® in combination with L-arginine as a dietary supplement is effective and safe in Japanese patients with mild to moderate erectile dysfunction. PMID:21618639

  2. Safety and Potential Effect of a Single Intracavernous Injection of Autologous Adipose-Derived Regenerative Cells in Patients with Erectile Dysfunction Following Radical Prostatectomy

    Haahr, Martha Kirstine; Jensen, Charlotte Harken; Toyserkani, Navid Mohamadpour;

    2016-01-01

    BACKGROUND: Prostate cancer is the most common cancer in men, and radical prostatectomy (RP) often results in erectile dysfunction (ED) and a substantially reduced quality of life. The efficacy of current interventions, principal treatment with PDE-5 inhibitors, is not satisfactory and this condi......BACKGROUND: Prostate cancer is the most common cancer in men, and radical prostatectomy (RP) often results in erectile dysfunction (ED) and a substantially reduced quality of life. The efficacy of current interventions, principal treatment with PDE-5 inhibitors, is not satisfactory...... for the presence of stem cell surface markers, viability and ability to differentiate. Primary endpoint was the safety and tolerance of the cell therapy while the secondary outcome was improvement of erectile function. Any adverse events were reported and erectile function was assessed by IIEF-5 scores. The study...... is registered with ClinicalTrials.gov, NCT02240823. FINDINGS: Intracavernous injection of ADRCs was well-tolerated and only minor events related to the liposuction and cell injections were reported at the one-month evaluation, but none at later time points. Overall during the study period, 8 of 17 men recovered...

  3. Levels of Human Erythrocyte Membrane-Bound and Cytosolic Glycohydrolases Are Associated with Oxidative Stress in Erectile Dysfunction Patients

    L. Massaccesi

    2014-01-01

    Full Text Available Oxidative stress (OS and production of NO, by endothelium nitric oxide synthetase (eNOS, are involved in the pathophysiology of erectile dysfunction (ED. Moreover, OS induces modifications of the physicochemical properties of erythrocyte (RBC plasma membranes and of the enzyme content of the same membranes. Due to their role in signalling early membrane alterations in OS-related pathologies, several plasma membrane and cytosolic glycohydrolases of human RBC have been proposed as new markers of cellular OS. In RBC, NOS can be activated and deactivated by phosphorylation/glycosylation. In this regulatory mechanism O-β-N-AcetylGlucosaminidase is a key enzyme. Cellular levels of O-GlcNAcylated proteins are related to OS; consequently dysfunctional eNOS O-GlcNAcylation seems to have a crucial role in ED. To elucidate the possible association between RBC glycohydrolases and OS, plasma hydroperoxides and antioxidant total defenses (Lag-time, cytosolic O-β-N-AcetylGlucosaminidase, cytosolic and membrane Hexosaminidase, membrane β-D-Glucuronidase, and α-D-Glucosidase have been studied in 39 ED patients and 30 controls. In ED subjects hydroperoxides and plasma membrane glycohydrolases activities are significantly increased whereas Lag-time values and cytosolic glycohydrolases activities are significantly decreased. These data confirm the strong OS status in ED patients, the role of the studied glycohydrolases as early OS biomarker and suggest their possible use as specific marker of ED patients, particularly in those undergoing nutritional/pharmacological antioxidant therapy.

  4. Prevalence, psychological impact, and risk factors of erectile dysfunction in patients with Peyronie's disease: a retrospective analysis of 309 cases.

    Paulis, Gianni; Romano, Gennaro; Paulis, Andrea

    2016-01-01

    Peyronie's disease (PD) is a chronic inflammatory disease involving the tunica albuginea of the penis. Erectile dysfunction (ED) is a possible invalidating symptom of PD. The aim of this study was to evaluate the prevalence, psychological impact, and risk factors of ED in patients with PD. The study was conducted by carrying out a retrospective analysis of the clinical records of 309 patients with PD who visited our andrology clinic. All patients underwent the following tests: body mass index, common blood tests and hormone assays, questionnaire for erectile function assessment, dynamic penile color Doppler ultrasonography, imaging of the penis at maximum erection with photographic poses according to Kelâmi, psychosexual impact evaluation with PD Questionnaire (symptom bother score), evaluation of depression symptoms with the Patient Health Questionnaire-9, and evaluation of the intensity of penile pain with the pain intensity numeric rating scale. ED was observed in 37.5% of the cases. We divided the cases into two groups: group A (PD + ED), 116 cases, and group B (PD without ED), 193 cases. After multivariate analysis, we concluded that the following comorbidities are independent risk factors for ED: dyslipidemia, obesity, chronic prostatitis, benign prostatic hyperplasia, and autoimmune diseases. A depressive disorder was observed in 62.4%, and it was more frequent in patients with PD + ED (91.37% versus 45.07% group B). Sexual bother was greater in group A compared with group B (9.7 versus 7.6). Intensities of depressive symptoms and sexual bother were significantly higher compared with cases with no curvature when the bend angle was ≥30°. Our study confirms that an integrated psychological support with medical treatment is needed in patients with PD. PMID:27486570

  5. Predictive factors for erectile dysfunction in men with prostate cancer after brachytherapy: Is dose to the penile bulb important?

    Purpose: To determine predictive factors for postimplant erectile dysfunction (ED) in a cohort of patients, according to prospectively collected data; specifically, to assess the impact of penile bulb volume and D50 and D95 (dose covering 50% and 95% of the penile bulb volume, respectively) on ED. Methods and Materials: Three hundred forty-two patients were identified who were potent before implant and who had at least 2 years' follow-up. Patient, tumor, treatment, and dosimetric data were collected on all patients. Postimplant ED was defined according to both physician-documented and patient-documented outcome data. Binary logistic regression analysis was used to create multivariable models of predictors for ED at 1, 2, and 3 years after implant. Results: Physician-documented rates of ED were 57%, 48%, and 38% at 1, 2, and 3 years after implant, respectively. Patient-documented rates of ED were 70% and 66% at 1 and 2 years, respectively. Multivariable analyses revealed age and degree of preimplant erectile function to be consistently significant predictors of ED. Use of hormones was significant at the 1-year physician-documented ED endpoint but not thereafter, in keeping with the time course of testosterone recovery. Penile bulb volume, D50, and D95 were not found to be predictive for ED at any time point, in contrast to previous studies. In addition, planning ultrasound target volume, number of needles, and institutional case sequence number were significant predictors of ED at various time points, consistent with a traumatic etiology of ED. Conclusions: We found no evidence to support penile bulb dosimetry as an independent predictive factor for ED after implant, using physician-documented or patient-documented outcomes

  6. Severity of coronary artery disease and symptoms of erectile dysfunction in males with a positive exercise treadmill test

    The objective of this study is to investigate the significance of erectile dysfunction in males with a positive exercise treadmill test (ETT) to predict the severity of coronary artery disease (CAD). With no previous marked CAD, and applying to our clinic with chest pain, 105 male patients (mean age: 56±8 years) underwent coronary angiography after the ETT. These patients met our criteria and were included in our study. All patients were requested to complete a brief, 5-item form by the International Index of Erectile Function, and the Sexual Health Inventory for Men (SHIM), and were classified into four groups according to coronary angiography results as follows: normal coronary artery (NCA), single-vessel CAD (1V), two-vessel CAD (2V) and three-vessel CAD (3V). The relation between SHIM scores and the number of arteries with significant lesions was evaluated. The median SHIM score was found to be significantly lower in both the 2V, 15 (IQR: 12-20) and 3V, 13 (IQR: 11-16) groups compared to the NCA, 22 (IQR: 17-23) and the 1V, 22 (IQR: 17-23) groups (P<0.05). Grouped as group I (NCA+1V) and group II (2V+3V), the patients were recompared. The SHIM score is an independent parameter to define the presence of significant lesions in two or more coronary arteries (odds ratio, 0.84; 95% Cl, 0.73-0.97; P=0.019). The fact that the SHIM score is <18 in ETT positive males may suggest that the probability of multivessel CAD should be high. (author)

  7. What do most erectile dysfunction guidelines have in common? No evidence-based discussion or recommendation of heart-healthy lifestyle changes and/or Panax ginseng

    Moyad, Mark A; Park, Kwangsung

    2012-01-01

    Sexual health or erectile dysfunction (ED) state of the art guidelines provide a thorough overview of conventional prescription or other notable extrinsic treatment options. Yet, over the past 10–15 years, a plethora of international researchers have established that individual and comprehensive lifestyle changes can prevent and potentially improve ED. We review the lifestyle evidence that should equate to grade A or level 1 evidence recommendations for ED. We also review the evidence for Pan...

  8. Phosphodiesterase type 5 inhibitors for treating erectile dysfunction and lower urinary tract symptoms secondary to benign prostatic hyperplasia: A comprehensive review

    Haddad, Albert; Jabbour, Michel; Bulbul, Muhammad

    2015-01-01

    Many men have coexistent erectile dysfunction (ED) and lower urinary tract symptoms secondary to benign prostatic hyperplasia (LUTS/BPH). Phosphodiesterase type 5 (PDE5) inhibitors are effective for treating both of these conditions independently. In this review we summarise the evidence supporting a link between ED and LUTS/BPH, and the results from key clinical studies related to the use of PDE5 inhibitors for treating both conditions. The results from these studies suggest that men who hav...

  9. Improvement in duration of erection following phosphodiesterase type 5 inhibitor therapy with vardenafil in men with erectile dysfunction: the ENDURANCE study

    Rosenberg, M. T.; Adams, P L; McBride, T A; Roberts, J N; McCallum, S W

    2009-01-01

    Objective: The ENDURANCE study evaluated the efficacy of vardenafil, a phosphodiesterase type 5 (PDE5) inhibitor, in men with erectile dysfunction (ED), by measuring the duration of erection leading to successful intercourse using a stopwatch as the assessment instrument. Methods: This was a randomised, multicentre, double-blind, placebo-controlled, crossover study consisting of a 4-week treatment-free run-in phase after which patients were randomised to either fixed-dose vardenafil 10 mg or ...

  10. A Double-blind Placebo-controlled Evaluation of the Effect of Topical Sildenafil on Erectile Dysfunction

    M. Yonessi

    2005-01-01

    Full Text Available Background and purpose: Several adverse effects were reported for oral sildenafil. In this research after formulation of sildenafil topical gel, the effect of gel was compared with sildenafil tablet in a double-blind placebo-controled clinical trial.Materials and methods: After choosing the solvent system, several formulations were prepared and the most suitable gel was chosen for clinical trial. The study was a controlled randomized (block-random sampling, double blind, prospective, placebo-controlled trial. 94 patients, with clinically diagnosed erectile dysfunction were recruited. This includes men with ED of organic, psychogenic, and mixed causes. Patients were divided into two categories of age under and over 50 . Six blocks were considered for including patients based on the nature of ED and age. All of the patients with ED from July 2003 to May 2004 diagnosed by one urologist were included in the study. The cases received 1% topical gel of sildenafil and placebo tablet, and the control group received sildenafil tablet (100 mg and gel base (without drug as placebo. The tablets were taken one hour before sexual action and the topical gel was used in 0.5g(approximatelyon the glans of penis and were massaged for 5min, before the sexual activity.Results: In the case group that topical gel of sildenafil was administered, 5 patients (12.5% had complete erection, 5 patients had moderate erection and erection was not observed in 30 (75% of them. In control group, that sildenafil tablet was administered, these results were 28 (70%, 6 (15% and 6 (15% respectively. The onset of erection in case group (in-patients with complete erection was 7.4 ± 3.6 min, but this time was 37.8 ± 14.9 min in control group. Four cases of mild headache were observed in-patients who administered topical gel of sildenafil. This was pain treated before 4 min. Two cases of severe headache were observed in-patients who were administered sildenafil tablet. The disorder on

  11. Study of efficiency of Likoprofit Potential-Formula biologically active additive (BAA in the treatment of patients with erectile dysfunction against the background of arterial hypertension

    A. I. Neimark

    2016-03-01

    Full Text Available The efficiency of the action of Likoprofit Potential biologically active additive (BAA on microcirculation of penis in patients with erectile dysfunction (ED against the background of arterial hypertension has been studied. All the patients have passed the laser Doppler flowmetry, assessment of the index of male copulatory function and the international index of erectile function. The course of administration was three months. All the patients in 100% of cases had mild arterial hypertension. The patients of the main group had decreased libido (50%, lack of self-confidence (7%, weak spontaneous and adequate erections (21%, ejaculatory component (7%, orgasmic dysfunction (28%, increased period of sexual stimulation, decreased number and quality of coiti (100%. In patients with erectile dysfunction against the background of arterial hypertension, Likoprofit Potential produces the stimulating effect on CNS, spasmolytic action on penis vessels, and improves hemodynamics in cavernous bodies of penis. The number of patients’ complains have decreased, the psycho-emotional state has improved, and the satisfaction of the sex life has appeared. The patients’ microcirculation has improved as well.

  12. The importance of radiation doses to the penile bulb vs. crura in the development of postbrachytherapy erectile dysfunction

    Purpose: Recent studies have implicated the proximal penis as a potential site-specific structure for radiation-related erectile dysfunction (ED). In this study, we evaluated by means of a validated patient-administered questionnaire whether radiation doses to the bulb of the penis and/or the proximal corporeal bodies were predictive for the development of brachytherapy-induced ED. Methods and Materials: Thirty patients who underwent permanent prostate brachytherapy between April 1995 and October 1999 and developed brachytherapy-induced ED were paired with 30 similar men who maintained potency after implantation. None of the 60 patients received supplemental external beam radiation therapy, either before or after implantation. Potency was assessed by patient self-administration of the specific erectile questions of the International Index of Erectile Function. The questionnaire consisted of 5 questions with a maximum score of 25. Postimplant potency was defined as an International Index of Erectile Function score ≥11. Mean and median follow-up was 48.3 ± 14.4 months and 48.0 months, respectively (range: 26.6-79.3 months). The bulb of the penis and the proximal crura were outlined at 0.5-cm intervals on the Day 0 postimplant CT scan. The radiation dose distribution to the bulb of the penis and adjacent crura was defined in terms of the minimum dose delivered to 25%, 50%, 70%, 75%, 90%, and 95% of the bulb (D25, D50, D70, D75, D90, and D95). Results: The radiation dose delivered to the bulb of the penis and the proximal crura in men with brachytherapy-induced ED was statistically greater for all evaluated dosimetric parameters (D25, D50, D70, D75, D90, and D95). Stepwise linear regression analysis indicated that penile bulb dose parameter D50, the postimplant prostate CT volume, and patient age at implant were predictive of postimplant ED, whereas the crura dose D25 approached statistical significance. Seventy-five percent of the impotent men had a bulb D25 >60

  13. Phosphodiesterase type 5 inhibitors for treating erectile dysfunction and lower urinary tract symptoms secondary to benign prostatic hyperplasia: A comprehensive review

    Haddad, Albert; Jabbour, Michel; Bulbul, Muhammad

    2015-01-01

    Many men have coexistent erectile dysfunction (ED) and lower urinary tract symptoms secondary to benign prostatic hyperplasia (LUTS/BPH). Phosphodiesterase type 5 (PDE5) inhibitors are effective for treating both of these conditions independently. In this review we summarise the evidence supporting a link between ED and LUTS/BPH, and the results from key clinical studies related to the use of PDE5 inhibitors for treating both conditions. The results from these studies suggest that men who have both ED and LUTS/BPH, and are concerned about their sexual dysfunction, might benefit from single-agent, holistic treatment with a PDE5 inhibitor. PMID:26413339

  14. Dynamic color Doppler sonography in the assessment of erectile dysfunctions; Utilizzazione dell'eco color Doppler dinamico del pene nello studio delle disfunzioni erettili

    Aversa, A.; Bonifacio, V.; Isidori, A.; Fabbri, A. [Rome Univ. (Italy). Cattedra di Andrologia. Dipt. di Fisiopatologia Medica; Bertucci, B. [Azienda Ospedaliera Pugliese Ciaccio, Catanzaro (Italy). Servizio di Radiologia

    1999-06-01

    The authors investigated the diagnostic accuracy of dynamic color Doppler sonography (D-CDS) in men with erectile dysfunctions (ED). Terminal microcirculation alterations and their correlation with erectile response after drug testing were investigated with power Doppler energy. Penile sonography in the flaccid state can show calcificic plaques and/or fibrosis of the corpora. Redosing of PGE{sub 1} plus phentolamine during D-CDS is a safe procedure and improves diagnostic accuracy in erectile dysfunctions, with significantly fewer non-responders than redosing of PGE{sub 1} alone. Power Doppler energy shows altered morphology of helicine arterioles otherwise missed at color Doppler and is thus recommended to make an accurate diagnosis in some men with erectile dysfunctions. [Italian] Scopo dello studio e' quello di valutare l'accuratezza diagnostica dell'eco color Doppler dinamico del pene nei soggetti affetti da disfunzione erettile. Inoltre si e' voluto verificale la presenza di alterazioni della vascolarizzazione arteriosa terminale con modulo power Doppler e come la presenza di queste alterazioni del microcircolo si correlino con la risposta erettiva della farmacoinfusione intracavernosa. Con l'eco color Doppler penieno basale e' possibile identificare placche calcifiche e/o fibrosi nei corpi cavernosi. Durante la fase dinamica con color Doppler , la re-iniezione con PGE{sub 1} e fentolamina si e' dimostrata sicura e ha migliorato l'accuratezza diagnostica riducendo il numero di soggetti con mancata risposta erettiva rispetto alla sola PGE{sub 1}. Con power Doppler sono state identificate alterazioni morfologiche delle arterioleelicine non visibili con il color Doppler consentendo la diagnosi piu' precisain alcuni casi di disfunzione erettile.

  15. AB094. High-throughput sequencing of small RNA component of penile in a post-radical prostatectomy model of erectile dysfunction

    Ruan, Yajun; Luan, Yang; Zhang, Yan; Li, Hao; Li, Rui; Cui, Kai; Jiang, Hongyang; Li, Mingchao; Wang, Tao; Liu, Jihong

    2016-01-01

    Objective The introduction of nerve-sparing radical prostatectomy represents a milestone in the treatment of prostate cancer. However, a certain percentage of cancer survivors still suffer from erectile dysfunction. Recent research has stated that using PDE 5-inhibitors after radical prostatectomy may lead to biochemical recurrence. This study was performed to identify the expression profile of small RNA in rats with neurogenic erectile dysfunction, and to investigate possible genes and signaling pathways involving in the disease. Methods Neurogenic erectile dysfunction (ED) was induced in male rats by bilateral cavernous nerve crushing injury (BCNI). After 28 days, erectile function was evaluated by cavernous nerve electrostimulation. Masson’s trichrome staining was performed to assess histologic changes. RNA was isolated from the corpus cavernosum (CC) of both control rats and neurogenic ED rats. Small RNA sequencing was conducted using an Illumina Hiseq 2,500/2,000 platform. Candidate small RNAs were validated by real-time polymerase chain reaction. Results Intracavernous pressure (ICP) was significantly decreased in BCNI group compared with SHAM group. Corporal tissue in the neurogenic ED rats showed a significantly lower smooth muscle/collagen ratio compared with tissue in the SHAM controls. Real time PCR validated that miR-9a-5p, miR-203a-5p, miR-378a-3p and miR-3557-5p were upregulated, and meanwhile miR-3084a-3p was downregulated. Conclusions Small RNA, including microRNA, may play an important role in the regulation of genes in CC and some certain miRs may participate in post-prostatectomy ED. Further studies will be designed to investigate the specific mechanisms of these changes.

  16. Phenolic Extract from Moringa oleifera Leaves Inhibits Key Enzymes Linked to Erectile Dysfunction and Oxidative Stress in Rats' Penile Tissues

    Oboh, Ganiyu; Ademiluyi, Adedayo O.; Ademosun, Ayokunle O.; Olasehinde, Tosin A.; Oyeleye, Sunday I.; Boligon, Aline A.; Athayde, Margareth L.

    2015-01-01

    This study was designed to determine the antioxidant properties and inhibitory effects of extract from Moringa oleifera leaves on angiotensin-I-converting enzyme (ACE) and arginase activities in vitro. The extract was prepared and phenolic (total phenols and flavonoid) contents, radical (nitric oxide (NO), hydroxyl (OH)) scavenging abilities, and Fe2+-chelating ability were assessed. Characterization of the phenolic constituents was done via high performance liquid chromatography-diode array detection (HPLC-DAD) analysis. Furthermore, the effects of the extract on Fe2+-induced MDA production in rats' penile tissue homogenate as well as its action on ACE and arginase activities were also determined. The extract scavenged NO∗, OH∗, chelated Fe2+, and inhibited MDA production in a dose-dependent pattern with IC50 values of 1.36, 0.52, and 0.38 mg/mL and 194.23 µg/mL, respectively. Gallic acid, chlorogenic acid, quercetin, and kaempferol were the most abundant phenolic compounds identified in the leaf extract. The extract also inhibited ACE and arginase activities in a dose-dependent pattern and their IC50 values were 303.03 and 159.59 µg/mL, respectively. The phenolic contents, inhibition of ACE, arginase, and Fe2+-induced MDA production, and radical (OH∗, NO∗) scavenging and Fe2+-chelating abilities could be some of the possible mechanisms by which M. oleifera leaves could be used in the treatment and/or management of erectile dysfunction. PMID:26557995

  17. Prevalence of erectile dysfunction and its correlates among men attending primary care clinics in three countries: Pakistan, Egypt, and Nigeria.

    Shaeer, K Z M; Osegbe, D N; Siddiqui, S H; Razzaque, A; Glasser, D B; Jaguste, V

    2003-04-01

    The prevalence and correlates of erectile dysfunction (ED) in developing countries are largely unknown. Our objectives were to determine the prevalence and associated factors of ED in three countries (Pakistan, Egypt, Nigeria) that represent very different cultures. Men 35-70y of age seeking primary medical care answered a structured questionnaire adapted to reflect local cultures. Degree of ED was categorized as 'none,' 'mild,' 'moderate,' or 'complete.' The age-adjusted prevalence rates of ED among men attending primary care clinics was 57.4% in Nigeria, 63.6% in Egypt, and 80.8% in Pakistan. Older age, diabetes, peptic ulcers, prostate disease, depression-related symptoms, and caffeine consumption were independently associated with increased prevalence of ED, whereas being moderately active to very active at work (hard physical labor) and during leisure time (strenuous exercise) was associated with half the prevalence of moderate-to-complete ED. Our multicultural study demonstrates that in every country studied, high proportions of men older than age 35 have some degree of ED (57-81%). Both severity and prevalence increase consistently with age. Factors associated with ED are similar, but their distribution differs across countries. PMID:12825103

  18. A clinical comparative study on effects of intracavernous injection of sodium nitroprusside and papaverine/phentolamine in erectile dysfunction patients

    QiangFU; De-HongYAO; Yue-QinJIANG

    2000-01-01

    Aim: To study the effect of intracavemous sodium nitropmsside (SNP), a nitric oxide (NO) donor, on penile erection. Methods: Forty-two patients with erectile dysfunction (ED) were randomly assigned to receive SNP 300μg or the control drugs (papaverine 30mg+phentolamine 1mg) intracavemously crosswise one week apart. The penile length, circumference and hardness after the administration of the experimental and control drugs were assessed and compared statistically. Results: (1)There was no significant difference between the changes in penile length and circumference in the two occasions; (2)In 25 SNP and 28 control cases, the hardness of the penis was scored above 100 as evaluated by the Virag method (P>0.05);(3)The duration of erection in the controls was longer than that in the SNP, but there were three priapism in the controls and not a single one in the SNP; (4)there was no apparent change in the heart rate and blood pressure in both occasions; other side effects were minimal except slight local pain in a few controls. Conclusion: SNP facilitates relaxation of the penile smooth muscle and penile erection without significant side effects. SNP may be used in ED patients that experience pain and priapism with papaverine/phentolamine.(Asian J Androl 2000 Dec;2:301-303)

  19. Clinical study on erectile dysfunction in diabetic and non-diabetic subjects and its management with Ficus relegiosa Linn.

    Virani, Nilesh V; Chandola, H M; Vyas, S N; Jadeja, D B

    2010-07-01

    Healthy sexual functioning plays an essential role in maintaining the harmony and happiness in marital life. It provides a media to express love, which is the base for all sorts of creative activities. The absence of this function hampers the marital relationship, leading to frustration and, sometimes, ending in divorce, and causes inadequacy in performing the routine duties. In this study, 53 patients having diabetes mellitus were surveyed to find out the incidence of erectile dysfunction (ED). Considering the high prevalence of the disease and the need to look for alternative medicine, a clinical trial on 44 patients of ED was carried out. These patients were divided into two main groups: diabetic and non-diabetic, and were further divided into two subgroups as trial group and placebo group. In the trial group, Ashvattha Kshirpaka prepared with 10 g powder of its root bark, stem bark, fruit and tender leaf buds was given twice a day. In both the diabetic and the non-diabetic subjects, Ashvattha provided encouraging results on ED as well as on seminal parameters in comparison to the placebo. PMID:22131726

  20. Efficacy of Avanafil 15 Minutes after Dosing in Men with Erectile Dysfunction: A Randomized, Double-Blind, Placebo Controlled Study

    Emre Bakırcıoğlu

    2015-09-01

    Full Text Available Phosphodiesterase type 5 (PDE 5 inhibitors are currently first-line medical treatment for erectile dysfunction (ED. PDE 5 inhibitors are differentiated by safety-tolerability profiles and efficacy considerations, such as time to onset and duration of action. The choice of PDE 5 inhibitors in a man with ED is generally based on quality of life factors such as patient and partner satisfaction as well as efficacy and safety. In this randomized, double-blind, placebo controlled study, a total of 440 men with ED randomly assigned to placebo, or avanafil 100 or 200 mg. Avanafil group with 100 mg and 200 mg showed significantly higher rate of successful intercourse compared to placebo approximately 15 minutes after dosing. The adverse effects of avanafil were headache, upper respiratory tract infection, and nasal congestion. This study showed that avanafil treatment significantly improved erection sufficient for penetration within 15 minutes of dosing which is particularly well suited for ED treatment on demand with favorable side effects.

  1. Nonalcoholic steatohepatitis as a novel player in metabolic syndrome-induced erectile dysfunction: an experimental study in the rabbit.

    Vignozzi, Linda; Filippi, Sandra; Comeglio, Paolo; Cellai, Ilaria; Sarchielli, Erica; Morelli, Annamaria; Rastrelli, Giulia; Maneschi, Elena; Galli, Andrea; Vannelli, Gabriella Barbara; Saad, Farid; Mannucci, Edoardo; Adorini, Luciano; Maggi, Mario

    2014-03-25

    A pathogenic link between erectile dysfunction (ED) and metabolic syndrome (MetS) is now well established. Nonalcoholic steatohepatitis (NASH), the hepatic hallmark of MetS, is regarded as an active player in the pathogenesis of MetS-associated cardiovascular disease (CVD). This study was aimed at evaluating the relationship between MetS-induced NASH and penile dysfunction. We used a non-genomic, high fat diet (HFD)-induced, rabbit model of MetS, and treated HFD rabbits with testosterone (T), with the selective farnesoid X receptor (FXR) agonist obeticholic acid (OCA), or with the anti-TNFα mAb infliximab. Rabbits fed a regular diet were used as controls. Liver histomorphological and gene expression analysis demonstrated NASH in HFD rabbits. Several genes related to inflammation (including TNFα), activation of stellate cells, fibrosis, and lipid metabolism parameters were negatively associated to maximal acetylcholine (Ach)-induced relaxation in penis. When all these putative liver determinants of penile Ach responsiveness were tested as covariates in a multivariate model, only the association between hepatic TNFα expression and Ach response was confirmed. Accordingly, circulating levels of TNFα were increased 15-fold in HFD rabbits. T and OCA dosing in HFD rabbits both reduced TNFα liver expression and plasma levels, with a parallel increase of penile eNOS expression and responsiveness to Ach. Also neutralization of TNFα with infliximab treatment fully normalized HFD-induced hypo-responsiveness to Ach, as well as responsiveness to vardenafil, a phosphodiesterase type 5 inhibitor. Thus, MetS-induced NASH in HFD rabbits plays an active role in the pathogenesis of ED, likely through TNFα, as indicated by treatments reducing liver and circulating TNFα levels (T or OCA), or neutralizing TNFα action (infliximab), which significantly improve penile responsiveness to Ach in HFD rabbits. PMID:24486698

  2. The prevalence of erectile dysfunction among subjects with late-onset hypogonadism: a population-based study in China

    Tang, Wen-Hao; Zhuang, Xin-Jie; Shu, Ru-Ming; Guan, Di; Ji, Yu-Dang; Zhang, Bao-Long; Wang, Can-Gang; Zhuang, Li-Hua; Yang, Zhuo; Hong, Kai; Ma, Lu-Lin; Jiang, Hui; Zhou, Shan-Jie; Gu, Yi-Qun

    2015-01-01

    Introduction: The concurrence of chronic diseases and some well-defined risk factors significantly impacts the prevalence of erectile dysfunction (ED). Aim: To determine whether late-onset hypogonadism (LOH) impacts the prevalence of ED using investigation reproductive health data of middle-aged and aging males in China. Methods: The reproductive health status of 1498 males, aged 40-69 years, was evaluated using questionnaires of LOH based on the Androgen Deficiency in Aging Males (ADAM) and Aging Male Symptoms scale (AMS), as well as the International Index of Erectile Function-5 (IIEF-5) assessment. The 10th percentile of serum total testosterone (TT) and calculated free testosterone (cFT) levels of controls were set as cut-off levels of AD. The main outcome measures were used to assess the prevalence of LOH and ED according to different subject characteristics. Results: Of the 1472 subjects who completed the questionnaires who supplied hormone measurements, the prevalence of self-reported ED and identified by the IIEF-5 assessment were 11.28% and 77.85%, respectively. The IIEF-5 assessment revealed a prevalence of ED of 55.34%, 88.20%, and 91.77%, respectively, among those aged 40-49, 50-59, and 60-69 years. AD rates of ED subjects were 13.73% and 40.69% according to the TT and cFT cut-off levels. The prevalence of ED among subjects positive for LOH (ADAM+ and AMS+) were 88.81% and 95.80%, respectively. The prevalence of ED among the AD subjects (TT and cFT cut-off levels) with LOH (ADAM+ and AMS+) were 86.67%/81.82%. And the prevalence of ED among clinical LOH subjects (ADAM+ and AMS+) were 89.51%/98.48%. Conclusions: We found that middle-aged and aging Chinese males were at a relatively high risk of ED. The prevalence of ED among subjects with LOH symptoms was greater than in all recruited subjects. The effect of LOH on the prevalence of ED far outweighed the risk of decreased testosterone levels. PMID:26550346

  3. A Multicenter, Randomized, Open-Labeled, Parallel Group Trial of Sildenafil in Alcohol-Associated Erectile Dysfunction: The Impact on Psychosocial Outcomes

    Alexander Grinshpoon

    2009-09-01

    Full Text Available To examine the effect of sildenafil on erectile dysfunction (ED and psychosocial outcomes in alcohol-dependent (AD men, 108 men with these diagnoses were randomly assigned to either take sildenafil (50 mg as add-on to standard treatment for AD, or the same treatment without sildenafil, for 12 weeks. Only 50 patients in sildenafil group and 51 in control group twice completed the International Index of Erectile Function (IIEF and a battery of self-report questionnaires. IIEF scores and psychosocial functioning, self-esteem and support from friends improved only for sildenafil-treated patients (P < 0.001. The high effect sizes suggest that the observed benefits are unlikely to be a placebo effect, although their unspecific nature could not be ruled out. In men with ED associated with AD, sildenafil improves both ED and psychosocial outcomes. Further placebo-controlled clinical trial is warranted.

  4. AB211. Effect of early chronic low-dose tadalafil administration on erectile dysfunction after cavernous nerve injury in the rat model

    Bian, Jun; Liu, Cundong; Yang, Jiankun; Zhou, Qizhao; Sun, Xiangzhou; Deng, Chunhua

    2016-01-01

    Objective To investigate the effect of early chronic tadalafil administration on erectile dysfunction after cavernous nerve (CN) injury in the rat model. Methods Using the CN crush injury model, animals were divided into four groups: no CN injury (sham), bilateral CN injury exposed to either no tadalafil (control) or tadalafil at a dose (2 mg/kg) daily postoperation for 4 weeks, and normal group. At the time point, we assessed erectile function by apomorphine test, measurement of maximum intracavernosal pressure (ICP)/mean arterial pressure (MAP) ratio with major pelvic ganglion (MPG) electrical stimulation. For the histological analyses, the mid-shaft of penis were harvested. Immunohistochemical antibody staining was performed for nNOS and the numbers of nNOS-positive nerve fibers were recorded. Results Penile erection was observed in 50% (6/12) of the rats for (1.13±0.92) times within 30 min in control group, as compared with 0% (0/11) of the rats for (0.00±0.00) times in CN crush group (P0.05), while ICP/MAP ratio after MPG electrical stimulation of control group was significantly higher than that of CN crush group (P<0.05), but significantly lower than that of sham group (P<0.05) and normal group (P<0.05). The numbers of nNOS-positive nerve fibers was significantly larger in control group than in CN crush group (54.11±5.02 vs. 21.34±3.17, P<0.05), but was significantly smaller than that of sham group (76.48±8.24, P<0.05) and normal group (81.09±7.25, P<0.05). Conclusions Early chronic low-dose tadalafil administration on erectile dysfunction after CN injury contributes to restoration of erectile function.

  5. Human urine-derived stem cells alone or genetically-modified with FGF2 Improve type 2 diabetic erectile dysfunction in a rat model.

    Bin Ouyang

    Full Text Available AIM: The aim of this study was to determine the possibility of improving erectile dysfunction using cell therapy with either human urine-derived stem cells (USCs or USCs genetically-modified with FGF2 in a type 2 diabetic rat model. METHODS: Human USCs were collected from 3 healthy donors. USCs were transfected with FGF2 (USCs-FGF2. Sixty-five SD male rats were divided into five groups (G. A control group of normal rats (G1, n = 10, and four other test groups of type 2 diabetic erectile dysfunction rats: PBS as a negative control (G2, n = 10, USCs (G3, n = 15, lentivirus-FGF2 (G4, n = 15, and USCs-FGF2 (G5, n = 15. Diabetes was induced in the rats via a high fat diet for 28 days and a subsequent intraperitoneal injection of streptozotocin (35 mg/kg. Erectile dysfunction was screened with apomorphine (100 μg/kg. Cell injections in the test groups (G2-G5 occurred directly into the corpora cavernosa. The implanted cells were tracked at 7 days (n = 5 animals/G and 28 days (n = 10 animals/G post injection. Mean arterial pressure (MAP, intracavernosal pressure (ICP, expression of endothelial markers (CD31, VEGF and eNOS, smooth muscle markers (desmin and smoothelin, histological changes and erectile function were assessed for each group. RESULTS: USCs expressed mesenchymal stem cell markers, and secreted a number of proangiogenic growth factors. USCs expressed endothelial cell markers (CD31 and vWF after transfection with FGF2. Implanted USCs or USCs-FGF2 displayed a significantly raised ICP and ICP/MAP ratio (p<0.01 28 days after intracavernous injection. Although few cell were detected within the implanted sites, histological and western blot analysis demonstrated an increased expression of endothelial and smooth muscle markers within the cavernous tissue following USC or USC-FGF2 injection. CONCLUSIONS: The paracrine effect of USCs or USCs-FGF2 induced improvement of erectile function in type 2 diabetic rats by

  6. Indirect comparison of interventions using published randomised trials: systematic review of PDE-5 inhibitors for erectile dysfunction

    McQuay Henry J

    2005-12-01

    Full Text Available Abstract Background There are no randomised and properly blinded trials directly comparing one PDE-5 inhibitor with another in a normal home setting. Valid indirect comparisons with a common comparator must examine equivalent doses, similar duration, similar populations, with the same outcomes reported in the same way. Methods Published randomised, double-blind trials of oral PDE-5 inhibitors for erectile dysfunction were sought from reference lists in previous reviews and electronic searching. Analyses of efficacy and harm were carried out for each treatment, and results compared where there was a common comparator and consistency of outcome reporting, using equivalent doses. Results Analysis was limited by differential reporting of outcomes. Sildenafil trials were clinically and geographically more diverse. Tadalafil and vardenafil trials tended to use enriched enrolment. Using all trials, the three interventions were similar for consistently reported efficacy outcomes. Rates of successful intercourse for sildenafil, tadalafil and vardenafil were 65%, 62%, and 59%, with placebo rates of 23–28%. The rates of improved erections were 76%, 75% and 71%, respectively, with placebo rates of 22–24%, and NNTs of 1.9 or 2.0. Reporting of withdrawals was less consistent, but all-cause withdrawals for sildenafil, tadalafil and vardenafil were 8% 13% and 20%. All three drugs were well tolerated, with headache being the most commonly reported event at 13–17%. There were few serious adverse events. Conclusion There were differences between trials in outcomes reported, limiting comparisons, and the most useful outcomes were not reported. For common outcomes there was similar efficacy between PDE-5 inhibitors.

  7. Phenolic Extract from Moringa oleifera Leaves Inhibits Key Enzymes Linked to Erectile Dysfunction and Oxidative Stress in Rats' Penile Tissues.

    Oboh, Ganiyu; Ademiluyi, Adedayo O; Ademosun, Ayokunle O; Olasehinde, Tosin A; Oyeleye, Sunday I; Boligon, Aline A; Athayde, Margareth L

    2015-01-01

    This study was designed to determine the antioxidant properties and inhibitory effects of extract from Moringa oleifera leaves on angiotensin-I-converting enzyme (ACE) and arginase activities in vitro. The extract was prepared and phenolic (total phenols and flavonoid) contents, radical (nitric oxide (NO), hydroxyl (OH)) scavenging abilities, and Fe(2+)-chelating ability were assessed. Characterization of the phenolic constituents was done via high performance liquid chromatography-diode array detection (HPLC-DAD) analysis. Furthermore, the effects of the extract on Fe(2+)-induced MDA production in rats' penile tissue homogenate as well as its action on ACE and arginase activities were also determined. The extract scavenged NO (∗) , OH (∗) , chelated Fe(2+), and inhibited MDA production in a dose-dependent pattern with IC50 values of 1.36, 0.52, and 0.38 mg/mL and 194.23 µg/mL, respectively. Gallic acid, chlorogenic acid, quercetin, and kaempferol were the most abundant phenolic compounds identified in the leaf extract. The extract also inhibited ACE and arginase activities in a dose-dependent pattern and their IC50 values were 303.03 and 159.59 µg/mL, respectively. The phenolic contents, inhibition of ACE, arginase, and Fe(2+)-induced MDA production, and radical (OH (∗) , NO (∗) ) scavenging and Fe(2+)-chelating abilities could be some of the possible mechanisms by which M. oleifera leaves could be used in the treatment and/or management of erectile dysfunction. PMID:26557995

  8. The value of maximal blood flow volume on duplex ultrasonography for the diagnosis of arteriogenic erectile dysfunction

    Ku, Ja Hyeon [Soonchunhyang University School of Medicine, Chunan (Korea, Republic of); Song, Yun Seob; Kim, Min Eui; Park, Young Ho; Lee, Hye Kyoung [Seoul and Military Manpower Administration, Taejeon (Korea, Republic of)

    2001-03-15

    To evaluate the usefulness of maximal blood flow volume (MBFV) measured by duplex ultrasonography (US) compared with penile tumescence measured by RigiScan in the diagnosis of arteriogenic erectile dysfunction (ED). This study included twenty six patients who performed both RigiScan and duplex US after intracorporeal injection of Prostaglandin EL. We measured tumescences of penile tip and base using RigiScan and maximal arterial diameter (MAD) and peak systolic velocity (PSV) using a 7 MHz color Doppler unit. MBFV was defined as (MAD/2){sup 2} X pi X PSV. Based on normal value, we compared MAD and MBFV, and PSV and MBFV and the correlations of each measurements were evaluated with Spearman's correlation analysis. The level of significance was P<0.05. The results between MAD and MBFV, and PSV ad MBFV based on normal values were similar, respectively. Tumescences of penile tip and base were significantly correlated with MAD (r=0.409, r=0.52, p<0.05), and PSV (r=0.565, r=0.396, p<0.05). MBFV was also significantly correlated with tumescences od penile tip and base (r=0.502, r=0.563, p<0.05). In 4 patients with abnormal MAD and normal PSV, 3 had abnormal MBFV and 1 had normal MBFV. All 3 patients with abnormal MBFV had abnormal penile tumescence and 1 patients with normal MBFV had normal tumescence. One patients with normal MAD and abnormal PSV had abnormal MBFV and penile tumescence. In our study, MBFV was accurate in the diagnosis of arteriogenic ED. Moreover, MBFV was usefulness in the diagnosis of arteriogenic ED as it could explain the case where MAD and PSV are not accoded.

  9. The value of maximal blood flow volume on duplex ultrasonography for the diagnosis of arteriogenic erectile dysfunction

    To evaluate the usefulness of maximal blood flow volume (MBFV) measured by duplex ultrasonography (US) compared with penile tumescence measured by RigiScan in the diagnosis of arteriogenic erectile dysfunction (ED). This study included twenty six patients who performed both RigiScan and duplex US after intracorporeal injection of Prostaglandin EL. We measured tumescences of penile tip and base using RigiScan and maximal arterial diameter (MAD) and peak systolic velocity (PSV) using a 7 MHz color Doppler unit. MBFV was defined as (MAD/2)2 X π X PSV. Based on normal value, we compared MAD and MBFV, and PSV and MBFV and the correlations of each measurements were evaluated with Spearman's correlation analysis. The level of significance was P<0.05. The results between MAD and MBFV, and PSV ad MBFV based on normal values were similar, respectively. Tumescences of penile tip and base were significantly correlated with MAD (r=0.409, r=0.52, p<0.05), and PSV (r=0.565, r=0.396, p<0.05). MBFV was also significantly correlated with tumescences od penile tip and base (r=0.502, r=0.563, p<0.05). In 4 patients with abnormal MAD and normal PSV, 3 had abnormal MBFV and 1 had normal MBFV. All 3 patients with abnormal MBFV had abnormal penile tumescence and 1 patients with normal MBFV had normal tumescence. One patients with normal MAD and abnormal PSV had abnormal MBFV and penile tumescence. In our study, MBFV was accurate in the diagnosis of arteriogenic ED. Moreover, MBFV was usefulness in the diagnosis of arteriogenic ED as it could explain the case where MAD and PSV are not accoded.

  10. Alga Ecklonia bicyclis, Tribulus terrestris, and glucosamine oligosaccharide improve erectile function, sexual quality of life, and ejaculation function in patients with moderate mild-moderate erectile dysfunction: a prospective, randomized, placebo-controlled, single-blinded study.

    Sansalone, Salvatore; Leonardi, Rosario; Antonini, Gabriele; Vitarelli, Antonio; Vespasiani, Giuseppe; Basic, Dragoslav; Morgia, Giuseppe; Cimino, Sebastiano; Russo, Giorgio Ivan

    2014-01-01

    We aimed to evaluate the efficacy of oral therapy with alga Ecklonia bicyclis, Tribulus terrestris, and glucosamine oligosaccharide (Tradamix TX1000) in patients with erectile dysfunction (ED) at 3 months of follow-up. From January 2013 to September 2013, 177 patients diagnosed with mild-moderate ED (IIEF-EF < 26) were enrolled in this multicenter, single-blinded, placebo-controlled study and randomized in Group A (Tradamix, n = 87) and Group B (placebo, n = 90). Penile color Doppler ultrasound measures, IIEF-15 questionnaire, male sexual health questionnaire-ejaculation disorder (MSHQ-EjD), and sexual quality of life (SQoL-M) were collected. We observed significant changes of the IIEF-15 in Group A (mean difference: 11.54; P < 0.05) at 3 months versus Group B (P < 0.05). PSV (P < 0.05), IIEF-intercourse satisfaction (P < 0.05), IIEF-orgasmic function (mean P < 0.05), IIEF-sexual desire (P < 0.05), IIEF-overall satisfaction (P < 0.05), MSHQ-EjD (mean difference: 1.21; P < 0.05), and SQoL-M (mean difference: 10.2; P < 0.05) were significantly changed in Group A versus baseline and Group B. Patients with moderate arterial dysfunction showed significant increase of PSV (P < 0.05), IIEF-EF (P < 0.05), MSHQ-EjD (P < 0.05), and SQoL-M (P < 0.05) in Group A. Therapy with Tradamix improves erectile and ejaculation function and sexual quality of life in patients with mild-moderate ED and in particular for those with moderate arterial dysfunction. PMID:25136552

  11. Alga Ecklonia bicyclis, Tribulus terrestris, and Glucosamine Oligosaccharide Improve Erectile Function, Sexual Quality of Life, and Ejaculation Function in Patients with Moderate Mild-Moderate Erectile Dysfunction: A Prospective, Randomized, Placebo-Controlled, Single-Blinded Study

    Sansalone, Salvatore; Leonardi, Rosario; Antonini, Gabriele; Vitarelli, Antonio; Vespasiani, Giuseppe

    2014-01-01

    We aimed to evaluate the efficacy of oral therapy with alga Ecklonia bicyclis, Tribulus terrestris, and glucosamine oligosaccharide (Tradamix TX1000) in patients with erectile dysfunction (ED) at 3 months of follow-up. From January 2013 to September 2013, 177 patients diagnosed with mild-moderate ED (IIEF-EF < 26) were enrolled in this multicenter, single-blinded, placebo-controlled study and randomized in Group A (Tradamix, n = 87) and Group B (placebo, n = 90). Penile color Doppler ultrasound measures, IIEF-15 questionnaire, male sexual health questionnaire-ejaculation disorder (MSHQ-EjD), and sexual quality of life (SQoL-M) were collected. We observed significant changes of the IIEF-15 in Group A (mean difference: 11.54; P < 0.05) at 3 months versus Group B (P < 0.05). PSV (P < 0.05), IIEF-intercourse satisfaction (P < 0.05), IIEF-orgasmic function (mean P < 0.05), IIEF-sexual desire (P < 0.05), IIEF-overall satisfaction (P < 0.05), MSHQ-EjD (mean difference: 1.21; P < 0.05), and SQoL-M (mean difference: 10.2; P < 0.05) were significantly changed in Group A versus baseline and Group B. Patients with moderate arterial dysfunction showed significant increase of PSV (P < 0.05), IIEF-EF (P < 0.05), MSHQ-EjD (P < 0.05), and SQoL-M (P < 0.05) in Group A. Therapy with Tradamix improves erectile and ejaculation function and sexual quality of life in patients with mild-moderate ED and in particular for those with moderate arterial dysfunction. PMID:25136552

  12. Alga Ecklonia bicyclis, Tribulus terrestris, and Glucosamine Oligosaccharide Improve Erectile Function, Sexual Quality of Life, and Ejaculation Function in Patients with Moderate Mild-Moderate Erectile Dysfunction: A Prospective, Randomized, Placebo-Controlled, Single-Blinded Study

    Salvatore Sansalone

    2014-01-01

    Full Text Available We aimed to evaluate the efficacy of oral therapy with alga Ecklonia bicyclis, Tribulus terrestris, and glucosamine oligosaccharide (Tradamix TX1000 in patients with erectile dysfunction (ED at 3 months of follow-up. From January 2013 to September 2013, 177 patients diagnosed with mild-moderate ED (IIEF-EF < 26 were enrolled in this multicenter, single-blinded, placebo-controlled study and randomized in Group A (Tradamix, n=87 and Group B (placebo, n=90. Penile color Doppler ultrasound measures, IIEF-15 questionnaire, male sexual health questionnaire-ejaculation disorder (MSHQ-EjD, and sexual quality of life (SQoL-M were collected. We observed significant changes of the IIEF-15 in Group A (mean difference: 11.54; P<0.05 at 3 months versus Group B (P<0.05. PSV (P<0.05, IIEF-intercourse satisfaction (P<0.05, IIEF-orgasmic function (mean P<0.05, IIEF-sexual desire (P<0.05, IIEF-overall satisfaction (P<0.05, MSHQ-EjD (mean difference: 1.21; P<0.05, and SQoL-M (mean difference: 10.2; P<0.05 were significantly changed in Group A versus baseline and Group B. Patients with moderate arterial dysfunction showed significant increase of PSV (P<0.05, IIEF-EF (P<0.05, MSHQ-EjD (P<0.05, and SQoL-M (P<0.05 in Group A. Therapy with Tradamix improves erectile and ejaculation function and sexual quality of life in patients with mild-moderate ED and in particular for those with moderate arterial dysfunction.

  13. Randomised, placebo-controlled, crossover trial of sildenafil citrate in the treatment of erectile dysfunction following external beam radiation treatment of prostate cancer

    Erectile dysfunction (ED) commonly affects the quality of life of men after treatment of prostate cancer. We conducted a placebo-controlled, crossover randomised trial to assess the efficacy and tolerability of sildenafil citrate in the treatment of ED developing after external beam radiation treatment (EBRT) of localized prostate cancer. Sixty-six patients who had developed ED following radiation treatment agreed to participate and were allocated to sildenafil or placebo to be taken prior to four sexual attempts. In the crossover period, subjects received the alternative tablet for a further four attempts. Allocation was centrally randomized, and researchers and patients were both blinded to the trial arm. Efficacy was assessed using the International Index of Erectile Function (IIEF) questionnaire and with a separate global efficacy question. Forty-three subjects completed the study. There was a significant increase in mean scores from baseline for all domains of the IIEF with sildenafil compared with placebo (P < 0.001). Affirmative response to the global efficacy question was more common after taking sildenafil compared with placebo. In approximately half of the patients, the improvement in the erectile function domain score corresponded to a moderate improvement in ED (e.g. success ‘sometimes’ to ‘most times’). Sildenafil was associated with mild flushing, nasal stuffiness or indigestion in 8–10% patients and moderate flushing in 10%. The current study adds to the evidence that phosphodiesterase inhibitors are an effective and well-tolerated treatment for ED after EBRT for prostate cancer.

  14. Erectile dysfunction in 1050 men following extended (18 cores) vs saturation (28 cores) vs saturation plus MRI-targeted prostate biopsy (32 cores).

    Pepe, P; Pennisi, M

    2016-01-01

    Erectile dysfunction (ED) following transperineal prostate biopsy (TPB) was prospectively evaluated. From January 2011 to January 2014, 1050 patients were submitted to TPB: 18 core (extended TPB) in 610 cases, 28 core (saturation TPB) in 360 cases and 32 core (saturation plus magnetic resonance imaging (MRI) targeted TPB) in 210 cases. The indications for biopsy were increasing prostate-specific antigen (PSA) or PSA>10 ng ml(-1). All patients were prospectively evaluated with the 5-item version of the International Index of Erectile Function (IIEF-5) at time zero and at 1, 3 and 6 months from TPB. Prostate cancer was diagnosed in 385/1050 (36.6%) patients; 560 men (350 vs 110 vs 100) having benign histology and normal sexual activity also completed the study. Overall, IEEF-5 score at time zero and at 1, 3 and 6 months did not significantly worsen (P>0.05); in detail, at 1 month from biopsy 15 extended TPB (4.2%) vs 7 saturation TPB (6.4%) vs 7 saturation plus MRI targeted TPB (7%) men referred mild ED that disappeared after 3 months. Irrespective of method (18 vs 28 vs 32 core) TPB did not significantly worsen erectile function at 3-6 months from the procedure. PMID:26289906

  15. Comparison of the efficacy and safety of once-daily dosing and on-demand use of udenafil for type 2 diabetic patients with erectile dysfunction

    Soon Hyun Park; Sung Woo Park; Bong Yun Cha; Ie Byung Park; Kyung Wan Min; Yeon Ah Sung; Tae Hwa Kim; Jae Min Lee; Kang Seo Park

    2015-01-01

    We compared the efficacy and safety between once-daily dosing and on-demand use of udenafil for type 2 diabetic patients with erectile dysfunction (ED). A multi-center, randomized, open-label, parallel-group, 12-week study was conducted. 161 patients who improved with on-demand 200 mg of udenafil according to Sexual Encounter Profile (SEP) diary Question 2 and 3 (Q2 and Q3) were randomized into 200 mg on-demand (n = 80) or 50 mg once-daily (n = 81) dosing groups for 8 weeks. The dosing period...

  16. PDE-5 inhibitors in monotherapy versus combination therapy in a sample of 1200 patients with erectile dysfunction

    Luis Labairu-Huerta

    2015-09-01

    Full Text Available Objectives: To compare the effectiveness in the treatment of erectile dysfunction when using PDE-5 inhibitors (PDE5i, alprostadil (PG-E1 and testosterone (TES in monotherapy or combination therapy. Material and Methods: Observational multicentre retrospective study of men diagnosed and treated for ED between January 2008 and January 2014. Age, social and employment situation, pathological medical history, risk factors, usual treatments, IIEF-5 at the first consultation and at first and each 6 months follow-ups, physical examination, calculated total and free testosterone and received treatment were analysed. Descriptive statistics, one-way ANOVA analysis, Chi2 for qualitative data, t-test, Fisher's exact test and Pearson's correlation coefficient were used; p < 0.05 is considered significant. Results: Average age was 58.61 years, SD5.02, average follow- up time 48.21 months, SD 6.21, range 6-174 months. Out of the patients 76.12% were married, 9.81% divorced/separated, 10.04% single, 4.03% widowed; 85.14% of the total in stable partnership but 66.16% were not accompanied by their partners. In total 844 patients received monotherapy (597 PDE5i; 62 PG-E1; 36 TES; 27 penile prosthesis; 121 psychotherapy/alternative therapies and 357 combination therapy (167 PDE5i+TES; 124 PDE5i+PGE1; 66 PG-E1+TES. There was a homogeneous distribution between risk factors and medical history groups. Satisfactory response according to IIEF-5 was achieved for 72.33% of patients on PDE5i monotherapy, 46.65% of patients on PDE5i+PG-E1 combination therapy and 83.41% of patients on PDE5i+TES. Conclusions: The best therapeutic success for ED in this series was achieved through a combination of testosterone+PDE-5 inhibitors without increasing morbidity and maintaining the response over time. Larger studies with longer follow-up will corroborate these findings.

  17. Influence of erectile dysfunction course on its progress and efficacy of treatment with phosphodiesterase type 5 inhibitors

    LIU De-feng; JIANG Hui; HONG Kai; ZHAO Lian-ming; TANG Wen-hao; MA Lu-lin

    2010-01-01

    Background Erectile dysfunction (ED) is a common impairment among older men, and the prevalence rates increase sharply after age of 60 years. Most studies have focused on the prevalence rate or dangerouse factors. The aim of this study was to investigate the basic epidemiologic data about ED patients with different ED courses. The purpose of this researth was to understand the therapeutic effect of phosphodiesterase type 5 inhibitor (PDE5-1) and see how and why the ED course impact the progress of ED and the therapeutic effect of PDE5-1 treatment.Methods From June 2008 to June 2009, 4252 questionnaires (Quality of Erection Questionnaire, QEQ) were gathered from 46 centers by urology or andrology doctors all around China. Patients with ED (age > 20 years) filled in first half of the questionnaires when they came for the first time, and then completed the second half 4 weeks after PDE5-1 therapy.Results ED courses of most patients were less than 5 years (<5 years, 74.0%; 5-10 years 20.8%; >10 years, 5.2%). As ED course increasing, the incidence of the risk factors of ED, such as smoking, drinking, hypertension, diabetes, heart disease and hyperlipidemia also increase (P ≤0.01). PDE5-1 was effective in improving the quality of sexual activities (P ≤0.01). Administration of PDE5-1 improves satisfaction, enjoyment and frequency of sexual activities. The longer the ED course, the worse the therapeutic effect (<5 years, 96.1%; 5-10 years, 94.9%; >10 years, 89.0%) (P<0.01).Conclusions The ED course greatly affected the therapeutic effect of PDE5-1, the patients with ED should consult doctor at early stage of the disease. Admistration of PDE5-1 effectively improves the penile erection and the quality of sexual life of the patients hence should be considered as first-line medicine in the treatment of ED.

  18. Erectile function and risk of Parkinson's disease.

    Gao, Xiang; Chen, Honglei; Schwarzschild, Michael A; Glasser, Dale B; Logroscino, Giancarlo; Rimm, Eric B; Ascherio, Alberto

    2007-12-15

    Erectile dysfunction is common among individuals with Parkinson's disease, but it is unknown whether it precedes the onset of the classic features of Parkinson's disease. To address this question, the authors examined whether erectile dysfunction was associated with Parkinson's disease risk in the Health Professionals Follow-up Study. Analyses included 32,616 men free of Parkinson's disease at baseline in 1986 who in 2000 completed a retrospective questionnaire with questions on erectile dysfunction in different time periods. Relative risks were computed using Cox proportional hazards models adjusting for age, smoking, caffeine intake, history of diabetes, and other covariates. Among men who reported their erectile function before 1986, 200 were diagnosed with Parkinson's disease during 1986-2002. Men with erectile dysfunction before 1986 were 3.8 times more likely to develop Parkinson's disease during the follow-up than were those with very good erectile function (relative risk = 3.8, 95% confidence interval: 2.4, 6.0; p disease were 2.7, 3.7, and 4.0 (95% confidence interval: 1.4, 11.1; p = 0.008) for participants with first onset of erectile dysfunction (before 1986) at 60 or more, 50-59, and less than 50 years of age, respectively, relative to those without erectile dysfunction. In conclusion, in this retrospective analysis in a large cohort of men, the authors observed that erectile dysfunction was associated with a higher risk of developing Parkinson's disease. PMID:17875583

  19. Erectile Dysfunction and Diabetes

    > Find Us On Facebook Twitter Pinterest Youtube Instagram Diabetes Stops Here Blog Online Community Site Menu Are You at Risk? Diagnosis Lower Your Risk Risk Test Alert Day Prediabetes My Health Advisor Tools to ...

  20. Hyperlipidemia and erectile dysfunction

    Sae-ChulKim

    2000-01-01

    We have done consecutive studies to investigate the effects of impaired lipid metabolism on the contractile and relaxation response of cavernous smooth muscles and to elucidate its pathogenesis: 1 ) incidence of hyperlipidemia in impotent patients; 2) erection response to intmcavemous injection of papaverine in impotent patients with hyperlipidemia; 3) relaxation responses of isolated cavemosal smooth muscles to endothelium-independent and endothelium-dependent vasodilators in impotent patients with hypercholesterolemia or hypertriglyceridemia; 4) involvement of superoxide radical in the impaired endothelium-dependent relaxation of cavernous smooth muscle in hypercholesterolemic rabbits; 5) effects of isolated lipoproteins and triglyceride, combined oxidized LDL plus triglyceride, and combined oxidized LDL plus HDL on contractile and relaxation response of rabbit cavernous smooth muscles; 6) involvement of e-NOS in the impaired endothelium-dependent relaxation of cavernous smooth muscle in hypercholesterolemic rabbit. Hypercholesterolemia may cause impairment of endothelium-dependent relaxation. Oxidized LDL is the major causative cholesterol of the impaired relaxation response. A chain reaction, the production of superoxide radicals and functional impairment of eNOS may be a major cause of the functional impairment in the early stages of hypercholesterolemia.

  1. Correction of diabetic erectile dysfunction with adipose derived stem cells modified with the vascular endothelial growth factor gene in a rodent diabetic model.

    Guihua Liu

    Full Text Available The aim of this study was to determine whether adipose derived stem cells (ADSCs expressing vascular endothelial growth factor (VEGF gene can improve endothelial function, recover the impaired VEGF signaling pathway and enhance smooth muscle contents in a rat diabetic erectile dysfunction (DED model. DED rats were induced via intraperitoneal injection of streptozotocin (40 mg/kg, and then screened by apomorphine (100 µg/kg. Five groups were used (n = 12/group-Group 1 (G1: intracavernous injection of lentivirus-VEGF; G2: ADSCs injection; G3: VEGF-expressing ADSCs injection; G4: Phosphate buffered saline injection; G1-G4 were DED rats; G5: normal rats. The mean arterial pressure (MAP and intracavernosal pressure (ICP were measured at days 7 and 28 after the injections. The components of the VEGF system, endothelial, smooth muscle, pericytes markers in cavernoursal tissue were assessed. On day 28 after injection, the group with intracavernosum injection of ADSCs expressing VEGF displayed more efficiently and significantly raised ICP and ICP/MAP (p<0.01 than those with ADSCs or lentivirus-VEGF injection. Western blot and immunofluorescent analysis demonstrated that improved erectile function by ADSCs-VEGF was associated with increased expression of endothelial markers (VEGF, VEGF R1, VEGF R2, eNOS, CD31 and vWF, smooth muscle markers (a-actin and smoothelin, and pericyte markers (CD146 and NG2. ADSCs expressing VEGF produced a therapeutic effect and restored erectile function in diabetic rats by enhancing VEGF-stimulated endothelial function and increasing the contents of smooth muscle and pericytes.

  2. There Is No Correlation Between Erectile Dysfunction and Dose to Penile Bulb and Neurovascular Bundles Following Real-Time Low-Dose-Rate Prostate Brachytherapy

    Purpose: We evaluated the relationship between the onset of erectile dysfunction and dose to the penile bulb and neurovascular bundles (NVBs) after real-time ultrasound-guided prostate brachytherapy. Methods and Materials: One hundred forty-seven patients who underwent prostate brachytherapy met the following eligibility criteria: (1) treatment with 125I brachytherapy to a prescribed dose of 160 Gy with or without hormones without supplemental external beam radiation therapy, (2) identification as potent before the time of implantation based on a score of 2 or higher on the physician-assigned Mount Sinai Erectile Function Score and a score of 16 or higher on the abbreviated International Index of Erectile Function patient assessment, and (3) minimum follow-up of 12 months. Median follow-up was 25.7 months (range, 12-47 months). Results: The 3-year actuarial rate of impotence was 23% (34 of 147 patients). An additional 43% of potent patients (49 of 113 patients) were using a potency aid at last follow-up. The penile bulb volume receiving 100% of the prescription dose (V100) ranged from 0-0.05 cc (median, 0 cc), with a dose to the hottest 5% (D5) range of 12.5-97.9 Gy (median, 40.8 Gy). There was no correlation between penile bulb D5 or V100 and postimplantation impotency on actuarial analysis. For the combined right and left NVB structures, V100 range was 0.3-5.1 cc (median, 1.8 cc), and V150 range was 0-1.5 cc (median, 0.31 cc). There was no association between NVB V100 or V150 and postimplantation impotency on actuarial analysis. Conclusion: Penile bulb doses are low after real-time ultrasound-guided prostate brachytherapy. We found no correlation between dose to either the penile bulb or NVBs and the development of postimplantation impotency.

  3. A meta-regression evaluating the effectiveness and prognostic factors of oral phosphodiesterase type 5 inhibitors for the treatment of erectile dysfunction

    Jin-Qiu Yuan

    2016-01-01

    Full Text Available The effectiveness of phosphodiesterase type 5 inhibitors (PDE5-Is for erectile dysfunction (ED varies considerably among trials, but available studies investigating the factors that affect the effectiveness are few and findings are not consistent. A systematic search was performed in PubMed, Cochrane Library, and EMBASE to identify randomized controlled trials comparing PDE5-Is with placebo for the treatment of ED. The methodological quality of included studies was assessed by the Cochrane Collaboration′s tool for assessing risk of bias. The associations between prespecified study-level factors and effectiveness were tested by a random effects meta-regression model. This study included 93 trials with 26 139 patients. When all PDE5-Is were grouped together, Caucasian ethnicity was associated with 15.636% (95% confidence interval [CI]: 0.858% to 32.579% increase in risk ratio (RR for Global Assessment Questionnaire question-1 (GAQ-1, and 1.473 (95% CI: 0.406 to 2.338 score increase in mean difference (MD for posttreatment International Index of Erectile Function-Erectile Function domain score (IIEF-EF, compared to Asian ethnicity. A one-score increase in baseline IIEF-EF was associated with −5.635% (95% CI: −9.120% to −2.017% reduction in RR for GAQ-1, and −0.229 (95% CI: −0.425 to −0.042 score decrease in MD for posttreatment IIEF-EF. In conclusion, PDE5-Is are more effective in Caucasians than Asians, and in patients with more severe ED.

  4. Modifiable risk factors for erectile dysfunction: an assessment of the awareness of such factors in patients suffering from ischaemic heart disease.

    Kałka, D; Domagała, Z; Rakowska, A; Womperski, K; Franke, R; Sylwina-Krauz, E; Stanisz, J; Piłot, M; Gebala, J; Rusiecki, L; Pilecki, W

    2016-01-01

    Up to 40% of cases of erectile dysfunction (ED) originate from vascular disturbances associated with atherosclerotic disease, leading to the previously proven concomitance between ischaemic heart disease (IHD) and ED. The aim of this study was to evaluate patients' knowledge about modifiable risk factors for ED. The evaluated group of patients was composed of 502 male patients undergoing cardiac rehabilitation and receiving treatment for IHD. The patients' knowledge of risk factors for ED linked to IHD was assessed with an original survey. The presence of ED was assessed using an abridged version of the International Index of Erectile Function-5 questionnaire. Increase in leisure-time physical activity was estimated using a leaflet based on the Framingham questionnaire. In all, 189 participants were unable to name any modifiable ED risk factors, and only 31 patients knew all 6 of them. The most frequently mentioned ED risk factor was smoking, whereas the least frequently mentioned was sedentary lifestyle. Awareness of smoking as an ED risk factor was closely related to the patients' level of education, place of residence, smoking and underlying ED in the individual patient. The ability to classify diabetes as a risk factor for ED was significantly related to the patients' level of education, place of residence, and the prevalence of diabetes in the evaluated group of respondents. The same relations were observed regarding hyperlipidaemia. Awareness of the negative impact a sedentary lifestyle has on the erectile process was found to be closely related to the patients' age, as well as their level of education. The performed study demonstrates the poor knowledge of IHD patients about the modifiable risk factors for ED. The factor that patients are the least aware of is sedentary lifestyle, which, simultaneously, is the risk factor that most frequently affects the respondents. PMID:26631924

  5. Efficacy and safety of phosphodiesterase type 5 (PDE5) inhibitors in treating erectile dysfunction after bilateral nerve-sparing radical prostatectomy.

    Cui, Y; Liu, X; Shi, L; Gao, Z

    2016-02-01

    We carried out a systematic review and meta-analysis to assess the efficacy and safety of phosphodiesterase type 5 (PDE5) inhibitors for treating erectile dysfunction (ED) after bilateral nerve-sparing radical prostatectomy (BNSRP). A literature review was performed to identify all published randomised double-blind, placebo-controlled trials of PDE5 inhibitors for the treatment of ED after BNSRP. The search included the following databases: MEDLINE, EMBASE and the Cochrane Controlled Trials Register. The reference lists of the retrieved studies were also investigated. Six publications involving a total of 1678 patients were used in the analysis, including six RCTs that compared PDE5 inhibitors (tadalafil, sildenafil, avanafil and vardenafil) with placebo. Co-primary efficacy end points: International Index of Erectile Function-Erectile Function (IIEF-EF) domain score [the standardised mean difference (SMD) = 4.04, 95% confidence interval (CI) = 2.87-5.22, P < 0.00001]; successful vaginal penetration (SEP2) [the odds ratio (OR) = 14.87, 95%CI = 4.57-48.37, P < 0.00001]; and successful intercourse (SEP3) (OR = 47, 95%CI = 3-13.98, P < 0.00001) indicated that PDE5 inhibitors was more effective than the placebo. Specific adverse events with PDE5 inhibitors included headache (12.08%), dyspepsia (6.76%) and flushing (6.52%), which were significantly less likely to occur with placebo. This meta-analysis indicates that PDE5 inhibitors to be an effective and well-tolerated treatment for ED after BNSRP. PMID:25684196

  6. Radiation dose delivered to the proximal penis as a predictor of the risk of erectile dysfunction after three-dimensional conformal radiotherapy for localized prostate cancer

    Purpose/objective: In this study, we evaluated in a serial manner whether radiation dose to the bulb of the penis is predictive of erectile dysfunction, ejaculatory difficulty (EJ), and overall satisfaction with sex life (quality of life) by using serial validated self-administered questionnaires. Methods and materials: Twenty-nine potent men with AJCC Stage II prostate cancer treated with three-dimensional conformal radiation therapy alone to a median dose 72.0 Gy (range: 66.6-79.2 Gy) were evaluated by determining the doses received by the penile bulb. The penile bulb was delineated volumetrically, and the dose-volume histogram was obtained on each patient. Results: The median follow-up time was 35 months (range, 16-43 months). We found that for D30, D45, D60, and D75 (doses to a percent volume of PB: 30%, 45%, 60%, and 75%), higher than the corresponding median dose (defined as high-dose group) correlated with an increased risk of impotence (erectile dysfunction firmness score = 0) (odds ratio [OR] = 7.5, p = 0.02; OR = 7.5, p = 0.02; OR = 8.6, p = 0.008; and OR = 6.9, p = 0.015, respectively). Similarly, for EJD D30, D45, D60, and D75, doses higher than the corresponding median ones correlated with worsening ejaculatory function score (EJ = 0 or 1) (OR = 8, p = 0.013; OR = 8, p 0.013; OR = 9.2, p = 0.015; and OR = 8, p = 0.026, respectively). For quality of life, low (≤median dose) dose groups of patients improve over time, whereas high-dose groups of patients worsen. Conclusions: This study supports the existence of a penile bulb dose-volume relationship underlying the development of radiation-induced erectile dysfunction. Our data may guide the use of inverse treatment planning to maximize the probability of maintaining sexual potency after radiation therapy

  7. Effect of weight loss on thiazide produced erectile problems in men.

    Langford, H. G.; Rockhold, R. W.; Wassertheil-Smoller, S.; Oberman, A.; Davis, B R; Blaufox, M. D.

    1990-01-01

    Thiazide-type diuretics frequently produce erectile dysfunction in men on a regular diet. However, men on a weight-loss diet have much less erectile dysfunction. Thiazide-type diuretics also produce erectile dysfunction in rats and interfere with normal copulation. The mechanism of the dysfunction and the favorable response to weight loss is unknown.

  8. Oral sildenafil (Viagra™ in male erectile dysfunction: use, efficacy and safety profile in an unselected cohort presenting to a British district general hospital.

    Boustead Gregory

    2002-04-01

    Full Text Available Abstract Introduction Sildenafil (Viagra® is one of the drugs used in the first line therapy of male erectile dysfunction (MED. We have recorded outcomes, adverse events and acceptability of Sildenafil (Viagra therapy in an unselected group of men presenting with ED to a British district general hospital. Methods In this prospective observational study, 147 men with ED were seen since Oct 1999. Study patients were reviewed at 4, 12 and 52 weeks. All the patients filled the International Index of Erectile Function (IIEF questionnaire and were asked about their willingness to pay (WTP for treatment. Results All suitable men accepted Viagra as first line therapy. 91% of our patients found sildenafil treatment successful. 80% of these patients were willing to continue with sildenafil therapy. Side effect profile of sildenafil was different in this study with much higher incidence of headache, dyspepsia, flushing and abnormal vision. 92% of men with ED expect to be treated by the NHS. Of those men eligible for treatment in the NHS, 30% qualify under the clinical categories and 18% under the 'distress' category. Only 55% of those with cardiovascular risk factors qualify for NHS treatment. Conclusions Sildenafil is widely accepted as first line therapy among British men with ED and has a success rate of 91%. Nearly half of men with ED qualify for NHS treatment. Nearly half of those with vascular risk factors do not qualify for NHS treatment. Most men with ED could possibly be managed in primary care.

  9. Lead acetate may cause erectile dysfunction by modulating NO/cGMP pathway in rat corpus cavernosum.

    Senbel, Amira M; Helmy, Mai M

    2013-10-01

    Despite the fact that metal toxicity has been widely reported in industrial toxicological studies, very little has been reported about the effect of lead exposure on erectile function. This study investigated the effect of lead on erectile function in rats and aimed to preliminarily test the mechanisms by which it might affect erection. Rats were injected with lead acetate (0.25-2 mg/kg) intraperitoneally for 21 days. Intracavernosal pressure/mean arterial pressure (ICP/MAP) next to nerve stimulation; nitrite/nitrate; malonaldehyde; and reduced glutathione levels and superoxide dismutase activity in the corpus cavernosum, kidney, and brain were measured in addition to creatinine, urea, and testosterone. For acute studies, rats were injected intravenously with lead acetate, and then ICP/MAP was recorded for 45 min. Subacute treatment significantly reduced erection with significant elevation of malonaldehyde and reduction of nitrite/nitrate levels in the corpus cavernosum. In acute studies, lead (2 and 5 mg/kg) reduced neurogenic erections by 28.42 ± 3.76 and 96.84 ± 8.52%, respectively, an effect that was masked in the presence of NG-nitro-L-arginine, tetraethyl ammonium, or methylene blue, but not zinc protoporphyrine, and reversed by vitamin C and partially by sildenafil. Lead acetate may inhibit the erectile process in rats. Besides its prooxidant effect and consequent inactivation of nitric oxide, lead may negatively modulate the action of nitric oxide on guanylate cyclase and potassium channels. PMID:23979109

  10. A STUDY ON THE EVALUATION OF EFFICACY AND SAFETY OF A MULTIHERBAL PREPARATION (ANDROMET IN ERECTILE DYSFUNCTION (ED: A RANDOMISED PLACEBO CONTROLLED TRIAL

    Adhikari Anjan

    2011-05-01

    Full Text Available Erectile Dysfunction (ED is a common problem with various aetiology. Recent advance discovered many drugs with specific mechanism of action. But till now there is no drug or medicine which is therapeutically successful. In Ayurveda, there was many formulations which can be tried on patients of ED. Present study is a double blind controlled randomised trial of efficacy and safety of a multiherbal preparation on ED. 35 patient of ED completed treatment with the multiherbal preparation (Andromet TM compared with 15 patient of ED completed treatment with identical looking placebo as control. Results showed significant improvement in ED amongst the patients treated with multiherbal preparation (Andromet in comparison with placebo treated group.

  11. Adulterated and Counterfeit Male Enhancement Nutraceuticals and Dietary Supplements Pose a Real Threat to the Management of Erectile Dysfunction: A Global Perspective.

    ElAmrawy, Fatema; ElAgouri, Ghada; Elnoweam, Ola; Aboelazayem, Samar; Farouk, ElMohanad; Nounou, Mohamed I

    2016-11-01

    Erectile dysfunction prevalence globally is noticeably high. This is accompanied by an increase in the use of nutraceuticals for male enhancement. However, the global market is invaded by counterfeit and adulterated nutraceuticals claimed to be of natural origin sold with a therapeutic claim. The objective of this article is to review male enhancement nutraceuticals worldwide with respect to claim, adulterants, and safety. The definition of such products is variable across countries. Thus, the registration procedures differ as well. This facilitates the manipulation of the process, which leads to widespread adulterated and counterfeit products without control. The tele-advertisement and Internet pharmacies aided the widespread sale of male enhancement nutraceuticals, unfortunately, the spurious ones. Finally, based on literature, most of these products were found to be adulterated with active pharmaceutical ingredients (API) and mislabeled as being natural. These products represent a major health hazard for consumers due to lack of clear regulations. PMID:26913542

  12. Prevalence, psychological impact, and risk factors of erectile dysfunction in patients with Peyronie’s disease: a retrospective analysis of 309 cases

    Paulis G

    2016-07-01

    Full Text Available Gianni Paulis,1,2 Gennaro Romano,3 Andrea Paulis4 1Department of Surgical Sciences, Andrology Center, Regina Apostolorum Hospital, Albano L., Italy; 2Department of Uro-Andrology, Peyronie’s Disease Care Center, Rome, Italy; 3Department of Urologic Oncology, Section of Avellino, Italian League Against Cancer, Avellino, Italy; 4Section of Psycho-Sexology, Peyronie’s Disease Care Center, Rome, Italy Abstract: Peyronie’s disease (PD is a chronic inflammatory disease involving the tunica albuginea of the penis. Erectile dysfunction (ED is a possible invalidating symptom of PD. The aim of this study was to evaluate the prevalence, psychological impact, and risk factors of ED in patients with PD. The study was conducted by carrying out a retrospective analysis of the clinical records of 309 patients with PD who visited our andrology clinic. All patients underwent the following tests: body mass index, common blood tests and hormone assays, questionnaire for erectile function assessment, dynamic penile color Doppler ultrasonography, imaging of the penis at maximum erection with photographic poses according to Kelâmi, psychosexual impact evaluation with PD Questionnaire (symptom bother score, evaluation of depression symptoms with the Patient Health Questionnaire-9, and evaluation of the intensity of penile pain with the pain intensity numeric rating scale. ED was observed in 37.5% of the cases. We divided the cases into two groups: group A (PD + ED, 116 cases, and group B (PD without ED, 193 cases. After multivariate analysis, we concluded that the following comorbidities are independent risk factors for ED: dyslipidemia, obesity, chronic prostatitis, benign prostatic hyperplasia, and autoimmune diseases. A depressive disorder was observed in 62.4%, and it was more frequent in patients with PD + ED (91.37% versus 45.07% group B. Sexual bother was greater in group A compared with group B (9.7 versus 7.6. Intensities of depressive symptoms and

  13. Prevalence and predictors of concomitant low sexual desire/interest and new-onset erectile dysfunction - a picture from the everyday clinical practice.

    Salonia, A; Clementi, M C; Ventimiglia, E; Colicchia, M; Capogrosso, P; Castiglione, F; Castagna, G; Boeri, L; Suardi, N; Cantiello, F; Damiano, R; Montorsi, F

    2014-09-01

    Prevalence and risk factors of concomitant primary low sexual desire/interest (LSD/I) and subsequent new-onset erectile dysfunction (ED) in men have been only partially investigated. We looked at the sociodemographic and clinical predictors of the concomitant condition of primary LSD/I - defined as the reduction in the usual level of SD/I which precedes ED or another sexual dysfunction - and new-onset ED (LSD/I + ED) in a cohort of consecutive Caucasian-European patients seeking their first medical help for sexual dysfunction at a single outpatient clinic in the everyday clinical practice setting. Data from 439 sexually active patients were analysed. Health-significant comorbidities were scored with the Charlson Comorbidity Index (CCI). Patients' LSD/I were evaluated according to the findings of a comprehensive sexual history. Moreover, patients completed the International Index of Erectile Function (IIEF). Descriptive statistics and logistic regression models tested the prevalence and predictors of LSD/I + ED as compared with ED only. Of the 439 men, LSD/I + ED was observed in 33 (4.2%) individuals. One of three men with LSD/I + ED was younger than 40 years. Patients complaining of LSD/I + ED or ED alone did not differ in terms of hormonal milieu. No significant differences emerged between groups in terms of sexual orientation, rates of stable sexual relationships, educational status, recreational habits and comorbid sexual dysfunctions. Patients with LSD/I + ED had significantly lower IIEF-sexual desire and IIEF-overall satisfaction scores than ED-only individuals (all p ≤ 0.003). At multivariable analysis younger age and severe CCI scores emerged as independent predictors of LSD/I + ED (all p ≤ 0.04). These findings showed that primary LSD/I is concomitant with new-onset ED in less than 5% of men seeking first medical help. Younger age and severe CCI emerged as independent predictors of LSD/I + ED. Patients with both conditions reported an impaired overall

  14. A randomized, double-blind, placebo-controlled, cross-over study to assess the efficacy of tadalafil (Cialis[reg]) in the treatment of erectile dysfunction following three-dimensional conformal external-beam radiotherapy for prostatic carcinoma

    Purpose: Erectile dysfunction after three-dimensional conformal external-beam radiotherapy (3DCRT) for prostatic carcinoma is reported in as many as 64% of those patients. The purpose of this study was to determine the efficacy of the oral drug tadalafil (Cialis (registered) ) in patients with erectile dysfunction after radiotherapy for prostatic carcinoma. Methods and Materials: Patients (N = 358) who completed radiotherapy at least 12 months before the study were approached by mail. All patients had been treated by 3DCRT; 60 patients were included and entered a double-blind, placebo-controlled, cross-over study lasting 12 weeks. They received 20 mg of tadalafil or placebo for 6 weeks. Drug or placebo was taken on demand at patient's discretion, with no restrictions regarding the consumption of alcohol or food, at least once a week and no more than once daily. At 6 weeks patients crossed over to the alternative treatment. Data were collected using the Sexual Encounter Profile (SEP) and the International Index of Erectile Function (IIEF) questionnaires. Side effects were also recorded. Results: Mean age at study entry was 69 years. All patients completed the study. For almost all questions of the IIEF questionnaire there was a significant increase in mean scores from baseline with tadalafil, but not with placebo. Sixty-seven percent of the patients reported an improvement of erectile function with tadalafil (placebo: 20%), and 48% reported successful intercourse with tadalafil (placebo: 9%) (p < 0.0001). Side effects were mild or moderate. Conclusions: Tadalafil is an effective treatment for erectile dysfunction after 3DCRT for prostatic carcinoma with successful intercourse reported in almost 50% of the patients, and it is well tolerated

  15. Evaluation of the erectile function after prostate interstitial brachytherapy by iodine 125 grains

    With a median decline of 4 years, the proportion of patients with no erectile dysfunction or a mild erectile dysfunction (score greater than 12) fell from 87% before treatment to 55% after treatment. In multivariate analysis, the incidence of erectile dysfunction correlates with the quality of erections before implantation and the age of patients. (N.C.)

  16. Increased subsequent risk of erectile dysfunction among middle and old age males with chronic osteomyelitis: a nationwide population-based cohort study.

    Wang, H-Y; Chao, C-H; Lin, C-L; Tseng, C-H; Kao, C-H

    2016-07-01

    Chronic inflammation may cause endothelial dysfunction and atherosclerosis, resulting in subsequent erectile dysfunction (ED). We examined the relationship between chronic osteomyelitis, which is a chronic inflammatory disease, and ED. A retrospective cohort study was conducted using data from the National Health Insurance Research Database. After excluding patients osteomyelitis (COM) from 1 January 2000 to 31 December 2011 were identified for the study. The non-osteomyelitis comparison cohort consisted of 2706 male participants. The incidence of ED was 2.66-fold higher in the COM cohort than in the non-osteomyelitis cohort (4.01 vs 1.51 per 10 000 person-years). After adjusting for age and comorbidities of coronary heart disease, hypertension, hyperlipidemia, depression, stroke, diabetes, peripheral vascular disease, chronic kidney disease, chronic obstructive pulmonary disease and asthma, the patients with COM had a 2.82-fold risk of ED (95% confidence interval=1.44-5.56). The incidence of ED increased with that of comorbidities in both cohorts. The highest hazard ratio was in patients between 40 and 59 years of age who had COM. Our data showed, for the first time, that COM is a possible risk factor for the development of ED. PMID:27169492

  17. Stress affects a gastrin-releasing peptide system in the spinal cord that mediates sexual function: implications for psychogenic erectile dysfunction.

    Hirotaka Sakamoto

    Full Text Available BACKGROUND: Many men suffering from stress, including post-traumatic stress disorder (PTSD, report sexual dysfunction, which is traditionally treated via psychological counseling. Recently, we identified a gastrin-releasing peptide (GRP system in the lumbar spinal cord that is a primary mediator for male reproductive functions. METHODOLOGY/PRINCIPAL FINDINGS: To ask whether an acute severe stress could alter the male specific GRP system, we used a single-prolonged stress (SPS, a putative rat model for PTSD in the present study. Exposure of SPS to male rats decreases both the local content and axonal distribution of GRP in the lower lumbar spinal cord and results in an attenuation of penile reflexes in vivo. Remarkably, pharmacological stimulation of GRP receptors restores penile reflexes in SPS-exposed males, and induces spontaneous ejaculation in a dose-dependent manner. Furthermore, although the level of plasma testosterone is normal 7 days after SPS exposure, we found a significant decrease in the expression of androgen receptor protein in this spinal center. CONCLUSIONS/SIGNIFICANCE: We conclude that the spinal GRP system appears to be a stress-vulnerable center for male reproductive functions, which may provide new insight into a clinical target for the treatment of erectile dysfunction triggered by stress and psychiatric disorders.

  18. Cavernous body reduction in four patients with erectile dysfunction due to insufficient venous occlusion and a deficit of elastic fibers in the tunica albugínea

    Fabrizio Iacono

    2007-12-01

    Full Text Available INTRODUCTION: The corpora cavernosa are cylindrical vessels containing fluid under pressure. Thus, if cavernous wall resistance decreases, the radius increases and internal pressure decreases (LaPlace's law. We reasoned that if we decrease the corpus cavernosum radius, by excising a strip from each tunica albuginea, intracavernous pressure would increase during erection. MATERIALS AND METHODS: We treated with this procedure, four patients (mean age 41.5 with long-standing erectile dysfunction due to veno-occlusive dysfunction, non-responders to phosphodiesterase-5 inhibitors and intracavernous PGE1 injection. RESULTS: Two months post-surgery, intracavernous PGE1 (40 mcg induced a satisfactory erection in two patients and a 45% and 58% tumescence in the other two. PGE1 responders also responded to 100 mg sildenafil. After 100 mg sildenafil and 20 mg tadalafil, the two non-responders had erections that enabled penetration but were short lasting. CONCLUSION: The procedure described could be more effective than cavernous revascularization operations. The results seem to confirm the mathematical assumptions.

  19. The effects of long-term administration of tadalafil on STZ-induced diabetic rats with erectile dysfunction via a local antioxidative mechanism

    Yun Chen; Xiao-Xin Li; Hao-Cheng Lin; Xue-Feng Qiu; Jing Gao; Yu-Tian Dai; Run Wang

    2012-01-01

    Type 5 phosphodiesterase inhibitors (PDE51s) are well known being effective viathe nitric oxide and cyclic guanosine monophosphate (NO-cGMP) pathway and are widely used in the treatment of diabetic erectile dysfunction (ED).However,it is unclear whether other pathways may be involved in the treatment of diabetic ED with PDE51s.The purpose of this study was to clarify the role of antioxidants in diabetic ED treatment through the long-term administration of PDE51s.Three groups of Sprague-Dawley rats were utilized:Group N,the normal control; Group D,streptozotocin (STZ)-induced diabetic rats as a control; and Group D+T,STZ-induced diabetic rats who received oral administration of tadalafil for 8 weeks.Erectile function was assessed by intracavernous pressure (ICP) and mean arterial pressure (MAP) during electrical stimulation of the cavernous nerve before euthanasia.The levels of malondialdehyde (MDA),superoxide dismutase (SOD) and mitochondrial membrane potential (MMP) of cavernous tissue were assessed by biochemical analysis.The morphology of mitochondria was observed by electron microscopy.The ICP/MAP ratio was higher in Group D+T than in Group D (P<0.05).The levels of MDA decreased and the activities of SOD increased in Group D+T in comparison with Group D (P<0.05).The mitochondrial membrane potential level of cavernous tissue in diabetic rats was partially recovered by tadalafil treatment for 8 weeks.The morphology changes of mitochondria were also remarkably ameliorated in Group D+T.Collectively,the long-term administration of tadalafil in diabetic rats partially reduced oxidative stress lesions of the penis viaa local antioxidative stress pathway.Long-term dosages of tadalafil given once daily beginning soon after the onset of diabetes may aid in preventing rats from developing diabetic ED.

  20. A 2-Stage Genome-Wide Association Study to Identify Single Nucleotide Polymorphisms Associated With Development of Erectile Dysfunction Following Radiation Therapy for Prostate Cancer

    Purpose: To identify single nucleotide polymorphisms (SNPs) associated with development of erectile dysfunction (ED) among prostate cancer patients treated with radiation therapy. Methods and Materials: A 2-stage genome-wide association study was performed. Patients were split randomly into a stage I discovery cohort (132 cases, 103 controls) and a stage II replication cohort (128 cases, 102 controls). The discovery cohort was genotyped using Affymetrix 6.0 genome-wide arrays. The 940 top ranking SNPs selected from the discovery cohort were genotyped in the replication cohort using Illumina iSelect custom SNP arrays. Results: Twelve SNPs identified in the discovery cohort and validated in the replication cohort were associated with development of ED following radiation therapy (Fisher combined P values 2.1 × 10−5 to 6.2 × 10−4). Notably, these 12 SNPs lie in or near genes involved in erectile function or other normal cellular functions (adhesion and signaling) rather than DNA damage repair. In a multivariable model including nongenetic risk factors, the odds ratios for these SNPs ranged from 1.6 to 5.6 in the pooled cohort. There was a striking relationship between the cumulative number of SNP risk alleles an individual possessed and ED status (Sommers’ D P value = 1.7 × 10−29). A 1-allele increase in cumulative SNP score increased the odds for developing ED by a factor of 2.2 (P value = 2.1 × 10−19). The cumulative SNP score model had a sensitivity of 84% and specificity of 75% for prediction of developing ED at the radiation therapy planning stage. Conclusions: This genome-wide association study identified a set of SNPs that are associated with development of ED following radiation therapy. These candidate genetic predictors warrant more definitive validation in an independent cohort.

  1. Comparison of tamsulosin vs tamsulosin/sildenafil effectiveness in the treatment of erectile dysfunction in patients affected by type III chronic prostatitis

    Ubaldo Cantoro

    2013-09-01

    Full Text Available Aim: We evaluated the effectiveness of tamsulosin monotherapy versus tamsulosin plus sildenafil combination therapy on erectile dysfunction (ED in young patients with type III chronic prostatitis and ED by using symptom score scales. Materials and methods: 44 male patients were divided into 2 groups: the first group (20 patients was treated with tamsulosin 0,4 mg monotherapy and the second one 24 patients was treated with tamsulosin 0,4 mg plus sildenafil 50 mg combination therapy. “International Prostate Symptom Score” (IPSS, “National Institute of Health Chronic Prostatitis Symptom Index” (NIH-CPSI and “International Index of Erectile Function” (IIEF-5 were inves- tigated in each group of patients, and scores calculated during the first medical examination. Both groups were treated with tamsulosin once daily for 60 days, while sildenafil 50 mg was given on demand (at least 2 times per week for 60 days. During the second medical examination IPSS, NIH-CPSI and IIEF-5 scores were analyzed once more. Afterwards, the alterations of scores among medical examinations in each group and between both groups were statistically compared. Results: The age average of the 44 cases included was 32.04 ± 3.15 years. Both groups present a statistically significant decrease, between the first and the second medical examination, in IPSS, NIH-CPSI scores and statistically significant increase in IIEF-5 score. In addition, there is no sta- tistically significant difference, in all scores, between mono and combination therapy. Conclusions: tamsulosin monotherapy, as well as a combination therapy (tamsulosin plus silde-nafil has an improving effect on symptoms and on ED in patients with type III prostatitis. In the near future alpha-blockers monotherapy could be used in the treatment of chronic prostatitis and ED cases instead of phosphodiesterase type 5 (PDE-5 inhibitors combination therapy.

  2. A 2-Stage Genome-Wide Association Study to Identify Single Nucleotide Polymorphisms Associated With Development of Erectile Dysfunction Following Radiation Therapy for Prostate Cancer

    Kerns, Sarah L. [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York (United States); Departments of Pathology and Genetics, Albert Einstein College of Medicine, Bronx, New York (United States); Stock, Richard [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York (United States); Stone, Nelson [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York (United States); Department of Urology, Mount Sinai School of Medicine, New York, New York (United States); Buckstein, Michael [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York (United States); Shao, Yongzhao [Division of Biostatistics, New York University School of Medicine, New York, New York (United States); Campbell, Christopher [Departments of Pathology and Genetics, Albert Einstein College of Medicine, Bronx, New York (United States); Rath, Lynda [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York (United States); De Ruysscher, Dirk; Lammering, Guido [Department of Radiation Oncology, Maastricht University Medical Center, Maastricht (Netherlands); Hixson, Rosetta; Cesaretti, Jamie; Terk, Mitchell [Florida Radiation Oncology Group, Jacksonville, Florida (United States); Ostrer, Harry [Departments of Pathology and Genetics, Albert Einstein College of Medicine, Bronx, New York (United States); Rosenstein, Barry S., E-mail: barry.rosenstein@mssm.edu [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York (United States); Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States); Departments of Dermatology and Preventive Medicine, Mount Sinai School of Medicine, New York, New York (United States)

    2013-01-01

    Purpose: To identify single nucleotide polymorphisms (SNPs) associated with development of erectile dysfunction (ED) among prostate cancer patients treated with radiation therapy. Methods and Materials: A 2-stage genome-wide association study was performed. Patients were split randomly into a stage I discovery cohort (132 cases, 103 controls) and a stage II replication cohort (128 cases, 102 controls). The discovery cohort was genotyped using Affymetrix 6.0 genome-wide arrays. The 940 top ranking SNPs selected from the discovery cohort were genotyped in the replication cohort using Illumina iSelect custom SNP arrays. Results: Twelve SNPs identified in the discovery cohort and validated in the replication cohort were associated with development of ED following radiation therapy (Fisher combined P values 2.1 Multiplication-Sign 10{sup -5} to 6.2 Multiplication-Sign 10{sup -4}). Notably, these 12 SNPs lie in or near genes involved in erectile function or other normal cellular functions (adhesion and signaling) rather than DNA damage repair. In a multivariable model including nongenetic risk factors, the odds ratios for these SNPs ranged from 1.6 to 5.6 in the pooled cohort. There was a striking relationship between the cumulative number of SNP risk alleles an individual possessed and ED status (Sommers' D P value = 1.7 Multiplication-Sign 10{sup -29}). A 1-allele increase in cumulative SNP score increased the odds for developing ED by a factor of 2.2 (P value = 2.1 Multiplication-Sign 10{sup -19}). The cumulative SNP score model had a sensitivity of 84% and specificity of 75% for prediction of developing ED at the radiation therapy planning stage. Conclusions: This genome-wide association study identified a set of SNPs that are associated with development of ED following radiation therapy. These candidate genetic predictors warrant more definitive validation in an independent cohort.

  3. Prevalence, psychological impact, and risk factors of erectile dysfunction in patients with Peyronie’s disease: a retrospective analysis of 309 cases

    Paulis, Gianni; Romano, Gennaro; Paulis, Andrea

    2016-01-01

    Peyronie’s disease (PD) is a chronic inflammatory disease involving the tunica albuginea of the penis. Erectile dysfunction (ED) is a possible invalidating symptom of PD. The aim of this study was to evaluate the prevalence, psychological impact, and risk factors of ED in patients with PD. The study was conducted by carrying out a retrospective analysis of the clinical records of 309 patients with PD who visited our andrology clinic. All patients underwent the following tests: body mass index, common blood tests and hormone assays, questionnaire for erectile function assessment, dynamic penile color Doppler ultrasonography, imaging of the penis at maximum erection with photographic poses according to Kelâmi, psychosexual impact evaluation with PD Questionnaire (symptom bother score), evaluation of depression symptoms with the Patient Health Questionnaire-9, and evaluation of the intensity of penile pain with the pain intensity numeric rating scale. ED was observed in 37.5% of the cases. We divided the cases into two groups: group A (PD + ED), 116 cases, and group B (PD without ED), 193 cases. After multivariate analysis, we concluded that the following comorbidities are independent risk factors for ED: dyslipidemia, obesity, chronic prostatitis, benign prostatic hyperplasia, and autoimmune diseases. A depressive disorder was observed in 62.4%, and it was more frequent in patients with PD + ED (91.37% versus 45.07% group B). Sexual bother was greater in group A compared with group B (9.7 versus 7.6). Intensities of depressive symptoms and sexual bother were significantly higher compared with cases with no curvature when the bend angle was ≥30°. Our study confirms that an integrated psychological support with medical treatment is needed in patients with PD. PMID:27486570

  4. [The evaluation of efficiency of PGE 1 (alprostadil) during intracavernous injection in the treatment of erectile dysfunctions].

    Sobociński, Z; Szymański, W; Kotzbach, R; Ludwikowski, G

    1998-06-01

    We have investigated the influence of PGE1 (alprostandil--"Prostavasin"--Schwarz Pharma company) on the erection in the group of 34 men with erectile disfunction (28 with and 6 without diabetes mellitus) treated in period from 1996 to 1998. Other diseases were excluded in all patients. The concentrations of FSH, LH, T, PRL, T3 and T4 were in normal range. The applied dose of PGE 1 varied from 5 mg to 20 mg maximum three times a week. The effect of the treatment was estimated according to subjective symptoms. The effectiveness of the treatment varied from 50% to 67%. The most effective dose was the maximal one (20 mg). The minimal effective dose of alprostadil was 10 mg. PMID:9695377

  5. [Chronobiological approach to the treatment of patients with erectile dysfunction using a combination of local negative pressure and laser illumination].

    Moskvin, S V; Ivanchenko, L P

    2014-01-01

    It is shown that the synchronization of energetic, spectral, frequency, and temporal parameters of technique with biorhythms of physiological processes in the organ, which is target of impact, and in the human body as a whole, allows to significantly improve efficiency, and achieve stable and reproducible results of treatment. The article presents the results of study including 62 patients with vasculogenic ED. The study design included the randomization of patients into 3 groups depending on the complex of the therapy with the use of combined techniques, including negative pressure and laser illumination (LLNP) as a part of combined therapy and as monotherapy. Significant increase in the peak flow velocity after a course of treatment was observed in all three groups of patients. Improvement in erectile function was observed in all groups; according to IIEF score, erectile function has increased by 22.3 +/- 0.05% in group 1, by 34 +/- 1.5% in the group 2, and by 19 +/- 1.7% in the group 3, indicating the best results of treatment in the group receiving combined therapy. Combination of LLNP with the administration of PDE5 inhibitors significantly increases the effectiveness of treatment of vasculogenic ED due to the influence of physical factors on the stabilization of hemodynamics in the main arteries of the penis. After a course of therapy, increase in systemic vascular elasticity by 39.8 +/- 1.5% was also noted. The efficiency of the LLNP methodology in the treatment of patients with vasculogenic ED is demonstrated. The best results were obtained in the group of patients treated with combined therapy, including the use of LLNP and PDE-5 inhibitor. PMID:25211927

  6. AB170. Effect of levitra on sustenance of erection (EROS): an open-label, prospective, multicenter, single-arm study to investigate erection duration measured by stopwatch with flexible dose vardenafil administered for 8-week in subjects with erectile dysfunction

    Shin, Yu Seob; Lee, Sung Won; Park, Kwangsung; Chung, Woo Sik; Kim, Sae Woong; Hyun, Jae Seog; Moon, Du Geon; Yang, Sang-Kuk; Ryu, Ji Kan; Yang, Dae Yul; Moon, Ki Hak; Min, Kweon Sik; Park, Jong Kwan

    2014-01-01

    Introduction To investigate the change of erection duration measured by stopwatch with flexible dose vardenafil administered for 8-week in subjects with erectile dysfunction (ED). Material and methods Effect of levitra on sustenance of erection (EROS) was an open-label, prospective, multicenter, single-arm study designed to measure the duration of erection in men with ED receiving a flexible dose of vardenafil over an 8-week treatment period. Patients were instructed to take vardenafil 10 mg ...

  7. Insulinorresistencia y disfunción eréctil: Efecto del tratamiento con metformina Insulin resistance and erectile dysfunction: Effect of treatment with metformin

    P.R. Costanzo

    2010-04-01

    largely on the release of nitric oxide (NO by vascular endothelium. Insulin resistance (IR, present in most subjects who have obesity, metabolic syndrome (MS or type 2 diabetes mellitus (DM2 is a metabolic abnormality that produces endothelial dysfunction determined by minor synthesis and release of NO. Treatment with metformin improves erectile function in mice with erectile dysfunction (ED and IR. Aims: To evaluate in ED patients: 1 the presence of IR; 2 the degree of severity of ED according to the presence of IR; 3 the effect of treatment with metformin on erectile function in patients with ED and IR. Methods: Prospective, randomized, controlled, double-blind placebo study. We included 81 patients with ED and 20 men without ED (control group. Exclusion criteria: pharmacologic, anatomic or endocrine ED (hypogonadism or hyperprolactinemia, DM2, prior prostatic surgery or chronic illnesses. The erectile function was rated according the International Index of Erectile Function 5. IR was measerud by HOMA index. Thirty patients with ED, IR and poor response to sildenafil were randomized to receive metformin or placebo. Results: Patients with ED had higher HOMA index versus control group: 4.9 ± 2.8 versus 3.6 ± 2.6, p=0.03. The prevalence of IR was higher in ED group versus control group: 77.7% versus 45.0%, p=0.008. We found a negative correlation between HOMA and IIEF-5: r:-0.21, p=0.04. Patients with ED and IR (n=62 had lower IIEF-5 score when compared with those without IR (n=19: 13.6 ± 4.3 versus 16.0 ± 3.1, p=0.04. After treatment with metformin patients with ED showed a significant increase in IIEF-5 score and a significant decrease in HOMA index both at 2 and 4 months of treatment. Changes in the IIEF-5 score and HOMA index were not observed in patients with ED receiving placebo. Conclusion: Our findings suggest that endothelial dysfunction caused by IR could be one of the pathophysiologial mechanisms of ED. Treatment with metformin in patients with ED reduces IR

  8. Reasons and predictive factors for discontinuation of PDE-5 inhibitors despite successful intercourse in erectile dysfunction patients.

    Kim, S-C; Lee, Y-S; Seo, K-K; Jung, G-W; Kim, T-H

    2014-01-01

    This study was aimed to identify characteristics of ED patients who discontinued PDE5i despite successful intercourse. Data were collected using a questionnaire from 34 urologic clinics regardless of the effect (success or failure) of PDE5i treatment by visiting the clinics (717), e-mail (64) or post (101) for 882 ED patients who had previously taken any kind of PDE5i on demand four or more times. Discontinuation of PDE5i was defined if the patient had never taken PDE5i for the previous 1 year despite successful intercourse. Of the 882 patients, 485 were included in the final analysis. Difference in the socio-demographic, ED- and partner-related data between the continuation and discontinuation group and factors influencing discontinuation of the PDE5i were analyzed. Among 485 respondents (mean age, 53.6), 116 (23.9%) had discontinued PDE5i use despite successful intercourse. Most common reasons for the discontinuation were 'reluctant medication-dependent intercourse' (31.0%), 'spontaneous recovery of erectile function without further treatment' (30.2%), and 'high cost' (26.7%). In multiple logistic regression analysis, independent factors influencing discontinuation of the drug were cause of ED (psychogenic), short duration of ED, low education (⩽ middle school), and religion (Catholic). In partner-related compliance, only partner's religion (Catholic) was a significant factor. PMID:24305610

  9. 性自慰行为与静脉性勃起功能障碍的相关性分析%Correlation between sexual masturbation behavior and venous erectile dysfunction

    刘勇刚; 孙毅海; 陶卫琦; 刘昕; 黄才胜; 黄超斌

    2014-01-01

    目的:探讨性自慰行为与静脉性勃起功能障碍的相关性。方法对173例确诊为静脉性勃起功能障碍患者的性自慰行为资料进行logistic回归分析,以初次性自慰年龄、频率、性自慰病程、性自慰时是否伴有阴茎不适症状,以及性自慰时期是否有性伴侣等5项因素为变量指标。结果性自慰频率、性自慰病程和性自慰时是否伴有阴茎不适症状与静脉性勃起功能障碍依次相关,P值分别为0.0069、0.0108、0.0195,标准化回归系数分别为0.4925、0.3687、0.2943;而性自慰时期是否有性伴侣和初次性自慰年龄与静脉性勃起功能障碍无显著相关性(P>0.05)。结论性自慰频率、性自慰病程以及是否伴有阴茎不适症状与静脉性勃起功能障碍的发生有密切关系。%Objective To study the correlation between sexual masturbation behavior and venous erectile dysfunction. Methods The clinical data of sexual masturbation behavior in 173 patients with venous erectile dysfunction were recorded and statistically analyzed with logistic regression model. Age of the first time masturbation, frequency, duration, penis symptoms, and sex partner were taken as variables. Results Venous erectile dysfunction was significantly related to the frequency, duration, penis symptoms. The P values were 0.0069,0.0108 and0.0195 The standard regression coefficients were 0.4925, 0.3687, and 0.2943 respectively. Sex partner and age of the first time masturbation were not associated with the venous erectile dysfunction (P>0.05). Conclusion Venous erectile dysfunction is corrected with the frequency, duration, penis symptoms in sexual masturbation behavior.

  10. What do most erectile dysfunction guidelines have in common? No evidence-based discussion or recommendation of heart-healthy lifestyle changes and/or Panax ginseng

    Mark A Moyad; Kwangsung Park

    2012-01-01

    Sexual health or erectile dysfunction (ED) state of the art guidelines provide a thorough overview of conventional prescription or other notable extrinsic treatment options.Yet,over the past 10-15 years,a plethora of international researchers have established that individual and comprehensive lifestyle changes can prevent and potentially improve ED.We review the lifestyle evidence that should equate to grade A or level 1 evidence recommendations for ED.We also review the evidence for Panax ginseng,an over-the-counter (OTC) dietary supplement with a 35-year history of laboratory investigations,multiple positive randomized trials over approximately 15 years and several independent meta-analyses and systematic reviews.Perhaps it is time to at least discuss and even emphasize lifestyle and other non-conventional interventions in ED guidelines so that patients can explore a diversity of potentially synergistic choices with their physicians and can improve their quality and quantity of life.Ignoring the consistent,positive data on lifestyle modifications in ED guidelines,for example,is tantamount to ignoring diet and lifestyle changes to reduce the risk of or ameliorate cardiovascular diseases.

  11. 勃起功能障碍基因疗法的现状%Gene therapy and erectile dysfunction: the current status

    D.H.W.Lau; S.S.Kommu; E.J.Siddiqui; C.S.Thompson; R.J.Morgan; D.P.Mikhailidis; F.H.Mumtaz

    2007-01-01

    Current available treatment options for erectile dysfunction (ED) are effective but not without failure and/or side effects. Although the development of phosphodiesterase type 5 (PDE5) inhibitors (I.e. Sildenafil, tadalafil and vardenafil) has revolutionized the treatment of ED, these oral medications require on-demand access and are not as effective in treating ED related to diabetic, post-prostatectomy and severe veno-occlusive disease states. Improvement in the treatment of ED is dependent on understanding the regulation of human corporal smooth muscle tone and on the identification of relevant molecular targets. Future ED therapies might consider the application of molecular technologies such as gene therapy. As a potential therapeutic tool, gene therapy might provide an effective and specific means for altering intracavernous pressure "on demand" without affecting resting penile function. However, the safety of gene therapy remains a major hurdle to overcome before being accepted as a mainstream treatment for ED. Gene therapy aims to cure the underlying conditions in ED, including fibrosis. Furthermore, gene therapy might help prolong the efficacy of the PDE5 inhibitors by improving penile nitric oxide bioactivity. It is feasible to apply gene therapy to the penis because of its location and accessibility, low penile circulatory flow in the flaccid state and the presence of endothelial lined (lacunar) spaces. This review provides a brief insight of the current role of gene therapy in the management of ED.

  12. Chinese Medicine Leading to Erectile Dysfunction When Treating Diabetes Mellitus%消渴病中药物引发阳痿概述

    张冕; 王东

    2013-01-01

    Erectile dysfunction (ED) is a common and easy neglected symptom in diabetes.Quality of life is seriously impacted.The reason is complex and mixed.The role of Xiaoke syndrome during the ED was realized earlier in TCM.With more and more medicine to treat diabetes mellitus,the phenomenon which uses medicine to treat illness turns to medicine leading to illness is being paid more and more attentions to.%勃起功能障碍是一种糖尿病患者常见而易被忽视的症状,严重影响患者的生活质量.其原因更是错综复杂,祖国医学则较早的就认识到消渴在阳痿病程中起到的作用.随着治疗糖尿病的药物越来越多,以药治病造成的以药致病现象越来越受到广泛关注.

  13. Clinical significance of erectile dysfunction developing after acute coronary event:exception to the rule or confirmation of the artery size hypothesis?

    Piero Montorsi; Paolo M Ravagnani; Charalambos Vlachopoulos

    2015-01-01

    Erectile dysfunction (ED) has been found to frequently precedes the onset of coronary artery disease (CAD), representing an early marker of subclinical vascular disease, included CAD. Its recognition is, therefore, a “window opportunity” to prevent a coronary event by aggressive treatment of cardiovascular risk factors. The artery size hypothesis (ASH) has been proposed as a putative mechanism to explain the relationship between ED and CAD. Since atherosclerosis is a systemic disorder all major vascular beds should be affected to the same extent. However, symptoms at different points in the system rarely become evident at the same time. This is likely the result of smaller vessels (i.e. the penile artery) being able to less well tolerate the same amount of plaque when compared with larger ones (i.e. the coronary artery). If true, ED will develop before CAD. We present a case in which ED developed after a coronary event yet before a coronary recurrence potentially representing a late marker of vascular progression. Reasons for this unusual sequence are discussed as they might still fit the ASH.

  14. Angiography in the diagnosis of erectile impotence

    The complex interactions of psychological, neurological, hormonal and vascular aspects of erectile dysfunctions require a standardised multidisciplinary diagnostic evaluation. The recent establishment of new noninvasive and invasive investigative procedures has led to a fundamental change in the assessment of erectile dysfunctions. Selective angiography of the internal pudendal artery and its branches represents the crucial diagnostic step before treatment can start. Indication, technique and results of 26 bilaterally performed pudendal angiographies on impotent patients are described. (orig.)

  15. Prevalence and associated risk factors of male erectile dysfunction among patients on hemodialysis and kidney transplant recipients: A cross-sectional survey from Sudan

    M O Mekki

    2013-01-01

    Full Text Available Male erectile dysfunction (ED is an important issue worldwide occurring in 5-69% of men in community-based studies. It is more common in patients with chronic kidney disease (CKD and those on peritoneal as well as hemodialysis (HD, occurring in more than 80% of patients. In Sudan, there is no pre-vious report on ED among patients with CKD. A cross-sectional study was done to determine the prevalence of ED and its associated risk factors among Sudanese CKD patients on HD and those who underwent renal transplant. This was conducted in Khartoum, Sudan from October 2005 to July 2006 including all married men who were on maintenance HD for more than three months and all married men who had received renal transplantation at least three months earlier. Single, divorced/separated men, those whose wives were living away, those who were bed-bound and those with cognitive impairment were also excluded. After obtaining consent for participation, demographic and clinical data were collected by using anonymous questionnaires and the Arabic version of International Index of Erectile Function (IIEF; the Egyptian version. Patients who did not participate in full and proper manner were considered as "non-responders." A total of 146 patients, 106 HD patients, and 40 renal transplant recipients completed the IIEF questionnaire. Non-responders constituted 43.7% and 54.5% of HD and transplant recipient patients, respectively. Blood samples were taken after completion of the IIEF questionnaire to determine the required investigations. ED prevalence was high among our study patients, 83% among the HD patients and 67.5% among the renal transplant recipients. Univariate analysis showed that there was a trend, although non-significant, of older age being associated with ED in both groups. Similar association was seen in those who were under-dialyzed in the HD group and DM in the transplant recipient group. Previous history of ED was significantly associated with current

  16. Erectile Function and Risk of Parkinson’s Disease

    Gao, Xiang; Chen, Honglei; Schwarzschild, Michael A.; Glasser, Dale B; Logroscino, Giancarlo; Rimm, Eric B; Ascherio, Alberto

    2007-01-01

    Erectile dysfunction is common among individuals with Parkinson’s disease, but it is unknown whether it precedes the onset of the classic features of Parkinson’s disease. To address this question, the authors examined whether erectile dysfunction was associated with Parkinson’s disease risk in the Health Professionals Follow-up Study. Analyses included 32,616 men free of Parkinson’s disease at baseline in 1986 who in 2000 completed a retrospective questionnaire with questions on erectile dysf...

  17. Evaluation of the erectile function after prostate interstitial brachytherapy by iodine 125 grains; Evaluation de la fonction erectile apres curietherapie interstitielle prostatique par grains d'iode 125

    Bachaud, J.M.; Delannes, M.; Marre, D.; Bonnet, J. [Institut Claudius-Regaud, 31 - Toulouse (France); Jonca, F. [Clinique Ambroise-Pare, 31 - Toulouse (France); Soulie, M.; Huyghe, E. [Centre Hospitalier Universitaire, 31 - Toulouse (France)

    2007-11-15

    With a median decline of 4 years, the proportion of patients with no erectile dysfunction or a mild erectile dysfunction (score greater than 12) fell from 87% before treatment to 55% after treatment. In multivariate analysis, the incidence of erectile dysfunction correlates with the quality of erections before implantation and the age of patients. (N.C.)

  18. Intratunical Injection of Genetically Modified Adipose Tissue-Derived Stem Cells with Human Interferon α-2b for Treatment of Erectile Dysfunction in a Rat Model of Tunica Albugineal Fibrosis

    Gokce, Ahmet; Abd Elmageed, Zakaria Y.; Lasker, George F.; Bouljihad, Mostafa; Braun, Stephen E.; Kim, Hogyoung; Kadowitz, Philip J.; Abdel-Mageed, Asim B.; Sikka, Suresh C.; Hellstrom, Wayne J.

    2016-01-01

    Introduction Peyronie's disease (PD) has frequently been associated with erectile dysfunction (ED) and may further compromise coitus. Aim To investigate the efficacy of intratunical injection of genetically modified rat adipose tissue-derived stem cells (ADSCs) expressing human interferon α-2b (ADSCs-IFN) in decreasing fibrosis and restoring erectile function in a rat model of tunica albugineal fibrosis (TAF). Methods A total of 36 Sprague-Dawley rats (12 weeks old; 300–350 g) were randomly divided in six equal groups: (i) sham group (50 μL saline-injected into the tunica albuginea [TA]); (ii) TAF group (transforming growth factor [TGF]-β1 [0.5 μg/50 μL] injected into the TA); (iii) TGF-β1 plus 5 × 105 control ADSCs injected same day; (iv) TGF-β1 plus 5 × 105 ADSCs-IFN injected same day; (v)TGF-β1 plus 5 × 105 control ADSCs injected after 30 days; and (vi) TGF-β1 plus 5 × 105 ADSCs-IFN injected after 30 days. Rat allogeneic ADSCs were harvested from inguinal fat tissue. Main Outcome Measures Forty-five days following the TGF-β1 injection, erectile function was assessed, and penile tissues were harvested for further evaluations. Results In the same-day injection groups, intratunical injection of ADSCs and ADSC-IFN improved erectile response observed upon stimulation of cavernous nerve compared with TAF group. Intratunical ADSC-IFN injection at day 30 improved erectile responses 3.1, 1.8, and 1.3 fold at voltages of 2.5, 5.0, and 7.0, respectively, when compared with TAF group. Furthermore, at voltages of 2.5 and 5.0, treatment on day 30 with ADSCs-IFN improved erectile responses 1.6- and 1.3-fold over treatment with ADSCs alone. Local injection of ADSCs or ADSCs-IFN reduced Peyronie's-like manifestations, and these effects might be associated with a decrease in the expression of tissue inhibitors of metalloproteinases. Conclusion This study documents that transplantation of genetically modified ADSCs, with or without human IFN α-2b, attenuated

  19. 高血压与勃起功能障碍相互关系研究进展%Correlation between hypertension and erectile dysfunction

    刘继红; 凌青

    2011-01-01

    勃起功能障碍(ED)与高血压之间的关系是男科学研究的重点领域.目前研究认为,这两种疾病拥有相似的病理生理过程,如氧化应激效应造成血管内皮损害以及RhoA/Rho激酶活性上调.两种疾病均为血管功能损害这一病理过程的不同阶段.定期细致而全面评估高血压合并ED患者病情,并予以合理药物治疗显得尤为重要.在高血压患者中,5型磷酸二酯酶抑制剂无论是单用还是联合抗高血压药物使用都取得了令人满意的效果.目前,基因治疗以及脂肪源性干细胞治疗都展现出了良好的前景,通过转化医学方法可使其更好的为临床服务.%The relationship between erectile dysfunction (ED) and hypertension is a focus in andrological research. ED and hypertension share some pathophysiologic pathways, such as oxidative stress-induced endothelial dysfunction and up-regulated RhoA/Rho kinase activity, and both are the diseases at different stages of the pathological process of vascular dysfunction. Thus, it is particularly important to conduct regular and meticulous evaluation of such patients, so as to give rational individualized medication. Phosphodiesterase-5 inhibitors have an excellent efficacy and safety profile in the management of hypertension, either used alone or with antihypertensive medication. At present, gene therapy and adipose-derived stem cell therapy have displayed favorable prospects in the management of ED and hypertension, and translational medicine may help bring more clinical benefits.

  20. Erectile Dysfunction in Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Outcomes from a Multi-Center Study and Risk Factor Analysis in a Single Center

    Chen, Xin; Wang, Zhu; Chen, Shengfu; Yang, Qiyun; Wan, Zi; Han, Dayu; Xiao, Haipeng; Sun, Xiangzhou; Deng, Chunhua

    2016-01-01

    The aim of this study was to investigate the prevalence of erectile dysfunction (ED) in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and explore the influence of UPOINT domains, National Institutes of Health-CP symptom index (NIH-CPSI) and other factors on ED prevalence. This was a prospective study of consecutive patients with CP/CPPS seen at 11 tertiary hospitals during January–July 2014. ED was diagnosed as a score ofclinical examination, asocio-demographic questionnaire, the Patient Health Questionnaire (PHQ), the Pain Catastrophizing Scale (PCS), NIH-CPSI and IIEF-5.1406 patients from 11 centers (mean age, 32.18 years; range 18–60 years) were enrolled. ED was found in 638/1406 patients (45.4%), and was categorized as mild in 291(45.6%), moderate in 297(46.6%) and severe in50(7.7%). 192 patients from one center(mean age,31.3 years; range 18–57 years) were further studied.IIEF-5 score correlated negatively with NIH-CPSI(r = 0.251), PHQ (r = 0.355) and PCS (r = 0.322)scores (P<0.001).PHQ score correlated positively with NIH-CPSI (r = 0.586) and PCS(r = 0.662) scores (P<0.001).NIH-CPSI, PHQ, PCS and IIEF-5 scores did not differ significantly between class IIIA and IIIB CP/CPPS. Multivariate logistic regression showed that UPOINT psychological (P) domain and NIH-CPSI symptom severity were independent risk factors for ED in CP/CPPS. It is concluded that psychological factors and symptom severity are independent risk factors for ED in CP/CPPS. PMID:27120096

  1. Dose-Volume Parameters of the Corpora Cavernosa Do Not Correlate With Erectile Dysfunction After External Beam Radiotherapy for Prostate Cancer: Results From a Dose-Escalation Trial

    Purpose: To analyze the correlation between dose-volume parameters of the corpora cavernosa and erectile dysfunction (ED) after external beam radiotherapy (EBRT) for prostate cancer. Methods and Materials: Between June 1997 and February 2003, a randomized dose-escalation trial comparing 68 Gy and 78 Gy was conducted. Patients at our institute were asked to participate in an additional part of the trial evaluating sexual function. After exclusion of patients with less than 2 years of follow-up, ED at baseline, or treatment with hormonal therapy, 96 patients were eligible. The proximal corpora cavernosa (crura), the superiormost 1-cm segment of the crura, and the penile bulb were contoured on the planning computed tomography scan and dose-volume parameters were calculated. Results: Two years after EBRT, 35 of the 96 patients had developed ED. No statistically significant correlations between ED 2 years after EBRT and dose-volume parameters of the crura, the superiormost 1-cm segment of the crura, or the penile bulb were found. The few patients using potency aids typically indicated to have ED. Conclusion: No correlation was found between ED after EBRT for prostate cancer and radiation dose to the crura or penile bulb. The present study is the largest study evaluating the correlation between ED and radiation dose to the corpora cavernosa after EBRT for prostate cancer. Until there is clear evidence that sparing the penile bulb or crura will reduce ED after EBRT, we advise to be careful in sparing these structures, especially when this involves reducing treatment margins

  2. 海绵体神经损伤所致ED大鼠模型建立%Rat model of erectile dysfunction caused by cavernous nerve ablation

    张新华; 胡礼泉; 尹静; 莫曾南; 陈坚

    2002-01-01

    目的寻找大鼠海绵体神经并建立神经损伤所致ED大鼠模型.方法对20只大鼠进行解剖,在外科显微镜下找到海绵体神经并经电刺激试验证实.随后将42只实验大鼠随机分为假手术对照组、单侧海绵体神经损伤组及双侧海绵体神经损伤组.术后3周用阿朴吗啡试验来评估所建动物模型.结果盆主要神经节位于背侧前列腺后外侧叶表面,其最大的传出神经就是海绵体神经.诱发阴茎勃起的电刺激参数是:电压5V、刺激频率20Hz及刺激时间5ms.术后3周,阿朴吗啡均能诱发对照组大鼠阴茎勃起,30分钟内平均勃起次数为2.57±1.40,实验组大鼠,无论单侧损伤还是双侧损伤,均丧失勃起功能(0.00±0.00).结论大鼠较大的盆主要神经节及海绵体神经易于辨认,电刺激反应明显,而且大鼠价格便宜,易于饲养及购买,是建立海绵体神经损伤性ED模型的理想动物.此外还发现,无论是单侧海绵体神经损伤还是双侧损伤,损伤后早期,大鼠均丧失勃起功能.%Objective To identify the rat cavernous nerve and establish a rat model of erectile dysfunction (ED) caused by injury of the cavernous nerve. Methods Twenty rats underwent dissections. Cavernous nerves were identified with the aid of an operating microscope and confirmed by electrical stimulation. Then, 42 experimental rats were randomized into 3 groups, including sham-operated controls and unilateral and bilateral cavernous nerve ablation groups. Three weeks after surgery, rat models were evaluated with the Apomorphine test.Results The major pelvic ganglion lies on either side of the dorsolateral lobes of the prostate. It includes 2 inflows, one called hypogastric nerve and the other, the pelvic nerve. The largest outflow is termed the cavernous nerve. Stimulus parameters which could induce obvious penile erection were 5 volts, a frequency of 20 Hertz and a duration of 5 milliseconds. Three weeks after surgery, apomorphine

  3. 骨髓间充质干细胞改善糖尿病大鼠勃起功能障碍的研究%Effect of bone marrow mesenchymal stem cells on improving erectile dysfunction in diabetic rats

    聂永华; 肖明朝; 苟欣; 汤为学; 陈力学; 蔡贤福

    2012-01-01

    目的:探讨骨髓间充质干细胞(Bone marrow mesenchymal stem cells,BMMSCs)移植到大鼠阴茎海绵体组织后对勃起功能的影响.方法:体外分离培养BMMSCs并利用形态学及流式细胞术进行鉴定证实.用腹腔注射链脲左菌素(Streptozotocin,STZ)建立糖尿病性大鼠模型,并用阿扑吗啡(Apomorphine,APO)筛选出糖尿病勃起功能障碍(Diabetes mellitus induced erectile dysfunction,DMED)大鼠模型,成模后将BMMSCs(2×106个)移植于大鼠阴茎海绵体内.2周后,分别对正常组、糖尿病组及治疗组进行海绵体内压(Intracorporeal pressure,ICP)及平均动脉压(Mean arterial blood pressure,MAP)测定并取大鼠阴茎海绵体组织,荧光显微镜下观察BMMSCs的局部存活情况,苏木素-伊红染色(Hematoxylin and eosin,HE)观察阴茎海绵体组织中血管.结果:荧光显微镜观察提示BMMSCs能在糖尿病大鼠体内存活;勃起功能测定结果表明治疗组大鼠ICP/MAP比值明显高于糖尿病组;HE染色结果显示在治疗组大鼠阴茎海绵体中血管数目[(12.75±1.89)根/HP]多于糖尿病组[(8.05±1.43)根/HP].结论:BMMSCs能够有效改善糖尿病性大鼠勃起功能.%Objective:To study the effect of bone marrow mesenchymal stem cells(BMMSCs) transplanted into corpus cavernosum on improving erectile dysfunction in diabetic rats. Methods: BMMSCs were separated and cultivated in vitro,then were identified by morphological method and flow cytometry. The diabetic rat model was constructed by intrapertoneal injection of streptozotocin(STZ), then model of diabetes mellitus induced erectile dysfunction(DMED) was sieved by apomorphine(APO). BMMSCs(2×l06 pieces) were transplanted into the corpus cavernosum of the rats in DMED model. Two weeks later.the intracorporeal pressure(ICP) and mean arterial blood pressure(MAP) of normal group,diabetic group and treatment group were determined respectively,the surviving and differentiation of BMMSCs in corpus cavernosum was

  4. Cell phone usage and erectile function

    Al–Ali, Badereddin Mohamad; Patzak, Johanna; Fischereder, Katja; Pummer, Karl; Shamloul, Rany

    2013-01-01

    Introduction The objective of this pilot study was to report our experience concerning the effects of cell phone usage on erectile function (EF) in men. Material and Methods We recruited 20 consecutive men complaining of erectile dysfunction (ED) for at least six months (Group A), and another group of 10 healthy men with no complaints of ED (Group B). Anamnesis, basic laboratory investigations, and clinical examinations were performed. All men completed the German version of the Sexual Health...

  5. [Updated relationship between sleep and erectile function].

    Zhang, Fan-bo; Jiang, Rui

    2016-03-01

    Penile erection (PE) is a physiological phenomenon involving complex mechanisms. PE may occur as reactive erections, psychogenic erections in the conscious state and spontaneous erections during the sleep. Sleep-related PE refers to the erections occurring spontaneously during the sleep with rapid eye movement. Studies have shown a correlation between sleep and PE as well as between sleep disorders and erectile dysfunction but not yet revealed the exact mechanisms. This paper updates the relationship between sleep and erectile function. PMID:27172667

  6. New pharmacological prospectives in erectile function

    Mitidieri, Emma

    2009-01-01

    Abstract Erectile dysfunction (ED), defined as the consistent or recurrent inability of a man to attain and/or maintain a penile erection sufficient for sexual activity ), can be caused by a number of different pathophysiological process. For these reasons, the present study can be divided into three steps in which we have analyzed various aspects of physiology and physiopathology of erectile function to give a contribution in the development of novel therapeutic approaches for treatment ...

  7. Evaluating the relationship between erectile dysfunction and dose received by the penile bulb: Using data from a randomised controlled trial of conformal radiotherapy in prostate cancer (MRC RT01, ISRCTN47772397)

    Aim: To evaluate the relationship between erectile function and the radiation dose to the penile bulb and other proximal penile structures in men receiving conformal radiotherapy (CFRT) for prostate cancer (PCa). Methods: The Medical Research Council (MRC) RT01 trial randomised 843 men who had localised PCa to receive either 64 or 74 Gy after 3-6 months neoadjuvant hormonal treatment. Fifty-one men were selected who were potent prior to hormonal treatment, having completed both pre-hormone and 2-year post-CFRT Quality of Life assessments, and on whom dose volume data were available for analysis. The men were divided into three groups according to 2-year follow-up: potent, reduced potency, and impotent. The bulb of the penis together with the crura, were outlined on restored treatment plans. Dose-volume histograms were generated and compared between the three groups. An ordered logistic regression model was used to calculate the odds ratio of a range of dose-volume parameters to the penile bulb and effect on erectile dysfunction. The dose to the penile bulb was correlated to the dose received by the crura. Results: Of the 51 patients, 12 remained potent, 22 had reduced potency, and 17 were impotent at 2 years. No differences were seen in mean dose to the penile bulb by allocated treatment (t test = 1.61, p = 0.11). The mean doses to the penile bulb received by the potent, reduced potency, and impotent groups were 45.5 Gy (SD 17.1), 48 Gy (SD 16.1), and 59.2 Gy (SD 13.8), respectively. There was a strong correlation between the mean dose received by the penile bulb and dose to the crura (r = 0.82, p < 0.0001). 83.3% of impotent patients received a D90 ≥50 Gy to the penile bulb compared with 29.4% of patients who maintained potency at 2 years (p 0.006). Conclusion: There is evidence from this study to suggest a dose volume effect on the penile bulb and erectile dysfunction. A D90 ≥50 Gy is associated with a significant risk of erectile dysfunction and this should

  8. The relationship between resting heart rate variability and erectile tumescence among men with normal erectile function

    Harte, Christopher B.

    2013-01-01

    Introduction Individuals with erectile dysfunction have been shown to display lower heart rate variability (HRV), suggesting dysregulation of cardiac autonomic function. No studies have explored whether HRV is predictive of erectile response among men with clinically normal erectile function. Aim To examine associations between resting HRV and objective measures of genital response (i.e., resting penile circumference; erectile tumescence) and self-reported sexual function. Methods The sample comprised 59 male community volunteers (mean age = 20.15 years; SD = 2.52) selected from the control conditions of two previously published studies. Participants reported erectile function in the normal range (scoring ≥ 26 on the International Index of Erectile Function [IIEF]) and had no history of cardiovascular disease or myocardial infarct. During a laboratory visit, self-report, anthropometric, cardiovascular, and electrocardiographic data were assessed, as well as resting penile circumference and erectile tumescence in response to viewing an erotic film. Main Outcome Measures Resting penile responses, erectile tumescence (circumferential change via penile plethysmography), self-reported sexual function per the IIEF, and both time-domain (standard deviation of beat-to-beat [NN] intervals [SDNN], square root of the mean squared difference of successive NN intervals [RMSSD], and percent of NN intervals for which successive heartbeat intervals differed by at least 50 msec [pNN50]) and frequency-domain (low frequency [LF], high frequency [HF], LF/HF ratio) parameters of HRV were assessed. Results Higher resting HF power and lower resting LF/HF ratio were associated with greater erectile tumescence. There were marginally significant positive associations between mean NN interval and pNN50 and penile tumescence. HRV was not associated with self-reported sexual function or with resting penile circumference. Conclusions Results suggested that, among men without erectile

  9. The role of intracavernosal injection therapy and the reasons of withdrawal from therapy in patients with erectile dysfunction in the era of PDE5 inhibitors.

    Sung, H H; Ahn, J S; Kim, J J; Choo, S H; Han, D H; Lee, S W

    2014-01-01

    There has been little data regarding the role of intracavernosal injection (ICI) treatment, its discontinuation rate and the reasons of withdrawal in patients with erectile dysfunction (ED) in the era of phosphodiesterase type 5 (PDE5) inhibitors. The aim of this study was to investigate the rate of withdrawal and its associated reasons in patients undergoing ICI therapy. Patients who were prescribed with ICI treatment two times or more were included since the introduction of sildenafil in Korea in 1999. Telephone surveys were performed to evaluate intercourse rates, withdrawal rates and their associated reasons, adverse events and the patients' satisfaction with their sex lives after the ICI treatments. Two hundred and ninety-four men were contacted by telephone. The mean age was 61.8 ± 7.9 years with a follow-up duration of 25.6 ± 32.1 months. At the last follow-up, 79.9% had discontinued the treatment. Most patients had previously failed PDE5 inhibitor treatment prior to the ICI therapy, and more than half had two or more risk factors of ED. Adequate penile rigidity after ICI therapy was restored in 60.2% of patients. The reasons for discontinuation of ICI were poor response (43.1%), inconvenience of use (18.3%), switch to other treatments (10.7%), loss of libido (6.7%), adverse events (5.5%) and return of spontaneous erection (2.8%). Pain was the most common adverse event in the withdrawal group, whereas prolonged erection was most common in the continuing group. Following ICI treatment, PDE5 inhibitors were the most common therapeutic option (63.1%). The overall satisfaction rate regarding sex life was significantly high in the treatment-continuing group. In conclusion, patients on ICI treatment had severe ED and high withdrawal rates in the era of PDE5 inhibitors. The most common reason for treatment discontinuation was poor response. Before initiating ICI treatments, sufficient counselling is necessary. PMID:24194017

  10. Genome-Wide Association Study to Identify Single Nucleotide Polymorphisms (SNPs) Associated With the Development of Erectile Dysfunction in African-American Men After Radiotherapy for Prostate Cancer

    Purpose: To identify single nucleotide polymorphisms (SNPs) associated with erectile dysfunction (ED) among African-American prostate cancer patients treated with external beam radiation therapy. Methods and Materials: A cohort of African-American prostate cancer patients treated with external beam radiation therapy was observed for the development of ED by use of the five-item Sexual Health Inventory for Men (SHIM) questionnaire. Final analysis included 27 cases (post-treatment SHIM score ≤7) and 52 control subjects (post-treatment SHIM score ≥16). A genome-wide association study was performed using approximately 909,000 SNPs genotyped on Affymetrix 6.0 arrays (Affymetrix, Santa Clara, CA). Results: We identified SNP rs2268363, located in the follicle-stimulating hormone receptor (FSHR) gene, as significantly associated with ED after correcting for multiple comparisons (unadjusted p = 5.46 x 10-8, Bonferroni p = 0.028). We identified four additional SNPs that tended toward a significant association with an unadjusted p value -6. Inference of population substructure showed that cases had a higher proportion of African ancestry than control subjects (77% vs. 60%, p = 0.005). A multivariate logistic regression model that incorporated estimated ancestry and four of the top-ranked SNPs was a more accurate classifier of ED than a model that included only clinical variables. Conclusions: To our knowledge, this is the first genome-wide association study to identify SNPs associated with adverse effects resulting from radiotherapy. It is important to note that the SNP that proved to be significantly associated with ED is located within a gene whose encoded product plays a role in male gonad development and function. Another key finding of this project is that the four SNPs most strongly associated with ED were specific to persons of African ancestry and would therefore not have been identified had a cohort of European ancestry been screened. This study demonstrates the

  11. Treatment satisfaction among men with concurrent benign prostatic hyperplasia and erectile dysfunction treated with tadalafil or other phosphodiesterase type-5 inhibitor combinations

    Lee, Lulu K; Goren, Amir; Boytsov, Natalie N; Donatucci, Craig F; McVary, Kevin T

    2016-01-01

    Objective Erectile dysfunction (ED) and benign prostatic hyperplasia (BPH) frequently co-occur in men aged ≥40, along with lower urinary tract symptoms (LUTS) secondary to BPH. Given little real-world evidence on treatment use or satisfaction with treatment for concurrent BPH/LUTS and/or ED, this study examined medication regimens and differences in satisfaction and health-related quality of life (HRQoL) across regimens among men with concurrent BPH and ED. Methods A cross-sectional study was conducted using an Internet survey of participants recruited through an online panel. Respondents (N=736) included men (aged ≥40) who self-reported a diagnosis of both ED and BPH with prescription treatment in the past 3 months for both conditions. Treatment satisfaction (eg, convenience and ease of planning) and HRQoL (eg, International Prostate Symptom Score, sleep quality) were self-reported. Generalized linear models examined the association of regimen with treatment satisfaction and HRQoL, adjusting for covariates (eg, age and comorbidities). Results Final analyses included participants (N=507) using: tadalafil once-daily monotherapy (22%), tadalafil for ED with an alternate BPH therapy (36%), or another phosphodiesterase type-5 inhibitor (PDE5-I) combination (41%). These groups represented the major categories of treatment regimens found in the sample, excluded participants with ambiguous regimens, and were aligned with current standard of care for BPH and ED. Overall, patients reported moderate levels of BPH and a moderate-to-severe degree of ED. Tadalafil monotherapy patients had higher treatment satisfaction scores and greater reported ease of treatment planning and convenience than PDE5-I combination patients. No significant intergroup differences were found on HRQoL. Conclusion A majority of patients (59%) took tadalafil alone or in combination for BPH/ED treatment. Tadalafil monotherapy patients reported greater treatment satisfaction than patients taking PDE5

  12. A comparison of radiation dose to the bulb of the penis in men with and without prostate brachytherapy-induced erectile dysfunction

    Purpose: To retrospectively evaluate the relationship between the radiation dose to the bulb of the penis and the development of erectile dysfunction (ED) in patients undergoing permanent prostate brachytherapy without external beam radiation therapy. Methods and Materials: Twenty-three men who developed ED after transperineal ultrasound-guided permanent prostate brachytherapy for clinical T1/T2 adenocarcinoma of the prostate gland were paired with 23 similar men who maintained potency after implantation. Potency was defined as an erection sufficient for vaginal penetration. The mean and median follow-up for the entire group was 34.6 ± 13.7 months and 32.8 months, respectively. Patients were implanted with either 125I (145 Gy TG-43) or 103Pd (115 Gy, pre-NIST-99). No patient received external beam radiation therapy either before or after brachytherapy. The bulb of the penis was outlined at 0.5-cm intervals on the Day 0 postimplant CT scan. The radiation dose distribution to the bulb of the penis was defined in terms of the minimal dose delivered to 25%, 50%, 70%, 75%, 90%, and 95% of the bulb (D25, D50, D70, D75, D90, and D95). Results: The radiation dose delivered to the bulb of the penis in men with postbrachytherapy-induced ED was statistically greater for all evaluated dosimetric parameters (D25, D50, D70, D75, D90, and D95). Multivariate analysis indicated that dose to the bulb of the penis and patient age at the time of implant were predictive of postimplant ED, whereas choice of isotope had no effect. Among potent patients, 19/23 had D50 ≤ 40% of prescribed minimal peripheral dose, whereas for the impotent patients, 19/23 had D50 >40% of the minimal peripheral dose. Of the impotent patients, 17 utilized sildenafil, with 15 experiencing a favorable response (88%). Conclusion: Our data suggest that prostate brachytherapy-induced impotence is highly correlated with the radiation dose delivered to the bulb of the penis. With Day 0 dosimetric evaluation, the

  13. Potential pathways of pesticide action on erectile function-a contributory factor in male infertility

    RP Kaur; V Gupta; AF Christopher; P Bansal

    2015-01-01

    One of the important objectives of this manuscript is to focus on the place of erectile dysfunction as an important factor for infertility. The review is about correlating the indiscriminate use of pesticides and to find out and highlight the evidences for mechanism of action of these pesticides for erectile dysfunction and find out the most used and most dangerous pesticide from erectile dysfunction point of view. The review suggests that erectile dysfunction is having a significant place as a causal factor for infertility. Study infers that pesticides are having multiple mechanisms of action through which these cause erectile dysfunction. It also reflects that acetamiprid is having most devastating effect causing erectile dysfunction as it acts through multiple inhibitory pathways. The review successfully highlights the indiscriminate regional use of pesticides.

  14. Evaluation of erectile function after urethral reconstruction: a prospective study

    Xie, Hong; Xu, Yue-Min; XU Xiao-lin; Sa, Yin-Long; Wu, Deng-Long; Zhang, Xin-Chi

    2009-01-01

    We conducted a prospective study of erectile dysfunction (ED) after urethral reconstructive surgery, using the 5-item International Index of Erectile Function (IIEF-5), the Sexual Life Quality Questionnaire (SLQQ) and the Quality of Life Questionnaire (QoLQ). Between January 2003 and July 2007, 125 male patients with urethral strictures underwent urethroplasty, and pre- and post-surgery erectile function was assessed using these three questionnaires. A formula to predict the probability of ED...

  15. Los inhibidores de las fosfodiesterasas en el tratamiento de la disfunción sexual eréctil The inhibitors of the phosphodiesterases in treatment of erectile sexual dysfunction

    Manuel Correa Jáuregui

    2010-12-01

    Full Text Available La disfunción sexual masculina impone una carga significativamente negativa en la salud, en las relaciones interpersonales, en la autoestima y en la calidad de vida de los que la padecen. Hasta finales de la década de los 80, el tratamiento se limitaba a la terapia psicosexual y a los implantes peneanos, y la causa se atribuía principalmente a factores psicológicos. El surgimiento de los inhibidores orales de fosfodiesterasa 5 con el lanzamiento del sildenafil (viagra en 1998, constituyó desde sus inicios una verdadera revolución y son ahora la primera elección del tratamiento en la disfunción eréctil, por ser bien tolerados, eficaces, no invasivos y con buenas tasas de respuesta.En el siguiente artículo se realizó una revisión del uso de los inhibidores de las fosfodiesterasas en el tratamiento de la disfunción sexual eréctil, así como las características relevantes de los medicamentos más usados en la actualidad, lo que contribuirá al conocimiento y a su mejor prescripción. Con este objetivo se consultaron los trabajos más actuales publicados en Pubmed y Medline. Los inhibidores de las fosfodiesterasa (sildenafil, vardenafil y tadalafil constituyen los medicamentos de elección en el tratamiento de la disfunción eréctil por su probada eficacia, seguridad y tolerancia.The male sexual dysfunction imposes a significantly negative burden in health, in the interpersonal relations, in self-esteem, and the quality of life of those suffering it. Up to at the end of the 80 decade, treatment was limited to psychosexual therapy and to penile implants and the cause was due to mainly to psychological factors. The appearance of oral inhibitors of phosphodiesterase-5 like the Sildenafil citrate (Viagra in1998, was from its onsets a real revolution and now are the first choice for treatment of erectile dysfunction because it is well tolerated, effective, non-invasive and with a good response rate. In present paper authors made a review

  16. Cardiovascular Implications of Erectile Dysfunction

    ... LIBRARY Hello, Guest! My alerts Sign In Join Facebook Twitter Home About this Journal Editorial Board General Statistics Circulation Cover Doodle → Blip the Doodle Go Red For Women's Issue Information for Advertisers Author Reprints Commercial Reprints Customer Service and Ordering ...

  17. Erectile dysfunction in patients with symptomatic benign prostatic hyperplasia.%前列腺增生症患者勃起功能障碍及其影响因素分析

    隆电熙; 吴莉红; 初铭彦; 王高兴

    2011-01-01

    目的 探讨老年男性在前列腺增生症(BPH)患者病史、年龄、IPSS、前列腺体积、最大尿流率及血清PSA与勃起功能障碍(ED)的相关性.方法 采用SPSS10.0软件总结并分析142例前列腺增生症患者病史、年龄、临床症状参数、前列腺体积、最大尿流率、血清PSA与勃起功能国际评分(ILEF-5)、性欲之间的关系.结果 BPH患者142例,年龄50~75岁.115例有ED(80.99%),72例有性欲低下(50.70%).研究显示年龄与性功能关系密切.IPSS评分在IIEF-5正常组与轻、中、重度ED组间比较,差异均有统计学意义(P<0.05).结论 年龄是性功能障碍的主要因素,BPH患者中ED的发生率较高,ED的程度与下尿路症状(LUTS)的严重程度有相关性.%Objective To explore the relationship between history, age, International Prostate Symptom Score (IPSS), prostate volume, maximum urinary flow rate, serum PSA of benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) in the patients with BPH. Methods Data of 142 patients' history of BPH, age, clinical parameters, prostate volume, maximum urinary flow rate, serum PSA and erectile dysfunction, sexual desire were collected and analyzed with software SPSSI0.0. Results 142 patients with BPH aged from 50 to 75 years. The morbidity of ED was 80.99% in the patients; the low sexual desire was 50.70%. Age was found to be associated with sexual function. There was significant difference in the value of IPSS between erectile function normal group and the other abnormal group. Conclusion Age is the main factor in sexual dysfunction. There were high in cadence rate of ED in the patients with BPH, and the degree of ED was related with sever degree of LUTS.

  18. Management of end-stage erectile dysfunction and stress urinary incontinence after radical prostatectomy by simultaneous dual implantation using a single trans-scrotal incision: surgical technique and outcomes.

    Martínez-Salamanca, Juan I; Espinós, Estefanía Linares; Moncada, Ignacio; Portillo, Luis Del; Carballido, Joaquín

    2015-01-01

    Stress urinary incontinence (SUI) and end-stage erectile dysfunction (ED) after radical prostatectomy (RP) can decrease a patient's quality of life (QoL). We describe a surgical technique involving scrotal incision for simultaneous dual implantation of an artificial urinary sphincter (AUS) and an inflatable penile prosthesis (IPP). Patients with moderate to severe SUI (>3 pads per day) and end-stage ED following RP were selected for dual implantation. An upper transverse scrotal incision was made, followed by bulbar urethra dissection and AUS cuff placement. Through the same incision, the corpora cavernosa was exposed, and an IPP positioned. Followed by extraperitoneal reservoirs placement and pumps introduced in the scrotum. Short-term, intra- and post-operative complications; continence status and erectile function; and patient satisfaction and QoL were recorded. A total of 32 patients underwent dual implantation. Early AUS-related complications were: AUS reservoir migration and urethral erosion. One case of distal corporal extrusion occurred. No prosthetic infection was reported. Over 96% of patients were socially the continent (≤1 pad per day) and > 95% had sufficient erections for intercourse. Limitations of the study were the small number of patients, the lack of the control group using a perineal approach for AUS placement and only a 12 months follow-up. IPP and AUS dual implantation using a single scrotal incision technique is a safe and effective option in patients with SUI and ED after RP. Further studies on larger numbers of patients are warranted. PMID:25657083

  19. Studies on sexual function of patients with erectile dysfunction-no sexual life using self-estimation index of erectile function-no sexual life%阴茎勃起功能自我评价表对中青年无性生活勃起功能障碍患者的多维评估

    张志超; 袁亦铭; 高冰; 彭靖; 宋卫东; 辛钟成; 金杰; 郭应禄

    2011-01-01

    Objective To estabalish a new conception, Erectile Dysfunction-no sexual life (ED-NS), so as create an evaluating questionnaire, Self-estimation Index of erectile function-No sexual life (SIEF-NS) so as to investigate its clinical reliability. Methods The conception of ED-NS was identified and the SIEF-NS questionnaire was established. Patients who complained of ED-NS and normal controls were enrolled into the research and assessed the erectile function was assessed with SIEF-NS.The SIEF-NS includes 12 questions, such as sexual libido, general erectile function, nocturnal penile erection, erectile function during foreplay, erectile function during audio-video sexual stimulation,confidence, depression, etc and each question has 5 point scales. Results Sixty-one ED-NS patients and 57 controls were enrolled into the study and assessed erectile function with SIEF-NS. The mean score of each question and integral score of SIEF-NS in ED-NS patients were significantly different from normal controls (P<0. 05). When the integral score was 35 points according to the ROC curve of integral score, the sensitivity of SIEF-NS was 88.5% and specificity was 96. 5%. Conclusions ED-NS is a new conception to define patients who have erectile dysfunction without sexual life. SIEFNS is suggested to be a useful method for the evaluation of ED-NS patients.%目的 确立无性生活勃起功能障碍(ED-NS)的定义,制定ED-NS问卷调查表评估勃起功能状态,并判断其效果.方法确立ED-NS定义,并设计制定勃起功能自我评价表(SIEFNS).收集符合ED-NS定义患者和正常对照病例作为研究对象,并分为ED-NS和正常对照2组.ED-NS患者61例,年龄18~38(26.2±4.3)岁;正常对照组57例,年龄18~33(24.9±4.1)岁.分别填写SIEF-NS问卷.问卷共有12个问题,涉及性欲、总体勃起情况、夜间和晨起勃起情况、异性相处条件下勃起情况和视听觉性刺激下勃起情况5个方面,每个问题分为5分,收集各项问题评

  20. Fruit and Vegetable Intake in Relation to Lower Urinary Tract Symptoms and Erectile Dysfunction Among Southern Chinese Elderly Men: A 4-Year Prospective Study of Mr OS Hong Kong.

    Liu, Zhao-min; Wong, Carmen Ka Man; Chan, Dicken; Tse, Lap Ah; Yip, Benjamin; Wong, Samuel Yeung-Shan

    2016-01-01

    The role of fruit and vegetable (FV) intake in relation to prostate health remains inconclusive. This 4-year longitudinal study aims to explore the association of FV intake and the development of lower urinary tract symptoms (LUTS, a cluster of chronic urinary symptoms occurring in bladder, prostate and urethra), incidence of symptomatic benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) in Chinese elderly men. Data were obtained from a 4 years longitudinal study (Mr OS Hong Kong, the largest prospective study on bone health in Chinese elderly). Two thousand Chinese men aged 65 years and older were recruited from the local community, of whom 1998 (99.9%) at baseline and 1564 (78.2%) at 4-year follow-up reported data on LUTS, which were evaluated by a validated International Prostate Symptoms Scale (IPSS). Erectile function was evaluated by the International Index of Erectile Dysfunction-5 (IIEF-5) questionnaires at 2- (n = 386) and 4-year (n = 475) follow-ups. Dietary intake was assessed using a validated food frequency questionnaire at baseline. Analysis was conducted using multivariate linear and logistic regression. For total FV and most of their subclasses, moderate consumption had the lowest mean changes of LUTS; we thus applied the moderate levels as the reference in the regression models. The high levels of total FV intake (>350  g/1000  kcal/day) were significantly associated with reduced IPSS by scores of -1.174 ± 0.459 (or -17.3% of basal IPSS, P = 0.011) relative to the moderate groups (250-350  g/1000  kcal/day). FV consumption had no significant association with the score change of ED or the odds of sexual activities at 4-year (all P > 0.05). High intake of dark and leafy vegetables (>50  g/1000  kcal/day) significantly reduced the risk of LUTS progression by 37.2% [odds ratio (OR) (95% confidence interval, 95% CI): 0.628 (0.466∼0.848), P = 0.002] or risk of symptomatic BPH by 34.3% [OR (95% CI): 0

  1. Transpenile venous occlusion for the treatment of erectile impotence

    In 15 of 18 patients, 2 of them with previous surgery, transpenile venoablation was performed for treatment of erectile dysfunction due to cavernous leakage. In 4 this was combined with retrograde venoocclusion via the internal iliac vein. In 4 patients normal erectile status could be obtained. In 3 other patients erections became possible with use of intracavernous vasoactive agents. In two only mild amelioration, and in two others no change of erectile dysfunction were obtained. Follow-up studies are yet missing in 3 patients. Complications of the procedure were not observed. (orig.)

  2. AB042. Implications for differentiation of endogenous stem cells: therapeutic effect from icariside II on a rat model of post-prostatectomy erectile dysfunction

    Xu, Yongde; Guan, Ruili; Lei, Hongen; Xin, Zhongcheng

    2016-01-01

    Self-renewal and differentiation of endogenous stem cells (SCs) are essential for adult tissue homoeostasis and intrinsic healing capacity. Here, we hypothesize that penis contains a small population of endogenous SCs which might help rejuvenation of damaged erectile function. In this study, 60 newborn male rats were intraperitoneally injected with 5-ethynyl-2-deoxyuridine (EdU; 50 mg) for the purpose of tracking endogenous SCs. Twelve weeks later, 48 rats underwent bilateral cavernous nerves (CN) injury and were randomized into gavage feeding of solvent (vehicle group) or icariside II (ICAII) (0.5, 1.5 and 4.5 mg per day, respectively). Twelve sham-operated rats received vehicle treatment and served as control. The treatments were continued for 4 weeks followed by a washout period of 72 h. Results showed that ICAII treatment significantly restored erectile function and effectively prevented distortion of normal neural anatomy, smooth muscle atrophy and collagen deposition compared to vehicle group. The numbers of label retaining cells (LRCs) co-expressing EdU and differentiated phenotypes (smooth muscle markerα-SMA or Schwann cell marker S100) were significantly higher in three ICAII-treated groups than those in vehicle group in a dose-dependent manner. In addition, the changing trend of p38 mitogen activated protein kinase (MAPK) activity in the penis between groups was same as that of the number of differentiated LRCs. Together, these results suggest that the underlying mechanisms of ICAII in ameliorating erectile function and pathological changes appear to involve enhanced endogenous SCs differentiation, which might be regulated by p38 MAPK signaling pathway.

  3. Effect of levitra on sustenance of erection (EROS): an open-label, prospective, multicenter, single-arm study to investigate erection duration measured by stopwatch with flexible dose vardenafil administered for 8 weeks in subjects with erectile dysfunction.

    Shin, Y S; Lee, S W; Park, K; Chung, W S; Kim, S W; Hyun, J S; Moon, D G; Yang, S-K; Ryu, J K; Yang, D Y; Moon, K H; Min, K S; Park, J K

    2015-01-01

    To investigate the change of erection duration measured by stopwatch with flexible dose vardenafil administered for 8 weeks in subjects with erectile dysfunction (ED). Effect of levitra on sustenance of erection was an open-label, prospective, multicenter and single-arm study designed to measure the duration of erection in men with ED receiving a flexible dose of vardenafil over an 8-week treatment period. Patients were instructed to take vardenafil 10 mg 60 min before attempting the intercourse. Vardenfil could be increased to 20 mg or decreased to 5 mg concerning patients' efficacy and safety. Following the initial screening, patients entered a 4-week treatment-free run-in phase and 8-week treatment period, during which they were instructed to attempt intercourse at least four times on four separate days. A total of 95 men were enrolled in 10 centers. After the 8 weeks treatment, the mean duration of erection leading to successful intercourse was statistically superior when patients were treated with vardenafil. After an 8-week treatment, the duration of erection leading to successful intercourse was 9.39 min. There were significant benefits with vardenafil in all domains of International Index of Erectile Function. Secondary efficacy end points included success rate of penetration, maintaining erection, ejaculation and satisfaction were superior when patients were treated with vardenafil. There was a significant correlation between duration of erection with other sexual factors. Also partner's sexual satisfaction was increased with vardenafil. Most adverse events were mild or moderate in severity. Vardenafil was safe and well tolerated. Vardenafil therapy provided a statistically superior duration of erection leading to successful intercourse in men with ED with female partner. PMID:25471318

  4. AB117. Efficacy and mechanism of combination therapy using Icariin and daily sildenafil citrate for the treatment of erectile dysfunction in a rat model of bilateral cavernous nerves injury

    Xu, Yongde; Guan, Ruili; Lei, Hongen; Yang, Yong; Xin, Zhongcheng

    2016-01-01

    The commonly utilized phosphodiesterase type 5 (PDE5) inhibitors does not lead to satisfactory penile erection after radical prostatectomy due to lack of nitric oxide (NO) released from the damaged cavernous nerves (CNs). Of particular interest is that Icariin (ICA) has been demonstrated to increase the expression of neuronal NO synthase (nNOS) in our previous work. In this study, the efficacy and mechanisms ICA in combination with daily sildenafil for the treatment of neurogenic erectile dysfunction (ED) was investigated in a rat model of bilateral CNs injury (BCNI). Sixty male Sprague-Dawley rats injected with 5-ethynyl-2-deoxyuridine (EdU; 50 mg/kg) at newborn were used to track endogenous stem cells (SCs). Fourty-eight rats of BCNI were randomized equally into gavage feeding of vehicle, sildenafil, ICA and sildenafil+ICA, respectively. Twelve sham-operated rats received vehicle treatment and served as control. Interestingly, ICA in combination with sildenafil resulted in better erectile function and effectively preserved the penile size compared with the control and sildenafil groups (P<0.05). In addition, the numbers of nNOS-positive nerves and EdU-positive cells coexpressing Schwann cell marker S100 in the ICA-treated groups were greater compared with the control group (P<0.05). These results indicate that ICA promotes endogenous SCs to differentiate into Schwann cells, which is essential for the regeneration of nNOS-positive nerves after BCNI; on this basis, sildenafil can then improve penile engorgement through the NO-activated smooth muscle relaxation. Therefore, the combined use of ICA and daily sildenafil may be a candidate for the treatment of neurogenic ED in the future.

  5. 韩国红参对治疗勃起功能障碍的疗效研究%Study of the efficacy of Korean Red Ginseng in the treatment of erectile dysfunction

    Enrico de Andrade; Alexandre A. de Mesquita; Joaquim de Almeida Claro; Priscila M. de Andrade; Valdemar Ortiz; Mário Paranhos; Miguel Srougi

    2007-01-01

    Aim: To examine the treatment efficacy of Korean Red Ginseng (KRG) in impotent men with erectile dysfunction (ED). Methods: A total of 60 patients presenting mild or mild to moderate ED were enrolled in a double-blind,placebo-controlled study in which the efficacies of KRG and a placebo were compared. The patients received either 1 000 mg (3 times daily) of KRG or a placebo. Results: The five-item version of the International Index of Erectile Function (IIEF-5) score after the treatment was significantly higher in the KRG group compared with that before the treatment (from 16.4 ± 2.9 to 21.0 ± 6.3, P < 0.0001). In contrast, there was no difference before and after the treatment in the placebo group (from 17.0 ± 3.1 to 17.7 ± 5.6, P > 0.05). In the KRG group, 20 patients (66.6%),reported improved erection, significant in the global efficacy question (P < 0.01); in the placebo group there was no significance. Scores on questions 2 (rigidity), 3 (penetration), 4 and 5 (maintenance), were significantly higher for KRG than those for the placebo when those questions were answered after 12 weeks of each treatment (P < 0.01).When the score in the KRG group was compared to the placebo group after the treatment, there was a significant improvement in total score (IIEF-5 score) in questions 3 and 5 for the KRG-treated group (P < 0.001 and P < 0.0001,respectively). The levels of serum testosterone, prolactine and cholesterol after the treatment were not statistically significant different between the KRG and the placebo group (P > 0.05). Conclusion: Our data show that KRG can be an effective alternative to the invasive approaches for treating male ED.

  6. Improvement in erectile dysfunction after insulin-like growth factor-1 gene therapy in diabetic rats%胰岛素样生长因子-1基因治疗改善了糖尿病型大鼠的勃起功能

    X.Y.Pu; L.Q.Hu; H.P.Wang; Y.X.Luo; X.H.Wang

    2007-01-01

    Aim:To determine whether adenoviral gene transfer of insulin like growth factor- 1 (IGF- 1) to the penis of streptozotocin (STZ)-induced diabetic rats could improve erectile capacity. Methods: The STZ diabetic rats were transfected with AdCMV-βgal or AdCMV-IGF-1. These rats underwent cavernous nerve stimulation to assess erectile function and their responses were compared with those of age-matched control rats 1 to 2 days after transfection. In control and transfected STZ diabetic rats, IGF-1 expression were examined by reverse transcription polymerase chain reaction (RT-PCR), Western blot and histology. The penis β-galactosidase activity and localization of the STZ diabetic rats were also determined. Results: One to two days after transfection, the β-galactosidase was found in the smooth muscle cells of the diabetic rat penis transfected with AdCMV-βgal. One to 2 days after administration of AdCMVIGF-1, the cavernosal pressure, as determined by the ratio of maximal intracavernous pressure-to-mean arterial pressure (ICP/MAP) and total intracavernous pressure (ICP), was increased in response to cavernous nerve stimulation.Transgene expression was confirmed by RT-PCR, Western blot and histology. Conclusion: Gene transfer of IGF-1 significantly increased erectile function in the STZ diabetic rats. These results suggest that in vivo gene transfer of IGF-1 might be a new therapeutic intervention for the treatment of erectile dysfunction (ED) in the STZ diabetic rats.

  7. Successful treatment of erectile disfunction with Fortisex coated tablets.

    Papp, G; Kopa, Z

    1991-01-01

    After a brief survey of treatment, possibilities of erectile dysfunction, the Authors describe their results with FORTISEX coated tablets playing an important role in the conservative therapy even in our days. Their results suggest that the primary advantage of the product appears in increasing the libido in sexual problems of psychic origin, but its secondary field of application is the minor improvement of erectile parameters of disfunctions of "mixed" history. PMID:1842475

  8. Bicycle Riding: Impact on Lower Urinary Tract Symptoms and Erectile Function in Healthy Men

    Baek, Seok; Lee, Sun Young; Kim, Jong Min; Shin, Esther; Kam, Sin; Jung, Hee Chang

    2011-01-01

    Purpose Recently, reports in the mass media have implicated that bicycle riding increases the risk of erectile dysfunction and prostatic diseases. So, we evaluate the impact of bicycle riding on erectile function and lower urinary tract symptoms (LUTS) in healthy general men. Methods From 26 June 2010 to 20 July 2010, we investigate degree of LUTS (voiding and storage symptoms), using International Continence Society-male Questionnaire (ICS-mQ) and erectile function using International Index ...

  9. Psychosocial outcomes after initial treatment of erectile dysfunction with tadalafil once daily, tadalafil on demand or sildenafil citrate on demand: results from a randomized, open-label study.

    Hatzimouratidis, K; Buvat, J; Büttner, H; Vendeira, P A S; Moncada, I; Boehmer, M; Henneges, C; Boess, F G

    2014-01-01

    Initiation of ED treatment with a particular PDE5I may influence treatment-adherence and other outcomes. In this multicenter, open-label study, men with ED, naïve to PDE5I, were randomized to tadalafil 5 mg once-a-day (OaD; N=257), 10 mg on demand (PRN; N = 252) or sildenafil-citrate (sildenafil) 50 mg PRN (N = 261) for 8 weeks (dose adjustments allowed), followed by 16 weeks of pragmatic treatment (switching between PDE5I allowed). Primary outcomes (treatment-adherence) were reported previously. Here, we report effects on: Psychological and Interpersonal Relationship Scales, Self-Esteem and Relationship (SEAR) questionnaire, ED Inventory of Treatment Satisfaction (EDITS), International Index of Erectile Function (IIEF), Sexual Encounter Profile (SEP) and Global Assessment Questions (GAQ). Mixed-model for repeated measures and analysis of covariance were used to analyze changes from baseline; GAQ-responses were evaluated by logistic regression. Analyses were adjusted for treatment, country, ED-severity, baseline and baseline-by-treatment interaction. Patients randomized to tadalafil OaD or PRN reported greater improvement (least-square mean (s.e.) change) in Sexual Self-Confidence (OaD +0.90 (0.048), PRN +0.93 (0.050), vs +0.73 (0.049); P=0.006 and P=0.001) and Spontaneity (OaD +0.11 (0.035), PRN +0.13 (0.035), vs +0.02 (0.035); P = 0.044 and P = 0.010) compared with sildenafil. Improvements in GAQ and SEP responses, IIEF-EF, orgasmic function, sexual desire, overall satisfaction domains, SEAR and EDITS scores did not differ significantly between treatment groups. PMID:24784894

  10. Erectile function following external beam radiotherapy for clinically organ-confined or locally advanced prostate cancer

    External beam radiotherapy (XRT) has been a standard treatment for clinically localized prostate cancer. However, preservation of erectile function following XRT is controversial. In this study, the influence of XRT on erectile function of patients with clinically organ-confined or locally advanced prostate cancer was retrospectively evaluated. The study included 34 of 84 patients with organ-confined or locally advanced prostate cancer who underwent XRT between 1995 and 2002. Erectile function following radiotherapy was assessed by a simple mailed questionnaire that was constructed for the study. To determine the predictive factors for erectile dysfunction following radiotherapy, data were analyzed by multivariate analysis with the Cox proportional hazards model. The modality of XRT was the only factor to independently predict erectile dysfunction following XRT. The maintenance rates of erectile function were 47.6% at 1 year and 19% at 3 years in patients who received the 3-dimensional conformal radiotherapy, which were significantly higher than in those who received conventional radiotherapy (P=0.026). XRT significantly reduced the maintenance rate of erectile function during the follow-up period, with the rate being 19% at 3 years in patients who received 3-dimensional conformal radiation. The XRT modality was involved in the reduction of erectile function. These results suggest that erectile dysfunction is a possible adverse event following XRT. (author)

  11. Prevalence and risk factors of erectile dysfunction in 126 cases of male post-stroke patients%126例男性脑卒中患者勃起功能障碍及影响因素分析

    辛家厚; 俞明明; 程晋宝; 汪青松

    2015-01-01

    Objective The aim of this study was to investigate the prevalence of erectile dysfunction (ED) and to assess the risk factors of ED in male post‐stroke patients .Methods One hundred and twenty six male post‐stroke patients were invited to par‐ticipate in this study .Patients were divided into ED group and non‐ED group according to the erectile function evaluated by Interna‐tional Index of Erectile Function‐5 (IIEF‐5) .The neurological impairment was measured using the National Institute of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS) .Depressive symptoms was measured using the Hamilton Depression Scales (HAMD) .The global cognitive function was measured using the Mini mental Status Examination (MMSE) .The clinical and psychosocial factors were compared between the ED and non‐ED groups .Univariate and multivariate Logistic regression analyses were employed to assess the risk factors with ED .Results There were 38 patients (30 .2% ) with ED in all the 126 male post‐stroke patients .Univariate Logistic regression analyses revealed that hypertension ,diabetes ,ACEI ,and depression were significantly related to ED in male post‐stroke patients (P<0 .05) .Multivariate Logistic regression analyses revealed that ACEI and depression were independently associated with ED in male post‐stroke patients (P<0 .05) .Conclusion ED is common in Chinese male post‐stroke patients .ACEI and depression are the major determinants of ED .%目的:探讨男性脑卒中患者勃起功能障碍(ED )发生情况及影响因素。方法选取126例男性脑卒中患者,采用国际勃起功能指数‐5(IIEF‐5)量表判定入选患者有无ED ,根据评分结果将患者分为ED组和非ED组。采用NIHSS评分量表及改良Rankin (mRS)评分量表评估患者神经功能缺损情况;采用抑郁自评量表(HAMD)评估患者抑郁状态;采用简易智能状态检查量表(MMSE)评估患者认知功能。比较ED组

  12. Male sexual dysfunction and infertility associated with neurological disorders

    Fode, Mikkel; Krogh-Jespersen, Sheila; Brackett, Nancy L.; Ohl, Dana A; Lynne, Charles M; Sønksen, Jens

    2011-01-01

    Normal sexual and reproductive functions depend largely on neurological mechanisms. Neurological defects in men can cause infertility through erectile dysfunction, ejaculatory dysfunction and semen abnormalities. Among the major conditions contributing to these symptoms are pelvic and retroperitoneal surgery, diabetes, congenital spinal abnormalities, multiple sclerosis and spinal cord injury. Erectile dysfunction can be managed by an increasingly invasive range of treatments including medica...

  13. 东莞市1812名流动男性勃起功能障碍流行病学调查%Epidemiological survey on erectile dysfunction of 1812 male lfoating population in Dongguan

    邓天勤; 谢雨莉; 阮建波; 邓敏芝; 万子; 陈鑫; 尧冰; 邓春华

    2015-01-01

    目的:了解东莞市流动人口男性勃起功能障碍(ED)患病率及其相关影响因素。方法采用整群、多级、分层、随机的抽样方法,对东莞市男性流动人口进行集中、现场问卷调查,问卷内容包括人口学信息(年龄、体质量、身高和文化程度等)、生殖健康信息接受情况(性知识来源、手淫、阴茎夜间勃起情况等)、性生活情况(性欲、性生活频率、射精潜伏时间等)以及国际勃起功能指数-5(IIEF-5)。结果完成调查人数共1952名,回收问卷1835份,回收率94.0%;有效问卷1812份,有效应答率92.8%。本组ED患病率为64.2%,15岁~、26岁~、36岁~、46岁~和56-~60岁5组中,ED患病率分别为72.7%、62.3%、61.7%、67.1%、75.0%。多因素分析结果显示已婚同居和收入与ED的发病相关。结论东莞市流动人口男性ED患病率为64.2%,以轻症ED为主;年龄大于56岁的患病率最高;年龄、文化程度、收入和同居情况是影响ED患病率的主要危险因素,已婚同居和收入与ED发病相关。%Objective To investigate the morbidity and its related factors of erectile dysfunction(ED) of male floating population in dongguan.Methods Stratified sampling method combining with the questionnaire including demographic information、reproductive health information、sexual situations and International index of Erectile Function -5 were used in the study.Results After removing the invalid questionnaire, 1812 valid questionnaire were acquired .The morbidity was 64.2%, and the prevalence of ED in five aged groups ,i.e.over 15 years,over 26 years ,over 36 years ,over 46 years ,over 56 years were 72.7%,62.3%, 61.7%, 67.1% and 75% respectively. Cohabitation and income were all related to the morbidity of ED.Conclusion The morbidity of ED of male floating population in Dongguan accounts for 64.2%, and MSED is the major type of ED. The highest prevalence age is below 25-year-old. The

  14. A survey on the experience of 136 Italian urologists in the treatment of erectile dysfunction with PDE5 inhibitors and recommendations for the use of Avanafil in the clinical practice

    Vincenzo Mirone

    2016-07-01

    Full Text Available Introduction: PDE5 inhibitors are the firstline treatment for erectile dysfunction. Although all these drugs share the same mechanism of action, each agent could have different characteristics in terms of selectivity, pharmacokinetics and tolerability profile. Materials and Methods: This manuscript illustrates a project, undertaken by the Italian Society of Urology in order to obtain a “snapshot” of the experience of Italian urologists with the use of PDE5 inhibitors in the clinical practice. This project included a survey, targeting a sample of 136 Italian urologists experienced in the treatment of ED, and the organization of a conference of experts who, based on the findings of the survey, the scientific literature and the clinical experience, would define some recommendations for the use of PDE5 inhibitors in clinical practice with a particular focus on Avanafil, the most recent drug in this class. Results: The following recommendations on the use of Avanafil were issued: 1 In patients who are candidates for the use of Avanafil, it is advisable to use the 200-mg dose from the first administration; 2 When used at the highest dose (200 mg, Avanafil shows a favourable tolerability profile with an efficacy similar to that of other agents; 3 The patient should be instructed to take Avanafil on an empty stomach, i.e., 30-45 minutes before or 2 hours after a meal; 4 The efficacy window of Avanafil is between 30 minutes and 6 hours after dosing, which qualifies this molecule as a new drug with an intermediate duration of action; 5 Avanafil at a dose of 50-100 mg/day may be a therapeutic option in chronic rehabilitation. Conclusions: Among PDE5 inhibitors, Avanafil is a new agent with an intermediate duration of action, characterized by high efficacy and good tolerability even at the highest dose (200 mg.

  15. An Observational Study to Evaluate the Prevalence of Erectile Dysfunction (ED) and Prescribing Pattern of Drugs in Patients with ED Visiting an Andrology Specialty Clinic, Mumbai: 2012-14

    Kulkarni, Vijay R.; Bhagat, Sagar B.; Beldar, Amit S.; Patel, Sadiq B.

    2015-01-01

    Introduction: Erectile dysfunction (ED) is a common occurrence and its incidence is expected to increase significantly along with the increase in various lifestyle diseases. The drug utilization for ED is very low. Also, studies describing the prescription pattern in ED are lacking. Materials and Methods: We conducted a retrospective cross-sectional observational study, including a drug utilization analysis, of 606 prescriptions as per the standard guidelines (WHO and STROBE). Results: Out of 606, 249 (41%) were from the age group of 30-39 years. Addictions were present in 388 (64%). Out of 606, 186 had urological, 154 had cardiovascular and 102 had psychological co-morbid disorders. Out of 348, 201 were prescribed Tadalafil (low dose) on a once daily basis. Out of 172, 121 were prescribed Sildenafil (high dose) on an ‘as and when required’ basis. Nutritional/ herbal supplements were prescribed in 126/606. The ratio of ‘Prescribed Daily Dose’ to ‘Defined Daily Dose’ of Tadalafil, Sildenafil, and Dapoxetine were 1.1, 1.3 and 1.5 respectively. Conclusion: Measures for de-addiction play an important role in the overall management of ED. The most common co-morbid disorders were urological, like BPH, LUTS, etc, followed by cardiovascular, psychological and diabetes. Overall, rational pharmacotherapy was observed. Tadalafil was the most commonly prescribed drug for ED. The main factor in the selection of a particular PDE5 inhibitor was its pharmacokinetics and cost. Udenafil, being the costliest, was the least prescribed. Dapoxetine was used in a significant number of individuals primarily for PE with ED. The combination of Papaverine, Chlorpromazine ± Alprostadil was used as intracavernosal injection in patients not responding to oral drugs. PMID:26393163

  16. Effects of low level testosterone on the corpus cavernosum cells in rats with diabetes mellitus-induced erectile dysfunction%糖尿病性勃起功能障碍大鼠中低睾酮水平对阴茎海绵体平滑肌的影响

    刘全亮; 王行环; 杨中华; 周章炎; 胡万里; 彭谋

    2012-01-01

    目的 观察糖尿病性勃起功能障碍(DMED)大鼠的睾酮水平变化对其阴茎海绵体平滑肌组织和超微结构的影响.方法 将3个月龄雄性Wistar大鼠20只随机等分为两组:正常对照组和DMED组,行放射免疫法测定其血清睾酮浓度和masson染色观察阴茎海绵体平滑肌(CCSM)密度以及通过透射电镜观察海绵体平滑肌细胞的超微结构.结果 DMED组大鼠的血清睾酮水平(17.445 ±2.540) nmol/L较正常组(338.457±63.802) nmol/L明显下降(P<0.01);同时DMED组大鼠CCSM密度(5.640±0.597)%较正常对照组(19.890±1.957)%亦明显减少(P<0.01),透射电镜下还观察到DMED组大鼠阴茎CSMC的核浆比增大,高尔基复合体明显肥大以及线粒体水肿.结论 睾酮水平下降可能导致DMED大鼠阴茎海绵体平滑肌发生病理变化.%Objective To investigate the changes of testosterone levels and the effect of low level testosterone on the corpus cavernosum tissue and its ultrastructure in rats with diabetes mellitus-induced erectile dysfunction.Methods Three-month-old male Wistar rats ( n =20) were divided into 2 groups:the contorl group (n =10) and the diabetes mellitus-induced erectile dysfunction group (n =10).Serum levels of testosterone were measured by radioimmunoassay and the percentage of corporal smooth muscle cells was detected by Masson staining.The ultrastructures of corporal smooth muscle cells were examined under the transmission electron microscopy.Results The serum levels of testosterone in the diabetes mellitus-induced erectile dysfunction group ( 17.445 ± 2.540) nmol/L were obviously lower than in the contorl group (338.457 ± 63.802) nmol/L,P < 0.01.The percentage of corporal smooth muscle cells ( 19.890 ±1.957) % was higher in the control group than in the diabetes mellitus-induced erectile dysfunction group (5.640 ± 0.597)%,P <0.01.Ultrastructurally,in the smooth muscle cells of cavernous tissue,there were more Goigi bodies and

  17. The Effect of Endovascular Revascularization of Common Iliac Artery Occlusions on Erectile Function

    To determine the incidence of erectile dysfunction in patients with common iliac artery (CIA) occlusive disease and the effect of revascularization on erectile function using the sexual health inventory for males (SHIM) questionnaire. All patients (35 men; mean age 57 ± 5 years; range 42–67 years) were asked to recall their sexual function before and 1 month after iliac recanalization. Univariate and multivariate analyses were performed to determine variables effecting improvement of impotence. The incidence of impotence in patients with CIA occlusion was 74% (26 of 35) preoperatively. Overall 16 (46%) of 35 patients reported improved erectile function after iliac recanalization. The rate of improvement of impotence was 61.5% (16 of 26 impotent patients). Sixteen patients (46%), including seven with normal erectile function before the procedure, had no change. Three patients (8%) reported deterioration of their sexual function, two of whom (6%) had normal erectile function before the procedure. The median SHIM score increased from 14 (range 4–25) before the procedure to 20 (range 1–25) after the procedure (P = 0.005). The type of recanalization, the age of the patients, and the length of occlusion were related to erectile function improvement in univariate analysis. However, these factors were not independent factors for improvement of erectile dysfunction in multivariate analysis (P > 0.05). Endovascular recanalization of CIA occlusions clearly improves sexual function. More than half of the patients with erectile dysfunction who underwent endovascular recanalization of the CIA experienced improvement.

  18. The Effect of Endovascular Revascularization of Common Iliac Artery Occlusions on Erectile Function

    Gur, Serkan, E-mail: mserkangur@yahoo.com [Sifa Hospital, Department of Radiology (Turkey); Ozkan, Ugur [Baskent University, Department of Radiology, Faculty of Medicine (Turkey); Onder, Hakan; Tekbas, Gueven [Dicle University, Department of Radiology, Faculty of Medicine (Turkey); Oguzkurt, Levent [Baskent University, Department of Radiology, Faculty of Medicine (Turkey)

    2013-02-15

    To determine the incidence of erectile dysfunction in patients with common iliac artery (CIA) occlusive disease and the effect of revascularization on erectile function using the sexual health inventory for males (SHIM) questionnaire. All patients (35 men; mean age 57 {+-} 5 years; range 42-67 years) were asked to recall their sexual function before and 1 month after iliac recanalization. Univariate and multivariate analyses were performed to determine variables effecting improvement of impotence. The incidence of impotence in patients with CIA occlusion was 74% (26 of 35) preoperatively. Overall 16 (46%) of 35 patients reported improved erectile function after iliac recanalization. The rate of improvement of impotence was 61.5% (16 of 26 impotent patients). Sixteen patients (46%), including seven with normal erectile function before the procedure, had no change. Three patients (8%) reported deterioration of their sexual function, two of whom (6%) had normal erectile function before the procedure. The median SHIM score increased from 14 (range 4-25) before the procedure to 20 (range 1-25) after the procedure (P = 0.005). The type of recanalization, the age of the patients, and the length of occlusion were related to erectile function improvement in univariate analysis. However, these factors were not independent factors for improvement of erectile dysfunction in multivariate analysis (P > 0.05). Endovascular recanalization of CIA occlusions clearly improves sexual function. More than half of the patients with erectile dysfunction who underwent endovascular recanalization of the CIA experienced improvement.

  19. Associations of unhealthy lifestyle factors with sexual inactivity and sexual dysfunctions in Denmark

    Christensen, Birgitte S; Grønbaek, Morten; Pedersen, Bo V;

    2011-01-01

    Studies have linked obesity, a sedentary lifestyle, and tobacco smoking to erectile dysfunction, but the evidence linking unhealthy lifestyle factors to other sexual dysfunctions or to sexual inactivity is conflicting.......Studies have linked obesity, a sedentary lifestyle, and tobacco smoking to erectile dysfunction, but the evidence linking unhealthy lifestyle factors to other sexual dysfunctions or to sexual inactivity is conflicting....

  20. Development of animal model for erectile dysfunction after radical prostatectomy%前列腺癌根治术后勃起功能障碍动物模型的建立

    卞军; 孙样宙; 戴宇平; 刘贵华; 邓春华; 杨国胜

    2011-01-01

    目的 对大鼠海绵体神经(CN)进行解剖并对其造成钳夹损伤,以建立前列腺癌根治术(RP)后勃起功能障碍(ED)的动物模型.方法 将36只雄性SD大鼠随机分为模型组、假手术组、正常组,术后4周通过阿朴吗啡(APO)实验及海绵体内压(ICP)/平均动脉压(MAP)测定、阴茎神经型一氧化氮合酶(nNOS)免疫组织化学检测以评估建立模型的效果.结果 术后4周3组大鼠的阴茎勃起率和平均勃起次数分别为0%和0次、100%(11/11)和(2.24±0.86)次、100%(12/12)和(2.39±0.92)次.模型组大鼠无明显勃起反应,假手术组、正常组可见明确勃起反应.电刺激盆腔星状神经节(MPG)前3组大鼠ICP/MAP分别为(0.13±0.04)、(0.10±0.03)、(0.12±0.03),电刺激MPG后分别为(0.12±0.05)、(0.57±0.08)、(0.58±0.06),电刺激MPG前3组ICP/MAP差异均无统计学意义(P>0.05),模型组与假手术组、正常组的电刺激MPG后ICP/MAP差异有统计学意义(P<0.05).3组大鼠阴茎nNOS阳性神经纤维数分别为(23.04±2.59)、(73.94±7.51)、(80.26±6.95),模型组大鼠阴茎nNOS阳性神经纤维数明显少于假手术组、正常组(P<0.05).结论 大鼠CN结构与人类非常相似,CN钳夹损伤是建立RP术后ED模型的可靠的方法.%Objective To identify rat cavernous nerve (CN) and develop a rat model of erectile dysfunction (ED) after radical prostatectomy (RP) caused by injury of cavernous nerve.Methods Thirty-six male SD rats were were randomly divided into 3 groups:model group,sham-operation group and nomal group.Four weeks after surgery,rat models were evaluated by apomorphine test,ICP/MAP measurement and nNOS-positive nerve fibres in penis.Results The rats in model group had no erectilty in apomorphine test and electical stimulating MPG.The rats in sham-operation group and nomal group had erectility at the same conditions,accompanied with increased ICP/MAP in electrical stimulation ( P<0.05 ).The nNOS-positive nerve fibres in model

  1. ED与血脂异常相关性及2种干预方式对比研究%CORRELATION BETWEEN DYSLIPIDEMIA AND ERECTILE DYSFUNCTION AND COMPARISON OF 2 INTERVENTION METHODS

    张冰; 任岩春; 李鸣晓; 邢文晓; 杨燕; 田硕

    2011-01-01

    Objective To investigate the correlation between dyslipidemia and erectile dysfunction( ED ), and compare two methods of intervention. Methods The clinical epidemiologic method was used to compare the ratio of ED in 150 patients of dyslipidemia to 150 healthy individual,meanwhile analyzed the relationship of ED and lipid profile Total cholesterol ( TC ), triglyceride ( TG ),low density lipoprotein -c( LDL - C ), high density lipoprotein - C ( HDL - C ), and then the 82 ED patients of 150 dyslipidemia patients were treated with two ways that were sexual function rehabilitation and changing lifestyle. Results The ratio of ED in dyslipidemia patients was 54.6% ,while was 12.6%in control group, there was a significant difference between two groups. There was a significant correlation between HDL - C and ED, only HDL - C was a protective factor of ED. There were positive correlation between ED and TC TG, on the contrary negative correlation between ED and HDL( r = 0. 218, P <0. 005 )( r = 0. 322, P < 0. 005 )( r = 0. 293, P < 0. 005 )( r = - 0. 467,P < 0. 005 ), respectively.International index of erectile function -5 ( lIEF -5 ) score can be improved by two ways of sexual function rehabilitation and changing lifestyle. Conclusion Dyslipidemia including high level of serum TC, high LDL, low HDL was related with ED,which was one of the main pathogenic factors of ED. ED can be treated by lipid -lowering therapy, sexual function rehabilitation and change lifestyle.%目的 探讨血脂异常与勃起功能障碍(erectile dysfunction,ED)的相关性,及2种干预方式疗效的对比.方法 应用临床流行病学研究方法,比较有血脂异常者150例ED发病情况和血脂正常男性150例ED的发病情况,并分析空腹三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low density lipoprotein -C,LDL-C)和高密度脂蛋白胆固醇(high density lipoprotein-C,HDL-C)与ED的关系.对血脂异常150

  2. La disfunción eréctil se asocia a elevada prevalencia de obesidad y síndrome metabólico Erectile dysfunction is associated with a high prevalence of obesity and metabolic syndrome

    P. Costanzo

    2008-09-01

    prevenir la progresión a DM2 y enfermedad cardiovascular.Introduction: The erectile dysfunction (ED is associated with metabolic and endocrine diseases and with high frequency to Type 2 Diabetes Mellitus (DM2, even with good glycemic control. Besides ED is associated with others metabolic syndrome (MS components like hypertension (HT, obesity and dyslipidemia (DLP, without hyperglycemia. These observations has guided us to consider the hypothesis that ED could be installed early in patients with the MS and previously to DM2 diagnosis. Aims: To evaluate in a ED patients group: 1 metabolic and cardiovascular risk factors and MS prevalence; 2 impaired glucose tolerance prevalence. Methods: We included 77 patients with ED (group P. Control group: 17 men without ED (group C. Exclusion criteria: pharmacologic, anatomic or endocrine ED (hypogonadism or hyperprolactinemia, DM2, prior prostatic surgery or chronic illnesses. The erectile function was rated according the International Index of Erectile Function 5. Multiple metabolic and cardiovascular risk factors were evaluated: HT, DLP, obesity, smoking and sedentarism lifestyle. The MS was evaluated according the International Diabetes Federation (IDF and National Cholesterol Education Program-Third Adult Treatment Panel (NCEP-ATPIII criteria. Results: The prevalence of HT and DLP was higher in group P vs group C: 82.2 % vs 23.5 % (p=0.03 and 68.5 % vs 23.5 % (p=0.04, respectively. Twenty new cases of HT and 24 new cases of DLP were detected. Group P patients had a higher waist circumference and body mass index than group C ones: 105.3 ± 9.7 vs 98.1 ± 7.5 cm (p=0.004 and 29.8 ± 4.3 vs 26.2 ± 2.9 kg/m² (p=0.0003, respectively. The prevalence of MSIDF and MS-NCEP-ATPIII was higher in group P vs group C: 68.5 % vs 23.5 % (p=0.04 and 52.1 % vs 11.8 % (p=0.02, respectively. No differences were found in impaired glucose tolerance prevalence. Conclusion: Men with ED have a high prevalence of HT, DLP, obesity and MS. Early detection

  3. Efficacy of Compound Xuanju Capsule combined with apomorphine hydrochloride on erectile dysfunction%复方玄驹胶囊联合盐酸阿朴吗啡治疗勃起功能障碍的临床研究

    王宝庆

    2012-01-01

    To investigate the clinical effect of Compound Xuanju Capsule combined with apomorphine hydrochloride on penile erectile dysfunction (ED). Methods: We treated 115 ED patients with Compound Xuanju Capsule plus apomorphine hydro-chlorid (trial group) , and another 111 with apomorphine hydrochloride alone (control group) , both for two months. Then we compared the IIEF-5 scores between the two groups. Results: After treatment, the IIEF-5 scores were 17. 85 ±2. 68 and 13. 96 ±3. 25 in the trial and control group, respectively, significantly higher than 11.42 ±2.68 and 13.96 ±3.25 before treatment (P<0.01). There were statistically significant differences between the two groups either in post-treatment IIEF-5 scores (P < 0.01) or in the rates of obvious effectiveness, effectiveness and total effectiveness. Conclusion: Compound Xuanju Capsule combined with apomorphine hydrochloride has a good curative effect on ED, and deserves general clinical application.%目的:观察复方玄驹胶囊联合盐酸阿朴吗啡治疗阴茎勃起功能障碍(ED)的疗效. 方法:采用复方玄驹胶囊联合盐酸阿朴吗啡治疗115例ED患者为治疗组,单用盐酸阿朴吗啡治疗111例作为对照组,经连续2个月的治疗后,观察两组的国际勃起功能问卷(IIEF-5)的评分改变情况. 结果:治疗组与对照组IIEF-5的评分在治疗前分别为(11.42±2.38)、(11.56±2.65)分,两组比较差异无显著性(P>0.05);治疗后分别为(17.85±2.68)、(13.96±3.25)分,均有明显提高(P<0.01),而治疗组在治疗后的评分明显高于对照组(P<0.01);治疗组的显效率、有效率和总有效率均高于对照组. 结论:复方玄驹胶囊联合盐酸阿朴吗啡治疗ED有较好疗效,值得临床推广使用.

  4. 勃起功能异常的影响因素及其与前列腺炎样症状的关系研究--防城港地区男性健康大型横断面调查%Related factors of erectile dysfunction and the relationship between erectile dysfunction and PLS:a large cross-sectional survey of male health in Fangchenggang area

    谭伟明; 莫曾南; 颜赟坤; 高勇; 谭爱华; 张海英; 杨晓波; 秦雪; 米华

    2016-01-01

    目的:调查广西南部防城港地区男性勃起功能异常(ED)的患病率及其危险因素,并探讨国际勃起功能指数(IIEF-5)评分与美国国立卫生研究院慢性前列腺炎症状指数(NIH-CPSI)评分两者之间有无关联,阐明前列腺炎样症状(PLS)对 ED 的影响。方法由统一培训合格的工作人员,对研究对象做问卷调查及采集信息,采集的资料包括 IIEF-5评分、NIH-CPSI 评分、社会学资料、医疗就医史等基本资料。调查结束后,结合体检结果以及问卷信息,采用 SPSS 17.0软件进行数据分析。结果回收有效调查表3193份,其中 ED 者1679例(52.58%),无 ED 者1514例(47.42%),PLS 者188例(5.89%),无 PLS 者3005例(94.11%),PLS 组 ED 发生率高于非 PLS 组,差异有统计学意义(χ2=34.731,P <0.01)。ED 的发生与年龄、NIH-CPSI 总评分、婚姻状况、教育程度具有相关性(P <0.05)。IIEF-5评分和 CPSI 总评分、疼痛程度评分、生命质量(QOL)评分及排尿困难程度评分等之间有负相关性(P <0.05)。结论在广西南部防城港地区的男性中人群中,ED 的发病率较高(52.58%),尤其是 PLS 者(73.40%)。勃起功能异常的危险因素可能包括年龄、CPSI 总评分、教育文化程度、婚姻状况等。勃起功能异常的严重程度与前列腺炎样症状的患病程度有相关性。%Objective This article aims to investigate the prevalence and the risk factors of male erectile dysfunction (ED)in Fangchenggang area of southern Guangxi,and to explore whether the International Index of Erectile Function 5 (IIEF-5)is correlated to the National Institutes of Health Chronic Prostatitis Symptom Index.The effects of prostatitis-like symptoms (PLS)on ED are elucidated. Methods From September 2009 to December 2009,a total of 4303 male residents aged 17 to 88 years who had received medical checkup as usual in Fangchenggang district of Guangxi province were invited to take part in the survey for completing the

  5. Retrograde ejaculation and sexual dysfunction in men with diabetes mellitus

    Fedder, J; Kaspersen, Maja Døvling; Brandslund, I;

    2013-01-01

    Retrograde ejaculation (RE) and erectile dysfunction may be caused by diabetes mellitus (DM), but the prevalence of RE among DM patients is unknown. A prospective, blinded case-control study comparing men with DM with matched controls according to RE and erectile dysfunction was performed. Twenty...

  6. 十一酸睾酮联合他达拉非治疗2型糖尿病合并勃起功能障碍115例%Effect of testosterone undecanoate combined with tadalafil in the treatment of erectile dysfunction in 115 patients with type 2 diabetes

    陈其超; 姜熙; 曹志刚

    2014-01-01

    目的:评估十一酸睾酮联合他达拉非( TUT )在男性患者2型糖尿病合并勃起功能障碍( type 2 diabetes erectile dysfunction,DED)中的治疗效果,为DED患者的治疗提供新的思路。方法:选择115例DED的中老年男性患者使用TUT方法治疗3个月。治疗前后记录患者国际勃起功能指数-5评分、患者性生活日记中能完成性交的成功率以及血清睾酮值,并比较分析。结果:治疗后患者国际勃起功能指数-5评分、能完成性交的成功率和血清总睾酮值均较治疗前明显提高(P<0.01)。结论:TUT疗法能够显著改善患者性生活质量,安全有效,不良反应少,值得推广。%Objective:To evaluate the efficacy of testosterone undecanoate combined with tadalafil(TUT) in the treatment of type 2 diabetic erectile dysfunction(DED) for providing a new treatment way. Methods:One hundred and fifteen patients with DED were treated with TUT for 3 months. The score of International Index of Erectile Function-5, sexual intercourse success rate and serum testosterone level in all patients before and after treatment were compared. Results:Compared with before treatment, the score of International Index of Erectile Function-5, sexual intercourse success rate and serum testosterone level of patients were obviously improved after treatment(P <0. 01). Conclusions:TUT therapy is safe,effective and less adverse reaction,which can significantly improve the quality of sex life of patients,and is worthy of promotion.

  7. Rehabilitation of erectile function following radical prostatectomy

    Andrew R. McCullough

    2008-01-01

    The concept of muscle rehabilitation after nerve injury is not a novel idea and is practiced in many branches of medicine, including urology. Bladder rehabilitation after spinal cord injury is universally practiced. The erectile dysfunction (ED) experienced after radical prostatectomy (RP) is increasingly recognized as being primarily neurogenic followed by secondary penile smooth muscle (SM) changes. There is unfortunately no standard approach to penile rehabilitation after RP because controlled prospective human studies are not available. This article reviews the epidemiology, experimental pathophysiological models, rationale for penile rehabilitation, and currently published rehabilitation strategies.

  8. Pituitary prolactinoma with severe erectile dysfunction as the initial symptom:Diagnosis and treatment of 4 cases%以重度ED为首发症状的垂体泌乳素瘤4例报告

    姜涛; 郑磊; 苏晓明; 彭进强; 孙冬晨; 李泉林; 张志伟; 王法鹏; 姜辉

    2013-01-01

    目的:以重度ED为首发症状的垂体泌乳素瘤易误诊,分析该病所致重度ED的特点,以提高诊治水平. 方法:回顾4例以重度ED(IIEF-5评分5~7分)为首发临床症状、经MRI检查确诊的垂体泌乳素瘤,结合文献诊治特点进行分析. 结果:4例因垂体泌乳素瘤引起的重度ED误诊时间长达2年,血清泌乳素(PRL)均为正常高值的10倍以上,开始应用PDE5抑制剂无效,3例行单鼻孔-蝶窦-垂体瘤全切除术,术后24个月随访:1例PRL正常,IIEF-5 19分,2例PRL分别降至600和768 IU/L,IIEF-5均为15分,此时再服用PDE5抑制剂获得满意效果;1例口服溴隐亭保守治疗,12个月后随访PRL正常,IIEF-5> 21分. 结论:检测血PRL和脑MRI检查可以确诊以重度ED为首发临床症状的垂体泌乳素瘤,在PRL极高的情况下,单纯应用PDE5抑制剂无效,通过手术或药物降低PRL后,ED症状可改善,若改善不明显,此时再应用PDE5抑制剂将会收到满意的效果.%Objective: Pituitary prolactinoma with severe erectile dysfunction (ED) as the initial symptom is often misdiag-nosed. This article explores the diagnosis and treatment of severe ED caused by pituitary prolactinoma. Methods; We retrospectively analyzed the diagnosis and treatment of 4 cases of pituitary prolactinoma with severe ED (IIEF-5 score 5 - 7) as the initial clinical symptom confirmed by MRI. Results: The 4 cases of pituitary prolactinoma-induced severe ED, with serum prolactin 10 times above the maximum normal level, were misdiagnosed for 2 years. AH failed to respond to the PDE5 inhibitor therapy, and then 3 of them underwent transnasal hypophysiectomy. Twenty-four months of follow-up found the level of prolactin restored to normal in 1 case (IIEF-5 = 19), and reduced to 600 and 768 IU/L respectively (IIEF-5 = 15) in the other 2. Then administration of the PDE5 inhibitor was followed, which produced satisfactory efficacy. One case was treated with oral bromocriptine, which restored the

  9. Erectile Dysfunction in Rats with Diabetes Induced by High-lipid Feeding and Low-dose Streptozotocin Injection%高脂饮食联合小剂量链脲佐菌素注射制备糖尿病大鼠模型勃起功能研究

    乐岭; 陈璐璐

    2012-01-01

    Objective To study the erectile dysfunction in rats with diabetes induced by high-lipid feeding and low-dose streptozotocin (STZ) intra-abdominal injection. Methods Sixty 6-week old healthy male Wistar rats with normal e-rectile function were randomly divided into diabetic group (50 rats) and control group (10 rats, normal diet feeding). After eight weeks of high-lipid diet feeding, the diabetic model group accepted intra-abdominal injection of STZ, 35 mg/kg. At the ninth week, the tail vein blood was sampled to test the fasting glucose and lipid profile (low-intensity lipoprotein cholesterol and triglyceride) and the fasting plasma insulin. Apomorphine (APO) function test was performed to test the erectile function. Results After 8-week of high-lipid diet feeding, the weight of rats was significant increased. After injecting STZ, the blood gluscose of the diabetic group (increased to (14. 8 ± 3. 9) mmol/L), the serum insulin (decreased to (4. 3 ± 0. 7) uIU/L) and the insulin resistance index were all significantly different from those of the control group (P <0. 05). Serum triglyceride and low-intensity lipoprotein cholesterol were higher in diabetic group than those in control group (P<0. 05). There was no obivous change of the erectile function in normal group and the erection rate was 100%. In diabetic group, 1 rat died after STZ injection, 24 rats showed erection and the erectile rate (48. 9%) was significantly lower than that in normal group. Conclusion Diabetes rats induced by high-lipid feeding and low-dose STZ intra-abdominal injection have increased glucose, insulin resistance and erectile dysfunction, which can be utilized as the the model of type 2 diabetes complicated with erectile dysfunction.%目的 研究高脂喂养联合小剂量链脲佐菌素注射制备的糖尿病(diabetes mellitus,DM)大鼠的勃起功能.方法 60只6周龄,勃起功能正常的SD大鼠随机分为对照组(10只)和实验组(50只).实验组高脂喂养8周

  10. Erectile function after permanent prostate brachytherapy

    Purpose: To determine the incidence of potency preservation after permanent prostate brachytherapy using a validated patient-administered questionnaire and to evaluate the effect of multiple clinical and treatment parameters on penile erectile function. Methods and Materials: Four hundred twenty-five patients underwent permanent prostate brachytherapy from April 1995 to October 1999. Two hundred nine patients who were potent before brachytherapy and who at the time of the survey were not receiving hormonal therapy were mailed the specific erectile questions of the International Index of Erectile Function (IIEF) questionnaire with a self-addressed stamped envelope. The questionnaire consisted of 5 questions, with a maximal score of 25. Of the 209 patients, 181 (87%) completed and returned the questionnaire. The mean and median follow-up was 40.4±14.9 and 40.6 months, respectively (range 19-75). Preimplant erectile function was assigned using a three-tiered scoring system (2 = erections always or nearly always sufficient for vaginal penetration; 1 = erections sufficient for vaginal penetration but considered suboptimal; 0 = the inability to obtain erections and/or erections inadequate for vaginal penetration). Postimplant potency was defined as an IIEF score ≥11. The clinical parameters evaluated for erectile function included patient age, preimplant potency, clinical T-stage, pretreatment prostate-specific antigen level, Gleason score, elapsed time after implantation, hypertension, diabetes mellitus, and tobacco consumption. Treatment parameters included radiation dose to the prostate gland, use of hormonal manipulation, use of supplemental external beam radiotherapy (EBRT), choice of isotope, prostate volume, and planning volume. The efficacy of sildenafil citrate in brachytherapy-induced erectile dysfunction (ED) was also evaluated. Results: Pretreatment erectile function scores of 2 and 1 were assigned to 125 and 56 patients, respectively. With a 6-year follow

  11. Erectile function after radical prostatectomy

    Fode, Mikkel; Frey, Anders; Jakobsen, Henrik; Sønksen, Jens

    OBJECTIVE: The aim of this study was to assess postprostatectomy erectile function compared to preoperative status by subjective patient perception and the abbreviated International Index of Erectile Function (IIEF-5) questionnaire. MATERIALS AND METHODS: The study used data from a prospectively...

  12. [Erectile disfunction and benign prostatic hyperplasia - causal relation or coincidence?].

    Gasser, Thomas

    2010-03-01

    There is increasing evidence of causal relation between benign prostatic hyperplasia (BPH) and erectile dysfunction (ED). BPH appears to have a negative impact on sexual function. Drugs commonly used for the treatment of BPH (i.e. alphablockers, 5-alpha reductase inhibitors) may cause retrograde ejaculation, ED and reduced libido. Physicians should be aware of these adverse events and inform their patients accordingly. Conversely, phosphodiestease-5-inhibitors may have a beneficial effect on BPH symptoms. PMID:20235043

  13. Radionuclide diagnosis of erectile disfunction

    Gamma-camera angio scintigraphy of the penis was performed in 17 patients, twelve of them with erectile disfunction. A new method of quantitative assessment of the blood flow and perfusion of the penis is described. New objective criteria have been established for differential diagnosis of psychogenic and vasculogenic impotence, as well as for severity of condition and for diagnosis of other causes of erectile disfunction. The method was developed using Tc99-HSA and a gamma-camera. The specific nature of radionuclide curves is a reliable diagnostic criterion for making differential diagnosis in assessment of the causes of erectile disfunction. 3 refs., 5 figs. (author)

  14. Sexual dysfunctions after prostate cancer radiation therapy

    Sexual dysfunctions are a quality of life main concern following prostate cancer treatment. After both radiotherapy and brachytherapy, sexual function declines progressively, the onset of occurrence of erectile dysfunction being 12-18 months after both treatments. The pathophysiological pathways by which radiotherapy and brachytherapy cause erectile dysfunction are multi-factorial, as patient co-morbidities, arterial damage, exposure of neurovascular bundle to high levels of radiation, and radiation dose received by the corpora cavernosa at the crurae of the penis may be important in the aetiology of erectile dysfunction. Diagnosis and treatment of postradiation sexual dysfunctions must integrate pre-therapeutic evaluation and information to provide to the patient and his partner a multidisciplinary sexual medicine management. (authors)

  15. Erectile function post robotic radical prostatectomy: technical tips to improve outcomes?

    Goonewardene, S S; Persad, R; Gillatt, D

    2016-09-01

    Robotic surgery is becoming more and more commonplace. At the same time, so are complications, especially related to erectile function. The population being diagnosed with cancer is younger, with more aggressive cancers and higher expectations for good erectile function postoperatively. We conduct a retrospective analysis of literature over 20 years for Embase and Medline. Search terms used include (Robotic) AND (prostatectomy) AND (erectile function). There are a variety of multifactorial causes, resulting in worsening ED post-robotic radical prostatectomy; however, there are a number of treatments that can support this. There is much we can do to help prevent patients getting postoperative erectile dysfunction post-radical surgery. However, part of this is management of realistic patient expectations. PMID:27272758

  16. Analysis of Small Dose of Sildenafil in the Treatment of Diabetic Patients with Erectile Dysfunction in 100 Cases%小剂量西地那非治疗糖尿病病人勃起功能障碍100例观察分析

    张锋

    2015-01-01

    目的:探讨小剂量西地那非治疗糖尿病病人勃起功能障碍的疗效。方法选取糖尿病勃起功能障碍患者200例,分为小剂量组和常规剂量组,每组100例。小剂量组给予小剂量西地那非,常规剂量组给予常规剂量西地那非进行治疗。结果两组患者治疗后及治疗后3个月时的IIEF-5评分改善程度相当(P>0.05)。两组患者与治疗前相比,治疗后及治疗3个月后,其阴茎勃起硬度等级评分均得到了显著改善,组内比较差异有统计学意义(P0.05). Two groups of patients compared with before treatment, after treatment and 3 months after treatment, their level of penile erectile hardness scores were significantly improved, compare differences in the group with statistical significance(P<0.05);And comparative differences between groups with statistical significance(P<0.05). Small dose group had a significantly lower than the incidence of adverse drug reactions regular dose(P<0.05). Conclusion Small dose of sildenafil erectile dysfunction in diabetic patients with obvious therapeutic effect, fewer side effects.

  17. Genitourinary dysfunction in Parkinson's disease.

    Sakakibara, Ryuji; Uchiyama, Tomoyuki; Yamanishi, Tomonori; Kishi, Masahiko

    2010-01-15

    Bladder dysfunction (urinary urgency/frequency) and sexual dysfunction (erectile dysfunction) are common nonmotor disorders in Parkinson's disease (PD). In contrast to motor disorders, genitourinary autonomic dysfunctions are often nonresponsive to levodopa treatment. The brain pathology causing the bladder dysfunction (appearance of overactivity) involves an altered dopamine-basal ganglia circuit, which normally suppresses the micturition reflex. By contrast, hypothalamic dysfunction is mostly responsible for the sexual dysfunction (decrease in libido and erection) in PD, via altered dopamine-oxytocin pathways, which normally promote libido and erection. The pathophysiology of the genitourinary dysfunction in PD differs from that in multiple system atrophy; therefore, it might aid in differential diagnosis. Anticholinergic agents are used to treat bladder dysfunction in PD, although these drugs should be used with caution particularly in elderly patients who have cognitive decline. Phosphodiesterase inhibitors are used to treat sexual dysfunction in PD. These treatments might be beneficial in maximizing the patients' quality of life. PMID:20077468

  18. Sildenafil or Vardenafil Nonresponders’ Erectile Response to Tadalafil

    Berat Cem Ozgur

    2009-12-01

    Full Text Available Introduction: Erectile dysfunction has usually been treated by a phosphodiesterase 5 inhibitor in men, especially in the past decade. Although sildenafil and vardenafil are widely used, there is a high percentage of people who do not respond to these drugs. This study was performed in order to evaluate the efficacy of the lastly presented phosphodiesterase 5 inhibitor, tadalafil, in nonresponder group of patients to sildenafil and vardenafil. Materials and Methods: Forty married men with erectile dysfunction who had taken sildenafil or vardenafil at the maximum recommended doses and had not responded to the treatment were included. They were treated with tadalafil, 20 mg, at least 4 doses at different days. The effectiveness of the treatment was reviewed by different questionnaires, including the International Index of Erectile Function-5 (IIEF-5, Sexual Encounter Profile (SEP questions 2 and 3, and the Global Assessment Question (GAQ, at the end of the 12th week. Results: The IIEF-5 scores were 11.90 ± 4.78 and 12.67±6.70, before and after at least 4 doses of tadalafil, respectively (P = .30. The rate of positive responses to SEP2, SEP3, and GAQ questions were also insignificantly different after the treatment. During this period, flushing was seen in 10 and headache was seen in 5 patients. Conclusion: The recommended maximum dose for tadalafil insignificantly improved the IIEF5, SEP2, SEP3, and GAQ scores in patients with erectile dysfunction who had not responded to sildenafil and vardenafil. The other treatment alternatives should be in mind after getting no response to the optimum doses and enough trials of sildenafil or vardenafil before trying a tadalafil regimen.

  19. Pharmacotherapy of Sexual Dysfunctions : Current Status

    Avasthi, Ajith; Biswas, Parthasarathy

    2004-01-01

    The sexual dysfunctions are one of the most prevalent conditions. Sexual dysfunctions can have profound effect on the psychological well-being of an individual and the psychosexual relationship of a couple. Management of the sexual dysfunction should be preceded by an accurate diagnosis reached after a complete medical and sexual history and physical examination. Current focus of researchers has been on understanding the pathophysiology of erectile dysfunction, premature ejaculation and other...

  20. Effect of Psychological Intervention on Erectile Dysfunction in Patients with Pelvic Fracture Posterior Urethral Injury%心理干预对骨盆骨折后尿道损伤后勃起功能障碍及心理状态的影响

    万国英; 欧恬; 王健; 朱心燊

    2015-01-01

    Objective To explore the effect of psychological intervention on psychological sta-tus and therapeutic efficacy in patients with erectile dysfunction after pelvic fracture posterior u-rethral injury.Methods Sixty patients with erectile dysfunction after pelvic fracture posterior u-rethral injury were randomly divided into two groups,with 30 patients in each group.Both groups were treated with oral tadalafil 5 mg once per day.In addition,the control group was given routine nursing care,including vital sign measurement,anti-inflammation,hemostasis,indwelling urinary catheter nursing,absolute bed rest,etc.On the basis of routine nursing care,the observation group was given psychological intervention,including establishment of harmonious relationship between nurses and patients,cognitive intervention,emotional intervention,close coordination with family members,health education,etc.The psychological status was evaluated using Zung Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)and the erectile dysfunction was e-valuated using International Index of Erectile Function(IIEF-5)before and after nursing interven-tion for 12 weeks.Results There were no significant differences in SAS,SDS and IIEF-5 scores between the two groups before nursing intervention(P >0.05).In observation group,SAS and SDS scores decreased and IIEF-5 scores increased after nursing intervention for 12 weeks(P 0.05).Compared with control group,SAS and SDS scores de-creased and IIEF-5 scores increased in observation group after nursing intervention for 12 weeks (P <0.05).Conclusion Psychological intervention can effectively reduce the levels of anxiety and depression,increase the scores of IIEF-5,improve the quality of life,and stabilize the family and social relations in patients with erectile dysfunction after pelvic fracture posterior urethral injury.%目的:探讨心理干预对骨盆骨折后尿道损伤后勃起功能障碍患者的心理状态及治

  1. Erectile function after prostate brachytherapy

    Purpose: To evaluate erectile function after permanent prostate brachytherapy using a validated patient-administered questionnaire and to determine the effect of multiple clinical, treatment, and dosimetric parameters on penile erectile function. Methods and materials: A total of 226 patients with preimplant erectile function determined by the International Index of Erectile Function (IIEF) questionnaire underwent permanent prostate brachytherapy in two prospective randomized trials between February 2001 and January 2003 for clinical Stage T1c-T2c (2002 American Joint Committee on Cancer) prostate cancer. Of the 226 patients, 132 were potent before treatment and, of those, 128 (97%) completed and returned the IIEF questionnaire after brachytherapy. The median follow-up was 29.1 months. Potency was defined as an IIEF score of ≥13. The clinical, treatment, and dosimetric parameters evaluated included patient age; preimplant IIEF score; clinical T stage; pretreatment prostate-specific antigen level; Gleason score; elapsed time after implantation; preimplant nocturnal erections; body mass index; presence of hypertension or diabetes mellitus; tobacco consumption; the volume of the prostate gland receiving 100%, 150%, and 200% of the prescribed dose (V100/150/200); the dose delivered to 90% of the prostate gland (D90); androgen deprivation therapy; supplemental external beam radiotherapy (EBRT); isotope; prostate volume; planning volume; and radiation dose to the proximal penis. Results: The 3-year actuarial rate of potency preservation was 50.5%. For patients who maintained adequate posttreatment erectile function, the preimplant IIEF score was 29, and in patients with brachytherapy-related ED, the preimplant IIEF score was 25. The median time to the onset of ED was 5.4 months. After brachytherapy, the median IIEF score was 20 in potent patients and 3 in impotent patients. On univariate analysis, the preimplant IIEF score, patient age, presence of nocturnal erections

  2. Inhibition of Ninjurin 1 restores erectile function through dual angiogenic and neurotrophic effects in the diabetic mouse

    Yin, Guo Nan; Choi, Min Ji; Kim, Woo Jean; Kwon, Mi-Hye; Song, Kang-Moon; Park, Jin-Mi; Das, Nando Dulal; Kwon, Ki-Dong; Batbold, Dulguun; Oh, Goo Taeg; Koh, Gou Young; Kim, Kyu-Won; Ryu, Ji-Kan; Suh, Jun-Kyu

    2014-01-01

    Curative treatment modalities for erectile dysfunction (ED) are not available. Penile erection is a neurovascular phenomenon, and ED is caused mainly by vascular and neurologic disturbances. Here we demonstrate that inhibition of nerve injury-induced protein 1 promotes penile angiogenesis and neural regeneration through angiopoietin-1–Tie2 signaling and rescues erectile function in diabetic mice. Our preclinical work shed light on the application of therapeutic angiogenesis and neural regener...

  3. Can lifestyle modification affect men’s erectile function?

    Hehemann, Marah C.

    2016-01-01

    Erectile dysfunction (ED) is a common condition affecting millions of men worldwide. The pathophysiology and epidemiologic links between ED and risk factors for cardiovascular disease (CVD) are well-established. Lifestyle modifications such as smoking cessation, weight reduction, dietary modification, physical activity, and psychological stress reduction have been increasingly recognized as foundational to the prevention and treatment of ED. The aim of this review is to outline behavioral choices which may increase ones risk of developing ED, to present relevant studies addressing lifestyle factors correlated with ED, and to highlight proposed mechanisms for intervention aimed at improving erectile function in men with ED. These recommendations can provide a framework for counseling patients with ED about lifestyle modification.

  4. Symptoms of Nerve Dysfunction After Hip Arthroscopy

    Dippmann, Christian; Thorborg, Kristian; Kraemer, Otto; Winge, Søren; Hölmich, Per

    2014-01-01

    PURPOSE: The primary purpose of this study was to analyze the rate, pattern, and severity of symptoms of nerve dysfunction after hip arthroscopy (HA) by reviewing prospectively collected data. The secondary purpose was to study whether symptoms of nerve dysfunction were related to traction time...... year after HA concerning symptoms of nerve dysfunction, possible localization, and erectile dysfunction. Fifty patients participated and returned fully completed questionnaires. Patients reporting symptoms of nerve dysfunction 1 year after HA were re-examined. RESULTS: Twenty-three of 50 patients (46......%) reported symptoms of nerve dysfunction during the first week after HA; this was reduced to 14 patients (28%) after 6 weeks, 11 patients (22%) after 26 weeks, and 9 patients (18%) after 1 year. One patient experienced temporary erectile dysfunction. No difference in traction time between patients with...

  5. Sildenafil Improves Erectile Function in Men with Chronic Heart Failure

    Niloufar Samiei

    2015-06-01

    Full Text Available Background: Patients with Chronic Heart Failure (CHF have been shown to have enhanced risk of Erectile Dysfunction (ED due to low cardiac output, endothelial dysfunction, medications, co-morbid conditions, and psychogenic factors. Objectives: The present study aimed to evaluate the effects of sildenafil on erectile function of patients with stable CHF using the abridged 5-item version of the International Index of Erectile Function (IIEF-5. Patients and Methods: Using convenience sampling, 222 sexually-active adult males with NYHA class I-III stable CHF were included in this cross-sectional study. All the patients filled out the IIEF-5 questionnaire, in which they were required to score the five domains of male sexual function, including erectile function, orgasm function, sexual desire, intercourse satisfaction, and overall satisfaction. All the analyses were performed using the SPSS statistical software (v. 19 and P < 0.05 was considered as statistically significant. Results: In our sample, the patients’ mean age was 47.14 ± 11.86 years, their mean left ventricular ejection fraction was 20% (15% - 25%, and the prevalence of ED was 70.3%. In addition, severe, moderate, mild to moderate, and mild ED were seen in 57%, 17%, 7%, and 19% of the patients with ED, respectively. ED was significantly more prevalent in the patients with ischemic heart failure compared to those with idiopathic dilated cardiomyopathy (84.68% vs. 55.85%, P < 0.001. Moreover, the prevalence of ED was significantly lower in the patients taking sildenafil compared to the other group (42.85% vs. 82.89%, P < 0.001. Conclusions: Sildenafil appears to provide satisfactory results toward improving sexual function in patients with CHF.

  6. Low dose tadalafil in the treatment of erectile dysfunction after nerves sparing radical prostatectomy%小剂量他达拉非治疗保留性神经的前列腺癌根治术后勃起功能障碍的探讨

    管建云; 刘宇军; 王家祥

    2014-01-01

    Objectives:To study the efficacy and safety of low doses tadalafil in the treatment of erectile dysfunction after nerves sparing radical prostatectomy.Method:The clinical data of 72 patients receiving nerves sparing radical prostatectomy was analyzed retrospectively.The 72 patients were classified into the tadalafil group (n=37)and the non-tadalafil group (n=35).Patients in tadalafil group took 5mg tadalafil once a day and patients in non-tadalafil group took nothing.The International Index of Erectile Function (IIEF-5 )was used to analyze the clinical data of the two groups before the surgery,6 months and 1 year after surgery.Results:6 months after surger-y,the total IIEF-5 scores of the tadalafil group and the non-tadalafil group were 9.7±3.2 and 6.7±3.5,respective-ly.1 year after surgery,the total IIEF-5 score in the tadalafil group was significantly greater than that in the non-tadalafil group (1 2.8±6.6 vs.7.8±2.9,P<0.05).The reported side effects were 4 cases of flushing (1 0.8%),2 cases of headache (5.4%)and 1 case of dizziness (2.7%).Conclusion:In ED patients after nerves sparing radical prostatectomy,a once-daily dose of tadalafil 5mg is well tolerated and can significantly improve the situation of erec-tile dysfunction.%目的:探讨小剂量他达拉非治疗保留性神经的前列腺癌根治术后勃起功能障碍的疗效和安全性。方法:回顾性分析72例保留神经的前列腺癌根治术后患者的临床资料,72例患者分为治疗组37例,每日服用他达拉非5mg 1次;观察组35例,不服药。分别在术前、术后6个月和1年,采用国际勃起功能指数-5对患者进行调查。结果:在术后6个月,治疗组和观察组的IIEF-5总分分别为(9.7±3.2)分和(6.7±3.5)分;在术后1年中,治疗组的IIEF-5总评分为(12.8±6.6)分,显著高于观察组(7.8±2.9)分,差别有统计学意义(P<0.05)。他达拉非的副作用有面部潮红4例(10.8%)、头痛2

  7. Sexual dysfunctions in men treated for testicular cancer

    Rosendal, Susanne; Kristensen, Ellids; Giraldi, Annamaria G E

    2008-01-01

    Patients treated for testicular cancer have increased risk of ejaculatory, orgasmic and erectile dysfunction compared with healthy men. The underlying relations are unclear. This review describes sexual dysfunctions that are associated with various treatment modalities. One meta-analysis and 11...... understanding sexual dysfunctions in patients with testicular cancer....

  8. Bicycle Riding: Impact on Lower Urinary Tract Symptoms and Erectile Function in Healthy Men

    Baek, Seok; Lee, Sun Young; Kim, Jong Min; Shin, Esther; Kam, Sin

    2011-01-01

    Purpose Recently, reports in the mass media have implicated that bicycle riding increases the risk of erectile dysfunction and prostatic diseases. So, we evaluate the impact of bicycle riding on erectile function and lower urinary tract symptoms (LUTS) in healthy general men. Methods From 26 June 2010 to 20 July 2010, we investigate degree of LUTS (voiding and storage symptoms), using International Continence Society-male Questionnaire (ICS-mQ) and erectile function using International Index of Erectile Function-5 Questionnaire (IIEF-5) in 5 work places (personnel of public office, hospital, university, etc.) of which bicycle riding club members were doing active club activities. Respondents, who participated in club activities for 6 months and longer, were classified as the bicycle club (142 men; age, 44.02±8.56). Ones who do not ride bicycles were classified as the control group (83 men; age, 42.13±7.85). People who were having the history of urological and other chronic diseases (diabetes, vascular disease, heart disease, etc) were excluded from both groups. Results Bicycle club is not significantly associated with increased prevalence of LUTS (bicycle club, 2.1 to 57.7% control, 4.8 to 73.5%) and erectile dysfunction (bicycle club, 46.1% control, 55.4%). The total mean score (storage/voiding/erectile function) of bicycle club (13.93±1.95/11.14±3.49/20.46±5.30) were not significantly different from control (14.35±2.49/11.52±3.38/20.40±4.07) (P=0.190 to 0.968). Conclusions These results suggested that bicycle riding as exercise or hobby has no negative effect on LUTS and erectile function in healthy general men, although this research data were limited to the questionnaire analysis. PMID:21811700

  9. Comparison between vardenafil plus testosterone undecanoate and vardena-fil alone in the treatment of diabetic patients with erectile dysfunction%伐地那非、十一酸睾酮合用与单用伐地那非治疗糖尿病患者勃起功能障碍的疗效比较

    张贤生; 刘吉双; 夏磊; 郝宗耀; 周骏; 梁朝朝

    2011-01-01

    Aim To compare the efficacy and safety of vardenafil plus testosterone undecanoate with those of vardenafil alone in the treat ment of diabetic patients with erectile dysfunction(ED). Methods Fifty-eight patients with diabetic ED were enrolled in this study. They were randomly divided into Groups A and B of equal number. Group A received 20 mg vardenafil 30min before planned sexual activ ity for 12 weeks, and Group B were given 20 mg vardenafil 30min before sexual activity plus 40 mg testosterone undecanoate after break fast and supper daily for 12 weeks. Before and after the treatment,IIEF-5 score,the intercourse satisfaction,the mean number of coituses per week and the drug-related side effects were evaluated. Results IIEF-5 scores were(11.3 ± 0.9) , (17.5 ± 1.7) respectively at base line and post-treatment in Group A,and ( 10.9 ± 1.2) , (22.3 ± 2.5) (P < 0.01) in Group B,improved in both of the two groups, but more significantly in Group B (P < 0.05 ). The mean numbers of coituses per week in Groups A and B were (0.8 ± 0.3), ( 1.7 ± 0.8 ) (P < 0.01) and (0.9 ± 0.5 ), (2.5 ± 0.9) (P < 0.01) respectively, significantly larger in Group B (P < 0.05) after the treatment. As for the side effects,there was no significant difference(P > 0.05) in Group B and in Group A. Conclusions Testosterone undecanoate combined with vardenafil can produce significantly better results than vardenafil alone in diabetic patients with erectile dysfunction. in the mean time,the combined treatment is associated with no increase in the drug-related side effects.%目的 比较联合应用伐地那非和十一酸睾酮与单用伐地那非治疗糖尿病患者勃起功能障碍的疗效及不良反应.方法 该院男科门诊患有糖尿病的勃起功能障碍患者58例,随机分成A、B组,每组29例,A组口服伐地那非20 mg,性生活前30 min服用;B组除了同样服用伐地那非外,每日早晚饭后服用十一酸睾酮40 mg,共观察12周.比较两组治疗

  10. Client attributions for sexual dysfunction.

    Fichten, C S; Spector, I; Libman, E

    1988-01-01

    This investigation examined attributions for sexual dysfunctions made by 63 individuals and 21 of their partners who presented at a sex therapy service for the following problems: erectile dysfunction, premature ejaculation, and female orgasmic dysfunctions. All participants completed measures of marital adjustment, locus of control, depression and a questionnaire which assessed: attributions of responsibility for the sexual problem, perceived control over sexual functioning, distress, effort made to improve the sexual relationship, and expectations about the efficacy of sex therapy for the problem. Results indicate that both identified patients and their partners, regardless of the dysfunction, blamed the sexual problem on the "dysfunctional individual" rather than on the circumstances or the partner. With respect to the partners, husbands of women with orgasmic dysfunction were more likely to blame themselves than the circumstances, while the opposite was true for wives of males with erectile difficulties. Individuals experiencing the dysfunction perceived themselves and their partners as having little, but equal control over the identified patient's sexuality. Correlational analyses indicate that in identified patients, the better the quality of the marital relationship, the greater the self-blame and the lower the partner blame. Those with happy marriages also made greater efforts to improve their sexual relationship and had higher expectations of success with therapy. The implications of the results for research on the role of attributions in sexual dysfunction and for assessment of cognitive factors in sexually dysfunctional individuals and their partners is discussed. PMID:3172253

  11. Sexual dysfunction in Obsessive-Compulsive disorder

    Firoozeh Raisi

    2015-05-01

    Conclusion: High prevalence of sexual dysfunction in OCD women and significant correlation between male sexual dysfunction and OCD (r= -481.0 between total score of OCI-R with erectile dysfunction and r= -458.0 between total score of OCI-R and sexual satisfaction could confirm a relation between OCD and sexual disorders. So, evaluation of sexual function in all patients with OCD is recommended.

  12. Sexual (dys)function after radiotherapy for prostate cancer: a review

    Purpose: Prostate cancer has become the most common nonskin malignant neoplasm in older men in Western countries. As treatment efficacy has improved, issues related to posttherapy quality of life and sexual functioning have become more important. Methods and materials: We discuss the various methods used to evaluate erectile and sexual dysfunction and the definition of potency. The etiologies of erectile dysfunction after external beam radiotherapy and brachytherapy for prostate cancer are also reviewed. The literature is summarized, and comparative studies of radiation and surgery are surveyed briefly. Results: Rates of erectile dysfunction vary from 6 to 84% after external beam radiotherapy and from 0 to 51% after brachytherapy. In most of the studies, the analysis is retrospective, the definition of erectile dysfunction is not clear, only one question about sexual functioning is asked, and nonvalidated instruments are used. The etiology of erectile dysfunction after radiation for prostate cancer is not completely understood. Conclusions: Because erectile function is only one component of sexual function, it is necessary to assess sexual desire, satisfaction, frequency of intercourse, and other such factors when evaluating the effects of therapy. Patients should be offered sexual counseling and informed about the availability of effective treatments for erectile dysfunction, such as sildenafil, intracavernosal injection, and vacuum devices

  13. 疏肝益阳胶囊对动脉性勃起功能障碍大鼠性功能及性腺质量的作用%Effect of Shuganyiyang Capsules on Sexual Function and Sex Gland Weight in Rats with Arteriogenic Erectile Dysfunction

    王济; 白明华; 刘保兴; 杨寅; 杨玲玲; 王琦

    2013-01-01

    目的 观察中药疏肝益阳胶囊对动脉性勃起功能障碍(arteriogenic erectile dysfunction,AED)模型大鼠性功能及睾丸和附属性腺器官质量的改善作用.方法 选取3月龄成年雄性SD大鼠50只,采用双侧髂内动脉结扎法复制AED模型.设假手术组、模型组、西地那非组(每日10.5 mg/kg)、疏肝益阳胶囊大剂量组(每日1 g/kg)、疏肝益阳胶囊小剂量组(每日0.5 g/kg),每组10只,灌胃给药,疗程30 d.行阿朴吗啡(apomorphine,APO)试验检测性功能,取双侧睾丸及附睾、前列腺、精囊腺、球海绵体肌,称湿质量并计算质量系数.结果 APO试验显示疏肝益阳胶囊大、小剂量可显著增加AED大鼠30 min内阴茎勃起次数(P<0.01).疏肝益阳胶囊大、小剂量可显著增加AED大鼠睾丸、附睾、球海绵体肌质量系数(P<0.05).结论 疏肝益阳胶囊可明显改善AED大鼠的性功能,并可使睾丸及其附属性器官质量系数显著增加.%Objective To observe the effect of Shuganyiyang (SGYY) Capsules (for dispersing stagnated liver qi and nourishing yang) on the sexual function and the weights of testes and accessory sex glands in rats with arteriogenic erectile dysfunction (AED). Methods Fifty male Sprague-Dawley rats aged 3 months were selected in the study. Bilateral internal iliac artery ligation was used to induce a rat model of AED. The rats were randomly and equally divided into sham operation group, model group, sidenafil (10. 5 mg/kg daily) group, high-dose SGYY Capsule (1 g/kg daily) group, and low-dose SGYY Capsule (0. 5 g/kg daily) group and received their respective treatments by intragastric administration for 30 d. The sexual function of rats in each group was evaluated by apomorphine (APO) test. The bilateral testes and epididymides, prostate, seminal vesicle, and bulbocavernosus muscle of rats were collected; the wet weight of each organ was measured, and the weight coefficient was calculated. Results The APO test showed that

  14. 十一酸睾酮改善糖尿病阴茎勃起功能障碍患者对西地那非的反应%Testosterone undecanoate improves response to Sildenafil in diabetic patients with erectile dysfunction

    高峰; 赵军

    2006-01-01

    目的 探讨十一酸睾酮与西地那非联用治疗糖尿病患者阴茎勃起功能障碍的效果.方法 将80例阴茎勃起功能障碍、且经西地那非治疗无效的2型糖尿病患者,随机分为两组:A组:40例,在用西地那非治疗的同时加用十一酸睾酮(120mg/d);B组:40例,在用西地那非治疗的同时加用维生素E(30mg/d)两组均治疗1个月.观察患者治疗前后血清睾酮水平、IIEF-5评分和阴茎海绵体血流量的变化.结果 A组较治前,血清睾酮明显升高(P<0.01),IIEF-5评分显著提高(P<0.05),阴茎海绵体血流量明显增加(P<0.05);其中30例(75%)患者性交时阴茎能满意地勃起;未出现任何不良反应.B组治疗前后上述指标无明显变化(均P>0.05).结论 十一酸睾酮能显著改善经用西地那非治疗无效的糖尿病患者的阴茎勃起功能,且安全性好.%[Objective] To evaluate the efficacy of Testosterone undercanoate combined with Sildenafil in treating diabetic erectile dysfunction. [Methods] Eighty cases of Sildenafil non-responders in type 2 diabetics with erectile dysfunction were randomized into two groups, 40 cases in each. Group A was given Testosterone undercanoate (120mg/d) combined with Sildenafil for 1 month. Whereas, group B received Vitamin E (30 mg/d) plus Sildenafil also for 1 month. Before and after the study the change of serum testosterone level, IIEF-5 score and intracavernous arterial inflow were investigated. [Results] In Testosterone undercanoate treated group, the serum testosterone was markedly increased (P <0.01), IIEF-5 score was significantly elevated (P <0.05) and intracavernous arterial inflow was greatly enhanced (P <0.05), consequently resulting in satisfactory penile erection during coitus in 30 cases (75%). By contrast, neither of the above parameters showed any significantly change in group B (P >0.05). There were no untoward reactions during Testosterone undercanoate treatment. [Conclusion] Testosterone

  15. Study of expression of neuropathic nitric oxide synthase, endothelial nitric oxide synthase and inducible nitric oxide synthase in penile tissue of erectile dysfunction rat models with prolactinoma%泌乳素瘤性阴茎勃起功能障碍大鼠阴茎各亚型一氧化氮合酶表达的变化

    翁博文; 祝海; 侯四川; 徐珞; 栾晓; 綦海燕; 刘之俊; 王伟民; 刘伟

    2015-01-01

    目的 探讨泌乳素瘤性勃起功能障碍的发病机制.方法 雄性Wistar大鼠腹腔内注射乙烯雌酚(DES)建立泌乳素瘤模型.8周通过阿扑吗啡(APO)实验筛选,建立泌乳素瘤性阴茎勃起功能障碍(P-ED)模型,应用免疫组织化学方法测定大鼠阴茎组织神经型一氧化氮合酶(nNOS)、内皮型一氧化氮合酶(eNOS)和诱导型一氧化氮合酶(iNOS)表达水平的变化.结果 DES注射8周后,垂体泌乳素瘤成模率为100%,P-ED成模率为75%.与对照组比较,注射DES 8周时大鼠垂体质量明显增加;血清泌乳素(PRL)水平升高而游离睾酮(FT)水平降低;阴茎勃起次数显著减少.阴茎组织nNOS、eNOS表达降低而iNOS表达增加.结论 P-ED大鼠模型阴茎组织nNOS、eNOS表达减少而iNOS表达增加.%Objective To investigate the mechanism of erectile dysfunction of prolactinoma.Methods Male Wistar rats were treated with diethylstilbestrol (DES) by peritoneal injection to establish the rat model of prolactinoma.After 8 weeks,the model rats were injected with apomorphine to screening ED rats models with DES-induced prolactinoma (P-ED).The changes of expression of neuropathic nitric oxide synthase (nNOS),endothelial nitric oxide synthase (eNOS) and inducible nitric oxide synthase (iNOS) in penis were detected with immunohistochemistry.Results By 8 weeks,100% pituitary glands of DES group developed prolactinomas and 75% DES-induced prolactinoma rats developed ED models.The weight of pituitary gland was dramatic increased.The Prolactin (PRL) level of P-ED group was significantly higher and FT level was lower than the control group.Erectile rate of DES group was significant lower than the control group after 8 weeks of DES injection.The expression of nNOS and eNOS in penis of P-ED group was significantly lower than the control group.However,the expression of iNOS in penis of P-ED group was significantly higher than the control group.Conclusion The expression of nNOS and e

  16. Beneficial effects of switching from β-blockers to nebivolol on the erectile function of hypertensive patients

    Michael Doumas; Alexandros Tsakiris; Stella Douma; Alkiviadis Grigorakis; Angelos Papadopoulos; Athina Hounta; Sotirios Tsiodras; Dimitrios Dimitriou; Helen Giamarellou

    2006-01-01

    Aim: To investigate the effect of substituting β-blockers with nebivolol on the erectile function of patients suffering from essential hypertension. Methods: Forty-four young and middle-aged men (31-65 years) with essential hypertension visited our outpatient clinic and took β-blocker treatment (atenolol, metoprolol or bisoprolol) for more than 6months. All the patients completed a questionnaire regarding erectile function (International Index for Erectile Function).Patients were then switched to an equipotent dose of nebivolol for 3 months and, at the end of this time period, filled out the same questionnaire. Results: Twenty-nine out of the 44 (65.9%) patients who took β-blockers (atenolol,metoprolol or bisoprolol) had exhibited erectile dysfunction (ED). Their systolic and diastolic blood pressure did not change significantly with the treatment switch. In 20 out of these 29 (69%) patients, a significant improvement in the erectile function score was exhibited after 3 months of nebivolol administration, and in 11 of these 20 patients, erectile function was normalized. Conclusion: Nebivolol seems to have a beneficial effect on ED (possibly due to increased nitric oxide availability); however, further prospective, randomized, placebo-controlled studies are needed to confirm the beneficial effects of nebivolol.

  17. Improvement of erectile function by Korean red ginseng(Panax ginseng) in a male rat model of metabolic syndrome

    Sung-Dae Kim; Young-Joo Kim; Jung-Sik Huh; Sae-Woong Kim; Dong-Wan Sohn

    2013-01-01

    The seriousness of metabolic syndrome is not due to the disease itself but its promotion of other diseases,such as erectile dysfunction and cardiovascular and cerebrovascular diseases.We investigated the effects of Korean red ginseng (KRG,Panax ginseng) extract on erectile function in a rat model of metabolic syndrome.We divided the rats into three groups:control,metabolic syndrome+normal saline (N/S) and metabolic syndrome+ KRG.To determine the occurrence of metabolic syndrome in all groups,body weight and various biochemical parameters (e.g.,blood glucose,insulin,cholesterol) were measured,and the intra-abdominal glucose tolerance test was performed.To investigate penile erection,the peak intracavernosal pressure (ICP),mean arterial pressure (MAP) and Masson's trichrome stain were evaluated.Erectile function was also investigated by measuring the cyclic guanosine monophosphate (cGMP)levels of the corpus cavernosum.We found that the various biochemical parameters and body weight were similar in the metabolic syndrome+KRG group and the control group,although the values were slightly higher.The peak ICP/MAP ratio of the metabolic syndrome+ N/S group was markedly decreased compared to the other groups.The cGMP level of the corpus cavemosum in the metabolic syndrome+N/S group was significantly lower than that of the other groups.As demonstrated in this model of metabolic syndrome with erectile dysfunction,KRG may improve erectile function.

  18. Clinical Study on WenShen Capsule and Trazodone Hydrochloride in the Treatment for Depression Complicated with Erectile Dysfunction%温肾胶囊联合盐酸曲唑酮治疗抑郁症伴勃起功能障碍的临床研究

    彭晓明; 陈林庆; 张震文; 郭霞

    2012-01-01

    Objective: To provide theoretical evidence for therapy of depression complicated with erectile dysfunction(ED) and clinical spread of WenShen capsule through observation to reveal the theory and advantages of TCM. Method: Sixty patients were divided into two groups with random number table. Control group took trazodone hydrochloride orally, 50-150mg each time, once per day; treatment group were also given with WenShen capsule, six pills each time, twice each day. Both groups were observed for eight consecutive weeks and disease changes were recorded at the beginning, the first, second, fourth and eighth week. Result:①After treating, scale of HAMD in treatment group and control group decreased significantly and the difference between both groups showed obvious statistical meaning (P0.05).Conclusion: Clinical effects of WenShen capsule and trazodone hydrochloride were superior to trazodone hydrochloride for depression complicated with ED.%目的:通过观察温肾胶囊联合盐酸曲唑酮治疗抑郁症伴勃起功能障碍的临床疗效,揭示中医药在该领域的理论、治疗优势,为该病的临床治疗和温肾胶囊的临床推广提供一定的理论依据.方法:将60例符合诊断的抑郁症伴勃起功能障碍患者采用随机数字表法分为治疗组和对照组各30 例,对照组给予盐酸曲唑酮口服,50~150 mg/ 次,1 次/d;治疗组在对照组基础上给予温肾胶囊6 粒/ 次,早晚口服,连续观察8周,在治疗开始后第0、1、2、4、8 周记录病情变化.结果:①治疗后治疗组和对照组汉密顿抑郁量表(HAMD)得分均明显下降,组间比较有统计学意义(P<0.05);②治疗后治疗组勃起ED 临床疗效总有效率为93.3%;对照组为76.3%,治疗组疗效明显优于对照组(P<0.05);③治疗组治疗后,勃起功能评分积分较治疗前明显增加,差异有显著性(P<0.05),与对照组比较,差异有显著性(P<0.05);④治疗后治疗组与对照组患者血清中T

  19. Validation of the International Index of Erectile Function (IIFE) for Use in Brazil

    Gonzáles, Ana Inês; Sties, Sabrina Weiss; Wittkopf, Priscilla Geraldine, E-mail: sabrinasties@yahoo.com.br; Mara, Lourenço Sampaio de; Ulbrich, Anderson Zampier; Cardoso, Fernando Luiz; Carvalho, Tales de [Universidade do Estado de Santa Catarina, Florianópolis, SC (Brazil)

    2013-08-15

    The International Index of Erectile Function has been proposed as a method for assessing sexual function assisting the diagnosis and classification of erectile dysfunction. However, IIEF was not validated for the Portuguese language. Validate the International Index of Erectile Function in patients with cardiopulmonary and metabolic diseases. The sample consisted of 108 participants of to Cardiopulmonary and Metabolic program Rehabilitation (CPMR) in southern Brazil. The clarity assessment of the instrument was performed using a scale ranging from zero to 10. The construct validity was carried out by confirmatory factor analysis (KMO = 0.85; Barllet p < 0.001), internal consistency by Cronbach's alpha and reproducibility and interrater reliability via the test retest method. The items were considered very clear with averages superior to 9. The internal consistency resulted in 0.89. The majority of items related correctly with their domains, with exception of three questions from sexual satisfaction domain, and one from erectile function. All items showed excellent stability of measure and substantial to almost perfect agreement. The present study showed that the IIEF is valid and reliable for use in participants of a cardiopulmonary and metabolic rehabilitation program.

  20. Meta-analysis of rates of erectile function after treatment of localized prostate carcinoma

    Purpose: The results of a 1997 meta-analysis of the rates of erectile function after external beam radiotherapy (EBRT) and radical prostatectomy have been widely used in patient and professional education materials and as a reference against which new findings are compared. With a number of recent publications, it is now possible to update this analysis and compare brachytherapy with or without EBRT with EBRT alone, standard and nerve-sparing radical prostatectomy, and cryotherapy. Methods: A comprehensive literature review and subsequent meta-analysis of the rates of erectile dysfunction associated with the treatments of localized prostate carcinoma was conducted. A simple logistic regression analysis was used to combine the data from the 54 articles that met the selection criteria. Results: The predicted probability of maintaining erectile function after brachytherapy was 0.76, after brachytherapy plus EBRT 0.60, after EBRT 0.55, after nerve-sparing radical prostatectomy 0.34, after standard radical prostatectomy 0.25, and after cryotherapy 0.13. When only studies reporting ≥2 years follow-up were considered, the only significant change was a decline in the probability for nerve-sparing radical prostatectomy. No brachytherapy studies had a follow-up of ≥2 years. When the probabilities were adjusted for age, the spread between the RT methods and surgical approaches was greater. Conclusion: The differences in the probability of maintaining erectile function after different treatments of localized prostate cancer are significant

  1. Validation of the International Index of Erectile Function (IIFE) for Use in Brazil

    The International Index of Erectile Function has been proposed as a method for assessing sexual function assisting the diagnosis and classification of erectile dysfunction. However, IIEF was not validated for the Portuguese language. Validate the International Index of Erectile Function in patients with cardiopulmonary and metabolic diseases. The sample consisted of 108 participants of to Cardiopulmonary and Metabolic program Rehabilitation (CPMR) in southern Brazil. The clarity assessment of the instrument was performed using a scale ranging from zero to 10. The construct validity was carried out by confirmatory factor analysis (KMO = 0.85; Barllet p < 0.001), internal consistency by Cronbach's alpha and reproducibility and interrater reliability via the test retest method. The items were considered very clear with averages superior to 9. The internal consistency resulted in 0.89. The majority of items related correctly with their domains, with exception of three questions from sexual satisfaction domain, and one from erectile function. All items showed excellent stability of measure and substantial to almost perfect agreement. The present study showed that the IIEF is valid and reliable for use in participants of a cardiopulmonary and metabolic rehabilitation program

  2. Beware When Buying "All Natural" Erectile Dysfunction Products

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  1. Beware When Buying "All Natural" Erectile Dysfunction Products

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  6. TESTOCAP: A HERBAL SOLUTION FOR ERECTILE DYSFUNCTION AND PREMATURE EJACULATION

    Satender Tanwar* and Shailaja SV

    2015-01-01

    Sexual activity is a vital principle of human living that connects the desire, energy and pleasure of the body to a knowledge of human intimacy, for the sake of erotic love, intimate friendship, human mating and procreation. Sexuality is the capacity to have erotic experiences and responses. According to Masters and Johnson, the human sexual response cycle consists of four phases: excitement, plateau, orgasm, and resolution. The World Health Organization's International Classifications of Dis...

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  9. Beware When Buying "All Natural" Erectile Dysfunction Products

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  10. Xanthone isolated from Securidaca longependunculata with activity against erectile dysfunction.

    Rakuambo, N C; Meyer, J J M; Hussein, A

    2004-07-01

    1,7-Dimethoxy-2-hydroxy-xanthone and 1,4-dihydroxy-7-methoxy-xanthone isolated from Securidaca longependunculata were tested for their activity on rabbit corpus cavernosum in vitro. Only the former relaxed the corpus cavernosum by 63% at 1.8 x 10(-5) mg/ml. PMID:15261388

  11. Sexual dysfunctions after prostate cancer radiation therapy; Dysfonctions sexuelles apres irradiation pour cancer de la prostate

    Droupy, S. [Service d' urologie-andrologie, CHU Caremeau, 30 - Nimes (France)

    2010-10-15

    Sexual dysfunctions are a quality of life main concern following prostate cancer treatment. After both radiotherapy and brachytherapy, sexual function declines progressively, the onset of occurrence of erectile dysfunction being 12-18 months after both treatments. The pathophysiological pathways by which radiotherapy and brachytherapy cause erectile dysfunction are multi-factorial, as patient co-morbidities, arterial damage, exposure of neurovascular bundle to high levels of radiation, and radiation dose received by the corpora cavernosa at the crurae of the penis may be important in the aetiology of erectile dysfunction. Diagnosis and treatment of postradiation sexual dysfunctions must integrate pre-therapeutic evaluation and information to provide to the patient and his partner a multidisciplinary sexual medicine management. (authors)

  12. 西地那非联合十一酸睾酮治疗糖尿病性勃起功能障碍的安全性有效性多中心研究*%A Multicenter Research of Sildenafil Combined with Testosterone Undecanoate for Treatment of Erectile Dysfunction with Diabetes

    钟锦卫; 梁国庆; 李朋; 戴继灿; 徐迪萍; 平萍; 李铮

    2013-01-01

      目的观察西地那非联合十一酸睾酮治疗糖尿病患者阴茎勃起障碍的疗效和安全性。方法2009年1月至2011年12月多中心收集广州市番禺区中心医院、上海交通大学医学院附属仁济医院、上海市中医医院泌尿男科门诊糖尿病性勃起功能障碍患者共100例,患者签署知情同意书后,根据国际勃起功能指数表(IIEF-5)进行自我评分。随机分为两组:A组:50例,控制血糖常规治疗的基础上服用西地那非(50mg prn)加十一酸睾酮(80mg/Bid);B组:50例,在控制血糖常规治疗的同时给予西地那非治疗,两组均治疗12周。观察两组患者治疗前后的疗效,并记录患者服药后的不良事件以评价其安全性。结果共计82例完成本次研究,其中A组42例、B组40例。两组患者IIEF-5评分在治疗后均显著增加,而A组较B组增加更显著,差异具统计学意义(P<0.05)。治疗后每周性交频率均显著增加,A组较B组增加更明显,差异具统计学意义(P<0.05)。其中A组显效率高达59.5%,有效率为88.1%,明显高于B组(显效率30.00%,有效率55.00%),P<0.05。A组37例患者性交时阴茎能满意勃起,而B组只有22例患者性交时阴茎能满意勃起;两组均未出现任何不良反应。结论西地那非联合十一酸睾酮治疗糖尿病性勃起功能障碍较单用西地那非可显著改善患者的勃起能力,且安全性好。%Objective To study the effects and safety of sildenafil combined with testosterone undecanoate for treatment of Erectile Dysfunction (ED)with Diabetes. Methods A total of 100 ED patients with diabetes from Panyu Central Hospital of Guangzhou, Renji Hospital, Shanghai Jiao Tong University School of Medicine, and Traditional Chinese Medicine Hospital of Shanghai, were recruited in the study. Informed consent was obtained from each patient. They were evaluated by the International Index of Erectile

  13. Neurturin enhances the recovery of erectile function following bilateral cavernous nerve crush injury in the rat

    Klein Robert D

    2007-03-01

    Full Text Available Abstract Background The molecular mechanisms responsible for the survival and preservation of function for adult parasympathetic ganglion neurons following injury remain incompletely understood. However, advances in the neurobiology of growth factors, neural development, and prevention of cell death have led to a surge of clinical interest for protective and regenerative neuromodulatory strategies, as surgical therapies for prostate, bladder, and colorectal cancers often result in neuronal axotomy and debilitating loss of sexual function or continence. In vitro studies have identified neurturin, a glial cell line-derived neurotrophic factor, as a neuromodulator for pelvic cholinergic neurons. We present the first in vivo report of the effects of neurturin upon the recovery of erectile function following bilateral cavernous nerve crush injury in the rat. Methods In these experiments, groups (n = 8 each consisted of uninjured controls and animals treated with injection of albumin (blinded crush control group, extended release neurotrophin-4 or neurturin to the site of cavernous nerve crush injury (100 μg per animal. After 5 weeks, recovery of erectile function (treatment effect was assessed by cavernous nerve electrostimulation and peak aortic pressures were measured. Investigators were unblinded to specific treatments after statistical analyses were completed. Results Erectile dysfunction was not observed in the sham group (mean maximal intracavernous pressure [ICP] increase of 117.5 ± 7.3 cmH2O, whereas nerve injury and albumin treatment (control produced a significant reduction in ICP elevation of 40.0 ± 6.3 cmH2O. Neurturin facilitated the preservation of erectile function, with an ICP increase of 55% at 62.0 ± 9.2 cmH2O (p Conclusion Treatment with neurturin at the site of cavernous nerve crush injury facilitates recovery of erectile function. Results support further investigation of neurturin as a neuroprotective and/or neuroregenerative

  14. A2B Adenosine Receptor Agonist Improves Erectile Function in Diabetic Rats.

    Wen, Jiaming; Wang, Bohan; Du, Chuanjun; Xu, Gang; Zhang, Zhewei; Li, Yi; Zhang, Nan

    2015-01-01

    Diabetes is an important risk factor for erectile dysfunction (ED). Recent studies have indicated that A2B adenosine receptor (ADORA2B) signaling is essential for penile erection. Thus, we hypothesize that diabetic ED may be attributed to impaired A2B adenosine signaling. To test this hypothesis, we generated diabetic rats by injecting streptozocin as animal model. After 12 weeks, immunohistochemistry staining was used to localize the expression of ADORA2B. Western Blot and quantitative PCR were employed to determine ADORA2B expression level. Intracavernosal pressure (ICP) measurement was used to evaluate erectile function. Diabetic rats received a single intravenous injection of BAY 60-6583, an ADORA2B agonist, or vehicle solution, at 60 min before the ICP measurement. The results showed that ADORA2B expressed in the nerve bundle, smooth muscle, and endothelium in penile tissue of control mice. Western Blot and quantitative PCR results indicated that the expression levels of ADORA2B protein and mRNA were significantly reduced in penile tissues of diabetic rats. Functional studies showed that the erectile response induced by electrical stimulation was remarkably decreased in diabetic rats, compared with age-matched control rats. However, at 60 min after BAY 60-6583 treatment, the erectile function was improved in diabetic rats, suggesting that enhancement of ADORA2B signaling may improve erectile function in diabetic ED. This preclinical study has revealed a previously unrecognized therapeutic possibility of BAY 60-6583 as an effective and mechanism-based drug to treat diabetic ED. In conclusion, we propose that impaired A2B adenosine signaling is one of the pathological mechanisms of diabetic ED. PMID:26447087

  15. Tratamiento de un caso de disfunción eréctil mediante terapia de pareja y terapia sexual (Treatment of a clinical case of erectile disfunction through sexual and couples therapies)

    Luis Valero Aguayo; Jonatán Bernet Carrero

    2015-01-01

    This article presents a single-case study of a 22-year-old man with erectile dysfunction. The first assessment revealed problems within his relationship as the basis of the disorder. Systemic couple therapy sessions were conducted with both members in combination with several behavioural sex therapy techniques (sexual egoism, sensorial focusing), and instructions and exercises as homework. This mix of therapies had the goal of treating both the erectile disorder and the relationsh...

  16. Neuromedin B Restores Erectile Function by Protecting the Cavernous Body and the Nitrergic Nerves from Injury in a Diabetic Rat Model.

    Hiroaki Nishimatsu

    Full Text Available Erectile dysfunction (ED is a major health problem worldwide and affects approximately 75% of diabetic patients, likely due to severely damaged cavernous body. While screening for cytokines produced by adipose tissue-derived stem cells, we detected neuromedin B (NMB. To explore a potential treatment option for ED, we examined whether NMB was capable of restoring erectile function. We also examined the potential mechanism by which NMB could restore erectile function. Male Wistar rats were injected with streptozotocin (STZ to induce diabetes. An adenovirus expressing NMB (AdNMB was injected into the penis 6 weeks after STZ administration. Four weeks after the injection of AdNMB, erectile function, penile histology, and protein expression were analyzed. As assessed by the measurement of intracavernous pressure, AdNMB injection significantly restored erectile function compared with the injection of an adenovirus expressing green fluorescent protein. This restoration was associated with conservation of the cavernous body structure and neural nitric oxide synthase (nNOS-expressing nerves, together with recovery of α-smooth muscle actin, vascular endothelial-cadherin, and nNOS expression. Furthermore, NMB significantly stimulated the survival of SH-SY5Y cells derived from human neuroblastoma tissue with characteristics similar to neurons. Collectively, these results suggested that NMB restored erectile function via protection of the cavernous body from injury and stimulation of the survival of the associated nerves. NMB may be useful to treat ED patients with a severely damaged cavernous body.

  17. Neuromedin B Restores Erectile Function by Protecting the Cavernous Body and the Nitrergic Nerves from Injury in a Diabetic Rat Model.

    Nishimatsu, Hiroaki; Suzuki, Etsu; Saito, Yasuho; Niimi, Aya; Nomiya, Akira; Yamada, Daisuke; Homma, Yukio

    2015-01-01

    Erectile dysfunction (ED) is a major health problem worldwide and affects approximately 75% of diabetic patients, likely due to severely damaged cavernous body. While screening for cytokines produced by adipose tissue-derived stem cells, we detected neuromedin B (NMB). To explore a potential treatment option for ED, we examined whether NMB was capable of restoring erectile function. We also examined the potential mechanism by which NMB could restore erectile function. Male Wistar rats were injected with streptozotocin (STZ) to induce diabetes. An adenovirus expressing NMB (AdNMB) was injected into the penis 6 weeks after STZ administration. Four weeks after the injection of AdNMB, erectile function, penile histology, and protein expression were analyzed. As assessed by the measurement of intracavernous pressure, AdNMB injection significantly restored erectile function compared with the injection of an adenovirus expressing green fluorescent protein. This restoration was associated with conservation of the cavernous body structure and neural nitric oxide synthase (nNOS)-expressing nerves, together with recovery of α-smooth muscle actin, vascular endothelial-cadherin, and nNOS expression. Furthermore, NMB significantly stimulated the survival of SH-SY5Y cells derived from human neuroblastoma tissue with characteristics similar to neurons. Collectively, these results suggested that NMB restored erectile function via protection of the cavernous body from injury and stimulation of the survival of the associated nerves. NMB may be useful to treat ED patients with a severely damaged cavernous body. PMID:26207818

  18. Penisimplantater er en god sidste behandlingsmulighed for erektil dysfunction

    Giraldi, Laura; Felbo, Jakob; Sønksen, Jens;

    2015-01-01

    When other treatments fail, penile implants represent the last treatment option in erectile dysfunction. The most commonly used implant is the inflatable three-piece device, which allows the penis to be rigid for sexual intercourse and flaccid during the remaining time. Earlier penile implants were...

  19. Erectile Function Durability Following Permanent Prostate Brachytherapy

    Purpose: To evaluate long-term changes in erectile function following prostate brachytherapy. Methods and Materials: This study included 226 patients with prostate cancer and preimplant erectile function assessed by the International Index of Erectile Function-6 (IIEF-6) who underwent brachytherapy in two prospective randomized trials between February 2001 and January 2003. Median follow-up was 6.4 years. Pre- and postbrachytherapy potency was defined as IIEF-6 ≥ 13 without pharmacologic or mechanical support. The relationship among clinical, treatment, and dosimetric parameters and erectile function was examined. Results: The 7-year actuarial rate of potency preservation was 55.6% with median postimplant IIEF of 22 in potent patients. Potent patients were statistically younger (p = 0.014), had a higher preimplant IIEF (p < 0.001), were less likely to be diabetic (p = 0.002), and were more likely to report nocturnal erections (p = 0.008). Potency preservation in men with baseline IIEF scores of 29-30, 24-28, 18-23, and 13-17 were 75.5% vs. 73.6%, 51.7% vs. 44.8%, 48.0% vs. 40.0%, and 23.5% vs. 23.5% in 2004 vs. 2008. In multivariate Cox regression analysis, preimplant IIEF, hypertension, diabetes, prostate size, and brachytherapy dose to proximal penis strongly predicted for potency preservation. Impact of proximal penile dose was most pronounced for men with IIEF of 18-23 and aged 60-69. A significant minority of men who developed postimplant impotence ultimately regained erectile function. Conclusion: Potency preservation and median IIEF scores following brachytherapy are durable. Thoughtful dose sparing of proximal penile structures and early penile rehabilitation may further improve these results.

  20. Management of erectile dysfunction: barriers faced by general practitioners

    Wah-YunLow; Chirk-JennNg; Ngiap-ChuanTan; Wan-YuenChoo; Hui-MengTan

    2004-01-01

    Aim: To explore the barriers faced by general practitioners (GPs) in the management of patients with erectile dysfunction (ED). Methods: This was a qualitative analysis of focus group discussions and in-depth interviews involving 28 Malaysian GPs. Results: GPs' perception of ED being not a serious condition was a major determinant of their prescribing practice. Doctor's age (younger), gender (female), short consultation time and lack of experience were cited as barriers. The GPs' prescribing habits were heavily influenced by the feedback from the first few patients under treatment, the uncertainty of etiology of ED without proper assessment and the profit margin with bulk purchase. Other barriers include Patients' coexisting medical conditions, older age, lower socio-economic status, unrealistic expectations and inappropriate use of the anti-impoteneet drugs. Cardiovascular side effects and cost were two most important drug barriers. Conclusion: The factors influencing the management of ED among the general practitioners were multiple and complex. An adequate understanding of how these factors (doctors, patientsand drugs) interact can assist in the formulation and implementation of strategies that encourage GPs to identify and manage ED patients.