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  1. Losartan Preserves Erectile Function by Suppression of Apoptosis and Fibrosis of Corpus Cavernosum and Corporal Veno-Occlusive Dysfunction in Diabetic Rats

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    Wen Ji Li

    2017-05-01

    Full Text Available Background/Aims: Transforming growth factor-β1 (TGF-β1 plays important roles in penile corporal fibrosis and veno-occlusive dysfunction (CVOD. Angiotensin II (Ang II is critically involved in erectile dysfunction, and blocking of Ang II is more important than inhibition of TGF-β in non-penile tissue fibrosis. However, the role of Ang II in corporal fbrosis and CVOD in a diabetic condition has not been investigated. Methods: Diabetic rats were treated with sildenafil or losartan (an Ang II antagonist alone or in combination. Intracavernosal pressure, dynamic infusion cavernosometry, and histological and molecular alterations of the corpus cavernosum were examined. Results: Diabetic rats exhibited decreases in erectile response, severe CVOD, apoptosis, fibrosis, and activation of the TGF-β1 pathway. Treatment with sildenafil had a modest effect on erectile response and an insignificant suppressive effect on CVOD, apoptosis, fibrosis, and the TGF-β1 pathway. Although losartan greatly improved the histological and molecular changes and CVOD as compared with sildenafil, its effect on erectile response was low. The combination of sildenafil and losartan had superior effects on these parameters than did either compound alone. Conclusion: Ang II activation may be involved in apoptosis and fibrosis of the corpus cavernosum through Smad and non-Smad pathways, resulting in CVOD and ED. The low efficacy of sildenafil in a diabetic ED rat model was at least partly due to its inadequate effects on apoptosis, fibrosis, and CVOD.

  2. Chronic prostatitis/chronic pelvic pain syndrome impairs erectile function through increased endothelial dysfunction, oxidative stress, apoptosis, and corporal fibrosis in a rat model.

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    Hu, Y; Niu, X; Wang, G; Huang, J; Liu, M; Peng, B

    2016-11-01

    Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is an independent risk factor for the development of erectile dysfunction (ED). But the molecular mechanisms underlying the relationship between CP/CPPS and ED are still unclear. The aim of this study was to investigate the effect of CP/CPPS on erectile function in a rat model and the possible mechanisms. A rat model of experimental autoimmune prostatitis (EAP) was established to mimic human CP⁄CPPS. Then twenty 2-month-old male Sprague-Dawley rats were divided into EAP group and control group. Intracavernosal pressure (ICP) and mean arterial pressure (MAP) were measured during cavernous nerve electrostimulation, the ratio of max ICP/MAP was calculated. Blood was collected to measure the levels of serum C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6) and testosterone, respectively. The expression of endothelial nitric oxide synthase (eNOS), cyclic guanosine monophosphate (cGMP) levels, superoxide dismutase (SOD) activity and malondialdehyde (MDA) levels in corpus cavernosum were detected. We also evaluated the smooth muscle/collagen ratio and apoptotic index (AI). The ratio of max ICP/MAP in EAP group were significantly lower than that in control group. The levels of serum CRP, TNF-α, IL-1β, and IL-6 in EAP group were all significantly higher than these in control group. The expression of eNOS and cGMP levels in corpus cavernosum of EAP rats were significantly downregulated. Furthermore, decreased SOD activity and smooth muscle/collagen ratio, increased MDA levels and AI were found in corpus cavernosum of EAP rats. In conclusion, CP/CPPS impaired penile erectile function in a rat model. The declines of eNOS expression and cGMP levels in corpus cavernosum may be an important mechanism of CP/CPPS-induced ED. CP/CPPS also increased oxidative stress, cell apoptosis and decreased smooth muscle/collagen ratio in corpus cavernosum of rats, which were

  3. Impaired Corpus Cavernosum Relaxation Is Accompanied by Increased Oxidative Stress and Up-Regulation of the Rho-Kinase Pathway in Diabetic (Db/Db) Mice.

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    Priviero, Fernanda B M; Toque, Haroldo A F; Nunes, Kenia Pedrosa; Priolli, Denise G; Teixeira, Cleber E; Webb, R Clinton

    2016-01-01

    Basal release of nitric oxide from endothelial cells modulates contractile activity in the corpus cavernosum via inhibition of the RhoA/Rho-kinase signaling pathway. We aimed to investigate nitric oxide bioavailability, oxidative stress and the Rho-kinase pathway in the relaxation of the corpus cavernosum of an obese and diabetic model of mice (db/db mice). We hypothesized that in db/db mice impaired relaxation induced by Rho-kinase inhibitor is accompanied by diminished NO bioavailability, increased oxidative stress and upregulation of the RhoA/Rho-kinase signalling pathway. Cavernosal strips from male lean and non-diabetic db/+ and db/db mice were mounted in myographs and isometric force in response to Rho-kinase inhibitor Y-27632 was recorded. Enzyme activity and protein expression of oxidative stress markers and key molecules of the RhoA/Rho-kinase pathway were analyzed. The Rho-kinase inhibitor Y-27632 concentration-dependently caused corpus cavernosum relaxation and inhibited cavernosal contractions. Nonetheless, a rightward shift in the curves obtained in corpus cavernosum of db/db mice was observed. Compared to db/+, this strain presented increased active RhoA, higher MYPT-1 phosphorylation stimulated by phenylephrine, and increased expression of ROKα and Rho-GEFs. Further, we observed normal expression of endothelial and neuronal NOS in corpus cavernosum of db/db mice. However, nitrate/nitrate (NOx) levels were diminished, suggesting decreased NO bioavailability. We measured the oxidant status and observed increased lipid peroxidation, with decreased SOD activity and expression. In conclusion, our data demonstrate that in db/db mice, upregulation of the RhoA/Rho-kinase signalling pathway was accompanied by decreased NO bioavailability and increased oxidative stress contributing to impaired relaxation of the corpus cavermosum of db/db mice.

  4. Impaired Corpus Cavernosum Relaxation Is Accompanied by Increased Oxidative Stress and Up-Regulation of the Rho-Kinase Pathway in Diabetic (Db/Db Mice.

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    Fernanda B M Priviero

    Full Text Available Basal release of nitric oxide from endothelial cells modulates contractile activity in the corpus cavernosum via inhibition of the RhoA/Rho-kinase signaling pathway. We aimed to investigate nitric oxide bioavailability, oxidative stress and the Rho-kinase pathway in the relaxation of the corpus cavernosum of an obese and diabetic model of mice (db/db mice. We hypothesized that in db/db mice impaired relaxation induced by Rho-kinase inhibitor is accompanied by diminished NO bioavailability, increased oxidative stress and upregulation of the RhoA/Rho-kinase signalling pathway. Cavernosal strips from male lean and non-diabetic db/+ and db/db mice were mounted in myographs and isometric force in response to Rho-kinase inhibitor Y-27632 was recorded. Enzyme activity and protein expression of oxidative stress markers and key molecules of the RhoA/Rho-kinase pathway were analyzed. The Rho-kinase inhibitor Y-27632 concentration-dependently caused corpus cavernosum relaxation and inhibited cavernosal contractions. Nonetheless, a rightward shift in the curves obtained in corpus cavernosum of db/db mice was observed. Compared to db/+, this strain presented increased active RhoA, higher MYPT-1 phosphorylation stimulated by phenylephrine, and increased expression of ROKα and Rho-GEFs. Further, we observed normal expression of endothelial and neuronal NOS in corpus cavernosum of db/db mice. However, nitrate/nitrate (NOx levels were diminished, suggesting decreased NO bioavailability. We measured the oxidant status and observed increased lipid peroxidation, with decreased SOD activity and expression. In conclusion, our data demonstrate that in db/db mice, upregulation of the RhoA/Rho-kinase signalling pathway was accompanied by decreased NO bioavailability and increased oxidative stress contributing to impaired relaxation of the corpus cavermosum of db/db mice.

  5. Effect of hydrogen sulphide-donating sildenafil (ACS6) on erectile function and oxidative stress in rabbit isolated corpus cavernosum and in hypertensive rats.

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    Shukla, Nilima; Rossoni, Giuseppe; Hotston, Matthew; Sparatore, Anna; Del Soldato, Piero; Tazzari, Valerio; Persad, Raj; Angelini, Gianni D; Jeremy, Jamie Y

    2009-06-01

    OBJECTIVE To study the effect of the H(2)S-donating derivative of sildenafil (ACS6) compared to sildenafil citrate and sodium hydrosulphide (NaHS) on relaxation, superoxide formation and NADPH oxidase and type 5 phosphodiesterase (PDE5) expression in isolated rabbit cavernosal tissue and smooth muscle cells (CSMCs), and in vivo on indices of oxidative stress induced with buthionine sulphoximine (BSO). MATERIALS AND METHODS Relaxation was studied in an organ bath in response to carbachol and after incubation with interleukin-1beta for 12 h. CSMCs were incubated with tumour-necrosis factor-alpha or the thromboxane A(2) (TXA(2)) analogue, U46619, with or with no sildenafil citrate, ACS6 or NaHS for 16 h. Superoxide formation and the expression of p47(phox) (an active subunit of the NADPH oxidase complex) and PDE5 protein was then assessed using Western blotting. Rats were also treated with BSO (with or with no sildenafil citrate or ACS6) for 7 days; cavernosal cGMP, cAMP, glutathionine and plasma TXA(2) and 8-isoprostane F(2alpha) was measured by enzyme-linked immunosorbent assay. RESULTS ACS6 and sildenafil citrate relaxed cavernosal smooth muscle equipotently; NaHS alone had little effect at up to 100 microm. The formation of superoxide and expression of p47(phox) and PDE5 was reduced by ACS6, sildenafil citrate and NaHS (order of potency: ACS6 > sildenafil citrate > NaHS). The effects of ACS6 were blocked by inhibitors of protein kinase A (PKA) and PKG. In rats treated with BSO, both ASC6 and sildenafil citrate reduced the increased plasma levels of TXA(2) and 8-isoprostane F(2alpha) but increased cGMP, cAMP and glutathionine levels in corpus cavernosum. CONCLUSIONS By virtue of a dual action on PKA and PKG activation, ACS6 not only promotes erection, acutely, but might also have a long-term beneficial effect through inhibition of oxidative stress and downregulation of PDE5.

  6. Reproducibility of corpus cavernosum electromyography in healthy young man

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    Jiang, X.; Frantzen, J.; Holsheimer, J.; Meuleman, E.

    2005-01-01

    Research on reproducibility of corpus cavernosum electromyography (CC-EMG) is relevant because reproducible signals indicate a biological phenomenon and not an artefact. Reproducible signals are also required to use CC-EMG as a diagnostic tool for erectile dysfunction. The aim of this study was to a

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

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    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.

  8. Effects of Icariside II on Corpus Cavernosum and Major Pelvic Ganglion Neuropathy in Streptozotocin-Induced Diabetic Rats

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    Guang-Yi Bai

    2014-12-01

    Full Text Available Diabetic erectile dysfunction is associated with penile dorsal nerve bundle neuropathy in the corpus cavernosum and the mechanism is not well understood. We investigated the neuropathy changes in the corpus cavernosum of rats with streptozotocin-induced diabetes and the effects of Icariside II (ICA II on improving neuropathy. Thirty-six 8-week-old Sprague-Dawley rats were randomly distributed into normal control group, diabetic group and ICA-II treated group. Diabetes was induced by a one-time intraperitoneal injection of streptozotocin (60 mg/kg. Three days later, the diabetic rats were randomly divided into 2 groups including a saline treated placebo group and an ICA II-treated group (5 mg/kg/day, by intragastric administration daily. Twelve weeks later, erectile function was measured by cavernous nerve electrostimulation with real time intracorporal pressure assessment. The penis was harvested for the histological examination (immunofluorescence and immunohistochemical staining and transmission electron microscopy detecting. Diabetic animals exhibited a decreased density of dorsal nerve bundle in penis. The neurofilament of the dorsal nerve bundle was fragmented in the diabetic rats. There was a decreased expression of nNOS and NGF in the diabetic group. The ICA II group had higher density of dorsal nerve bundle, higher expression of NGF and nNOS in the penis. The pathological change of major pelvic nerve ganglion (including the microstructure by transmission electron microscope and the neurite outgrowth length of major pelvic nerve ganglion tissue cultured in vitro was greatly attenuated in the ICA II-treated group (p < 0.01. ICA II treatment attenuates the diabetes-related impairment of corpus cavernosum and major pelvic ganglion neuropathy in rats with Streptozotocin-Induced Diabetes.

  9. [Expressions of CSE and CBS in the corpus cavernosum of spontaneous hypertensive rats].

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    Zhu, Xiu-Bo; Jiang, Jun; Jiang, Rui; Chen, Feng

    2014-01-01

    To investigate the expressions of cystathionine gamma-lyase (CSE) and cystathionine beta-synthase (CBS) in the corpus cavernosum of spontaneous hypertensive rats (SHR) and their relationship with erectile dysfunction. This study included 10 male SHRs and 10 healthy male Wistar-Kyoto (WKY) rats as controls, all aged 12 weeks. We applied a series of electric stimuli to the major pelvic ganglions of the rats, observed changes in the ratio of intracavernosal to mean arterial blood pressure (ICP/MAP), measured the levels of serum testosterone (T) and endogenous H2S, and determined the expressions of CSE and CBS in the corpus cavernosum by Western blot and immunohistochemistry. No obvious difference was found in the serum T level between the two groups. Compared with the WKY rats, the SHRs showed significant reduction in the ICP/MAP ratio, the contents of plasma H2S ([21.92 +/- 2.75] micromol/L vs [10.49 +/- 1.35] micromol/L, P CBS and CSE (P CBS were distributed mainly in the smooth muscle cells and vascular endothelial cells of the corpus cavernosum. The ICP/MAP ratio was highly positively correlated with the expressions of CSE (r = 0.977, P CBS (r = 0.955, P CBS in the corpus cavernosum, which might be related with hypertension-induced reduction of erectile function.

  10. The Protective Effect of Salidroside on Hypoxia-Induced Corpus Cavernosum Smooth Muscle Cell Phenotypic Transformation

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    Zhang, Xiang; Zhao, Jian-feng; Zhao, Fan; Yan, Jun-Feng; Yang, Fan; Huang, Xiao-jun; Chen, Gang; Fu, Hui-Ying; Lv, Bo-Dong

    2017-01-01

    Salidroside, a major active ingredient isolated from Rhodiola rosea, has a long application in Chinese medical history. It has widely demonstrated effects on fatigue, psychological stress, and depression and exhibits potential antihypoxia activity. Emerging evidence shows that hypoxia is an important independent risk factor for erectile dysfunction (ED). The aim of this study was to clarify the effect of salidroside on hypoxia-induced phenotypic transformation of corpus cavernosum smooth musc...

  11. Angiotensin-(1-7) Downregulates Diabetes-Induced cGMP Phosphodiesterase Activation in Rat Corpus Cavernosum

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    Benter, Ibrahim F.

    2017-01-01

    Molecular mechanisms of the beneficial effects of angiotensin-(1-7), Ang-(1-7), in diabetes-related complications, including erectile dysfunction, remain unclear. We examined the effect of diabetes and/or Ang-(1-7) treatment on vascular reactivity and cyclic guanosine monophosphate (cGMP) phosphodiesterase (PDE) in corpus cavernosum. Male Wistar rats were grouped as (1) control, (2) diabetic (streptozotocin, STZ, treated), (3) control + Ang-(1-7), and (4) diabetic + Ang-(1-7). Following 3 weeks of Ang-(1-7) treatment subsequent to induction of diabetes, rats were sacrificed. Penile cavernosal tissue was isolated to measure vascular reactivity, PDE gene expression and activity, and levels of p38MAP kinase, nitrites, and cGMP. Carbachol-induced vasorelaxant response after preincubation of corpus cavernosum with PE was significantly attenuated in diabetic rats, and Ang-(1-7) markedly corrected the diabetes-induced impairment. Gene expression and activity of PDE and p38MAP kinase were significantly increased in cavernosal tissue of diabetic rats, and Ang-(1-7) markedly attenuated STZ-induced effects. Ang-(1-7) significantly increased the levels of nitrite and cGMP in cavernosal tissue of control and diabetic rats. Cavernosal tissue of diabetic rats had significantly reduced cGMP levels and Ang-(1-7) markedly prevented the STZ-induced cGMP depletion. This study demonstrates that attenuation of diabetes-induced PDE activity might be one of the key mechanisms in the beneficial effects of Ang-(1-7).

  12. Experimental study of verapamil on the relaxation of isolated human corpus cavernosum tissues

    Institute of Scientific and Technical Information of China (English)

    Lu-Lin Ma; Yu-Qing Liu; Wen-Hao Tang; Lian-Ming Zhao; Hui Jiang

    2006-01-01

    Aim: To evaluate the relaxant effect of verapamil on human corpus cavernosum in vitro and to assess the drug's potential as a treatment for erectile dysfunction (ED). Methods: Preparations of the human corpus cavernosum were obtained from recently deceased young men who had had normal erectile function. The isometric tension and detailed curves were recorded when contractions induced by 10 mmol/L phenylephrine were reduced by different doses of verapamil or the vehicle control (sterile water). The tension of human corpus cavernosum preparations are described as a percentage of their top tension before adding verapamil or the vehicle. ANOVA and least significant difference tests were used for statistical analysis. Results: Doses of 1 μmol/L, 10 μmol/L and 100 μmol/L verapamil resulted in relaxation of (35.28 ± 7.96)%, (55.91 ± 6.41)%, (85.68 ± 4.16)% after 30 min, respectively. The vehicle control at the same time point produced relaxation of (-0.06 ± 10.57)% (P<0.05). Conclusion: Verapamil is significantly effective in relaxing normal human corpus cavernous smooth muscle induced by phenylephrine in vitro and the relaxant effect depends on the concentration of verapamil.

  13. Changes in erectile organ structure and function in a rat model of chronic prostatitis/chronic pelvic pain syndrome.

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    Wang, X-J; Xia, L-L; Xu, T-Y; Zhang, X-H; Zhu, Z-W; Zhang, M-G; Liu, Y; Xu, C; Zhong, S; Shen, Z-J

    2016-04-01

    There is a growing recognition of the association between chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and erectile dysfunction (ED); however, most of the reports are based on questionnaires which cannot distinguish between organic and functional ED. The purpose of this study was to determine the exact relationship between CP/CPPS and ED, and to investigate the changes in erectile organ structure and function in a rat model of CP/CPPS. We established a rat model of experimental autoimmune prostatitis (EAP), which is a valid model for CP/CPPS. Erectile function in EAP and normal rats was comparable after cavernous nerve electrostimulation. The serum testosterone and oestradiol levels, ultrastructure of the corpus cavernosum and expression of endothelial nitric oxide synthase and neuronal nitric oxide synthase in the two groups were similar; however, there was a decrease in smooth muscle-to-collagen ratio and alpha-smooth muscle actin expression and an increase in transforming growth factor-beta 1 expression was observed in EAP rats. Thus, organic ED may not exist in EAP rats. We speculate that ED complained by patients with CP/CPPS may be psychological, which could be caused by impairment in the quality of life; however, further studies are needed to fully understand the potential mechanisms underlying the penile fibrosis in EAP rats.

  14. Effects of NCX 4050, a new NO donor, in rabbit and human corpus cavernosum.

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    Filippi, S; Crescioli, C; Vannelli, G B; Fazzini, A; Natali, A; Riffaud, J P; Maggi, M; Ledda, F

    2003-04-01

    The effects of NCX 4050, a drug belonging to a new class of NO donors, was investigated in isolated preparations of human and rabbit corpus cavernosum (CC) and in human foetal corpora cavernosa (hfCC) smooth muscle cells. In strips of rabbit CC, NCX 4050 (0.001-100 microM) induced a concentration-dependent relaxation which was influenced neither by Nw-nitro-l-arginine-methyl-ester (l-NAME; 100 microm) nor by endothelium deprivation. The NCX 4050-induced relaxation was significantly reduced by the guanylate cyclase inhibitor 1H-[1,2,4]-oxadiazolo[4,3-a]quinoxalin-1-one (ODQ; 1 microm) and enhanced by a specific phosphodiesterase 5 inhibitor, sildenafil (300 nm). Moreover, NCX 4050 (0.01-1 microm), induced a concentration-dependent potentiation of the relaxant response induced by electrical field stimulation (EFS) in rabbit preparations pre-treated with guanethidine and indomethacin. The relaxant effect of NCX 4050 was similar to that obtained by increasing concentrations (0.001-100 microm) of sodium nitroprusside (SNP) in either rabbit or human preparations. To further investigate the activity of NCX 4050 on human corpora cavernosa, we exposed cultured hfCC smooth muscle cells to increasing concentrations of NCX 4050 and SNP. We found that both compounds dose-dependently reduced cell proliferation. The antiproliferative effect of all the concentration tested of NCX 4050 was completely blocked by ODQ (1 microm). These results suggest that in rabbit and human corpora cavernosa NCX 4050 acts by activating guanylate cyclase activity, induces smooth muscle relaxation and quiescence. Our results provide a rationale for a possible future use of NCX 4050 in the pharmacotherapy of erectile dysfunction linked to an impaired release of NO from the endothelium.

  15. Partial segmental thrombosis of the corpus cavernosum presenting with perineal pain.

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    Christodoulidou, Michelle; Parnham, Arie; Ramachandran, Navin; Muneer, Asif

    2016-11-22

    We describe the case of a man aged 43 years who presented with a 2-week history of a palpable lump in the right proximal penile shaft. This was preceded by a 6-month history of perineal pain, accompanied by erectile dysfunction. An urgent MRI scan of his penis identified a thrombus within the right crus and corpus of the penis. His thrombophilia screen was normal. The patient was started on oral anticoagulation and a phosphodiesterase inhibitor (PDE-5i) to prevent thrombus progression and maintain erectile function. At 5 months, the patients' symptoms had resolved and an MRI showed a reduction in the thrombus size. MRI is a useful imaging modality to diagnose a thrombus within the corpus cavernosum in patients presenting with a history of penile and perineal pain together with a palpable lump. The non-enhancement of the lesion helps to differentiate this from alternative rare lesions within the penis and perineum.

  16. Erectile dysfunction.

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    Wylie, Kevan

    2008-01-01

    Erectile dysfunction is a common problem affecting sexual function in men. Approximately one in 10 men over the age of 40 is affected by this condition and the incidence is age related. Erectile dysfunction is a sentinel marker for several reversible conditions including peripheral and coronary vascular disease, hypertension and diabetes mellitus. Endothelial dysfunction is a common factor between the disease states. Concurrent conditions such as depression, late-onset hypogonadism, Peyronie's disease and lower urinary tract symptoms may significantly worsen erectile function, other sexual and relationship issues and penis dysmorphophobia. A focused physical examination and baseline laboratory investigations are mandatory. Management consists of initiating modifiable lifestyle changes, psychological and psychosexual/couples interventions and pharmacological and other interventions. In combination and with treatment of concurrent comorbid states, these interventions will often bring about successful resolution of symptoms and avoid the need for surgical interventions.

  17. Contrast radiographic study of venous drainage of the corpus cavernosum and the corpus spongiosum of the cat penis.

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    Amiri, Ali Akbar; Gilanpour, Hassan; Veshkini, Abbas

    2014-01-01

    The aim of this study was to determine the drainage routes of the corpus cvernosum penis and the corpus spongiosum penis in the cat using contrast cavernosography. Five male cats, 1.5-2.5 years old, weighing between 4.5 and 5.5 kg were investigated. The cats were anesthetized and the root and the proximal part of the penis were exposed by an incision on the perineum reaching the scrotum. Each cat was radiographed in lateral and dorsal recumbency before and during injection of contrast medium into the erectile bodies. The corpus spongiosum penis was injected at the bulb of the penis and the corpus cavernosum penis at the root. Injection of contrast media into the cavernous bodies showed that both the external and internal iliac veins drain the erectile bodies into the caudal vena cava. Drainage from the corpus spongiosum penis was from the bulb for the proximal part and from the glans for the distal part. The corpus cavernosum penis was drained only proximally, from the crura. There was a network of veins above the pelvic symphysis and the drainage of erectile bodies where through various routes into the internal and external iliac veins.

  18. The effect of mirodenafil on the penile erection and corpus cavernosum in the rat model of cavernosal nerve injury

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    Kim, H; Sohn, D W; Kim, S D; Hong, S-H; Suh, H J; Lee, C B; Kim, S W

    2010-01-01

    Impotence is one of the common complications after the radical prostatectomy. One of the main reasons of this complication is due to the dysfunction of the veins in corpus cavernosum. Recent studies have shown that the erectile function is improved after the long-term therapy of phosphodiesterase type 5 inhibitor among patients with post-prostatectomy erectile dysfunction. In this study, we evaluated the effects of mirodenafil on the penile erection and corpus cavernosum tissues in the rat model of cavernosal nerve injury. Rats were divided into four groups: (1) control group, (2) bilateral cavernosal nerve injury group, (3) mirodenafil 10 mg therapy group after the nerve injury and (4) mirodenafil 20 mg therapy group after the nerve injury. After we identified the nerve from the pelvic nerve complex on the lateral side of the prostate, the rats in the control group were sutured without causing any nerve injury and in other groups we damaged the nerve by compressing it with a vessel clamp. Then, 10 and 20 mg kg−1 of mirodenafil were orally administered to two experimental groups. After 8 weeks, the intracavernosal pressure (ICP) was recorded. The immunohistochemical staining and western blot were performed, and the effect of mirodenafil on the expression of cyclic guanosine monophosphate (cGMP) was evaluated through enzyme-linked immunosorbent assay. The ICP of nerve-injured group was decreased compared with the control group; however, the ICP of the mirodenafil-administered groups was improved compared with the nerve-injured group. The Masson's trichrome staining confirmed that the smooth muscle (SM) component was increased in the mirodenafil-administered groups. The nitric oxide synthase expression and cGMP of mirodenafil-administered groups was increased compared with the nerve-injured group. Long-term therapy of mirodenafil may improve the erectile function after the radical prostatectomy by preserving the SM content and inhibiting the fibrosis of the

  19. Erectile dysfunction

    African Journals Online (AJOL)

    that increase blood flow to the penis. The blood ... The pressure of the blood in the chambers makes the ... What are the risk factors for erectile dysfunction? The most .... losing excessive weight and increasing physical activity, may improve the ...

  20. The Protective Effect of Salidroside on Hypoxia-Induced Corpus Cavernosum Smooth Muscle Cell Phenotypic Transformation

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    Xiang Zhang

    2017-01-01

    Full Text Available Salidroside, a major active ingredient isolated from Rhodiola rosea, has a long application in Chinese medical history. It has widely demonstrated effects on fatigue, psychological stress, and depression and exhibits potential antihypoxia activity. Emerging evidence shows that hypoxia is an important independent risk factor for erectile dysfunction (ED. The aim of this study was to clarify the effect of salidroside on hypoxia-induced phenotypic transformation of corpus cavernosum smooth muscle cells (CCSMCs. Our results showed that salidroside decreased the hypoxia-induced expression of collagen and content of vimentin, a corpus cavernosum smooth muscle synthetic protein, in vitro. Simultaneously, salidroside increased expression of the CCSMC contractile proteins, α-smooth muscle actin (α-SMA and desmin. In vivo, similarly, the expressions of collagen and hypoxia-inducible factor-1α were increased in bilateral cavernous neurectomy (BCN rats while they were decreased in the salidroside group. Among the phenotypic proteins, α-SMA and desmin increased and vimentin decreased after treating BCN rats with salidroside compared with the BCN alone group. Overall, our results demonstrate that salidroside has the ability to oppose hypoxia and can inhibit the CCSMC phenotypic transformation induced by hypoxia. Salidroside may provide a new treatment method for ED.

  1. The Protective Effect of Salidroside on Hypoxia-Induced Corpus Cavernosum Smooth Muscle Cell Phenotypic Transformation.

    Science.gov (United States)

    Zhang, Xiang; Zhao, Jian-Feng; Zhao, Fan; Yan, Jun-Feng; Yang, Fan; Huang, Xiao-Jun; Chen, Gang; Fu, Hui-Ying; Lv, Bo-Dong

    2017-01-01

    Salidroside, a major active ingredient isolated from Rhodiola rosea, has a long application in Chinese medical history. It has widely demonstrated effects on fatigue, psychological stress, and depression and exhibits potential antihypoxia activity. Emerging evidence shows that hypoxia is an important independent risk factor for erectile dysfunction (ED). The aim of this study was to clarify the effect of salidroside on hypoxia-induced phenotypic transformation of corpus cavernosum smooth muscle cells (CCSMCs). Our results showed that salidroside decreased the hypoxia-induced expression of collagen and content of vimentin, a corpus cavernosum smooth muscle synthetic protein, in vitro. Simultaneously, salidroside increased expression of the CCSMC contractile proteins, α-smooth muscle actin (α-SMA) and desmin. In vivo, similarly, the expressions of collagen and hypoxia-inducible factor-1α were increased in bilateral cavernous neurectomy (BCN) rats while they were decreased in the salidroside group. Among the phenotypic proteins, α-SMA and desmin increased and vimentin decreased after treating BCN rats with salidroside compared with the BCN alone group. Overall, our results demonstrate that salidroside has the ability to oppose hypoxia and can inhibit the CCSMC phenotypic transformation induced by hypoxia. Salidroside may provide a new treatment method for ED.

  2. Chronic administration of imipramine but not agomelatine and moclobemide affects the nitrergic relaxation of rabbit corpus cavernosum smooth muscle.

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    Gocmez, Semil Selcen; Utkan, Tijen; Gacar, Nejat

    2013-08-15

    Sexual dysfunction is a common and underestimated effect of antidepressants. However, the mechanism by which these drugs cause erectile dysfunction is unclear. We investigated the reactivity of the corpus cavernosum of rabbits that were treated with either chronic imipramine, which is a tricyclic agent; agomelatine, which is a melatonergic agonist and serotonin 5HT(2c) antagonist; or moclobemide, which is a reversible inhibitor of monoamine-oxidase A. Twenty rabbits were randomly divided into four groups: the control group (n=5), the imipramine-treated group (n=5), which received i.p. injections of 10 mg/kg/day of imipramine, the moclobemide-treated group (n=5), which received i.p. injections of 20 mg/kg/day of moclobemide, and the agomelatine-treated group (n=5), which was orally administered 10 mg/kg/day of agomelatine. The reactivities of corpus cavernosum tissue obtained from the antidepressant-treated and the control groups were studied in organ chambers after the animals were subjected to 21 days of drug administration. The acetylcholine-induced endothelium-dependent and the electrical field stimulation (EFS)-induced neurogenic relaxation of the corpus cavernosum of the imipramine-treated group was significantly decreased compared with the control group. However, neither the acetylcholine- nor EFS-induced relaxation was changed in the moclobemide- or agomelatine-treated groups. There were no change in the relaxant response to the nitric oxide (NO) donor sodium nitroprusside and contractile response to KCl between the groups. This study suggests that chronic imipramine treatment but not agomelatine and moclobemide treatments causes significant functional changes in the penile erectile tissue of rabbits and that these changes may contribute to the development of impotence.

  3. Modifications of erectile tissue components in the penis during the fetal period.

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    Carla B M Gallo

    Full Text Available The penile erectile tissue has a complex microscopic anatomy with important functions in the mechanism of penile erection. The knowledge of such structures is necessary for understanding the normal physiology of the adult penis. Therefore, it is important to know the changes of these penile structures during fetal development. This study aims to analyze the development of the main components of the erectile tissue, such as collagen, smooth muscle fibers and elastic system fibers, in human fetuses.We studied the penises of 56 human fetuses aged 13 to 36 weeks post-conception (WPC. We used histochemical and immunohistochemical staining, as well as morphometric techniques to analyze the collagen, smooth muscle fibers and elastic system fibers in the corpus cavernosum and in the corpus spongiosum. These elements were identified and quantified as percentage by using the Image J software (NIH, Bethesda, USA. From 13 to 36 WPC, in the corpus cavernosum, the amount of collagen, smooth muscle fibers and elastic system fibers varied from 19.88% to 36.60%, from 4.39% to 29.76% and from 1.91% to 8.92%, respectively. In the corpus spongiosum, the amount of collagen, smooth muscle fibers and elastic system fibers varied from 34.65% to 45.89%, from 0.60% to 11.90% and from 3.22% to 11.93%, respectively.We found strong correlation between the elements analyzed with fetal age, both in corpus cavernosum and corpus spongiosum. The growth rate of these elements was more intense during the second trimester (13 to 24 WPC of gestation, both in corpus cavernosum and in corpus spongiosum. There is greater proportional amount of collagen in the corpus spongiosum than in corpus cavernosum during all fetal period. In the corpus spongiosum, there is about four times more collagen than smooth muscle fibers and elastic system fibers, during all fetal period studied.

  4. Small and intermediate conductance Ca(2+)-activated K+ channels confer distinctive patterns of distribution in human tissues and differential cellular localisation in the colon and corpus cavernosum.

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    Chen, Mao Xiang; Gorman, Shelby A; Benson, Bill; Singh, Kuljit; Hieble, J Paul; Michel, Martin C; Tate, Simon N; Trezise, Derek J

    2004-06-01

    The SK/IK family of small and intermediate conductance calcium-activated potassium channels contains four members, SK1, SK2, SK3 and IK1, and is important for the regulation of a variety of neuronal and non-neuronal functions. In this study we have analysed the distribution of these channels in human tissues and their cellular localisation in samples of colon and corpus cavernosum. SK1 mRNA was detected almost exclusively in neuronal tissues. SK2 mRNA distribution was restricted but more widespread than SK1, and was detected in adrenal gland, brain, prostate, bladder, liver and heart. SK3 mRNA was detected in almost every tissue examined. It was highly expressed in brain and in smooth muscle-rich tissues including the clitoris and the corpus cavernosum, and expression in the corpus cavernosum was upregulated up to 5-fold in patients undergoing sex-change operations. IK1 mRNA was present in surface-rich, secretory and inflammatory cell-rich tissues, highest in the trachea, prostate, placenta and salivary glands. In detailed immunohistochemical studies of the colon and the corpus cavernosum, SK1-like immunoreactivity was observed in the enteric neurons. SK3-like immunoreactivity was observed strongly in smooth muscle and vascular endothelium. IK1-like immunoreactivity was mainly observed in inflammatory cells and enteric neurons of the colon, but absent in corpus cavernosum. These distinctive patterns of distribution suggest that these channels are likely to have different biological functions and could be specifically targeted for a number of human diseases, such as irritable bowel syndrome, hypertension and erectile dysfunction.

  5. [Treatment of erectile insufficiency].

    Science.gov (United States)

    Bondil, P

    1995-10-28

    Impotency, or impaired erectile function, affects approximately 10% of the adult males in France. The psychological consequences can have a major impact not only on the subject's sexual life but also his familial and professional relationships. The task facing the urologists is to carefully evaluate the patient's request for care and adapt treatment not only to the physiological situation but also the patient's psychological and social context. Several approaches have been developed. Search for an aetiology, excepting exceptional cases with a recognized organic origin, is often unsatisfactory due to the multifactor processes involved and the self-sustaining inter-relationship between the psychological impact and the physiological disorder. Sex therapy is aimed at reducing anxiety and helping the couple better understand their sexual relationship. Such behavioural counselling is particularly indicated in absence of organic disorders or as complementary therapy combined with medical or surgical treatment. The pharmacological approach relies on alphablockers or certain psychotropic drugs which have a moderate but real effect when taken orally. Local non-invasive applications of protaglandin E1 can also improve erectile function. The mechanism of intrapenial injections is to release the erectile smooth muscles. The most widely used drugs in France are papaverine, phentolamine and moxisylite as well as prostaglandin E1. Self-injections may be required in certain cases but are abandoned by about half of the patients after one or two months. Vacuum with a mechanical pump can produce a non-physiological erection but is rarely used in France. Surgical repair of arterial or venous disorders can also provide excellent, particularly long-term, results in carefully selected patients. Despite undeniable progress, the treatment of impotency remains a difficult therapeutic challenge, basically due to the large number of casual factors and their complex interactions.

  6. Light-controlled relaxation of the rat penile corpus cavernosum using NOBL-1, a novel nitric oxide releaser

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    Yuji Hotta

    2016-05-01

    Full Text Available Purpose: To investigate whether relaxation of the rat penile corpus cavernosum could be controlled with NOBL-1, a novel, lightcontrollable nitric oxide (NO releaser. Materials and Methods: Fifteen-week-old male Wistar-ST rats were used. The penile corpus cavernosum was prepared and used in an isometric tension study. After noradrenaline (10−5 M achieved precontraction, the penile corpus cavernosum was irradiated by light (470–500 nm with and without NOBL-1 (10−6 M. In addition, we noted rats’ responses to light with vardenafil (10−6 M, a phosphodiesterase-5 (PDE-5 inhibitor. Next, responses to light in the presence of a guanylate cyclase inhibitor, ODQ (1H-[1,2,4] oxadiazolo[4,3-a]quinoxalin-1-one (10−5 M, were measured. All measurements were performed in pretreated L-NAME (10−4 M conditions to inhibit endogenous NO production. Results: Corpus cavernosal smooth muscle, precontracted with noradrenaline, was unchanged by light irradiation in the absence of NOBL-1. However, in the presence of NOBL-1, corpus cavernosal smooth muscle, precontracted with noradrenaline, relaxed in response to light irradiation. After blue light irradiation ceased, tension returned. In addition, the light response was obviously enhanced in the presence of a PDE-5 inhibitor. Conclusions: This study showed that rat corpus cavernosal smooth muscle relaxation can be light-controlled using NOBL-1, a novel, light sensitive NO releaser. Though further in vivo studies are needed to investigate possible usefulness, NOBL-1 may be prove to be a useful tool for erectile dysfunction therapy, specifically in the field of penile rehabilitation.

  7. [Expressions of CSE and CBS in the penile corpus cavernosum of hyperglycemia rats and their implications].

    Science.gov (United States)

    Huang, Yi-Ming; Xia, Ji-Yi; Jiang, Rui

    2014-04-01

    To investigate the impact of hyperglycemia on the hydrogen sulfide (H2S) signaling pathway in rat penile tissue and its relationship with erectile function. Twenty healthy male Sprague Dawley (SD) rats aged 8 weeks were randomly divided into groups A (4-week healthy control), B (4-week diabetes mellitus model), C (6-week healthy control) and D (6-week diabetes mellitus model). The rats in groups B and D were injected intraperitoneally with streptozotocin at 50 mg/kg to induce diabetes mellitus, while those in groups A and C with the same volume of normal saline. The animals were killed at 4 (groups A and B) and 6 weeks (groups C and D) after treatment for measurement of the maximal intracavernous pressure/mean arterial blood pressure (ICP(max)/MAP) by electrostimulation, determination of the H2S concentration in the plasma and penile tissue, and detection of the expressions of cystathionine-beta-synthetase (CBS) and cystathionine-gamma-lyase (CSE) in the penile corpus cavernosum by immunohisto- chemistry and Western blot. With electrostimulation of the pelvic ganglia at 5V and 7 V, ICP(max)/MAP was significantly reduced in groups B (0.19 +/- 0.03 and 0.29 +/- 0.04) and D (0.14 +/- 0.04 and 0.25 +/- 0.04) as compared with A (0.46 +/- 0.07 and 0.68 +/- 0.09) and C (0.43 +/- 0.07 and 0.65 +/- 0.16) (P 0.05) or between C and D ([470.44 +/- 209.28] ng/dl vs [297.01 +/- 96.58] ng/dl, P > 0.05). Groups B and D showed remarkable reduction in the H2S concentration (P CBS and CSE (P CBS and CSE expressions were even more significantly decreased in D than in B (P CBS and CSE in the penile corpus cavernosum of the diabetic rats suggested that the H2S signaling pathway might be involved in hyperglycemia-induced erectile dysfunction.

  8. Taurine Supplementation Improves Erectile Function in Rats with Streptozotocin-induced Type 1 Diabetes via Amelioration of Penile Fibrosis and Endothelial Dysfunction.

    Science.gov (United States)

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

    2016-05-01

    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. To investigate whether taurine, a sulfur-containing amino acid, affects diabetic ED (DED). Type 1 diabetes mellitus was induced in male rats by using streptozotocin. After 12 weeks, an apomorphine test was conducted to confirm DED. Only rats with DED were administered taurine or vehicle for 4 weeks. Age-matched nondiabetic rats were administered saline intraperitoneally for 4 weeks. Erectile function was evaluated by electrical stimulation of the cavernous nerve. Histologic and molecular alterations of the corpus cavernosum also were analyzed. Erectile function was significantly reduced in the diabetic rats compared with in the nondiabetic rats, and was improved 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 ameliorated erectile response as well as histologic and molecular alterations. 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. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  9. The impact of transrectal prostate biopsy on erectile function.

    Science.gov (United States)

    Linden-Castro, E; Pelayo-Nieto, M; Espinosa-Perezgrovas, D; Rubio-Arellano, E D; Catalán-Quinto, G; Guzmán-Hernández, F; Morales-Covarrubias, J A; Cortez-Betancourt, R

    2016-09-01

    To assess erectile function at different periods of time in patients who undergo transrectal prostate biopsy (TRPB). A total of 364 patients underwent TRPB. All of the patients were assessed using the International Index of Erectile Function-5 (IIEF-5). All patients with a positive result for cancer or with previous erectile dysfunction in the initial assessment were excluded. Ninety-three patients were included and were assessed before the biopsy and at 4, 12 and 24 weeks after the TRPB, using the IIEF-5 and assessing erectile function across these time periods. We assessed 93 patients. During the first prebiopsy assessment, 100% of the patients scored ≥22 points. In the first postbiopsy evaluation at 4 weeks, 66.6% scored ≥ 22 points, and 33.3% had erectile dysfunction, thereby indicating a statistically significant reduction in the IIEF-5 score (P=.001). In the second postbiopsy evaluation, only 9.1% patients still had mild to moderate erectile dysfunction (P=.04). By the end, 92.48% of the patients scored ≥ 22 points, and 7.52% still had mild erectile dysfunction, without presenting a significant difference (P=.1). After a TRPB, the drop in IIEF-5 scores and the presence of erectile dysfunction are temporary and transient, with greater impairment during the first month following the procedure and improvement starting after the first month, with almost total recovery at 6 months. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  11. Fibrosis of corpus cavernosum in animals following cavernous nerve ablation

    Institute of Scientific and Technical Information of China (English)

    Wan-LiHu; Li-QuanHu; jianSong; Shi-WenLi; Xin-MinZheng; BeiCheng; Bing-ChunTian

    2004-01-01

    t Aim: To investigate alterations of smooth muscle cells and collagen fibers in corpus cavernosum following cavernous neurectomy and its relation to the expression of transforming growth factor-β1 (TGF-β1). Methods: Ten adult male SD rats (neurectomy group) were subject to a bilateral cavernous nerve (CN) resection aseptically under an operating microscope, with 6 sham-operated rats as the control. Fifteen weeks after the operation, the penile specimens were collected and prepared for quantitative-analyzing of ratio of smooth muscle to collagen fibers in corpus cavernosum with confocal microscopy, and for detecting the expression of TGF-β1 by RT-PCR and westernblot.Results: Smooth muscle cells that show red color after fluorescent-labeling with tetramethylrhodamine isothiocyanatephalloidin and collagen fibers that produce green autofluorescence after paraformaldehyde fixation were clearly identified under the confocal microscope. Quantification of fluorescent intensity showed that the ratio of smooth muscle to collagen fibers in corpus cavernosum in neurectomy group was 0.265± 0.125, which was significantly lower than that in sham-operated group (0.760±0.196, P<0.01). RT-PCR and western-blot analyses revealed a significantlyhigher expression of TGF-β1 in the penile tissues of the neurectomy animals than that in sham-operated group.Conclusion: Bilateral ablation of CN can lead to fibrosis of corpus cavernosum, which may be related to an increased expression of TGF-β1 induced by hypoxia in cavernous tissue after denervation.

  12. Comparative effects of sildenafil, phentolamine, yohimbine and L-arginine on the rabbit corpus cavernosum.

    Science.gov (United States)

    Sharabi, F M; Daabees, T T; El-Metwally, M A; Senbel, A M

    2004-04-01

    Penile erection involves relaxation of smooth muscle of corpus cavernosum and associated arterioles. Sildenafil, a highly selective inhibitor of phosphodiesterase type 5, is effective in the treatment of erectile dysfunction. The aim of this study is to investigate the effect of sildenafil on smooth muscle of the rabbit corpus cavernosum (RCC) and to compare its effect with those of phentolamine, yohimbine and L-arginine. The effects of sildenafil, phentolamine, yohimbine and L-arginine were studied on the response of the RCC to electrical field stimulation (EFS) as well as on the phenylephrine (PE, 3 x 10(-6) M)-induced tone. EFS caused transient, frequency-dependent relaxation of the RCC that was inhibited by the nitric oxide synthase inhibitor NG-nitro-L-arginine (3 x 10(-5) M). Sildenafil (1 x 10(-9)-1 x 10(-6) M) and phentolamine (1 x 10(-9)-1 x 10(-6) M) enhanced the EFS-induced relaxation in a concentration-dependent manner with ED50 of 0.056 +/- 0.004 and 0.572 +/-0.035 microM at 8 Hz, respectively, yohimbine (3 x 10(-7)-3 x 10(-5) M) and L-arginine (3 x 10(-6)-3 x 10(-4) M) did not show significant effects (ED50 at 8 Hz = 35.84 +/-2.24 and 2.164 +/- 0.174 microM, respectively). Sildenafil (1 x 10(-9) and 1 x 10(-8) M) potentiated the EFS-induced relaxation caused by L-arginine (3 x 10(-5) m). Sildenafil, phentolamine, yohimbine and L-arginine reduced the PE-induced tone to different extents; the ED50 values were 0.81 +/- 0.097, 0.49 +/- 0.025 and 13.97 +/- 1.10 microM, respectively. Maximum concentration of L-arginine used failed to produce 50% relaxation (ED20 = 221.82 +/- 15.71 microM). The muscle relaxant effects of different combinations of sildenafil and L-arginine on PE-induced tone did not differ significantly from the sum of the individual effects. The results demonstrate that sildenafil, when compared to other drugs used in penile erection dysfunction, shows the highest potency on the nitrergic transmission in the RCC. On the other hand

  13. Depression and erectile dysfunction.

    Science.gov (United States)

    Makhlouf, Antoine; Kparker, Ashay; Niederberger, Craig S

    2007-11-01

    Depression and erectile dysfunction (ED) clearly are associated. Although urologists and psychiatrists have long recognized that antidepressant medications affect erectile function negatively, the interplay between the two conditions remains underappreciated. Psychiatrists may be reluctant to question a patient in detail about ED, and urologists seldom perform a formal assessment of the presence of depression in patients who have ED. This article gives a quick overview of the relationship between these two conditions and provides the clinician with the knowledge required to effectively manage ED with comorbid depression.

  14. Improvement of erectile function by Korean red ginseng(Panax ginseng) in a male rat model of metabolic syndrome

    Institute of Scientific and Technical Information of China (English)

    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.

  15. Chronic Cigarette Smoking Impairs Erectile Function through Increased Oxidative Stress and Apoptosis, Decreased nNOS, Endothelial and Smooth Muscle Contents in a Rat Model.

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    Yun-Ching Huang

    Full Text Available Cigarette use is an independent risk factor for the development of erectile dysfunction (ED. While the association between chronic smoking and ED is well established, the fundamental mechanism(s of cigarette-related ED are incompletely understood, partly due to no reliable animal model of smoking-induced ED. The present study was designed to validate an in vivo rat model of chronic cigarette-induced ED. Forty 12-week old male Sprague-Dawley rats were divided into 4 groups. Ten rats served as control group and were exposed only to room air. The remaining 30 rats were passively exposed to cigarette smoke (CS for 4 weeks (n = 10, 12 weeks (n = 10, and 24 weeks (n = 10. At the 24-week time point all rats were assessed with intracavernous pressure (ICP during cavernous nerve electrostimulation. Blood and urine were collected to measure serum testosterone and oxidative stress, respectively. Corporal tissue was assessed by Western blot for neuronal nitric oxide synthase (nNOS. Penile tissues were subjected to immunohistochemistry for endothelial, smooth muscle, and apoptotic content. Mean arterial pressure (MAP was significantly higher in 24-week cigarette exposed animals compared to the control animals. Mean ICP/MAP ratio and cavernosal smooth muscle/endothelial contents were significantly lower in the 12- and 24-week rats compared to control animals. Oxidative stress was significantly higher in the 24-week cigarette exposed group compared to control animals. Mean nNOS expression was significantly lower, and apoptotic index significantly higher, in CS-exposed animals compared to control animals. These findings indicate that the rat model exposure to CS increases apoptosis and oxidative stress and decreases nNOS, endothelial and smooth muscle contents, and ICP in a dose dependent fashion. The rat model is a useful tool for further study of the molecular and cellular mechanisms of CS-related ED.

  16. Phentolamine mesylate relaxes rabbit corpus cavernosum by a nonadrenergic, noncholinergic mechanism.

    Science.gov (United States)

    Vemulapalli, S; Kurowski, S

    2001-02-01

    The contribution of NO-cGMP dependent pathway to phentolamine mesylate-evoked nonadrenergic, noncholinergic relaxation of rabbit corpus cavernosum was investigated in vitro. Stimulation of nonadrenergic, noncholinergic neurons of the rabbit corpus cavernosum elicited frequency-related relaxation that was significantly attenuated by L-NAME (NO synthase inhibitor) or ODQ (an inhibitor of guanylate cyclase). Moreover, tetrodotoxin, a sodium channel blocker, abolished the electrical field stimulation-induced relaxation of rabbit corpus cavernosum, suggesting that neuronal release of NO mediates relaxation to electrical field stimulation. Phentolamine mesylate (30 and 100 nM) dose-dependently enhanced electrical field stimulation-induced relaxation of the rabbit corpus cavernosum. Prazosin (30 microM) and yohimbine (30 microM) failed to affect phentolamine mesylate-mediated nonadrenergic, noncholinergic rabbit penile smooth muscle relaxation, suggesting that phentolamine relaxes rabbit corpus cavernosum independent of alpha-adrenergic receptor blockade. In contrast, pretreatment of the rabbit cavernosal strips with L-NAME significantly-attenuated electrical field stimulation produced relaxations to phentolamine mesylate, suggesting that phentolamine mesylate relaxes rabbit corpus cavernosum by activating NO synthase. The data suggest that phentolamine mesylate relaxes nonadrenergic noncholinergic neurons of the rabbit corpus cavernosum by activating NO synthase and is independent of alpha-adrenergic receptor blockade.

  17. Pharmacotherapy of erectile dysfunction: Current standards

    Directory of Open Access Journals (Sweden)

    Kew-Kim Chew

    2006-01-01

    Full Text Available Pharmacotherapy is currently the therapeutic option of choice for erectile dysfunction. Comprising mainly intracavernosal injection therapy using alprostadil or alprostadil combined with phentolamine and/or papaverine and oral phosphodiesterase-5 inhibitors, it is safe and effective if appropriately prescribed and administered. The medications in current use produce satisfactory erectile responses by enhancing cavernosal vasodilatation mainly through their ability to promote relaxation of the smooth muscle cells in the corpora cavernosa involving the synthesis and activity of nitric oxide via the cyclic guanosine monophosphate and cyclic adenosine monophosphate biochemical pathways. The main side-effects and complications of intracavernosal injections are postinjection pain, prolonged erections, priapism and penile fibrosis. There may be a variety of side-effects with phosphodiesterase-5 inhibition but these are usually inconsequential. Recent serious ill health and the need for ongoing long-acting nitrate therapy or frequent use of short-acting nitrates for angina are absolute contraindications to the use of phosphodiesterase-5 inhibitors. Caution has to be exercised in prescribing phosphodiesterase-5 inhibitors for patients with impaired renal or hepatic functions or receiving multi-drug therapy for any systemic disease. All patients presenting with erectile dysfunction should be investigated and treated for cardiovascular risk factors. They should also be counseled regarding lifestyle factors particularly healthy balanced diet, regular physical exercise and inappropriate social habits.

  18. Mobilisation of endothelial progenitor cells: one of the possible mechanisms involved in the chronic administration of melatonin preventing erectile dysfunction in diabetic rats

    Institute of Scientific and Technical Information of China (English)

    Xue-Feng Qiu; Xiao-Xin Li; Yun Chen; Hao-Cheng Lin; Wen Yu; Run Wang; Yu-Tian Dai

    2012-01-01

    Diabetes-induced oxidative stress plays a critical role in the mobilisation of endothelial progenitor cells (EPCs) from the bone marrow to the circulation.This study was designed to explore the effects of chronic melatonin administration on the promotion of the mobilisation of EPCs and on the preservation of erectile function in type Ⅰ diabetic rats.Melatonin was administered to streptozotocin-induced type Ⅰdiabetic rats.EPCs levels were determined using flow cytometry,Oxidative stress in the bone marrow was indicated by the levels of superoxide dismutase and malondialdehyde.Erectile function was evaluated by measuring the intracavemous pressure during an electrostimulation of the cavernous nerve.The density of the endothelium and the proportions of smooth muscle and collagen in the corpus cavernosum were determined by immunohistochemistry.The administration of melatonin increased the superoxide dismutase level and decreased the malondiaidehyde level in the bone marrow,This effect was accompanied by an increased level of circulating EPCs in the diabetic rats.The intracavernous pressure to mean arterial pressure ratio of the rats in the treatment group was significantly greater,compared with diabetic control rats.The histological analysis demonstrated an increase in the endothelial density of the corpus cavernosum after the administration of melatonin.However,melatonin treatment did not change the proportions of smooth muscle and collagen in the corpus cavernosum of diabetic rats.Chronic administration of melatonin has a beneficial effect on preventing erectile dysfunction (ED) in type Ⅰ diabetic rats.Promoting the mobilisation of EPCs is one of the possible mechanisms involved in the improvement of ED.

  19. Erectile function after radical prostatectomy

    DEFF Research Database (Denmark)

    Fode, Mikkel; Frey, Anders; Jakobsen, Henrik;

    2016-01-01

    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 ...

  20. The effects of androgen on penile reflex, erectile responseto electrical stimulation and penile NOS activity in the rat

    Institute of Scientific and Technical Information of China (English)

    SeongIISeo

    1999-01-01

    Aim: To investigate the effects of androgen on penile erection through the reflex arc and penile corpus cavernosum,and study the respective roles of testosterone (T) and dihydrotestosterone (DHT) in penile erection ira rats. Methods:Male Sprague-Dawley rats were castrated and implanted with silastic brand silicone tube containing T or DHT, with orwithout daily injections of a 5a-reductase inhibitor, MKM-434. The penile reflex, erectile response to electrical stimula-tion (ES) of the cavernous nerves and penile nitric-oxide synthase (NOS) activity were observed under varying andro-genic status. Results: Penile reflex erection in the rat was, on the whole, related to serum T levels though the numberof glans engorgernents was not. The number of cups and flips was significantly decreased by castration, and restoredto the control level by T supplementation. Erectile response to ES and NOS activity in penile tissue was also related toserum T level. T administered together with a ,5a-reductase inhibitor no longer restored the number of reflex erection,erectile responses to ES and NOS activity in the corpus cavemosum. Conclusion: Androgen influenced the penile re-flex arc, corpus cavemosum, and the perinea] striated muscles, ha reflex erection, erectile response to ES and penileNOS activity in the rat, T seeras to be first conyerted to DHT, the more active androgen modality. (Asian JAndrol1999Dec; 1: 169-174)

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

    Directory of Open Access Journals (Sweden)

    M. N. Mamedov

    2010-01-01

    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. Icariin on relaxation effect of corpus cavernosum smooth muscle

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    NO-cGMP pathway in penile corpus cavernosal smooth muscle plays an important role in penile erection. The level of cGMP is regulated by a balance between the rate of synthesis by guanylate cyclase and the rate of hydrolytic breakdown to guanosine 5′monophosphate (GMP) by phos- phodiesterase 5(PDE5). Icariin is isolated from natural drug Epimedii herba, it is shown to have the relaxation effect on corpus cavernosal smooth muscle of rabbit (IC50: 4×10-4 mol/L), and the mechanism of the relaxation effect of Icariin on corpus cavernosum believed to have the inhibiting effect on PDE5 and activation of NO-cGMP pathway to enhancing penile erection.

  3. Acetylsalicylic acid protects erectile function in diabetic rats.

    Science.gov (United States)

    Hafez, G; Gonulalan, U; Kosan, M; Arioglu, E; Ozturk, B; Cetinkaya, M; Gur, S

    2014-01-01

    We aimed to evaluate the effect of acetylsalicylic acid (ASA) treatment on diabetes-induced erectile dysfunction. Adult male Sprague-Dawley rats were divided into four groups as follows: (i) control (C), (ii) diabetic (D), (iii) ASA-treated control (C+ASA) and (iv) ASA-treated diabetic (D+ASA) groups. In groups 2 and 4, diabetes was induced by injection of 35 mg kg(-1) streptozotocin. ASA (100 mg kg(-1) day(-1) , orally) was administrated to rats in groups 3 and 4 for 8 weeks. Both intracavernosal pressure (ICP) and mean arterial blood pressure (MAP) were measured in in vivo studies. In organ bath, the relaxation responses to acetylcholine (ACh), electrical field stimulation (EFS) and sodium nitroprusside were tested in corpus cavernosum (CC) strips. The mRNA expression for neuronal nitric oxide synthase (nNOS) was calculated using reverse transcription polymerase chain reaction technique. In in vivo experiments, diabetic rats displayed reduced ICP/MAP values, which were normalised with ASA treatment. The relaxant response to high-dose ACh and EFS at low frequencies (1-8 Hz) in CC strips from the D+ASA group were significantly higher when compared to the D group. Treatment with ASA normalised the raised mRNA expressions of nNOS in diabetic penile tissues. ASA may be involved in mRNA of protein synthesis of NO released from nonadrenergic and noncholinergic cavernosal nerve in diabetes.

  4. Acute effect of rosiglitazone on relaxation responses in hypercholesterolemic corpus cavernosum.

    Science.gov (United States)

    Akdag, H; Murat, N; Evcim, S; Esen, A; Gidener, S

    2016-05-01

    Thiazolidinediones (TZDs) improve vascular endothelial dysfunction through non-genomic effects of peroxisomal proliferator-activated receptor γ. This study investigated the acute effect of one of the TZD, rosiglitazone, on endothelium-dependent relaxation response of corpus cavernosum (CC) in hypercholesterolemic rabbits. New Zealand rabbits were divided into two groups randomly as control and cholesterol groups. Hypercholesterolemia was induced by feeding rabbits with 2% cholesterol diet (w/w) for 6 weeks. Endothelium-dependent and -independent relaxation response of CC were evaluated in the presence of rosiglitazone by organ bath studies with cumulative doses of acetylcholine (Ach) and sodium nitroprusside (SNP). Maximal relaxation (Emax) response to Ach significantly decreased owing to hypercholesterolemia in CC tissues. However, in vitro incubation of rosiglitazone with different concentrations (0.1, 1 and 10 μm) did not improve the Ach-dependent Emax responses in hypercholesterolemic rabbit CC. Surprisingly, rosiglitazone caused a significant decrease in Ach-dependent relaxation in healthy CC. Emax responses to SNP did not differ in the presence of rosiglitazone in both the control and hypercholesterolemic groups. Rosiglitazone does not improve hypercholesterolemia-induced endothelial dysfunction in CC tissues while it dose-dependently impairs endothelium-dependent relaxation in healthy CC tissue.

  5. Relaxation of rabbit corpus cavernosum smooth muscle and aortic vascular endothelium induced by new nitric oxide donor substances of the nitrosyl-ruthenium complex

    Directory of Open Access Journals (Sweden)

    Joao B. G. Cerqueira

    2008-10-01

    Full Text Available INTRODUCTION: Endothelial dysfunction characterized by endogenous nitric oxide (NO deficiency made 56% of patients affected with erectile dysfunction decline treatment with PDE-5 inhibitors. New forms of treatment are currently being developed for this group of patients. MATERIALS AND METHODS: The study compared the effect of sodium nitroprusside (SNP and two substances of the nitrosyl-ruthenium complex, cis-[Ru(bpy2(SO3(NO]PF-6-9 ("FONO1” and trans-[Ru(NH34(caffeine(NO]C13 ("LLNO1” on relaxation of rabbit corpus cavernosum smooth muscle and aortic vascular endothelium. The samples were immersed in isolated baths and precontracted with 0.1 µM phenylephrine (PE and the corresponding relaxation concentration/response curves were plotted. In order to investigate the relaxation mechanisms involved, 100 µM ODQ (a soluble guanylate cyclase-specific inhibitor, 3 µM or 10 µM oxyhemoglobin (an extracellular NO scavenger or 1 mM L-cysteine (a nitrosyl anion-specific scavenger was added to the samples. RESULTS: All the NO donors tested produced a significant level of relaxation in the vascular endothelium. In corpus cavernosum samples, FONO1 produced no significant effect, but LLNO1 and SNP induced dose-dependent relaxation with comparable potency (pEC50 = 6.14 ± 0.08 and 6.4 ± 0.14, respectively and maximum effect (Emax = 82% vs. 100%, respectively. All NO donors were found to activate soluble guanylate cyclase, since the addition of the corresponding inhibitor (100 µM ODQ completely neutralized the relaxation effect observed. The addition of oxyhemoglobin reduced the relaxation effect, but did not inhibit it completely. In aortic vascular endothelium 3 µM oxyhemoglobin decreased the relaxation effect by 26% on the average, while 10 µM oxyhemoglobin reduced it by over 52%. The addition of 100 µM L-cysteine produced no significant inhibiting effect. CONCLUSIONS: These results suggest that LLNO1 and FONO1 are potent vasodilators. LLNO1 was

  6. Effects of icariin on erectile function and expression of nitric oxide synthase isoforms in castrated rats

    Institute of Scientific and Technical Information of China (English)

    Wu-Jiang Liu; Zhong-Cheng Xin; Hua Xin; Yi-Ming Yuan; Long Tian; Ying-Lu Guo

    2005-01-01

    Aim: To investigate the effect of icariin on erectile function and the expression of nitric oxide synthase (NOS)isoforms in castrated rats. Methods: Thirty-two adult male Wistar rats were randomly divided into one sham-operated group (A) and three castrated groups (B, C and D). One week after surgery, rats were treated with normal week after treatment, the erectile function of the rats was assessed by measuring intracavernosal pressure (ICP)during electrostimulation of the cavernosal nerve. The serum testosterone (ST) levels, the percent of smooth muscle (PSM) in trabecular tissue, and the expression of mRNA and proteins of neuronal nitric oxide synthase (nNOS),inducible nitric oxide synthase (iNOS), endothelial nitric oxide synthase (eNOS) and phosphodiesterase V (PDE5) in corpus cavernosum (CC) were also evaluated. Results: ICP, PSM, ST and the expression of nNOS, iNOS, eNOS and PDE5 were significantly decreased in group B compared with those in group A (P < 0.01). However, ICP, PSM and the expression of nNOS and iNOS were increased in groups C and D compared with those in group B (P < 0.05).Changes in ST and the expression of eNOS and PDE5 were not significant (P > 0.05) in groups C and D compared with those in group B. Conclusion: Oral treatment with icariin (> 98.6 % purity) for 4 weeks potentially improves erectile function. This effect is correlated with an increase in PSM and the expression of certain NOS in the CC of castrated rats. These results suggest that icariin may have a therapeutic effect on erectile dysfunction.

  7. Erectile dysfunction after radical prostatectomy: hemodynamic profiles and their correlation with the recovery of erectile function.

    Science.gov (United States)

    Mulhall, John P; Slovick, Ron; Hotaling, James; Aviv, Nadid; Valenzuela, Rolando; Waters, W Bedford; Flanigan, Robert C

    2002-03-01

    Despite the advent of nerve sparing radical prostatectomy some men experience erectile dysfunction. Many of these men have vasculogenic erectile impairment in the form of arterial insufficiency or venous leakage. Recent data imply that early postoperative injection therapy may decrease the rate of erectile dysfunction. We defined hemodynamic patterns in patients who underwent bilateral nerve sparing radical prostatectomy to assess the chronology of venous leakage development and explore the correlation of hemodynamic profiles with the return of functional erection 12 months postoperatively. Patients with excellent preoperative erectile function who underwent bilateral nerve sparing surgery and had no pharmacological support for erectile dysfunction in the initial 12 months after surgery received vascular evaluation at presentation. Vascular evaluation involved cavernosometry or penile ultrasonography. Patients were then interviewed again at least 12 months postoperatively to assess the ability to achieve sexual intercourse. Our study group comprised 96 men with a mean age plus or minus standard deviation of 54 +/- 12 years who met all inclusion criteria. All patients had pathologically proved organ confined disease. Mean time to the initial postoperative presentation was 6 +/- 5 months. Patients were divided into 4 groups according to the time of vascular studies postoperatively, namely less than 4 to 8, 9 to 12 and greater than 12 months. Normal vascular status, arterial insufficiency and venous leakage were diagnosed in 35%, 59% and 26% of the group, respectively. No difference in the incidence of arterial insufficiency was noted in the 4 time groups. Time postoperatively was significantly associated with the incidence of venous leakage (14% at less than 4 months and 35% at between 9 and 12). In regard to the correlation of the vascular diagnosis with the return to functional erection 47% of the normal, 31% of the arteriogenic and 9% of the venous leakage group

  8. Cycling and erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Ina Šibli

    2015-01-01

    Full Text Available Abstract: For many years medical studies have implicated bicycle riding is causing erectile dysfunction (ED in association with higher perineal pressure. This review focuses upon epidemiological studies assesing the impact of cycling on ED, pathogenesis of ED in cyclists  as well as on research considering changes of perineal pressure, hemodynamics, and nerve conduction when cycling. Investigestors were also interested in different saddle sizes, materials and geometry and also in the impact of saddle and riders position on changes to the perineum. Research on female cyclists is very limited but indicates similar genitourinary disorders as in male cyclists. We also review  research on preventative and therapeutic options regarding bicycle riding and ED.

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

    OpenAIRE

    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...

  10. Markers of erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Kelvin P Davies

    2008-01-01

    Full Text Available With the development and marketing of oral pharmacotherapy that is both noninvasive and successful in treating erectile dysfunction (ED, the quest to identify markers of organic ED lost ground. Indeed, the multi-factorial nature of ED may have led many researchers to conclude that searching for a universal marker of ED was futile. However, the realization that ED is strongly correlated with the overall health of men, and may act as a predictor for the development of cardiovascular disease (CVD and diabetes, has stimulated interest in identifying genes that can distinguish organic ED. In addition, the potential ability to suggest to the patient that ED is reversible (i.e., psychogenic with a simple test would be of significance to both the physician and patient, as well as for reimbursement issues for therapy by insurance companies. Such a marker may also act as a non-subjective measure of the degree of ED and the efficacy of treatment. This review discusses the importance of identifying such markers and recent work identifying potential markers in human patients.

  11. Erectile Dysfunction and Hypertension: Impact on Cardiovascular Risk and Treatment

    Directory of Open Access Journals (Sweden)

    Valter Javaroni

    2012-01-01

    Full Text Available Erectile dysfunction (ED is a common complaint in hypertensive men and can represent a systemic vascular disease, an adverse effect of antihypertensive medication or a frequent concern that may impair drug compliance. ED has been considered an early marker of cardiovascular disease. The connection between both conditions seems to be located in the endothelium, which may become unable to generate the necessary dilatation in penile vascular bed in response to sexual excitement, producing persistent impairment in erection. On the other hand, the real influence of antihypertensive drugs in erectile function still deserves discussion. Therefore, regardless of ED mechanism in hypertension, early diagnosis and correct approach of sexual life represent an important step of cardiovascular evaluation which certainly contributes for a better choice of hypertension treatment, preventing some complications and restoring the quality of life.

  12. Hyperlipidemia and erectile dysfunction

    Institute of Scientific and Technical Information of China (English)

    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.

  13. Relaxant mechanisms of 3, 5, 7, 30, 40-pentamethoxyflavone on isolated human cavernosum

    DEFF Research Database (Denmark)

    Jansakul, Chaweewan; Tachanaparuksa, Kuldej; Mulvany, Michael J.

    2012-01-01

    We have investigated effects and mechanisms responsible for the activity of 3, 5, 7, 30, 40-pentamethoxyflavone (PMF) on isolated human cavernosum. PMF is the major flavone isolated from Kaempferia parviflora claimed to act as an aphrodisiac. PMF caused relaxation of phenylephrine precontracted h...

  14. Relaxant mechanisms of 3, 5, 7, 3', 4'-pentamethoxyflavone on isolated human cavernosum.

    Science.gov (United States)

    Jansakul, Chaweewan; Tachanaparuksa, Kuldej; Mulvany, Michael J; Sukpondma, Youwapa

    2012-09-15

    We have investigated effects and mechanisms responsible for the activity of 3, 5, 7, 3', 4'-pentamethoxyflavone (PMF) on isolated human cavernosum. PMF is the major flavone isolated from Kaempferia parviflora claimed to act as an aphrodisiac. PMF caused relaxation of phenylephrine precontracted human cavernosal strips, and this effect was slightly inhibited by N(G)-nitro-l-arginine, a nitric oxide synthase inhibitor, but not by ODQ (soluble guanylate cyclase inhibitor), TEA (tetraethylammonium, blocker of voltage-dependent K(+) channels) or glybenclamide (blocker of ATP-dependent K(+) channels). PMF did not significantly inhibit the relaxant activity of glyceryltrinitrate or acetylcholine on human cavernosal strips precontracted with phenylephrine. In contrast, sildenafil (phosphodiesterase inhibitor) potentiated the relaxant activity of glyceryl trinitrate but not of acetylcholine. In normal Krebs solution with nifedipine (blocker of l-type Ca(2+) channels), or in Ca(2+)-free Krebs solution, PMF caused a further inhibition of human cavernosum contracted with phenylephrine. In human cavernosum treated with thapsigargin (inhibitor of sarcoplasmic reticulum Ca(2+)-ATPase) in Ca(2+)-free medium, PMF suppressed the concentration-response curve of human cavernosum to phenylephrine and a further suppression was found when SKF-96365 (a blocker of store-operated Ca(2+) channels and Y-27632 (inhibitor of Rho-kinase)), but not nifedipine, were added sequentially. Thus, PMF had only a weak effect on the release of nitric oxide, and had no effect as a K(ATP)- or K(Ca) channel opener, a phosphodiesterase inhibitor, a store-operated Ca(2+) channel blocker or a Rho-kinase inhibitor. Therefore, these studies suggest that PMF causes relaxation of human cavernosum through voltage-dependent Ca(2+) channels and other mechanisms associated with calcium mobilization. Copyright © 2012 Elsevier B.V. All rights reserved.

  15. Combined effects of brain-derived neurotrophic factor immobilized poly-lactic-co-glycolic acid membrane with human adipose-derived stem cells and basic fibroblast growth factor hydrogel on recovery of erectile dysfunction.

    Science.gov (United States)

    Lee, Seung Hwan; Kim, In Gul; Jung, Ae Ryang; Shrestha, Kshitiz Raj; Lee, Jin Ho; Park, Ki Dong; Chung, Byung Ha; Kim, Sae Woong; Kim, Ki Hean; Lee, Ji Youl

    2014-09-01

    Erectile dysfunction (ED) is the most frequent long-term problem after radical prostatectomy. We aimed to evaluate whether the use of combination therapy with basic fibroblast growth factor (bFGF)-hydrogel on corpus cavernosum and with adipose-derived stem cells (ADSCs) and brain-derived neurotrophic factor (BDNF)-immobilized poly-lactic-co-glycolic acid (PLGA) membrane on the cavernous nerve (CN) could improve erectile function in a rat model of bilateral cavernous nerve crush injury (BCNI). Rats were randomly divided into five groups (n=15 per group): a normal group (N group), a group receiving saline application after bilateral cavernous nerve crush injury (BCNI), a group undergoing bFGF-hydrogel injection in the corpus cavernosum after BCNI (bFGF), a group receiving ADSC application covered with BDNF-membrane after BCNI (ADSC/BDNF), and a group undergoing coadministration of bFGF-hydrogel injection and BDNF-membrane with ADSCs after BDNF (bFGF+ADSC/BDNF). Four weeks postoperatively, the erectile function was assessed by detecting the ratio of intracavernous pressure (ICP) to mean arterial pressure (MAP). Smooth muscle and collagen contents were measured using Masson's trichrome staining. Neuronal nitric oxide synthase (nNOS) expression in the dorsal penile nerve was detected by immunostaining. The protein expression of the α-smooth muscle actin (α-SMA) and the cyclic guanosine monophosphate (cGMP) level of the corpus cavernosum were quantified by western blot and cGMP assay, respectively. In the bFGF+ADSC/BDNF group, the erectile function was significantly elevated compared with the BCNI and other treated groups and showed a significantly increased smooth muscle/collagen ratio, nNOS content, α-SMA expression, and cGMP level. In particular, there were no statistical differences in the ICP/MAP ratio, smooth muscle/collagen ratio, and α-SMA and cGMP levels between the bFGF+ADSC/BDNF group and normal group. Application of the BDNF-immobilized PLGA membrane with

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Erectile Dysfunction and Undiagnosed Diabetes, Hypertension, and Hypercholesterolemia

    National Research Council Canada - National Science Library

    Skeldon, Sean C; Detsky, Allan S; Goldenberg, S Larry; Law, Michael R

    2015-01-01

    .... Erectile dysfunction was determined by a single, validated survey question. We used logistic regression analyses to investigate the relationship between erectile dysfunction and undiagnosed hypertension, hypercholesterolemia, and diabetes...

  18. Chuanxiongzine relaxes isolated corpus cavernosum strips and raises intracavernous pressure in rabbits

    Science.gov (United States)

    Xiao, H-J; Wang, T; Chen, J; Fan, L-C; Yin, C-P; Liu, J-H; Gao, X

    2009-01-01

    It has been shown that there are many Chinese traditional herbals that can enhance sexual activity. Chuanxiongzine is a vasoactive ingredient that has been isolated and purified from Ligusticum chuanxiong Hort. In previous studies, it has been found that chuanxiongzine was effective in relaxing rabbit corpus cavernosum smooth muscle. We determined the effects of chuanxiongzine on relaxation of isolated corpus cavernosum strips in vitro and on increase of intracavernous pressure (ICP) in vivo in rabbits. Chuanxiongzine caused a concentration-dependent relaxation of phenylephrine precontracted isolated corpus cavernosum strips (EC50 1.58 × 10−4 mol l−1), which were endothelium independent and NO independent. However, the guanylyl cyclase inhibitor 1-H-[1,2,4] oxadiazolo [4,3-a] quinoxalin-1-one significantly shifted the chuanxiongzine concentration–response relationship to the right. Although there was no significant difference in the level of cyclic guanosine monophosphate (cGMP) and cyclic adenosine monophosphate (cAMP) in isolated corpus cavernosum strips treated with chuanxiongzine or vehicle, chuanxiongzine caused a significant rise in the level of cGMP and cAMP in isolated corpus cavernosum strips pretreated with the activator of adenylyl cyclase forskolin and the source of NO sodium nitroprusside. In an in vivo study, chuanxiongzine dose-dependently raised ICP after the intracavernous injection of its cumulative doses (0.5, 1, 2 and 5 mg kg−1). The ICP increased from baseline to 19.1±3.7, 24.8±2.1, 30.2±4.8 and 39.7±6.1 mm Hg, respectively, and the duration of tumescence ranged from 8.5±2.8 to 22.9±7.3 min. Our results show that chuanxiongzine can relax isolated corpus cavernosum strips of rabbits in vitro and increase ICP of rabbits in vivo, which is neither endothelium dependent nor NO dependent, but may be partly mediated by the inhibition of cAMP phosphodiesterase or cGMP phosphodiesterase. PMID:19940852

  19. Evaluation of the Effect of Different Doses of Low Energy Shock Wave Therapy on the Erectile Function of Streptozotocin (STZ-Induced Diabetic Rats

    Directory of Open Access Journals (Sweden)

    Zhong-Cheng Xin

    2013-05-01

    Full Text Available To investigate the therapeutic effect of different doses of low energy shock wave therapy (LESWT on the erectile dysfunction (ED in streptozotocin (STZ induced diabetic rats. SD rats (n = 75 were randomly divided into 5 groups (normal control, diabetic control, 3 different dose LESWT treated diabetic groups. Diabetic rats were induced by intra-peritoneal injection of STZ (60 mg/kg and rats with fasting blood glucose ≥ 300 mg/dL were selected as diabetic models. Twelve weeks later, different doses of LESWT (100, 200 and 300 shocks each time treatment on penises were used to treat ED (7.33 MPa, 2 shocks/s three times a week for two weeks. The erectile function was evaluated by intracavernous pressure (ICP after 1 week washout period. Then the penises were harvested for histological study. The results showed LESWT could significantly improve the erectile function of diabetic rats, increase smooth muscle and endothelial contents, up-regulate the expression of α-SMA, vWF, nNOS and VEGF, and down- regulate the expression of RAGE in corpus cavernosum. The therapeutic effect might relate to treatment dose positively, and the maximal therapeutic effect was noted in the LESWT300 group. Consequently, 300 shocks each time might be the ideal LESWT dose for diabetic ED treatment.

  20. Hypogonadism and erectile dysfunction in myotonic dystrophy type 1.

    Science.gov (United States)

    Peric, Stojan; Nisic, Tanja; Milicev, Milena; Basta, Ivana; Marjanovic, Ivan; Peric, Marina; Lavrnic, Dragana; Rakocevic Stojanovic, Vidosava

    2013-10-01

    Myotonic dystrophy type 1 (DM1) is the most common form of muscular dystrophy in adults. It affects many organs and systems besides muscle. Aim of this study was to assess frequency of erectile dysfunction (ED) and hypogonadism, the correlation between them and the impact of ED on quality of life (QoL) in patients with DM1. A series of 25 men (aged from 22 to 58 years) with a diagnosis of DM1 was analyzed. Muscular Impairment Rating Scale (MIRS) was used to assess severity of muscular involvement. Erectile function was assessed using the short form of the International Index of Erectile Function test (IIEF-5). Levels of follicle stimulating hormone (FSH), luteinizing hormone (LH) and testosterone were assessed. All patients completed the Serbian version of the SF-36 questionnaire as a measure of health-related QoL. ED was present in 18 (72%) of patients. Seven (28%) patients were euogonadic, 16 (64%) had compensated hypogonadism and 2 (8%) had primary hypogonadism. ED was somewhat more common in patients with hypogonadism (78% vs. 57%). Mental composite score of SF-36 was lower in patients with ED (p<0.05). Our results showed that 72% of men with DM1 had ED and hypogonadism. Studies with larger number of subjects are needed to resolve cascade of events that lays behind ED in DM1. Development of therapeutic strategies may have positive impact on QoL. Substitutive therapy with androgens may be benefitial.

  1. Relaxant mechanisms of 3, 5, 7, 30, 40-pentamethoxyflavone on isolated human cavernosum

    DEFF Research Database (Denmark)

    Jansakul, Chaweewan; Tachanaparuksa, Kuldej; Mulvany, Michael J.

    2012-01-01

    We have investigated effects and mechanisms responsible for the activity of 3, 5, 7, 30, 40-pentamethoxyflavone (PMF) on isolated human cavernosum. PMF is the major flavone isolated from Kaempferia parviflora claimed to act as an aphrodisiac. PMF caused relaxation of phenylephrine precontracted...... did not significantly inhibit the relaxant activity of glyceryltrinitrate or acetylcholine on human cavernosal strips precontracted with phenylephrine. In contrast, sildenafil (phosphodiesterase inhibitor) potentiated the relaxant activity of glyceryl trinitrate but not of acetylcholine. In normal...... of nitric oxide, and had no effect as a KATP- or KCa channel opener, a phosphodiesterase inhibitor, a store-operated Ca2þ channel blocker or a Rho-kinase inhibitor. Therefore, these studies suggest that PMF causes relaxation of human cavernosum through voltagedependent Ca2þ channels and other mechanisms...

  2. Effects of buried penis on the structure and function of corpus cavernosum in a rat model

    Institute of Scientific and Technical Information of China (English)

    CHENG Fan; YU Wei-min; XIA Yue; ZHANG Xiao-bin; YANG Si-xing; GE Ming-huan

    2010-01-01

    Background While the abnormal appearance of the concealed penis has been well recognized, the effect of buried penis on the structure and function of corpus cavernosum has not been well studied. To explore this issue, we established a rat model and evaluated the effect of buried penis on cavernosum weight, contents and ultrastructure of tissue, and nitric oxide synthase (NOS) activity.Methods Two hundred and ten rats were randomly divided into 3 equal cohorts for 2, 4 and 6 months study (groups A, B and C). Each group was randomly divided into buried group (n=40), control group (n=15), and normal group (n=15), respectively. Intra-purse-string suture of the root of the penis was used to establish the model. Macroscopic development was judged by measuring the weight of the corpus cavernosum. Masson's trichrome staining was performed for observing microstructure while a transmission electron microscope was used for observing ultrastructure. The NOS activity was detected by a NOS activity assay kit.Results Buried penis had no significant influence on the appearance and weight of the corpus cavemosum. Buried penis resulted in decreased smooth muscle content (P>0.05 in group A, and P0.05 in groups A and B, and P <0.05 in group C) compared with the normal and control groups. Ultrastructural abnormalities of corpus cavernosum were observed in the 6-month buried group. Moreover, there was decrease of NOS activity in groups B and C (P<0.05 in group B and P<0.01 in group C) when compared with the normal and control groups.Conclusion Buried penis affects the structure and function of corpus cavemosum in rats and the effect is positively correlated with the buried time, but there is no significant effect on the macroscopic development.

  3. Erectile dysfunction in heart failure patients: a critical reappraisal.

    Science.gov (United States)

    Alberti, L; Torlasco, C; Lauretta, L; Loffi, M; Maranta, F; Salonia, A; Margonato, A; Montorsi, F; Fragasso, G

    2013-03-01

    Heart failure (HF) is a complex clinical syndrome with a constantly increasing incidence and prevalence in western countries. Total absence of sexual activity is registered in 30% of HF patients. Moreover, HF-induced reduction in exercise tolerance, side effects of HF medications and the coexistence of shared risk factors between HF and sexual dysfunction may further aggravate the sexual health of HF patients. The purpose of this review is to examine the pathophysiological mechanisms behind the association of erectile dysfunction (ED) and HF, the potential therapeutic approaches and the eventual indications for sexual activity in HF patients. Medline and Cochrane Library search was performed from January 1970 through October 2012 to retrieve relevant papers outlining the association between ED and HF. Many evidences have outlined a tight association between ED and HF pathophysiological standpoint. Shared risk factors, common pathogenic traits and epidemiologic association represent some of the links between these conditions. Erectile dysfunction has been recognized as an earlier predictor of cardiovascular events; moreover, HF itself may cause and/or worsen ED because of its particular feature and co-morbidities. Furthermore, some cardiovascular drugs may contribute to impaired erectile function. In stable patients with stable HF, sexual activity is generally not contraindicated but it should be encouraged, as a form of moderate-intensity physical exertion. An effective treatment of ED in HF patients should be founded on the correction of reversible risk factors, on the choice of cardiovascular drugs with the lowest effect upon patient's erectile function, and on the use of phosphodiesterase-5-inhibitors. Physicians should be aware of the close relation between HF and ED and of the related clinical and therapeutic implications, in order to improve patients quality of life and clinical outcome. © 2013 American Society of Andrology and European Academy of Andrology.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Effect of tadalafil in chronic renal failure rabbits: relevance to erectile dysfunction

    Institute of Scientific and Technical Information of China (English)

    Meng-yuan ZHANG; Qiang FU; Wei BIAN

    2011-01-01

    It is of great importance to investigate an effective and reliable medication against chronic renal failure (CRF)-related erectile dysfunction (ED), which aims to improve patients' life qualities. The concentrations of cyclic guanosine monophosphate (cGMP) in the corpus cavernosal smooth muscle of both CRF and control rabbits were measured. The effects of various concentrations of tadalafil, papaverine, and sodium nitroprusside on the relaxation responses of corpus cavernosal smooth muscle pre-contracted with phenylephrine in CRF rabbits were observed. There was significant difference in the concentration of cGMP between CRF and control rabbits (P<0.01). Tadalafil had the greatest impacts on CRF rabbits when given the same concentration of papaverine or sodium nitroprusside and particularly significant differences were identified under the concentration levels of 10-5 and 10-4 mol/L (P<0.01). The results suggest that the cGMP concentrations of the corpus cavernosum had been greatly reduced in CRF rabbits compared with control rabbits and that tadalafil may be an ideal medication for use in the treatment of CRF-related ED.

  6. The Beneficial Effect of Fesoterodine, a Competitive Muscarinic Receptor Antagonist on Erectile Dysfunction in Streptozotocin-induced Diabetic Rats.

    Science.gov (United States)

    Yilmaz-Oral, Didem; Bayatli, Nur; Gur, Serap

    2017-09-01

    To investigate the possible role of fesoterodine (a competitive muscarinic receptor antagonist) on erectile dysfunction in streptozotocin-induced diabetic rats. A total of 16 adult male Sprague-Dawley rats were equally divided into control and diabetic groups. Diabetes was induced by a single intravenous injection of streptozotocin (25-35 mg/kg). In vivo erectile responses were evaluated by the stimulation of cavernosal nerves, and measurements were repeated after the intracavernosal injection of fesoterodine (1 µM) in rats. The relaxation responses to fesoterodine were examined via incubation with various inhibitors. The relaxant responses of corpus cavernosum (CC) strips were observed in the presence or the absence of fesoterodine (10 µM). Intracavernous administration of fesoterodine restored in vivo erectile response at 5.0- and 7.5-V levels, except for 2.5 V in diabetic rats. Basal intracavernosal pressure (5.4 ± 0.9 mm Hg) in diabetic rats was markedly increased after injection of fesoterodine (33.9 ± 7.9 mm Hg, P fesoterodine resulted in a relaxation of CC in a concentration-dependent manner, which was reduced in diabetic rats. Nifedipine (l-type Ca(2+) channel blocker) inhibited maximum fesoterodine-induced relaxation by 58%. The nonselective K(+) channel blocker tetraethylammonium and glibenclamide incubation did not change the relaxant response to fesoterodine. The relaxant responses to acetylcholine (10 µM), electrical field stimulation (10 Hz), and sodium nitroprusside (0.01 µM) in diabetic rats were increased after incubation with fesoterodine (10 µM). Fesoterodine improved erectile function and relaxation of isolated strips of rat CC. The underlying mechanism of fesoterodine is likely due to the blocking of l-type calcium channels independent of the nitric oxide-cyclic guanosine monophosphate pathway. Further investigations are warranted to fully elucidate the restorative effects of fesoterodine on overactive

  7. 雄激素联合5型磷酸二酯酶抑制剂治疗大鼠糖尿病性勃起功能障碍的研究%Androgen combined with phosphodiesterase type 5 inhibitor for the treatment of erectile dysfunction in diabetic rats

    Institute of Scientific and Technical Information of China (English)

    夏磊磊; 沈周俊; 王先进; 许天源; 秦亮; 张祥; 朱照伟; 张小华; 钟山; 张敏光

    2015-01-01

    ABSTRACT:Objective To establish the rat model of diabetes mellitus erectile dysfunction (DMED) and evaluate the ther‐apeutic effect of androgen combined with phosphodiesterase type 5 (PDE5) inhibitor .Methods DMED models were estab‐lished by peritoneal injection of streptozotocin (STZ) .Four weeks later the DMED rats were randomly divided into 4 groups:DM group ,testosterone group ,sildenafil group ,and testosterone plus sildenafil group .Healthy rats served as controls .Six weeks after the initiation of treatments ,the erectile function of each group was evaluated using electrostimulation of the cav‐ernous nerve .The serum testosterone levels were determined with enzyme‐linked immunosorbent assay (ELISA) .The morpho‐logical changes of corpus cavernosum of penis were evaluated with hematoxylin‐eosin staining and masson staining .The endo‐thelial nitric oxide synthase (eNOS) level were determined with Western blot and immunohistochemistry .Results Compared with healthy rats ,the erectile function ,testosterone level and eNOS level of diabetic rats were significantly decreased .The smooth muscle cells of diabetic rats'corpus cavernosum were reduced while extracellular matrix fibrosis was increased .Testos‐terone replacement and chronic sildenafil treatment could ameliorate erectile function and extracellular matrix fibrosis ,and combined treatment with testosterone and sildenafil had the most significant effect .Conclusions The erectile function of DM rats is significantly impaired .The pathogenesis of DMED may be partly attributed to the low androgen level .Combined treatment of testosterone and sildenafil can significantly improve erectile function and extracellular matrix fibrosis of DMED rats .%目的:建立糖尿病性勃起功能障碍(DMED)大鼠模型,评价雄激素联合5型磷酸二酯酶抑制剂对DMED的治疗作用。方法通过链脲佐菌素(STZ)腹腔注射的方法建立DMED大鼠模型,造模成功4周后随机分

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

    Science.gov (United States)

    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.

  9. Involvement of DDAH/ADMA/NOS/cGMP and COX-2/PTGIS/cAMP Pathways in Human Tissue Kallikrein 1 Protecting Erectile Function in Aged Rats

    Science.gov (United States)

    Tang, Zhe; Rao, Ke; Wang, Tao; Chen, Zhong; Wang, Shaogang; Liu, Jihong; Wang, Daowen

    2017-01-01

    Our previous studies had reported that Human Tissue Kallikrein 1 (hKLK1) preserved erectile function in aged transgenic rats, while the detailed mechanism of hKLK1 protecting erectile function in aged rats through activation of cGMP and cAMP was not mentioned. To explore the latent mechanism, male wild-type Sprague-Dawley rats (WTR) and transgenic rats harboring the hKLK1 gene (TGR) were fed to 4 and 18 months old and divided into four groups: young WTR (yWTR) as the control, aged WTR (aWTR), aged TGR (aTGR) and aged TGRs with HOE140 (aTGRH). Erectile function of all rats was evaluated by cavernous nerve electrostimulation method and measured by the ratio of intracavernous pressure/ mean arterial pressure (ICP/MAP) in rats. Expression levels of cAMP and cGMP were assessed, and related signaling pathways were detected by western blot, immunohistochemistry and RT-PCR. Our experiment results showed erectile function of the aWTR group and aTGRH group was lower compared with those of other two groups. Also, expression levels of cAMP and cGMP were significantly lower than those of other two groups. Moreover, expressions of related signaling pathways including DDAH/ADMA/NOS/cGMP and COX-2/PTGIS/cAMP were also downregulated in the corpus cavernosum of rats in aWTR group. Our finding revealed hKLK1 played a protective role in age-related ED. The DDAH/ADMA/NOS/cGMP and COX-2/PTGIS/cAMP pathways that were linked to the mechanism hKLK1 could increase the levels of cGMP and cAMP, which might provide novel therapy targets for age-related ED. PMID:28103290

  10. Erectile Dysfunction: Viagra and Other Oral Medications

    Science.gov (United States)

    ... loss or vision loss. Some men have had sudden loss of hearing or loss of vision after taking one of ... taking an oral erectile dysfunction medication and have sudden loss of hearing or vision, seek prompt medical attention. An erection ...

  11. Erectile Dysfunction: A Sign of Heart Disease?

    Science.gov (United States)

    ... High cholesterol. A high level of low-density lipoprotein (LDL, or "bad") cholesterol can lead to atherosclerosis. ... Erectile-Dysfunction-and-High-Blood-Pressure_UCM_301827_Article.jsp. Accessed July 8, 2015. Ma RCW, et ...

  12. Erectile impotence in chronic alcoholics.

    Science.gov (United States)

    Tan, E T; Johnson, R H; Lambie, D G; Vijayasenan, M E; Whiteside, E A

    1984-01-01

    Erectile impotence is a common complaint in alcoholics, but its mechanism is unknown. We have studied nocturnal penile erection in 13 alcoholics who complained of impotence. Seven had normal erections and their impotence was therefore psychogenic. Six were found to have diminished or absent nocturnal erections. Plasma concentrations of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were elevated in this latter group, with the exception of one patient who had only raised FSH. They also had more evidence of neurological damage than the other seven alcoholics, and two had evidence of damage to the parasympathetic nervous system. Investigation of erection during sleep in alcoholic patients with impotence may be useful in differentiating clinically between patients with psychogenic causes and patients with organic causes of impotence.

  13. Animal models of erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Snehlata V Gajbhiye

    2015-01-01

    Full Text Available Animal models have contributed to a great extent to understanding and advancement in the field of sexual medicine. Many current medical and surgical therapies in sexual medicine have been tried based on these animal models. Extensive literature search revealed that the compiled information is limited. In this review, we describe various experimental models of erectile dysfunction (ED encompassing their procedures, variables of assessment, advantages and disadvantages. The search strategy consisted of review of PubMed based articles. We included original research work and certain review articles available in PubMed database. The search terms used were "ED and experimental models," "ED and nervous stimulation," "ED and cavernous nerve stimulation," "ED and central stimulation," "ED and diabetes mellitus," "ED and ageing," "ED and hypercholesteremia," "ED and Peyronie′s disease," "radiation induced ED," "telemetric recording," "ED and mating test" and "ED and non-contact erection test."

  14. Psychogenic erectile dysfunction. Classification and management.

    Science.gov (United States)

    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.

  15. Ultrastructural effect of sildenafil citrate on corpus cavernosum and other genital organs in female rats

    Institute of Scientific and Technical Information of China (English)

    K.Kilinc; M.I.Guenduez; B.H.Guemues; S.Vatansever; F.Kaymaz

    2003-01-01

    Aim:To determine the ultrastructural effects of sildenafil on the female genital organs.Methods:Twenty female cycling Wistar albino rats weighing 250±20 g were randomly divided into two groups of 10 each.Rats of one group were gavaged with 0.5mg·kg-1·d-1 of sildenafil 3 days in a week for 4 weeks and the other served as the controls.After cessation of treatment animals were sacrificed by cervical dislocation under methoxyflurane anaesthesia.The clitoris,vagina,uterus and bartholin glands were taken at the estrous and were fixed with 10% formalin solution for light microscopy and 2.5% glutaraldehyde and osmic acid for electron microscopy.Results:Under the light microscope,the fibrocollageous tissue was found increased,the capillaries enlarged and the connecting tissue elements increased in the corpus cavernosum in the treated group.On electron microscopy,increased connective tissue,fibroblasts with notched nucleus,shorten immature collagen fibers without striation were seen.Abundant foldings and penetration with collagen bundles were observed in the basal membrane.Large connection complexes,especially gap junctions among the wide capillary endothelial cells were observed.Conclusion:There are evident histological changes due to sildenafil citrate in female rat corpus cavernosum.The clitoris and bartholin glands were the most effected organs.While the histopathological changes of clitoral tissue could be expected,and increase in the mass of bartholin gland was surprised.

  16. Effectiveness of intracavernous delivery of adenovirus encoding Smad7 gene on erectile function in a mouse model of cavernous nerve injury.

    Science.gov (United States)

    Song, Kang Moon; Chung, Jae-Seung; Choi, Min Ji; Jin, Hai-Rong; Yin, Guo Nan; Kwon, Mi-Hye; Park, Jin-Mi; Kim, Woo Jean; Lee, Sang-Jin; Kim, Seong-Jin; Ryu, Ji-Kan; Suh, Jun-Kyu

    2014-01-01

    Men with erectile dysfunction (ED) respond poorly to oral phosphodiesterase-5 inhibitors following radical prostatectomy. Recent studies have reported that up-regulation of transforming growth factor-β1 (TGF-β1) and activation of the Smad signaling pathway play important roles in cavernous fibrosis and in the deterioration of erectile function in a mouse model of cavernous nerve injury (CNI) and in patients with spinal cord injury. The mothers against decapentaplegic homolog 7 (Smad7) is known to inhibit the phosphorylation of Smad2 and Smad3. To investigate the effectiveness of adenoviruses encoding Smad7 gene (Ad-Smad7) on erectile function in a mouse model of CNI. Twelve-week-old C57BL/6J mice were used and distributed into 7 groups: sham operation group, untreated CNI group, and CNI groups receiving a single intracavernous injection of adenovirus encoding LacZ (1 × 10(8) virus particles [vp]/20 μL) or adenovirus encoding Smad7 (Ad-Smad7; 1 × 10(7), 1 × 10(8), 2 × 10(8), or 1 × 10(9) vp/20 μL). Two weeks after bilateral cavernous nerve crushing and treatment, erectile function was measured by electrical stimulation of the cavernous nerve. The penis was harvested for histologic examinations and Western blot analysis. The highest erectile response was noted in CNI mice treated with Ad-Smad7 at a dose of 1 × 10(8)  vp, which reached up to 82-85% of sham control values. Local delivery of Ad-Smad7 significantly decreased endothelial cell apoptosis and the production of extracellular matrix proteins, including plasminogen activator inhibitor-1, fibronectin, collagen I, and collagen IV, and induced endothelial nitric oxide synthase phosphorylation in the corpus cavernosum tissue of CNI mice. The adenovirus-mediated gene transfer of Smad7 successfully restored erectile function by enhancing endothelial cell function and through antifibrotic effects. These findings suggest that inhibition of the TGF-β signaling pathway by use of

  17. Effects of plant extract neferine on cyclic adenosine monophosphate and cyclic guanosine monophosphate levels in rabbit corpus cavernosum in vitro

    Institute of Scientific and Technical Information of China (English)

    Jun Chen; Ji-Hong Liu; Tao Wang; Heng-Jun Xiao; Chun-Ping Yin; Jun Yang

    2008-01-01

    Aim: To further investigate the relaxation mechanism of neferine (Nef), a bis-benzylisoquinoline alkaloid extracted (isolated) from the green seed embryo of Nelumbo nucifera Gaertn in China, on rabbit corpus cavernosum tissue in vitro. Methods: The effects of Nef on the concentrations of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) in isolated and incubated rabbit corpus cavernosum tissue were re-corded using125Ⅰ radioimmunoassay. Results: The basal concentration of cAMP in corpus cavernosum tissue was 5.67±0.97 pmol/mg. Nef increased the cAMP concentration in a dose-dependent manner (P 0.05). The accumulation of cAMP induced by prostaglandin E1(PGE1, a stimulator of cAMP production) was also augmented by Nef in a dose-dependent manner (P 0.05). Also,sodium nitroprusside (SNP, a stimulator of cGMP production)-induced cGMP production was not enhanced by Nef (P > 0.05). Conclusion: Nef, with its relaxation mechanism, can enhance the concentration of cAMP in rabbit corpus cavernosum tissue, probably by inhibiting phosphodiesterase activity.

  18. Molecular and functional characterization of Kv 7 channels in penile arteries and corpus cavernosum of healthy and metabolic syndrome rats

    DEFF Research Database (Denmark)

    Jepps, T A; Olesen, S P; Greenwood, I A

    2016-01-01

    BACKGROUND AND PURPOSE: KCNQ-encoded voltage-dependent potassium channels (Kv 7) are involved in the regulation of vascular tone. In this study we evaluated the influence of Kv 7 channel activation on smooth muscle relaxation in rat penile arteries and corpus cavernosum from normal and spontaneou......BACKGROUND AND PURPOSE: KCNQ-encoded voltage-dependent potassium channels (Kv 7) are involved in the regulation of vascular tone. In this study we evaluated the influence of Kv 7 channel activation on smooth muscle relaxation in rat penile arteries and corpus cavernosum from normal...... and spontaneously hypertensive, heart failure-prone (SHHF) rats - a rat model of human metabolic syndrome. EXPERIMENTAL APPROACH: Quantitative PCR and immunohistochemistry were used to determine the expression of KCNQ isoforms in penile tissue. Isometric tension was measured in intracavernous arterial rings...... and corpus cavernosum. The Kv 7.2-7.5 activators, ML213 and BMS204352, relaxed pre-contracted penile arteries and corpus cavernosum independently of nitric oxide synthase or endothelium-derived hyperpolarization. Relaxations to sildenafil, a PDE5 inhibitor, and sodium nitroprusside (SNP), an nitric oxide...

  19. Erectile dysfunction and central obesity: an Italian perspective

    Directory of Open Access Journals (Sweden)

    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.

  20. Erectile dysfunction in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    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.

  1. Hypogonadism and erectile dysfunction: an overview

    Institute of Scientific and Technical Information of China (English)

    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.

  2. Effects of cigarette smoking on erectile dysfunction.

    Science.gov (United States)

    Kovac, J R; Labbate, C; Ramasamy, R; Tang, D; Lipshultz, L I

    2015-12-01

    Cigarette smoking is a leading cause of preventable morbidity and mortality in the United States. Although public policies have resulted in a decreased number of new smokers, smoking rates remain stubbornly high in certain demographics with 20% of all American middle-aged men smoking. In addition to the well-established harmful effects of smoking (i.e. coronary artery disease and lung cancer), the past three decades have led to a compendium of evidence being compiled into the development of a relationship between cigarette smoking and erectile dysfunction. The main physiologic mechanism that appears to be affected includes the nitric oxide signal transduction pathway. This review details the recent literature linking cigarette smoking to erectile dysfunction, epidemiological associations, dose dependency and the effects of smoking cessation on improving erectile quality.

  3. Characterization of cyclic AMP accumulation in cultured human corpus cavernosum smooth muscle cells.

    Science.gov (United States)

    Palmer, L S; Valcic, M; Melman, A; Giraldi, A; Wagner, G; Christ, G J

    1994-10-01

    Intracavernous pharmacotherapy relies heavily on the use of vasoactive agents which act by increasing intracellular cAMP levels in human corpus cavernosum smooth muscle. Yet little is known about the cAMP generating system in this tissue, and how it may affect observed patient variability. Thus, the goal of these studies was to better characterize the biochemistry of cAMP formation in human corpus cavernosum smooth muscle, and thus provide more insight into the mechanisms of corporal smooth muscle relaxation in vivo. We studied both receptor and nonreceptor mediated increases in cAMP formation in short-term cultures of human corpus cavernosum smooth muscle cells. Both isoproterenol (ISO) and prostaglandin E1 (PGE1) produced concentration-dependent increases in cAMP, but histamine, serotonin and vasoactive intestinal polypeptide did not. Forskolin, a relatively specific activator of adenylate cyclase, was also a potent stimulant of cAMP formation in these cells. Moreover, there was a direct correlation between the degree of forskolin-induced cAMP accumulation in cultured corporal smooth muscle cells and the magnitude of the forskolin-induced relaxation response of precontracted isolated corporal smooth muscle strips. Prostaglandin E1 and ISO concentration response curves (CRCs) were then assayed in the absence and presence of subthreshold forskolin (0.1 microM.). In the presence of forskolin, the calculated maximal PGE1-induced cAMP accumulation (Emax) was significantly greater than that elicited by PGE1 alone, ISO alone, or ISO + forskolin (p protocol was used to demonstrate that both 80:20 and 70:30 FMRs (but not 95:5 or 90:10), were associated with significantly greater cAMP Emax values than that observed for PGE1 alone (p < or = 0.01). These data provide direct evidence that the degree of cAMP formation in cultured corporal smooth muscle cells is strongly correlated with the magnitude of relaxation of isolated corporal smooth muscle strips. In addition, since

  4. Penile rehabilitation with a vacuum erectile device in an animal model is related to an antihypoxic mechanism: blood gas evidence.

    Science.gov (United States)

    Lin, Hao-Cheng; Yang, Wen-Li; Zhang, Jun-Lan; Dai, Yu-Tian; Wang, Run

    2013-05-01

    Our previous study showed that vacuum erectile device (VED) therapy has improved erectile function in rats with bilateral cavernous nerve crush (BCNC) injuries. This study was designed to explore the mechanism of VED in penile rehabilitation by analyzing cavernous oxygen saturation (SO2) and to examine the effect of VED therapy on preventing penile shrinkage after BCNC. Thirty adult Sprague-Dawley rats were randomly assigned into three groups: group 1, sham surgery; group 2, BCNC; and group 3, BCNC+VED. Penile length and diameter were measured on a weekly basis. After 4 weeks of therapy, the penile blood was extracted by three methods for blood gas analysis (BGA): method 1, cavernous blood was aspirated at the flaccid state; method 2, cavernous blood was aspirated at the traction state; and method 3, cavernous blood was aspirated immediately after applying VED. SO2 values were tested by the blood gas analyzer. The results showed that VED therapy is effective in preventing penile shrinkage induced by BCNC (Penile shortening: BCNC group 1.9±1.1 mm; VED group 0.3±1.0 mm; P<0.01. Penile diameter reduction: BCNC group 0.28±0.14 mm; VED group 0.04±0.14 mm; P<0.01). The mean SO2±s.d. values were increased by VED application (88.25%±4.94%) compared to the flaccid (76.53%±4.16%) or traction groups (78.93%±2.56%) (P<0.05). The calculated blood constructs in the corpus cavernosum right after VED application were 62% arterial and 38% venous blood. These findings suggest that VED therapy can effectively preserve penile size in rats with BCNC injury. The beneficial effect of VED therapy is related to antihypoxia by increasing cavernous blood SO2.

  5. Modulation of Dopaminergic Pathways to Treat Erectile Dysfunction

    DEFF Research Database (Denmark)

    Simonsen, Ulf; Comerma-Steffensen, Simon; Andersson, Karl-Erik

    2016-01-01

    The currently recommended first-line treatments of erectile dysfunction, phosphodiesterase type 5 inhibitors (PDE5i), e.g. sildenafil, are efficacious in many patients with erectile dysfunction of vascular origin, but this therapy is insufficient in approximately 30-40% of men with erectile...... preoptic area, the spinal cord, and in the erectile tissue are involved in erection, and several agonists developed for treatment of Parkinson's disease are associated with increased libido. A therapeutic window for treatment of erectile dysfunction was found by sublingual administration of the general...

  6. On-demand IC351 (Cialis) enhances erectile function in patients with erectile dysfunction

    National Research Council Canada - National Science Library

    Padma-Nathan, H; McMurray, J G; Pullman, W E; Whitaker, J S; Saoud, J B; Ferguson, K M; Rosen, R C

    2001-01-01

    IC351 (Cialis) is a selective inhibitor of PDE5. The efficacy and safety of on-demand dosing of IC351 in men with erectile dysfunction was assessed in a multicenter, double-blind, placebo-controlled study...

  7. Effectiveness of sildenafil citrate (Viagra) and tadalafil (Cialis) on sexual responses in Saudi men with erectile dysfunction in routine clinical practice.

    Science.gov (United States)

    Ali, Syed Tabrez

    2008-07-01

    Satisfaction with the sexual experience is considered important when evaluating the impact of treatments for erectile dysfunction, yet enhanced satisfaction has been infrequently assessed in the sexual trials. We evaluated the efficacy of sildenafil vs. tadalafil, in Saudi men with erectile dysfunction and determined the self-based rating of medicinal preference. Sildenafil citrate (Viagra) is a potent inhibitor of the electrolytic enzyme type V phosphodiesterase (PDE5), in the corpus cavernosum and therefore increases the penile response to sexual stimulation. Tadalafil (Cialis) is also a PDE5 inhibitor that increases the level of cyclic guanosine monophosphate (cGMP) in cavernous smooth muscle cells. Whereas cGMP is a second messenger for the vasodilator effects of nitric oxide causing smooth muscle relaxation, which in turn leads to penile erection; however the mechanism by which cGMP stimulates relaxation of the smooth muscles remains to be elucidated. Both sildenafil and tadalafil have a rapid onset with the effectiveness up to 4 hours and 36 hours respectively. In this study subjects treated with 100 mg oral dose of sildenafil / 20 mg tadalafil were found to be associated with higher mean scores for the questions of the International Index of Erectile Function (IIEF). Frequency of penetration and maintenance of erection after sexual penetration and/or during masturbation were found to be enhanced significantly (psexual-desire domain in sildenafil treated men with respect to their aged matched controls showed a non-significant difference, where as this difference was found to be highly significant in tadalafil treated group. Similarly mean scores for the overall satisfaction domains of the IIEF in comparison with the untreated subjects showed a significant positive response in the sildenafil treated group (pexcitement phase or prolonging the sexual interaction. These studies further conclude that there is a major point of difference between the short

  8. Effects of prolonged ingestion of epigallocatechin gallate on diabetes type 1-induced vascular modifications in the erectile tissue of rats.

    Science.gov (United States)

    Lombo, C; Morgado, C; Tavares, I; Neves, D

    2016-07-01

    Diabetes Mellitus type 1 is a metabolic disease that predisposes to erectile dysfunction, partly owing to structural and molecular changes in the corpus cavernosum (CC) vessels. The aim of this study was to determine the effects of early treatment with the antioxidant epigallocatechin gallate (EGCG) in cavernous diabetes-induced vascular modifications. Diabetes was induced in two groups of young Wistar rats; one group was treated with EGCG for 10 weeks. A reduction in smooth muscle content was observed in the CC of diabetic rats, which was significantly attenuated with EGCG consumption. No differences were observed among groups, neither in the expression of VEGF assayed by western blotting nor in the immunofluorescent labeling of vascular endothelial growth factor (VEGF) and its receptors (VEGFR1 and VEGFR2). VEGFR2 was restricted to the endothelium, whereas VEGF and VEGFR1 co-localized in the smooth muscle layer. With regard to the Angiopoietin/Tie-2 system, no quantitative differences in Angiopoietin 1 were observed among the experimental groups. Ang1 localization was restricted to the smooth muscle layer, and receptor Tie2 and Angiopoietin 2 were both expressed in the endothelium. In brief, our results suggest that EGCG consumption prevented diabetes-induced loss of cavernous smooth muscle but does not affect vascular growth factor expression in young rats.

  9. Study on the alteration of nNOS, eNOS expression in corpus cavernosum of prostate hyperplasia model in rats%大鼠前列腺增生模型阴茎海绵体内nNOS、eNOS表达研究

    Institute of Scientific and Technical Information of China (English)

    金重睿; 俞建军; 徐月敏; 冯超; 叶绪晓

    2011-01-01

    Objective To investigate the alteration of Nnos, Enos expression in corpus cavernosum of rats with BPH, and explore possible relationship between BPH and erectile dysfunction. Methods Twenty adult Sprague-Dawley rats were randomly divided into experiment prostate hyperplasia model group and normal control group. The other 10 old rats were as the old control group. After 4 weeks, wet weight of prostate, the index of prostate, morphological and pathological changes were detected respectively. The expressions of Nnos and Enos in the corpus cavernosum were measured by immunohistochemistry. Results Compared with those of the normal control group, the wet weight and the index of the prostate were- significantly increased in the experiment group. Remarkable prostate hyperplasia were observed by microscopy in the experiment group. The rat model of prostate hyperplasia was established successfully. The expressions of Nnos and Enos in corpus cavernosum were significantly decreased in the experiment group and theold control group. There were differences in the expressions of Nnos andeNOS between the experiment group, old control group and the normal control group; Whereas no differences in the expressions of Nnos, Enos were found between the experiment group and the old control group. Conclusion Penile erection is regulated by NO which is synthesized by Nnos andeNOS in rat penile tissues. Downregulation of Nnos and Enos in corpus cavernosum of rat with benign prostate hyperplasia might be a reason for erectile dysfunction.%目的 分析引起阴茎勃起的主要神经递质NO合成的限速酶nNOS和eNOS在BPH模型大鼠阴茎海绵体中的表达.试探讨BPH引起ED的可能因素.方法 20只雄性SD大鼠随机分为正常对照组和BPH模型组.通过去势后丙酸睾酮注射建立BPH模型,10只老年大鼠为老年对照组.4周后处死大鼠,分析不同组前列腺湿质量与前列腺指数,并在光镜下观察前列腺组织病理学改变.应用免疫组

  10. Erectile dysfunction in ankylosing spondylitis patients.

    Science.gov (United States)

    Santana, Thiago; Skare, Thelma; Delboni, Vitor Steil; Simione, Juliana; Campos, Ana Paula B; Nisihara, Renato

    2017-01-01

    Rheumatic diseases such as ankylosing spondylitis (AS) may be associated with sexual dysfunction. To study erectile function of a group of Brazilian AS patients comparing them with controls. This was a cross sectional study approved by the local Committee of Ethics in Research. The questionnaire IIEF (International Index of Erectile Function) was applied to 40 AS patients and 40 healthy controls. AS patients had determination of disease activity (through BASDAI or Bath Ankylosing Spondylitis Disease activity index), ASDAS (Ankylosing Spondylitis Disease Activity Score, MASES or Maastricht Ankylosing Spondylitis Score and SPARCC or Spondyloarthritis Research Consortium of Canada), function (through BASFI or Bath Ankylosing Spondylitis Functional Index and HAQ or Health Assessment Questionnaire) and BASMI (Bath Ankylosing Spondylitis Metrological Index). AS patients had a median score on IIEF of 22.0 (IQR=18-25) while controls had 29 (IQR=27-30) with p<0.0001 Only 17.5% of the AS patients had no erectile dysfunction, in opposite to 87.5% of controls (p<0.0001). IIEF scores had a negative association with BASDAI (p<0.0001), HAQ (p=0.05), body mass index (P=0.03), MASES (P=0.02) and SPARCC (P=0.02) in a univariate analysis. Multiple regression showed that BASDAI was the only variable independently associated with IIEF. There is a high prevalence of erectile dysfunction among AS patients that is associated with disease activity measured by BASDAI. Copyright® by the International Brazilian Journal of Urology.

  11. Chronic treatment with Ang-(1-7) reverses abnormal reactivity in the corpus cavernosum and normalizes diabetes-induced changes in the protein levels of ACE, ACE2, ROCK1, ROCK2 and omega-hydroxylase in a rat model of type 1 diabetes.

    Science.gov (United States)

    Yousif, Mariam H M; Makki, Batoul; El-Hashim, Ahmed Z; Akhtar, Saghir; Benter, Ibrahim F

    2014-01-01

    Angiotensin-(1-7) [Ang-(1-7)] may have beneficial effects in diabetes mellitus-induced erectile dysfunction (DMIED) but its molecular actions in the diabetic corpus cavernosum (CC) are not known. We characterized the effects of diabetes and/or chronic in vivo administration of Ang-(1-7) on vascular reactivity in the rat corpus cavernosum (CC) and on protein expression levels of potential downstream effectors of the renin-angiotensin-aldosterone system (RAAS) such as angiotensin-converting enzyme (ACE), ACE2, Rho kinases 1 and 2 (ROCK1 and ROCK2), and omega-hydroxylase, the cytochrome-P450 enzyme that metabolizes arachidonic acid to form the vasoconstrictor, 20-hydroxyeicosatetraenoic acid. Streptozotocin-treated rats were chronicically administered Ang-(1-7) with or without A779, a Mas receptor antagonist, during weeks 4 to 6 of diabetes. Ang-(1-7) reversed diabetes-induced abnormal reactivity to vasoactive agents (endothelin-1, phenylepherine, and carbachol) in the CC without correcting hyperglycemia. Six weeks of diabetes led to elevated ACE, ROCK1, ROCK 2, and omega-hydroxylase and a concomitant decrease in ACE2 protein expression levels that were normalized by Ang-(1-7) treatment but not upon coadministration of A779. These data are supportive of the notion that the beneficial effects of Ang-(1-7) in DMIED involve counterregulation of diabetes-induced changes in ACE, ACE2, Rho kinases, and omega-hydroxylase proteins in the diabetic CC via a Mas receptor-dependent mechanism.

  12. Chronic Treatment with Ang-(1-7 Reverses Abnormal Reactivity in the Corpus Cavernosum and Normalizes Diabetes-Induced Changes in the Protein Levels of ACE, ACE2, ROCK1, ROCK2 and Omega-Hydroxylase in a Rat Model of Type 1 Diabetes

    Directory of Open Access Journals (Sweden)

    Mariam H. M. Yousif

    2014-01-01

    Full Text Available Angiotensin-(1-7 [Ang-(1-7] may have beneficial effects in diabetes mellitus-induced erectile dysfunction (DMIED but its molecular actions in the diabetic corpus cavernosum (CC are not known. We characterized the effects of diabetes and/or chronic in vivo administration of Ang-(1-7 on vascular reactivity in the rat corpus cavernosum (CC and on protein expression levels of potential downstream effectors of the renin-angiotensin-aldosterone system (RAAS such as angiotensin-converting enzyme (ACE, ACE2, Rho kinases 1 and 2 (ROCK1 and ROCK2, and omega-hydroxylase, the cytochrome-P450 enzyme that metabolizes arachidonic acid to form the vasoconstrictor, 20-hydroxyeicosatetraenoic acid. Streptozotocin-treated rats were chronicically administered Ang-(1-7 with or without A779, a Mas receptor antagonist, during weeks 4 to 6 of diabetes. Ang-(1-7 reversed diabetes-induced abnormal reactivity to vasoactive agents (endothelin-1, phenylepherine, and carbachol in the CC without correcting hyperglycemia. Six weeks of diabetes led to elevated ACE, ROCK1, ROCK 2, and omega-hydroxylase and a concomitant decrease in ACE2 protein expression levels that were normalized by Ang-(1-7 treatment but not upon coadministration of A779. These data are supportive of the notion that the beneficial effects of Ang-(1-7 in DMIED involve counterregulation of diabetes-induced changes in ACE, ACE2, Rho kinases, and omega-hydroxylase proteins in the diabetic CC via a Mas receptor-dependent mechanism.

  13. Combination of mesenchymal stem cell injection with icariin for the treatment of diabetes-associated erectile dysfunction

    Science.gov (United States)

    Wang, Xiyou; Liu, Chuanhai; Xu, Yong; Chen, Ping; Shen, Yue; Xu, Yansheng; Zhao, Yubo; Chen, Weihao; Zhang, Xinyu; Ouyang, Yun; Wang, Yi; Xie, Changliang; Zhou, Maojun; Liu, Cuilong

    2017-01-01

    The present study was aimed to examine whether icariin, a traditional Chinese medicine, could improve therapeutic effects of adipose derived mesenchymal stem cells (ADSCs) for diabetes-associated erectile dysfunction (DMED). DMED were induced in rats by intraperitoneal injection of streptozotocin and confirmed by erectile function measurement. Then, rats of diabetic ED were randomly divided to receive the treatment of saline, ADSCs, icariin or ADSCs combined with icariin respectively. Compared with the treatment by ADSCs or icariin alone, intracavernosum injection of ADSCs combined with the following daily gastric gavage of icariin significantly augmented the value of ICP and ICP/MAP (p<0.01). Meanwhile, the survival of transplanted ADSCs was much improved due to the application of icariin. Similarly, immunofluorescent staining analysis demonstrated that the improved erectile tissue structure by combination of ADSCs and icariin was significantly associated with the increased expression of endothelial markers (vWF) (p<0.01) and smooth muscle markers (α-SMA) (p<0.01). Furthermore, the structure changes in corpus cavernosum were further confirmed by the Masson’s trichrome staining. To explore the possible mechanism underlying icariin-enhanced therapeutic efficacy of MSCs, we employed an in vitro testing system by introducing H2O2 to imitate oxidative stress condition considering the oxidative environment faced by engrafted ADSCs and anti-oxidative capacity of icariin. In vitro, we found that the addition of icariin considerably reduced the apoptosis of ADSCs, and attenuated the intracellular reactive oxygen species (ROS), the superoxidase dismutase (SOD) activity and the lactate dehydrogenase (LDH). Subsequently, we examined the expression of apoptosis-related proteins and explored the potential signaling pathway through which icariin promoted the survival of ADSCs against oxidative stress. It was demonstrated that icariin significantly inhibited the upregulation

  14. Risk Factors for Erectile Dysfunction in Men With HTLV-1.

    Science.gov (United States)

    de Oliveira, Cassius José Vitor; Neto, José Abraão Carneiro; Andrade, Rosana C P; Rocha, Paulo Novis; de Carvalho Filho, Edgar Marcelino

    2017-10-01

    syndrome and severity of ED. Neurologic impairment is the major cause of ED in individuals infected with HTLV-1 and risk factors for atherosclerosis did not have a strong relation with ED in this population. de Oliveira CJV, Neto JAC, Andrade RCP, et al. Risk Factors for Erectile Dysfunction in Men With HTLV-1. J Sex Med 2017;14:1195-1200. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  15. Erectile function after anastomotic urethroplasty for pelvic fracture urethral injuries.

    Science.gov (United States)

    El-Assmy, A; Harraz, A M; Benhassan, M; Nabeeh, A; Ibrahiem, El Hi

    2016-07-01

    There is an established association between ED and pelvic fracture urethral injuries (PFUIs). However, ED can occur after the injury and/or the urethral repair. To our knowledge, only one study of erectile function (EF) after urethroplasty for PFUIs used a validated questionnaire. This study was carried out to determine the impact of anastomotic posterior urethroplasty for PFUIs on EF. We retrospectively reviewed the computerized surgical records to identify patients who underwent anastomotic urethroplasty for PFUIs from 1998 to 2014. Those patients were contacted by phone or mail and were re-evaluated in the outpatient clinic by International Index of Erectile Function questionnaire; in unmarried men, the single-question self-report of ED was used for evaluation of EF, clinical examination and penile color Doppler ultrasonography (CDU) for men with ED. Overall, 58 patients were included in the study among whom 36 (62%) men were sexually active and the remaining 22 (38%) were single. The incidence of ED among our group is 72%. All patients developed ED after initial pelvic trauma and none of our patients had impaired EF after urethroplasty. The incidence of ED increased proportionally with severity of pelvic trauma. All patients with type-C pelvic fracture, associated symphysis pubis diastasis, sacroiliac joints diastasis and bilateral pubic ramus fractures had ED. Men with PFUIs had worse EF than men in other series with pelvic fractures without urethral injury. The majority (88%) of men with ED showed veno-occlusive dysfunction on penile CDU. So we concluded that men with PFUIs had a high incidence of ED up to 72%. Anastomotic posterior urethroplasty had no negative impact on EF and the development of ED after PFUIs was related to the severity of the original pelvic trauma. Veno-occlusive dysfunction is the commonest etiology of ED on penile CDU.

  16. Yohimbine in the treatment of erectile disorder.

    Science.gov (United States)

    Riley, A J

    1994-01-01

    Yohimbine is an alkaloid derived mainly from the bark of the African tree, Pausinystalia yohimbe. Although many pharmacological properties of yohimbine have been described, at the plasma concentration attained at recommended dosages in man the predominant activity is antagonism of alpha 2-adrenoceptors. For more than 70 years yohimbine has been used as a treatment for male and female sexual difficulties. It has enjoyed a reputation as an aphrodisiac although no effect on sexual drive in humans has been adequately demonstrated. Yohimbine has been evaluated in the management of erectile disorder by means of placebo-controlled but often poorly designed trials. It does appear to have a modest therapeutic benefit over placebo, particularly in essentially psychogenic erectile disorder, and is generally well tolerated. Yohimbine is not licensed in the UK.

  17. Pure Obstructive Sleep Apnea Syndrome and Erectile Dysfunction

    Directory of Open Access Journals (Sweden)

    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.

  18. [Psychological theories and treatments of erectile impotence].

    Science.gov (United States)

    Mormont, C

    1985-01-01

    The conceptual inaccuracies and the diagnostic difficulties encountered in the study of erectile impotence are underlined by the author. After a review and critique of the psychoanalytical and behavioral trends, of the "new sex therapy" and of cognitivism, the therapeutic methods which derive from these concepts are compared with each other. A particular attention is devoted to anxiety since its definition and prevalence varies considerably in the literature despite a misleading superficial similarity.

  19. Role of Nanotechnology in Erectile Dysfunction Treatment.

    Science.gov (United States)

    Wang, Alice Y; Podlasek, Carol A

    2017-01-01

    The biological importance of nanotechnology-based delivery vehicles for in vivo tissue regeneration is gaining acceptance by the medical community; however, its relevance and incorporation into the treatment of sexual dysfunction are evolving and have not been well evaluated. To provide scientific evidence examining the use of state-of-the-art nanotechnology-based delivery methodology in the treatment of erectile dysfunction (ED) in animal models and in patients. This review assessed the current basic science literature examining the role of nanotechnology-based delivery vehicles in the development of potential ED therapies. There are four primary areas where nanotechnology has been applied for ED treatment: (i) topical delivery of drugs for on-demand erectile function, (ii) injectable gels into the penis to prevent morphologic changes after prostatectomy, (iii) hydrogels to promote cavernous nerve regeneration or neuroprotection, and (iv) encapsulation of drugs to increase erectile function (primarily of phosphodiesterase type 5 inhibitors). Basic science studies provide evidence for a significant and evolving role for nanotechnology in the development of therapies for ED and suggest that properly administered nano-based therapies might be advantageous for treating male sexual dysfunction. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  20. Prevalence and independent risk factors for erectile dysfunction in Spain: results of the Epidemiologia de la Disfuncion Erectil Masculina Study.

    Science.gov (United States)

    Martin-Morales, A; Sanchez-Cruz, J J; Saenz de Tejada, I; Rodriguez-Vela, L; Jimenez-Cruz, J F; Burgos-Rodriguez, R

    2001-08-01

    We determined the prevalence of and risks factors for erectile dysfunction in Spain in a cross-sectional study. A total of 2,476 noninstitutionalized Spanish men 25 to 70 years old were interviewed at home and answered a self-administered questionnaire of 71 items, including 2 instruments to define erectile dysfunction, a simple self-assessment question to estimate erectile function and the International Index of Erectile Function. Data on disease, medication and toxic habits were also obtained. With an overall participation rate of 75% the prevalence of erectile dysfunction according to the simple question was 12.1%. According to the erectile function domain of the International Index of Erectile Function the overall prevalence was 18.9%. Several independent risk factors were significantly associated with the probability of erectile dysfunction. Some differences arose according to the tool used to define the condition. However, there was a strong relationship of patient age with frequency or severity no matter which instrument was used to define erectile dysfunction. Diabetes (age adjusted odds ratio 4), high blood pressure (odds ratio 1.58), high cholesterol (1.63), peripheral vascular disorder (2.63), lung disease (3.11), prostate disease (2.93), cardiac problems (1.79), rheumatism (2.37) and allergy (3.08) were significantly associated with erectile dysfunction. Drug intake, which respondents called medication for nerves and sleeping pills, correlated strongly (odds ratio 2.78 and 4.27, respectively), as did tobacco use (2.5) and alcohol consumption (1.53). This study provides data on the prevalence of and risks factors for erectile dysfunction in Spain. The relationship of erectile dysfunction with certain risk factors, such as cardiovascular risk factors and drugs intake, are well known and our study corroborates these associations. Other associations with erectile dysfunction, such as prostate disease, allergy and rheumatism, support findings in previous

  1. Angiography of the corpus cavernosum penis in the pony stallion during erection and quiescence.

    Science.gov (United States)

    Bartels, J E; Beckett, S D; Brown, B G

    1984-07-01

    Serial arteriography was used to determine the vascular pattern and blood flow in the penis of the pony stallion. Ponies were anesthetized with pentobarbital sodium, and catheters were surgically introduced into the internal pudendal and obturator arteries. The vascular anatomy was visualized by angiography via image-intensified fluoroscopy and was recorded on 70-mm film at 3 frames/s or by direct radiography. Blood flow into the corpus cavernosum penis (CCP) was limited during quiescence because the blood was immediately shunted into the venous system. After vasodilation with mild stimulation from an electroejaculator, there was increased filling of the CCP and corpus spongiosum penis. Contrast medium injected into the internal pudendal artery entered the bulb of the penis during peak erection, but medium injected into the obturator artery could not enter the crus penis during peak erection. The contrast medium stopped in the obturator artery at the edge of the ischiocavernous muscles due to the occlusion of the deep arteries of the penis by contraction of these muscles. When contrast medium was injected directly into the CCP near the glans to outline the body of the penis, there was no evidence of venous outlets along the body.

  2. [Salidroside inhibits hypoxia-induced phenotypic modulation of corpus cavernosum smooth muscle cells in vitro].

    Science.gov (United States)

    Chen, Gang; Huang, Xiao-Jun; Lü, Bo-Dong; Chen, Shi-Tao; Zhang, Shi-Geng; Yang, Ke-Bing

    2013-08-01

    To explore the effects of salidroside on the phenotypic modulation of corpus cavernosum smooth muscle cells (CCSMC) in hypoxic SD rats. CCSMCs were cultured in vitro and identified by immunohistochemistry. The cells were divided into six groups: normal control (21% O2), hypoxia (1% O2), hypoxia + salidroside 1 mg/L, hypoxia + salidroside 3 mg/L, hypoxia + salidroside 5 mg/L and hypoxia + PGE1 0.4 microg/L, and then cultured for 48 hours. The relative expressions of alpha-actin and osteopontin (OPN) in each group were determined by RT-PCR. The in vitro cultured CCSMCs grew well, with anti-alpha-smooth muscle actin monoclonal antibodies immunohistochemically positive. The relative expression of alpha-actin was markedly decreased while that of OPN remarkably increased in the hypoxia group as compared with the normal control group (P salidroside 5 mg/L group showed a significantly higher expression of alpha-actin and lower expression of OPN than the hypoxia group (P 0.05). Hypoxia can reduce the relative expression level of alpha-actin and increase that of OPN in the CCSMCs of SD rats, namely, induce their phenotypic modulation from the contraction to the non-contraction type. Salidroside can restrain hypoxia-induced phenotypic modulation of CCSMCs, and its inhibitory effect at 5 mg/L is similar to that of PGE1.

  3. Phentolamine relaxes human corpus cavernosum by a nonadrenergic mechanism activating ATP-sensitive K+ channel.

    Science.gov (United States)

    Silva, L F G; Nascimento, N R F; Fonteles, M C; de Nucci, G; Moraes, M E; Vasconcelos, P R L; Moraes, M O

    2005-01-01

    To investigate the pharmacodynamics of phentolamine in human corpus cavernosum (HCC) with special attention to the role of the K+ channels. Strips of HCC precontracted with nonadrenergic stimuli and kept in isometric organ bath immersed in a modified Krebs-Henseleit solution enriched with guanethidine and indomethacine were used in order to study the mechanism of the phentolamine-induced relaxation. Phentolamine caused relaxation (approximately 50%) in HCC strips precontracted with K+ 40 mM. This effect was not blocked by tetrodotoxin (1 microM) (54.6+/-4.6 vs 48.9+/-6.4%) or (atropine (10 microM) (52.7+/-6.5 vs 58.6+/-5.6%). However, this relaxation was significantly attenuated by L-NAME (100 microM) (59.7+/-5.8 vs 27.8+/-7.1%; Pphentolamine relaxations (54.6+/-4.6 vs 59.3+/-5.2%). Glibenclamide (100 microM), an inhibitor of K(ATP)-channel, caused a significant inhibition (56.7+/-6.3 vs 11.3+/-2.3%; Pphentolamine-induced relaxation. In addition, the association of glibenclamide and L-NAME almost abolished the phentolamine-mediated relaxation (54.6+/-5.6 vs 5.7+/-1.4%; Pphentolamine relaxes HCC by a nonadrenergic-noncholinergic mechanism dependent on nitric oxide synthase activity and activation of K(ATP)-channel.

  4. Erectile dysfunction in patients with chronic viral hepatitis: a systematic review of the literature.

    Science.gov (United States)

    Fusco, Ferdinando; D'Anzeo, Gianluca; Rossi, Andrea; Sciorio, Carmine; Buonomo, Antonio Riccardo; d'Emmanuele di Villa Bianca, Roberta; Borgia, Guglielmo; Mirone, Vincenzo; Gentile, Ivan

    2013-12-01

    This article reviews the literature on epidemiology and pathogenetic factors of erectile dysfunction in patients with chronic viral hepatic (CVH) diseases in men and the potential implications for diagnosis and treatment. A search to identify original articles, reviews and any other article suitable for the purposes of this review was conducted by combining the following terms: erectile dysfunction and/or sexual dysfunction, chronic viral hepatitis, hepatitis B virus infection and hepatitis C virus infection. The results of this review have led to the following main observations: i) there is scarce documentation on the association between CVH and sexual dysfunction; ii) hormonal impairment seems to be a major component in the development of erectile dysfunction in CVH; however, published evidence concerning the contribution of other pathogenetic factors is rare and inconclusive and iii) available treatment options for CVH potentially contribute to the development of sexual dysfunction in these patients. Due to the scarce body of evidence, more research is needed to better clarify the mechanisms underlying the association between CVH and sexual dysfunction, the impact of therapy and associated comorbidities on sexual dysfunction and the role of pharmacological treatments in the management of these patients.

  5. Long-term effect of inhibition of the angiotensin-converting enzyme (ACE) on cavernosal perfusion in men with atherosclerotic erectile dysfunction: a pilot study.

    NARCIS (Netherlands)

    Speel, T.G.M.; Kiemeney, L.A.L.M.; Thien, Th.; Smits, P.; Meuleman, E.J.H.

    2005-01-01

    INTRODUCTION: Impaired perfusion of the corpora cavernosa is considered an important causal factor of erectile dysfunction (ED) in the aging male with atherosclerosis. Aim. On the basis of this notion, we hypothesized that inhibition of angiotensin-converting enzyme (ACE) may have a structural benef

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    DEFF Research Database (Denmark)

    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 ...... are needed. KEYWORDS: Erectile dysfunction; extracorporeal shockwave; penis...

  8. Low-intensity shockwave therapy for erectile dysfunction

    DEFF Research Database (Denmark)

    Fode, Mikkel; Hatzichristodoulou, Georgios; Serefoglu, Ege Can

    2017-01-01

    , such as ischaemic heart disease, bone fractures, and burns, in which it improves neoangiogenesis; similar principles seem to apply in the erectile tissue. The major potential advantage of the treatment, therefore, is the possibility to restore natural erectile function. Thus, Li-ESWT is the only currently marketed...

  9. Depression: links with ischemic heart disease and erectile dysfunction.

    Science.gov (United States)

    Roose, Steven P

    2003-01-01

    This article examines the relationships among depression, ischemic heart disease, and erectile dysfunction. Depression is an independent risk factor for the development of ischemic heart disease, and depression in the post-myocardial infarction patient is associated with increased morbidity and mortality. Ischemic heart disease and erectile dysfunction are also frequently comorbid and share many common risk factors including age, hypertension, diabetes, dyslipidemia, obesity, sedentary lifestyle, and smoking. Depression and erectile dysfunction often occur together; however, the causal relation may be difficult to determine because erectile dysfunction may be a symptom of depression, social distress accompanying erectile dysfunction may precipitate depressive symptoms, or both conditions may result from a common factor such as vascular disease.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  11. Three-dimensional mapping and comparative analysis of the distal human corpus cavernosum and the inflatable penile prosthesis

    OpenAIRE

    2013-01-01

    The intricate anatomy of the corpus cavernosum in both the flaccid and tumescent state has not been fully elucidated. We report our experience using a three-dimensional (3D) scanner to reconstruct cadaveric casts and compare them with 3D images of two prototypes of penile prosthesis. Two different models of the Titan Coloplast inflatable penile prosthesis were analyzed using a 3D scanner. The first was the standard model and the second was a newer model with a rounder silicone tip. Two cadave...

  12. Effect of Mesenchymal Stem Cells Associated to Matrixen on the Erectile Function in the Rat Model with Bilateral Cavernous Nerve Crushing Injury

    Directory of Open Access Journals (Sweden)

    Su Jin Kim

    2012-12-01

    Full Text Available Objectives To evaluate the effect of mesenchymal stem cells (MSCs and MSCs mixed with Matrixen as a cell carrier on the erectile dysfunction caused by bilateral cavernous nerve crushing injury. Materials and Methods White male Sprague-Dawley rats were divided into 4 groups: sham-operated control group (n = 5, bilateral cavernous nerve crushing group (BCNC group, n = 10, BCNC administered with MSCs group (n = 10,1×106 in 20 µL, BCNC administered with Matrixen group (n = 10.1×106 in 20 µL, BCNC administered with MSCs/Matrixen group (n = 10.1×106 in 20 µL. After functional assessment at 4 weeks, major pelvic ganglion (MPG and penile tissue were collected. Immunofluorescent staining of MPG was performed with PKH26 and Tuj1. Western blot analysis of endothelial nitric oxide synthase (eNOS and neuronal nitric oxide synthase (nNOS were done in corpus cavernosum. Results ICP/MAP ratios of BCNC with MSCs and MSCs/Matrixen groups were significantly increased compared with BCNC and BCNC with Matrixen group. Moreover, ICP/MAP ratios of MSCs/Matrixen group were significantly increased compared with BCNC with MSCs group. In MPG, the more implantation of MSCs and increased expression of nerve cells were observed in MSCs/Matrixen group compared with BCNC with MSCs group. Significant increase expression of eNOS and nNOS was also noted in BCNC with MSCs/Matrixen group. Conclusion The erectile function was more preserved in MSCs/Matrixen group compared with the administration of MSCs alone in the rats with bilateral cavernous nerve crushing injury. Therefore, we consider that the use of transplant cell carrier such as Matrixen may help the implantation of MSCs and improve the therapeutic effect of MSCs.

  13. Phantom erectile penis after sex reassignment surgery

    Directory of Open Access Journals (Sweden)

    Kimata,Yoshihiro

    2008-06-01

    Full Text Available Between January 2001 and December 2007, we performed vaginoplasty as sex reassignment surgery in a total of 14 male-to-female transsexual (MTFTS patients [1]. Several complications occurred such as partial flap necrosis, rectovaginal fistula formation and hypersensitivity of the neoclitoris. Just after the operation, some patients feel that their penises still exist, but by several weeks postoperatively, this sensation has disappeared. Herein we report a case of MTFTS in whom the sensation of a phantom erectile penis persisted for much longer.

  14. Rehabilitation of erectile function following radical prostatectomy

    Institute of Scientific and Technical Information of China (English)

    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.

  15. Erectile dysfunction and depression: screening and treatment.

    Science.gov (United States)

    Perelman, Michael A

    2011-05-01

    The comorbid conditions erectile dysfunction (ED) and depression are highly prevalent in men. Multiple regression analysis to control for all other predictors of ED indicate that men with high depression scores are nearly twice as likely to report ED than nondepressed men. Depression continues to be among the most common comorbid problems in men with ED, both in the community and in clinical samples. This article reviews the current knowledge about the relationship between ED and depression, the effect of treatments for depression on ED, ways to improve screening for depression, and treatment of ED in patients with this comorbidity.

  16. The relationship between depression and erectile dysfunction.

    Science.gov (United States)

    Seidman, S N; Roose, S P

    2000-06-01

    Normal sexual function is a biopsychosocial process; sexual dysfunction almost always has organic and psychologic components, and it requires multidisciplinary, goal-directed evaluation and treatment. Factors such as aging, declining testosterone levels, medical illness, certain medications, and comorbid depressive illness can contribute to sexual dysfunction. Erectile dysfunction (ED) is the most common male sexual dysfunction encountered in the clinical setting. Comorbidity between ED and depressive illness is high, but the causal relationship is unclear, and likely bidirectional. In this article, we review the existing literature on the relationship between depression and ED.

  17. Endovascular treatment of vasculogenic erectile dysfunction

    Directory of Open Access Journals (Sweden)

    O. B. Zhukov

    2014-01-01

    Full Text Available Method of choice for surgical treatment of vasculogenic erectile dysfunction (ED is the genesis of arteriovenous falloprosthetics. In the initial stages of the disease, young men, dissatisfied inhibitor therapy 5-phosphodiesterase and/or intracavernous injections do not agree to such a view of his proposed lecheniya. Authors give the results we operated 26 patients 25–48 year old (mean age 34.3± 7.4 with vasculogenic ED. Of these, 23 patients with venoocclusive ED, 3 patients had arterial insufficiency of the corpora cavernosa. Of these 3 patients, 2 were haemodynamic and clinical features with arteriovenous ED step subcompensation. Maximum period of observation data up was 23 months. Overall clinical compensation of these patients and subsequent sexual rehabilitation was evaluated as satisfactory: the total value of transactions amounted to international index of erectile function 9–13 (10.5 ± 3.6, after surgery 14–25 (21.3 ± 4.2 (p = 0.001. Use this innovative technology allows you to make a sexual rehabilitation most of these patients and avoid falloprosthetics.

  18. Tadalafil in the treatment of erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Robert M Coward

    2008-12-01

    Full Text Available Robert M Coward, Culley C CarsonDivision of Urologic Surgery, University of North Carolina, Chapel Hill, NC, USAAbstract: The treatment for erectile dysfunction (ED was revolutionized with the development of phosphodiesterase type 5 (PDE5 inhibitors. Tadalafil (Cialis®; Eli Lilly and Company, Indianapolis, IN, USA is the newest and most versatile PDE5 inhibitor in the clinical armamentarium for the treatment of ED. Its most unique characteristic is its long half-life of 17.5 hours, which lends itself to a longer therapeutic window with on-demand dosing and effective steady-state plasma concentrations with once-daily dosing. Clinical trials have proven its safety and efficacy with both dosing strategies for all severities and etiologies of ED, including difficult-to-treat ED. This thorough review will discuss ED, the physiology of penile erection and the role of PDE5, and all aspects of tadalafil, from its development, through its pharmacology, to its latest clinical studies and indications.Keywords: tadalafil, Cialis, PDE5 inhibitors, phosphodiesterase type 5, erectile dysfunction, penile erection

  19. Association of erectile dysfunction and urolithiasis

    Directory of Open Access Journals (Sweden)

    Alper Otunctemur

    2014-09-01

    Full Text Available Objectives: In recent years, it has been shown that there is association between metabolic syndrome and urinary stone disease. Stone disease and erectile dysfunction (ED are considered as systemic diseases which are associated with hormonal and metabolic disorders. Therefore we investigated the relationship between ED and urinary tract calculi. Material and methods: 98 male patients with urolithiasis and 59 randomly selected male patients without stone disease were included in the study. Serum testosterone (T levels were measured and International Index of Erectile Function (IIEF-15 questionnaire forms were used to assess ED. Results: The prevalence of ED was found 29% (29 patients in the urolithiasis group. Sixty-nine patients (71% had no ED; 16 (16.3% had mild, 5 (5.1% had moderate and 8 (8.2% had severe ED. None of the patients in the control group had severe or modarete ED, six patients (10.2% had mild ED. Serum T levels were detected at the level of biochemical hypogonadism on 13 patients with stones (13.3% and T levels were detected at the lower limit in 18 (18.3% patients. Conclusion: In our study we have shown that ED and low T levels are significantly associated with urolithiasis. We propose that the patients with urolitiasis should be evaluated for ED and hypogonadism.

  20. Stem cell-based therapy for erectile dysfunction

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Science.gov (United States)

    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.

  2. Antioxidant properties of berberine on cultured rabbit corpus cavernosum smooth muscle cells injured by hydrogen peroxide

    Institute of Scientific and Technical Information of China (English)

    Yan TAN; Qiang TANG; Ben-rong HU; Ji-zhou XIANG

    2007-01-01

    Aim: To investigate the antioxidant properties of berberine (Ber) on corpus cavenosum smooth muscle cells (CCSMC) in penile erectile dysfunction. Methods: We examined the effects of Ber on cultured rabbit CCSMC damaged by hydrogen peroxide (H2O2) through examining cell viability by methyl thiazolyl tetrazolium assay and assessing the level of malondialdehyde (MDA), superoxide dismutase (SOD) activity, nitric oxide (NO) products, and lactate dehydrogenase (LDH) re- lease in cells after stimulation with H202. Results: Treatment with 1 mmol/L H2O2 significantly decreased the cell viability, NO products, and SOD activity of CCSMC from 100% to 48.57%+4.1% (P<0.01), 66.8±16.3 to 6.7±2.1 μmol/L (P<0.01), and 49.5±1.8 to 30.1±2.6 U/mL (P<0.01), respectively, and increased LDH release and MDA content from 497.6±69.5 to 1100.5±56.3 U/L (P<0.01) and 3.7±1.3 to 78.4±2.9 nmol/mg protein (P<0.01), respectively. However, treatment with different con- centrations of Ber (10-1000 μmol/L) inhibited the damaging effects of H2O2, with increased cell viability (P<0.05 or P<0.01), NO production (P<0.01), and SOD activity (P<0.01) and decreased LDH release and MDA content (both P<0.01). Conclusion: Bet could produce its antioxidant action on oxidative stress-induced cultured CCSMC. These effects may be of benefit in the prevention of penile erectile dysfunction.

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

    Institute of Scientific and Technical Information of China (English)

    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,

  4. A Retrospective Study of Erectile Function and Use of Erectile Aids in Prostate Cancer Patients After Radical Prostatectomy in Denmark

    DEFF Research Database (Denmark)

    Haahr, Martha Kirstine; Azawi, Nessn H; Andersen, Line Grønbaek

    2017-01-01

    INTRODUCTION: Radical prostatectomy (RP) offers a good long-term cancer control for clinically localized prostate cancer. However, complications such as erectile dysfunction and substantial decreases quality of life of the afflicted men and their sexual partners. Identification of pre-, per......-, and postoperative factors that correlate with poor postoperative erectile status must be considered an important step to improving penile rehabilitation. AIM: To describe postoperative erectile function after RP in a Danish cohort. METHODS: The medical records of 1,127 patients undergoing RP from March 2003 through...

  5. The prevalence and associations of erectile dysfunction in a South ...

    African Journals Online (AJOL)

    Multiple predictors of ED were identified in this study. ED ... diabetic men.1–3 The prevalence of erectile dysfunction in the general adult ... prevalence in acute coronary syndrome was found to differ ..... Bull World Health Organ. 1962 ...

  6. Erectile dysfunction: prevalence, risk factors and involvement of ...

    African Journals Online (AJOL)

    is more prevalent in elderly male patients. ... Keywords: Hypertension, Antihypertensive drugs, β-Blockers, Propranolol, Erectile dysfunction, Life style, Risk .... Depression and anxiety. 1 [59] .... mg/day) and 28 % cases of decrease in quality.

  7. PREVENTION OF TADALAFIL INDUCED BACKACHE IN ERECTILE DYSFUNCTION PATIENTS

    Directory of Open Access Journals (Sweden)

    Sri Sennath Joseph Arul

    2016-04-01

    Full Text Available Back pain is a known side effect associated with tadalafil use in erectile dysfunction patients. This is a unique and first of kind study that deals with its prevention. AIMS AND OBJECTIVES To prevent discontinuation of tadalafil in needy patients with erectile dysfunction due to back pain. MATERIALS AND METHODS Among 956 erectile dysfunction patients started on tadalafil 10 mg daily in an outpatient clinic over 2 yrs., 79 patients discontinued due to back pain. They were restarted with tadalafil 10 mg daily and two add-on drugs (Combination for initial three days. The observations were noted. RESULTS This add-on regimen was 96.2% successful in preventing tadalafil induced backache when tadalafil was reintroduced. CONCLUSION Tadalafil discontinuation due to back pain can be avoided in needy erectile dysfunction patients by following this add-on regimen for just three days.

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

    Science.gov (United States)

    ... Radiation-Emitting Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products For Consumers Home For Consumers Protect Yourself Health Fraud Beware When Buying "All Natural" Erectile Dysfunction Products Share Tweet Linkedin Pin it ...

  9. Specific aspects of erectile dysfunction in sexology.

    Science.gov (United States)

    Borrás-Valls, J J; Gonzalez-Correales, R

    2004-10-01

    The sexology of erectile dysfunction (ED) is approached from a perspective that integrates medical, psychological, and social aspects. This article reviews the clinical intervention in sexology beginning with the diagnostic evaluation, where the organic and psychological factors (predisposing, precipitating, and perpetuating) contributing to ED are determined. A description of the differential diagnosis process follows, which establishes the relevance of organic factors in order to organize therapeutic strategies. There are three possible treatment processes: psychological intervention with the patient, intervention on the partner relationship, or intervention with the partner. Referral criteria are also described, such as when patients with ED should be referred to a sexologist, and to whom sexologists should refer patients with ED.

  10. Erectile dysfunction and depression: category or dimension?

    Science.gov (United States)

    Strand, Julia; Wise, Thomas N; Fagan, Peter J; Schmidt, Chester W

    2002-01-01

    Depression, as a risk factor for erectile dysfunction (ED), has received minimal systematic attention. One-hundred twenty men with ED evaluated in a sexual behaviors clinic were studied. The categorical Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994) diagnosis of a depressive disorder was found in only 14 subjects (14.7%). Dimensional quantification of depression was measured with the Brief Symptom Inventory (BSI). The BSI data revealed clinically significant elevations of depression and other dysphoric affects. The presence of a comorbid medical diagnosis did not affect the rates of categorical diagnosis of depression or the dimensional levels. The five factors of personality in the NEO-PI were within normal range. The data demonstrates that men with ED are affectively distressed but infrequently meet criteria for categorical DSM-IV depression.

  11. The current treatment of erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Maria Isabela Sarbu

    2016-10-01

    Full Text Available Erectile dysfunction (ED is the inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse. It is the most frequent sexual dysfunction in elderly men and its prevalence increases with age. Ever since ED was recognized as a real health problem, several treatment options became available and some of them proved to be very efficient. PDE5 inhibitors are the mainstay treatment of ED. However, other treatment options such as intracorporal injections, surgery, vacuum devices and prosthesis are also available for patients who are unresponsive to PDE5 inhibitors. Since none of the treatment options available so far has proven ideal, research in the field of sexual medicine continues. The aim of this paper is to review the most advances in the treatment of ED.

  12. Relationship between metabolic syndrome and erectile dysfunction

    Institute of Scientific and Technical Information of China (English)

    M.I.Gǘiundǘz; B.H.Gǘmǘs; C.Sekuri

    2004-01-01

    Aim: To determine the relationship between metabolic syndrome (MS) and erectile dysfunction (ED) and to see which risk factors correlated the best with ED. Methods: Seventy-nine cardiology clinic outpatients with coronary artery disease (CAD) and lipid metabolism disorder were recruited. They were categorized as having MS,hypertension (blood pressure greater than 130/85 mmHg) and dyslipidemia. ED was classified based on International Index of Erectile Function scores. Patients were grouped into quartiles based on body mass index (BMI). Chi-square,Pearson's correlation and regression tests were used for statistical analysis. Results: The mean age of the patients was 56.6 years. ED was diagnosed in 59 (74.7 %) of the 79 patients. In the 38 patients with MS, all had ED. ED was not significantly correlated with cholesterol levels (P>0.05), but was found often in patients who had both hypercholesterolemia and HT (P<0.01). Nineteen(76 %) of the 25 patients who had dyslipidemia had ED. However, ED wasnot significantly correlated with dyslipidemia (P>0.05). Tweenty-two of the 23 patients who had BMI greater than30 had ED, which was significantly more prevalent than that in those who had normal BMI (P<0.01). ED was seen in 38 of 53 smoker patients. Although ED was more prevalent in cigarette smokers, it was not significantly different from non-smokers (P>0.5). Conclusion: ED is present in a high percentage of patients with MS. Among multiple risk factors for ED, MS correlates the most highly. The next most important risk group is the patients with hypertension +hypercholestrolemia and obesity (BMI>30). (Asian JAndrol 2004 Dec; 6: 355-358)

  13. Erectile Dysfunction in Male Adults With Atopic Dermatitis and Psoriasis

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Hansen, Peter R; Gislason, Gunnar H

    2017-01-01

    INTRODUCTION: Patients with psoriasis have increased risk of cardiovascular disease, but data on atopic dermatitis (AD) are less clear-cut. However, it is well-established that erectile dysfunction (ED) can serve as a risk marker for coronary disease. AIM: To investigate the incidence, prevalence...... population for men with AD. Egeberg A, Hansen PR, Gislason GH, et al. Erectile Dysfunction in Male Adults With Atopic Dermatitis and Psoriasis. J Sex Med 2017;XX:X-XX....

  14. [Ultrasonic methods and semiotics in patients with vasculogenic erectile dysfunction].

    Science.gov (United States)

    Zhukov, O B; Zubarev, A R

    2001-01-01

    The authors have developed criteria for ultrasonic assessment of cavernous bodies, arterial and venous circulation in normal penile vessels and in erectile dysfunction in 125 patients; describe modern ultrasound modalities in differential diagnosis of various forms of vasculogenic erectile dysfunction basing on the experience with 92 patients; validate hydrodynamic role of the tunica albuginea in pathogenesis of venocorporal dysfunction and pathological venous drainage. Early ischemic signs of arterial insufficiency were revealed.

  15. Physiotherapy of chronic prostatitis complicated with erectile dysfunction

    OpenAIRE

    2012-01-01

    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...

  16. Physiotherapy of chronic prostatitis complicated with erectile dysfunction

    Directory of Open Access Journals (Sweden)

    I. A. Kolmatsui

    2012-01-01

    Full Text Available 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 quality of life of men.

  17. Treatment of Erectile Dysfunction in Type 2 Diabetic Men

    Directory of Open Access Journals (Sweden)

    V.Ye. Luchytskyi

    2016-01-01

    Full Text Available Background. One of the most frequent complications of diabetes in men is erectile dysfunction. Phosphodiesterase-5 inhibitors (IPDE-5: sildenafil, vardenafil and tadalafil are the drugs of choice for the treatment of erectile dysfunction. Objective. To study the effectiveness and safety of treatment of erectile dysfunction with inhibitor of phosphodiesterase 5 in type 2 diabetic men. Material and methods. The study involved 89 men aged 39–69 years old. Рatients with type 2 diabetes mellitus and erectile dysfunction with diabetes duration of 1–12 years were examined in a state of diabetes mellitus compensation (average glycated hemoglobin 7.3 ± 1.1 %. Sildenafil 100 mg on demand before coitus during 12 weeks led to the significant growth rate of domain of «Erectile function» on 10.54 score. Sildenafil was effective in 76.2 % of patients. Increment of such parameter as erectile function during tadalafil treatment was 9.81 scores. Efficacy of tadalafil was 73.1 %. Application of vardenafil led to the improvement of erectile function to an average of 25.22 ± 1.80 scores. Efficacy of vardenafil in our patients was 76.2 %. Conclusions. The study confirmed the high efficiency of three IPDE-5 as the first-line drugs for the treatment of erectile dysfunction in men with diabetes. All three drugs were used in maximum doses, as lower doses are not always effective enough. All patients with reduced blood levels of total testosterone should receive replacement therapy to achieve levels of testosterone within the normal hormone fluctuations. Further study of the effects IPDE-5 in type 2 diabetic men are necessary to improve their effectiveness.

  18. Effects of Adenosine Monophosphate Used in Combination with L‐Arginine on Female Rabbit Corpus Cavernosum Tissue

    Directory of Open Access Journals (Sweden)

    Olivier Stücker, PhD

    2014-04-01

    Conclusions: Our results demonstrate that AMP induces a relaxing effect on the female rabbit corpora. They also show that L‐Arginine and AMP can potentiate each other and that a synergistic effect can be obtained by their combined use. Because only slight differences exist between both sexes in response to NO donors and/or nucleotide purines or in their use together, it is very likely that close biochemical mechanisms, although not to the same degree and not quite similar, are involved in the engorgement of the penis and the clitoris of New Zealand White rabbits. Stücker O, Pons C, Neuzillet Y, Laemmel E, and Lebret T. Original research‐sexual medicine: Effects of adenosine monophosphate used in combination with L‐Arginine on female rabbit corpus cavernosum tissue. Sex Med 2014;2:1–7.

  19. Three-dimensional mapping and comparative analysis of the distal human corpus cavernosum and the inflatable penile prosthesis

    Institute of Scientific and Technical Information of China (English)

    Tariq S Hakky; Daniel Ferguson; Philippe E Spiess; Paul Bradley; Tom F Lue; Rafael E Carrion

    2013-01-01

    The intricate anatomy of the corpus cavernosum in both the flaccid and tumescent state has not been fully elucidated.We report our experience using a three-dimensional (3D) scanner to reconstruct cadaveric casts and compare them with 3D images of two prototypes of penile prosthesis.Two different models of the Titan Coloplast inflatable penile prosthesis were analyzed using a 3D scanner.The first was the standard model and the second was a newer model with a rounder silicone tip.Two cadaveric phalluses were harvested using Smooth-Cast 300Q polyurethane molding.The molds were excised and scanned along side the penile prosthesis.3D scans were completed and analyzed using Leios Mesh software,and GOM Inspect software.The 3D scans demonstrated the mean human corporal radii 2 mm from the distal tip to be 36.51 mm (36.01-37.0 mm),which is an obtuse angle.The standard Titan penile prosthesis spherical radius at the same level was 202.52 mm,while the new silicone tip prosthesis had a radius of 139.33 mm.3D mapping further demonstrated the trajectory of the cavernosa appeared curvilinear and the distal ends appeared blunt.The use of cadaveric cavernosal molds in combination with the 3D scanner allowed us to accurately image the corpus cavernosum for the first time.Our findings suggest that anatomically accurate corporal tips appear to be relatively blunt and that the new Titan silicone tip penile prosthesis more closely resembles the human corporal tip.

  20. Three-dimensional mapping and comparative analysis of the distal human corpus cavernosum and the inflatable penile prosthesis.

    Science.gov (United States)

    Hakky, Tariq S; Ferguson, Daniel; Spiess, Philippe E; Bradley, Paul; Lue, Tom F; Carrion, Rafael E

    2013-07-01

    The intricate anatomy of the corpus cavernosum in both the flaccid and tumescent state has not been fully elucidated. We report our experience using a three-dimensional (3D) scanner to reconstruct cadaveric casts and compare them with 3D images of two prototypes of penile prosthesis. Two different models of the Titan Coloplast inflatable penile prosthesis were analyzed using a 3D scanner. The first was the standard model and the second was a newer model with a rounder silicone tip. Two cadaveric phalluses were harvested using Smooth-Cast 300Q polyurethane molding. The molds were excised and scanned along side the penile prosthesis. 3D scans were completed and analyzed using Leios Mesh software, and GOM Inspect software. The 3D scans demonstrated the mean human corporal radii 2 mm from the distal tip to be 36.51 mm (36.01-37.0 mm), which is an obtuse angle. The standard Titan penile prosthesis spherical radius at the same level was 202.52 mm, while the new silicone tip prosthesis had a radius of 139.33 mm. 3D mapping further demonstrated the trajectory of the cavernosa appeared curvilinear and the distal ends appeared blunt. The use of cadaveric cavernosal molds in combination with the 3D scanner allowed us to accurately image the corpus cavernosum for the first time. Our findings suggest that anatomically accurate corporal tips appear to be relatively blunt and that the new Titan silicone tip penile prosthesis more closely resembles the human corporal tip.

  1. Preoperative erectile function and the pathologic features of prostate cancer

    Directory of Open Access Journals (Sweden)

    Chang Wook Jeong

    2015-04-01

    Full Text Available Purpose We evaluated whether preoperative erectile function is associated with pathologic features in the patients who underwent radical prostatectomy (RP. Materials and Methods We reviewed medical records of 1,743 men who underwent RP from November 2003 through May 2012. Of these, 50 patients who had prior hormone therapy and 272 patients who had lacking data of International Index of Erectile Function-5 (IIEF-5 were excluded. Men whose IIEF-5 was in the lower 25 percentile were assigned as Low Erectile Function group and the others were assigned as Control group. We compared pathologic features using univariable and multivariable logistic regression analysis between two groups. Results A total of 1,421 patients were included in the analysis. Patients’ age was 65.8 ± 6.7 years and prostate-specific antigen (PSA was 12.8±16.1 ng/mL. Median and low 25 percentile of IIEF-5 were 14 and 8, respectively. Low Erectile Function group (IIEF-5<8 had higher risk to have high Gleason score (≥7(4+3, odds ratio (OR 1.642, p<0.001 and large tumor volume (≥5 mL, OR 1.292, p=0.042. Even after adjusting age, year of surgery, body mass index, Charlson comorbidity index, PSA, clinical stage and biopsy Gleason score, Low Erectile Function group still had higher risk of high Gleason score (OR 1.910, p<0.001 and large tumor volume (OR 1.390, p=0.04 by multivariable logistic regressions. Conclusions Lower erectile function before RP was associated with higher Gleason’s score and larger tumor volume in final pathology. Thus, erectile function could be a surrogate barometer for prostate cancer aggressiveness.

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

    Directory of Open Access Journals (Sweden)

    E. V. Minakov

    2009-01-01

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

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    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.

  4. Alpha-adrenergic receptor blockade by phentolamine increases the efficacy of vasodilators in penile corpus cavernosum.

    Science.gov (United States)

    Kim, N N; Goldstein, I; Moreland, R B; Traish, A M

    2000-03-01

    Penile trabecular smooth muscle tone, a major determinant of erectile function, is highly regulated by numerous inter- and intracellular pathways. The interaction between pathways mediating contraction and relaxation has not been studied in detail. To this end, we investigated the functional effects of alpha adrenergic receptor blockade with phentolamine and its interaction with vasodilators (sildenafil, vasoactive intestinal polypeptide (VIP) and PGE1) that elevate cyclic nucleotides on penile cavernosal smooth muscle contractility. In organ bath preparations of cavernosal tissue strips contracted with phenylephrine, phentolamine significantly enhanced relaxation induced by sildenafil, VIP and PGE1. Sildenafil, VIP or PGE1 also significantly enhanced relaxation induced by phentolamine in cavernosal tissue strips contracted with phenylephrine. To study the effects of alpha adrenergic receptor blockade and modification of cyclic nucleotide metabolism during active neurogenic input, cavernosal tissue strips in organ bath preparations were contracted with the non-adrenergic agonist endothelin-1 and subjected to electrical field stimulation (EFS) in the absence or presence of phentolamine and/or sildenafil. EFS (5-40Hz) typically caused biphasic relaxation and contraction responses. Phentolamine alone enhanced relaxation and reduced or prevented contraction to EFS. Sildenafil enhanced relaxation to EFS at lower frequencies (phentolamine and sildenafil enhanced EFS-induced relaxation at all frequencies tested. EFS, in the presence of 10 nM phentolamine and 30 nM sildenafil, produced enhanced relaxation responses which were quantitatively similar to those obtained in the presence of 50 nM sildenafil alone. Thus, blockade of alpha-adrenergic receptors with phentolamine increases the efficacy of cyclic nucleotide-dependent vasodilators. Furthermore, phentolamine potentiates relaxation and attenuates contraction in response to endogenous neurotransmitters which are released

  5. The role of arachidonic acid/cyclooxygenase cascade, phosphodiesterase IV and Rho-kinase in H2S-induced relaxation in the mouse corpus cavernosum.

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    Aydinoglu, Fatma; Ogulener, Nuran

    2017-08-01

    Penile corpus cavernosum is an extremely vascularized tissue and cavernosal smooth muscle tone is regulated by the balance between contractile and relaxant factor. We investigated the possible role of arachidonic acid/cyclooxygenase cascade, phosphodiesterase IV (PDEIV) and Rho-kinase in exogenous hydrogen sulfide (H2S)-induced relaxation in mouse corpus cavernosum. The relaxant response to H2S (NaHS as exogenous H2S; 1-1000μM) were obtained in isolated mouse corpus cavernosum tissues which pre-contracted by phenylephrine (5μM). The effects of 4-(4-octadecylphenyl)-4-oxobutenoic acid (OBAA; 10μM), a selective phospholipase A2 (PLA2) inhibitor, indomethacin (1μM), a non-selective cyclooxygenase (COX) inhibitor, baicalein (10μM), a lipoxygenase (LOX) inhibitor, and proadifen (10μM), cytochrome P450 inhibitor, on the relaxant responses to H2S were investigated. Furthermore, the effects of theophylline (500μM) and rolipram (1μM), a non-selective and selective PDEIV inhibitor, and fasudil (3μM), a specific Rho-kinase inhibitor, were studied on H2S-induced relaxation. H2S-induced relaxations were significantly reduced by OBAA, indomethacin and proadifen but not baicalein. Furthermore, theophylline, rolipram and fasudil reduced H2S-induced relaxations. These results suggest that PLA2, COX, cytochrome P450, PDEIV and Rho-kinase pathway may involve in H2S-induced relaxation in mouse corpus cavernosum tissues. Copyright © 2017 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  6. Circulating Concentrations of Adipocytokines and Their Receptors in the Isolated Corpus Cavernosum and Femoral Artery from Trained Rats on a High-Fat Diet.

    Science.gov (United States)

    Sponton, Amanda C S; Silva, Fábio H; Araujo, Hygor N; Valgas da Silva, Carmem P; de Moraes, Camila; Antunes, Edson; Zanesco, Angelina; Delbin, Maria A

    2017-01-01

    The aim of the present study was to evaluate different signaling pathways by which exercise training would interfere in endothelial function in obesity. Therefore, we examined adipocytokine levels and their receptors in the corpus cavernosum and femoral artery from trained rats on a high-fat diet. Functional experiments were performed in control sedentary and trained rats, and sedentary (h-SD) and trained male Wistar rats on a high-fat diet (h-TR). Nitric oxide (NO) and reactive oxygen species (ROS) were evaluated in vascular tissue. Circulating adipocytokines and their receptors were analyzed. In the h-SD group, the maximal responses to acetylcholine (ACh) were reduced in the femoral artery and corpus cavernosum as well as the electrical field stimulation, accompanied by an increase in circulating insulin, leptin, TNF-α, MCP-1, and PAI-1. Downregulation of ObR protein expression in the femoral artery was observed without alterations in AdipoR1 and TNFR1 in both preparations. A positive effect was observed in the h-TR group regarding the relaxation response to ACh and circulating adipocytokines, resulting in increased NO production and reduced ROS generation. Exercise restored the ObR protein expression only in the femoral artery. Aerobic exercise training ameliorated the inflammatory adipocytokines and restored the relaxation responses in the corpus cavernosum and femoral artery in rats on a high-fat diet. © 2017 S. Karger AG, Basel.

  7. Dimethylarginine dimethylaminohydrolase in rat penile tissue: reduced enzyme activity is responsible for erectile dysfunction in a rat model of atherosclerosis

    Science.gov (United States)

    Park, K; Lee, D G; Kim, S W; Paick, J-S

    2009-01-01

    Asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide synthase (NOS), is mainly metabolized by NG,NG-dimethylarginine dimethylaminohydrolase (DDAH). We investigated whether altered cavernosal ADMA–DDAH metabolism might cause impairment of erection in rat model of atherosclerosis (AS). Male Sprague–Dawley rats (3 months old) were divided into an AS group and a normal control (Con) group (n=20 in each group). The AS rats received AS-prone treatment (6 weeks of 1% cholesterol diet plus early 2 weeks of NG-nitro-L-arginine methyl ester (3 mg ml−1 per day) treatment). After 6 weeks, rats underwent cavernosometry measuring the maximal intracavernosal pressure/mean arterial pressure (ICP/MAP) ratios as a surrogate marker of erectile function. The amount of cavernosal ADMA was assessed by immunoblot analysis and correlated with the ICP/MAP. Isoform-specific DDAH expression was compared by immunohistochemistry. Cavernosal DDAH and NOS activity were measured. Cavernosal malondialdehyde levels were assayed to determine the degree of lipid peroxidation. Compared to the controls, the AS rats had signs of impaired erectile function. Higher cavernosal ADMA was observed in the AS rats. The cavernosal ADMA had a moderately negative correlation with the ICP/MAP. Immunohistochemistry revealed the expression of both isoforms was not affected by the presence of AS. However, significantly diminished DDAH as well as NOS activity was observed in the AS group. In addition, elevated cavernosal malondialdehyde levels were noted in the AS rats. Our study showed that decreased cavernosal DDAH activity is the cause of cavernosal ADMA accumulation leading to reduced cavernosal NOS activity and impairment of erectile function. PMID:19603041

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

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    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.

  9. Risk of Erectile Dysfunction in Transfusion-naive Thalassemia Men

    Science.gov (United States)

    Chen, Yu-Guang; Lin, Te-Yu; Lin, Cheng-Li; Dai, Ming-Shen; Ho, Ching-Liang; Kao, Chia-Hung

    2015-01-01

    Abstract Based on the mechanism of pathophysiology, thalassemia major or transfusion-dependent thalassemia patients may have an increased risk of developing organic erectile dysfunction resulting from hypogonadism. However, there have been few studies investigating the association between erectile dysfunction and transfusion-naive thalassemia populations. We constructed a population-based cohort study to elucidate the association between transfusion-naive thalassemia populations and organic erectile dysfunction This nationwide population-based cohort study involved analyzing data from 1998 to 2010 obtained from the Taiwanese National Health Insurance Research Database, with a follow-up period extending to the end of 2011. We identified men with transfusion-naive thalassemia and selected a comparison cohort that was frequency-matched with these according to age, and year of diagnosis thalassemia at a ratio of 1 thalassemia man to 4 control men. We analyzed the risks for transfusion-naive thalassemia men and organic erectile dysfunction by using Cox proportional hazards regression models. In this study, 588 transfusion-naive thalassemia men and 2337 controls were included. Total 12 patients were identified within the thalassaemia group and 10 within the control group. The overall risks for developing organic erectile dysfunction were 4.56-fold in patients with transfusion-naive thalassemia men compared with the comparison cohort after we adjusted for age and comorbidities. Our long-term cohort study results showed that in transfusion-naive thalassemia men, there was a higher risk for the development of organic erectile dysfunction, particularly in those patients with comorbidities. PMID:25837766

  10. Macrostructural alterations of subcortical grey matter in psychogenic erectile dysfunction.

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    Nicoletta Cera

    Full Text Available Psychogenic erectile dysfunction (ED has been defined as the persistent inability to attain and maintain an erection sufficient to permit sexual performance. It shows a high incidence and prevalence among men, with a significant impact on the quality of life. Few neuroimaging studies have investigated the cerebral basis of erectile dysfunctions observing the role played by prefrontal, cingulate, and parietal cortices during erotic stimulation. In spite of the well-known involvement of subcortical regions such as hypothalamus and caudate nucleus in male sexual response, and the key role of nucleus accumbens in pleasure and reward, poor attention was paid to their role in male sexual dysfunction. In this study, we determined the presence of grey matter (GM atrophy patterns in subcortical structures such as amygdala, hippocampus, nucleus accumbens, caudate nucleus, putamen, pallidum, thalamus, and hypothalamus in patients with psychogenic ED and healthy men. After Rigiscan evaluation, urological, general medical, metabolic and hormonal, psychological and psychiatric assessment, 17 outpatients with psychogenic ED and 25 healthy controls were recruited for structural MRI session. Significant GM atrophy of nucleus accumbens was observed bilaterally in patients with respect to controls. Shape analysis showed that this atrophy was located in the left medial-anterior and posterior portion of accumbens. Left nucleus accumbens volumes in patients correlated with low erectile functioning as measured by IIEF-5 (International Index of Erectile Function. In addition, a GM atrophy of left hypothalamus was also observed. Our results suggest that atrophy of nucleus accumbens plays an important role in psychogenic erectile dysfunction. We believe that this change can influence the motivation-related component of sexual behavior. Our findings help to elucidate a neural basis of psychogenic erectile dysfunction.

  11. Cigarette Smoking and Erectile Dysfunction: Focus on NO Bioavailability and ROS Generation

    Science.gov (United States)

    Tostes, Rita C.; Carneiro, Fernando S.; Lee, Anthony J.; Giachini, Fernanda R.C.; Leite, Romulo; Osawa, Yoichi; Webb, R. Clinton

    2010-01-01

    Introduction Thirty million men in the United States suffer from erectile dysfunction (ED) and this number is expected to double by 2025. Considered a major public health problem, which seriously affects the quality of life of patients and their partners, ED becomes increasingly prevalent with age and chronic smoking is a major risk factor in the development of ED. Aim To review available evidence concerning the effects of cigarette smoking on vascular changes associated with decreased nitric oxide (NO) bioavailability and increased reactive oxygen species (ROS) generation. Methods We examined epidemiological and clinical data linking cigarette smoking and ED, and the effects of smoking on vascular NO bioavailability and ROS generation. Main Outcome Measures There are strong parallels between smoking and ED and considerable evidence supporting the concept that smoking-related ED is associated with reduced bioavailability of NO because of increased ROS. Results Cigarette smoking-induced ED in human and animal models is associated with impaired arterial flow to the penis or acute vasospasm of the penile arteries. Long-term smoking produces detrimental effects on the vascular endothelium and peripheral nerves and also causes ultrastructural damage to the corporal tissue, all considered to play a role in chronic smoking-induced ED. Clinical and basic science studies provide strong indirect evidence that smoking may affect penile erection by the impairment of endothelium-dependent smooth muscle relaxation or more specifically by affecting NO production via increased ROS generation. Whether nicotine or other products of cigarette smoke mediate all effects related to vascular damage is still unknown. Conclusions Smoking prevention represents an important approach for reducing the risk of ED. The characterization of the components of cigarette smoke leading to ED and the mechanisms by which these components alter signaling pathways activated in erectile responses are

  12. Penile rehabilitation with a vacuum erectile device in an animal model is related to an antihypoxic mechanism:blood gas evidence

    Institute of Scientific and Technical Information of China (English)

    Hao-Cheng Lin; Wen-Li Yang; Jun-Lan Zhang; Yu-Tian Dai; Run Wang

    2013-01-01

    Our previous study showed that vacuum erectile device (VED) therapy has improved erectile function in rats with bilateral cavernous nerve crush (BCNC) injuries.This study was designed to explore the mechanism of VED in penile rehabilitation by analyzing cavernous oxygen saturation (S02) and to examine the effect of VED therapy on preventing penile shrinkage after BCNC.Thirty adult SpragueDawley rats were randomly assigned into three groups:group 1,sham surgery; group 2,BCNC; and group 3,BCNC+VED.Penile length and diameter were measured on a weekly basis.After 4 weeks of therapy,the penile blood was extracted by three methods for blood gas analysis (BGA):method 1,cavernous blood was aspirated at the flaccid state; method 2,cavernous blood was aspirated at the traction state; and method 3,cavernous blood was aspirated immediately after applying VED.SO2 values were tested by the blood gas analyzer.The results showed that VED therapy is effective in preventing penile shrinkage induced by BCNC (Penile shortening:BCNC group 1.9±1.1 mm; VED group 0.3±1.0 mm; P<0.01.Penile diameter reduction:BCNC group 0.28±0.14 mm; VED group 0.04±0.14 mm; P<0.0 1).The mean S02±s.d.values were increased by VED application (88.25%±4.94%) compared to the flaccid (76.53%±4.16%) or traction groups (78.93%±2.56%) (P<0.05).The calculated blood constructs in the corpus cavernosum right after VED application were 62% arterial and 38% venous blood.These findings suggest that VED therapy can effectively preserve penile size in rats with BCNC injury.The beneficial effect of VED therapy is related to antihypexia by increasing cavernous blood S02.

  13. eNOS-uncoupling in age-related erectile dysfunction

    Science.gov (United States)

    Johnson, JM; Bivalacqua, TJ; Lagoda, GA; Burnett, AL; Musicki, B

    2011-01-01

    Aging is associated with ED. Although age-related ED is attributed largely to increased oxidative stress and endothelial dysfunction in the penis, the molecular mechanisms underlying this effect are not fully defined. We evaluated whether endothelial nitric oxide synthase (eNOS) uncoupling in the aged rat penis is a contributing mechanism. Correlatively, we evaluated the effect of replacement with eNOS cofactor tetrahydrobiopterin (BH4) on erectile function in the aged rats. Male Fischer 344 ‘young’ (4-month-old) and ‘aged’ (19-month-old) rats were treated with a BH4 precursor sepiapterin (10 mg/kg intraperitoneally) or vehicle for 4 days. After 1-day washout, erectile function was assessed in response to electrical stimulation of the cavernous nerve. Endothelial dysfunction (eNOS uncoupling) and oxidative stress (thiobarbituric acid reactive substances, TBARS) were measured by conducting western blot in penes samples. Erectile response was significantly reduced in aged rats, whereas eNOS uncoupling and TBARS production were significantly increased in the aged rat penis compared with young rats. Sepiapterin significantly improved erectile response in aged rats and prevented increase in TBARS production, but did not affect eNOS uncoupling in the penis of aged rats. These findings suggest that aging induces eNOS uncoupling in the penis, resulting in increased oxidative stress and ED. PMID:21289638

  14. Topical minoxidil in the treatment of male erectile dysfunction.

    Science.gov (United States)

    Radomski, S B; Herschorn, S; Rangaswamy, S

    1994-05-01

    Topically applied 2% minoxidil solution has been reported to increase diameter, rigidity and arterial flow to the penis. As a result it has been suggested as a possible treatment for erectile dysfunction. A total of 21 patients received 2% minoxidil for treatment of erectile dysfunction with instructions to apply 1 cc of the solution slowly over the glans penis 20 minutes before intercourse. Average patient age was 52.5 years (range 29 to 65 years). The etiology of the impotence was neurogenic in 8 patients, vascular in 7, psychogenic in 4 and other causes in 2. Two patients also had clinical evidence of venous incompetence and 4 were diabetics. One patient with psychogenic impotence noticed improvement in the duration of erection but no increase in rigidity or size after minoxidil application. One patient with impotence after excision of a Peyronie's plaque reported a rigid erection adequate for intercourse after using minoxidil. This patient subsequently was able to achieve erections without using minoxidil. The remaining 19 patients had no improvement in erectile rigidity, or the ability to obtain or maintain an erection. One patient did notice some mild burning on the glans penis after applying the minoxidil. No other side effects were noted in any patient. These results indicate that 2% topical minoxidil solution is not effective when applied to the penis in the treatment of erectile dysfunction. It is possible that a higher concentration, a different delivery medium or a different chemical composition may yield better results.

  15. Prevalence of erectile dysfunction in Tehranian diabetic men

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    Alireza Mofid

    2007-09-01

    Full Text Available Background: Erectile dysfunction (ED is an important impediment to quality of life. Diabetes mellitus is one of the most common causes of ED. In other hand, it has been one of the most neglected complications of diabetes mellitus. Our objective was to study prevalence of ED and its relative factors in diabetetes. Methods: During 2002-2004, 700 diabetic men aged 20-69 years were studied at Sina hospital and Abouzahr Health Center. Patients were screened for erectile dysfunction using the International Index of Erectile Function (IIEF questionnaire. Results: ED was found in 246 (35.1% of 700 diabetic men. Prevalence of ED was increased with age from 9.7% in men aged 20-30 years to 35% in those aged over 60 years. Men with type I diabetes reported ED less frequently than did men with type II diabetes (odds ratio=1.6. In comparison with reporting diabetes lasting ≤ 5 years, the odds ratio for ED were 1.5 and 2.2 for subject with diabetes lasting 6-10 and 11-30 years respectively. In comparison to the men with good glycemic control, the odds ratio for ED was 1.6 and 2.07 in the men with fair and poor control, respectively. Conclusion: Erectile dysfunction is common in diabetic Iranian men. Further studies on ED risk factors and relation between ED and other complications of diabetes are warranted.

  16. Linear shock wave therapy in the treatment of erectile dysfunction.

    Science.gov (United States)

    Pelayo-Nieto, M; Linden-Castro, E; Alias-Melgar, A; Espinosa-Pérez Grovas, D; Carreño-de la Rosa, F; Bertrand-Noriega, F; Cortez-Betancourt, R

    2015-09-01

    Linear Shock Wave Therapy (LSWT) is a new noninvasive therapy that uses low-intensity shock waves to induce local angiogenesis promising modality in the treatment of erectile dysfunction (ED). To evaluate the effectiveness of LSWT in men with vasculogenic erectile dysfunction (ED), in a Tertiary Care Center. Included 15 men aged 45-70 years, sexually active with mild and moderate vascular ED evaluated with the International Index of Erectile Function (IIEF). The study was conducted in three stage: screening, treatment and results. Treatment stage: 4 weekly sessions LSWT (RENOVA ®) 5000 waves (.09mJ/mm(2)). Erectile function was assessed with IIEFF-EF, SEP (Sexual Encounter Profile) and GAQ (Global Assessment Questions) at one and six months after treatment. The rate of success was 80% (12/15). Patients with mild ED (6/15) 40% and moderate ED (9/15) 60%. We found a positive association between IIEF-Basal (average 14.23 pts) and IIEF at one month and six months after therapy (19.69 pts) a difference of 5.46 pts. (P<.013). The feasibility and tolerability of this treatment, and rehabilitation potential features, make it this an attractive new treatment option for patients with ED. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

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

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    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.

  18. Management of erectile dysfunction post-radical prostatectomy

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    Saleh A

    2015-02-01

    Full Text Available Alan Saleh, Hamid Abboudi, MB Ghazal-Aswad, Erik K Mayer, Justin A Vale Division of Surgery and Cancer, Imperial College Healthcare NHS Trust, St Mary's Hospital, London, UK Abstract: Radical prostatectomy is a commonly performed procedure for the treatment of localized prostate cancer. One of the long-term complications is erectile dysfunction. There is little consensus on the optimal management; however, it is agreed that treatment must be prompt to prevent fibrosis and increase oxygenation of penile tissue. It is vital that patient expectations are discussed, a realistic time frame of treatment provided, and treatment started as close to the prostatectomy as possible. Current treatment regimens rely on phosphodiesterase 5 inhibitors as a first-line therapy, with vacuum erection devices and intraurethral suppositories of alprostadil as possible treatment combination options. With nonresponders to these therapies, intracavernosal injections are resorted to. As a final measure, patients undergo the highly invasive penile prosthesis implantation. There is no uniform, objective treatment program for erectile dysfunction post-radical prostatectomy. Management plans are based on poorly conducted and often underpowered studies in combination with physician and patient preferences. They involve the aforementioned drugs and treatment methods in different sequences and doses. Prospective treatments include dietary supplements and gene therapy, which have shown promise with there proposed mechanisms of improving erectile function but are yet to be applied successfully in human patients. Keywords: erectile dysfunction, phosphodiesterase 5 inhibitors, vacuum erection devices, intraurethral suppositories, intracavernosal injections

  19. [Inhibitory effect of salidroside on hypoxia-induced apoptosis of corpus cavernosum smooth muscle cells in rats].

    Science.gov (United States)

    Zhao, Jian-Feng; Fu, Hui-Ying; Yang, Fan; Huang, Xiao-Jun; Chen, Gang; Lü, Bo-Dong

    2014-04-01

    To investigate the effect of salidroside on hypoxia-induced apoptosis of corpus cavernosum smooth muscle cells (CCSMCs) in rats. Rat CCSMCs were cultured in vitro by the enzyme digestion method and identified by immunofluorescent staining of anti-alpha-SMA and anti-Desmin. The non-toxic dose of salidroside was determined by MTT assay. Low-oxygen mixed gas (1% O2, 5% CO2, and 94% N2) was piped into a modular incubator chamber to induce hypoxia. The CCSMCs were divided into a normal, a hypoxia, and a 32 microg/mL salidroside intervention group. The apoptosis of the CCSMCs was detected by flow cytometry and the expression of the caspase-3 protein determined by Western blot. The majority of the CCSMCs were positive for alpha-SMA and Desmin at immunofluorescent staining. Salidroside at salidroside significantly reduced hypoxia-induced early apoptosis of CCSMCs ([13.46% +/- 1.87]%, P Salidroside can reduce the expression of cleaved caspase-3 and inhibit hypoxia-induced apoptosis of CCSMCs in rats.

  20. Cardiometabolic Risk Factors in Patients with Erectile Dysfunction

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    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.

  1. Down-regulation of KCa2.3 channels causes erectile dysfunction in mice

    DEFF Research Database (Denmark)

    Comerma Steffensen, Simon Gabriel; Hedegaard, Elise; Kun, Attila

    2017-01-01

    in transgenic mice with overexpression (KCa2.3T/T(−Dox)) or down-regulation (KCa2.3T/T(+Dox)) of the KCa2.3 channels and wild-type C57BL/6-mice (WT). QPCR revealed that KCa2.3 and KCa1.1 channels were the most abundant in mouse corpus cavernosum. KCa2.3 channels were found by immunoreactivity and electron...... microscopy in the apical-lateral membrane of endothelial cells in the corpus cavernosum. Norepinephrine contraction was enhanced in the corpus cavernosum of KCa2.3T/T(+Dox)versus KCa2.3T/T(−Dox) mice, while acetylcholine relaxation was only reduced at 0.3 µM and relaxations in response to the nitric oxide...... donor sodium nitroprusside were unaltered. An opener of KCa2 channels, NS309 induced concentration-dependent relaxations of corpus cavernosum. Mean arterial pressure was lower in KCa2.3T/T(−Dox) mice compared with WT and KCa2.3T/T(+Dox) mice. In anesthetized mice, cavernous nerve stimulation augmented...

  2. A comparative study of erectile function and use of erectile aids in high-risk prostate cancer patients after robot-assisted laparoscopic prostatectomy

    DEFF Research Database (Denmark)

    Østby-Deglum, Marie; Brennhovd, B.; Axcrona, K.

    2015-01-01

    Objective. Erectile function with and without use of erectile aids was compared in high-, intermediate- and low-risk prostate cancer patients at a mean of 3 years after robot-assisted laparoscopic prostatectomy (RALP). Materials and methods. A sample of 982 men who underwent RALP at Oslo University...

  3. Erectile dysfunction in a sample of patients attending a psychiatric outpatient department.

    Science.gov (United States)

    Mosaku, K S; Ukpong, D I

    2009-01-01

    To assess the prevalence of erectile dysfunction among a sample of patients attending a psychiatric clinic, we administered the International Index of Erectile Function on 108 male patients attending the clinic. We also obtained sociodemographic and clinical variables from the patients. The mean age of the patients studied was 39.6 (s.d.=11.6), with a mean duration of illness of 10.24 (s.d.=8.2) years. There were 46.8% schizophrenics; other diagnoses include bipolar affective disorder, recurrent depressive disorder and substance use disorder. The prevalence of erectile dysfunction was 83%. Age, marital status, current medications and the presence of comorbid medical conditions were significantly associated with erectile dysfunction; however, only age and marital status significantly predicted erectile dysfunction. We concluded that erectile dysfunction is highly prevalent among patients attending the psychiatric clinic, as such inquiries about sexual function should be routinely carried out by clinicians.

  4. Potential pathways of pesticide action on erectile function-a contributory factor in male infertility

    Institute of Scientific and Technical Information of China (English)

    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.

  5. Effect of biliary cirrhosis on nonadrenergic noncholinergic-mediated relaxation of rat corpus cavernosum: Role of nitric oxide pathway and endocannabinoid system

    Directory of Open Access Journals (Sweden)

    Dehpour A.R.

    2008-06-01

    Full Text Available Background: Relaxation of the corpus cavernosum plays a major role in penile erection. Nitric oxide (NO is known to be the most important factor mediating relaxation of corpus cavernosum, which is mainly derived from nonadrenergic noncholinergic (NANC nerves. The aim of the present study was to investigate the effect of biliary cirrhosis on nonadrenergic noncholinergic (NANC-mediated relaxation of rat corpus cavernosum as well as the possible relevant roles of endocannabinoid and nitric oxide systems.Methods: Corporal strips from sham-operated and biliary cirrhotic rats were mounted under tension in a standard oxygenated organ bath with guanethidine sulfate (5 µM and atropine (1 µM to induce adrenergic and cholinergic blockade. The strips were precontracted with phenylephrine hydrochloride (7.5 µM and electrical field stimulation was applied at different frequencies (2, 5, 10, 15 Hz to obtain NANC-mediated relaxation. In separate precontracted strips of the sham and cirrhotic groups, the concentration-dependent relaxant responses to sodium nitroprusside (10 nM-1mM, as an NO donor, were assessed.  Results: The NANC-mediated relaxation was significantly enhanced in cirrhotic animals (P<0.01. Anandamide potentiated the relaxations in both groups (P<0.05. The cannabinoid CB1 receptor antagonist AM251 (10 µM and the vanilloid receptor antagonist capsazepine (10 µM each significantly prevented the enhanced relaxations in cirrhotic rats (P<0.01. The CB2 receptor antagonist AM630 had no effect on relaxations in the cirrhotic group. In a concentration-dependent manner, L-NAME (30-1000 nM inhibited relaxations in both the sham and cirrhotic groups, although cirrhotic groups were more resistant to the inhibitory effects of L-NAME. The degree of relaxation induced by sodium nitroprusside (10 nM-1 mM was similar in the two groups.Conclusions: Biliary cirrhosis enhances the neurogenic relaxation in rat corpus cavernosum probably via the NO pathway and

  6. Pistachio diet improves erectile function parameters and serum lipid profiles in patients with erectile dysfunction.

    Science.gov (United States)

    Aldemir, M; Okulu, E; Neşelioğlu, S; Erel, O; Kayıgil, O

    2011-01-01

    We investigated the effects of Antep pistachio on International Index of Erectile Function (IIEF) scores, penile color Doppler ultrasound (PCDU) parameters and serum lipid levels in patients with ED. A total of 17 married male patients with ED for at least 12 months were included in this prospective study. Patients were put on a 100 g pistachio nuts diet for 3 weeks. IIEF and PCDU were evaluated before and after the pistachio diet. In addition, plasma total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and triglyceride were measured before and after dietary modifications from all subjects. Mean IIEF-15 score was 36 ± 7.5 before the diet and 54.2 ± 4.9 after the diet (P=0.001). Similarly, an increase in all five domains of IIEF was observed after the diet (Ppistachio diet were 35.5 ± 15.2 and 43.3 ± 12.4 cm s(-1), respectively (P=0.018). After the pistachio diet, TC and LDL levels decreased significantly, whereas HDL level increased (P=0.008, 0.007 and 0.001, respectively). We demonstrated that a pistachio diet improved IIEF scores and PCDU parameters without any associated side effects in patients with ED. Furthermore, the lipid parameters showed statistically significant improvements after this diet.

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

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    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.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  10. Diagnosis and treatment of erectile dysfunction--a practical update.

    Science.gov (United States)

    Persu, C; Cauni, V; Gutue, S; Albu, Elena Simona; Jinga, V; Geavlete, P

    2009-01-01

    During the last decades, erectile dysfunction was considered a direct consequence of aging and, although of a great concern for the affected patient, little was available to evaluate and treat this problem. If aging could not be invoked in all cases, than the psychogenic etiology was the only explanation. Over the coming years, a better understanding of the physiology involved in the penile process of tumescence and detumescence has allowed for better approach of each disease asociated with erectile dysfunction so that adequate treatment modalities can be applied to the pacient. As we all know, every pacient is a particular case. The development of modern PDE-5 inhibiters, along with other more or less invasive therapies, puts a new light on the medical approach of ED.

  11. Acupuncture for erectile dysfunction: a systematic review protocol

    OpenAIRE

    Cui, Xiaoming; Li, Xiaoli; Peng, Weina; Zhou, Jing; Yu, Jinna; Ye, Yongming; Liu, Zhishun

    2015-01-01

    Introduction This systematic review protocol aims to provide a protocol for assessing the safety and effectiveness of acupuncture for the treatment of erectile dysfunction(ED). Previous systematic reviews did not draw convincing conclusions owing to high heterogeneity and few included randomised controlled trials, so it is necessary to reassess the efficacy and safety of acupuncture for ED. Methods and analysis Eight electronic databases will be searched: the Cochrane Central Register of Cont...

  12. Cardiovascular drugs and erectile dysfunction - a symmetry analysis

    DEFF Research Database (Denmark)

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

    2015-01-01

    in prescribing. This asymmetry was most profound for thiazides (1.28, 95% CI 1.20, 1.38), calcium channel blockers (1.29, 95% CI 1.21, 1.38) and ACE inhibitors (1.29, 95% CI 1.21, 1.37), suggesting a small liability of these drugs to provoke erectile dysfunction. NNTH values were generally large, in the range...

  13. Sildenafil Improves Erectile Function in Men with Chronic Heart Failure

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    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.

  14. Are erectile functions affected by AB0 blood group?

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    Erdal Benli

    2016-12-01

    Full Text Available Aim: The aim of this study was to investigate whether there is a relationship between erectile dysfunction (ED, thought to be a vascular disease, and AB0 blood group. Material and Method: The study included 350 people abiding by the study criteria who applied to our clinic from April 2012-April 2015. The patients were divided into two groups including those with ED (Group 1 and those without (Group 2. Age, blood group, IIEF-5 score and presence of additional diseases were recorded. Erectile functions were analyzed according to blood group. Results: There was no difference between the mean age of 111 patients with ED and that of 239 patients without ED included in the study (p = 0.284. There was no difference between patients in the two groups in terms of smoking, alcohol use, hypertension and diabetes (p > 0.05. Among patients in the ED group, the mean IIEF-5 score according to blood group was 19.8 ± 5.04 in the 0 blood group, 16.5 ± 5.2 in the A blood group, 17.2 ± 5.3 in the B blood group and 13.3 ± 3.02 in the AB blood group. The IIEF-5 scores of individuals in the 0 blood group were significantly high compared to individuals in other blood groups (p = 0.004. Logistic regression analysis found that compared to the 0 blood group, the erectile dysfunction risk was 3.9 times greater for the A blood group, 3.5 times greater for the B blood group and 4.7 times greater for the AB blood group (p = 0.001 (Table 3. Conclusion: The risk of erectile dysfunction was significantly increased for individuals in the A, B and AB blood groups compared to individuals in the 0 blood group.

  15. Penile prosthesis surgery in the management of erectile dysfunction

    OpenAIRE

    2013-01-01

    Introduction We reviewed retrospectively the use of penile prostheses, including the indications and complications of penile prosthesis surgery. Methods We identified publications and the reported advances in penile prosthesis surgery between 1987 and 2012 in Pub-Med, and published information from American Medical Systems, Inc. (Minnetonka, MN, USA) and Coloplast Corporation (Humlebaek, Denmark), using the keywords ‘penile prosthesis’, ‘erectile dysfunction’, ‘mechanical reliability’, ‘compl...

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

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    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.

  18. [Legal medical considerations on a case of erectile dysfunction].

    Science.gov (United States)

    Ricci, S; Massoni, F; Troili, G M; Onofri, E; Letizia, P; Alei, G

    2013-08-01

    The primary obstruction of the bladder neck is a condition which is diagnosed in many young people with symptoms of lower urinary tract, such as obstructive symptoms (difficulty in the initial phase of urination and urinary retention) and irritative symptoms (pollakiuria, dysuria and nocturia). These tests are needed for the diagnosis: uroflowmetry, urodynamics, rx urethrocystography. For the treatment are used alpha-blockers or surgery. The main diagnostic test is the urodynamic study. Even though the alpha-blockers are effective and safe drugs, sometimes the treatment is surgical. The gold standard is the transurethral incision of the prostate or bladder neck (TUIP), a technique with good results, but with some complications, including retrograde ejaculation, that is the most dangerous, and erectile dysfunction, that occurs in a lower percentage of patients. In this work was studied, in terms of forensic medicine, the case of a patient who is 35 years old and reported erectile dysfunction after an intervention of transurethral incision of the prostate or bladder neck. Although there is a limited possibility, documented in the literature, of erectile dysfunction as a result of TUIP, there is no sufficient evidence to confer the responsibility of patient's organic nature impotence to the health professional civil conduct which is directly related to the transurethral incision of the bladder neck, considering the presence of a lumbo-sacral disc disease in the patient, documented by CT two years before the surgery.

  19. Tadalafil as New Treatment in Erectile Dysfunction: A Review

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    Bagus Komang Satriyasa

    2017-01-01

    Full Text Available Erectile dysfunction is disability to achieve  or sustain erection to do satisfying intercourse, that occur at lest for three month. Erectile dysfunction patients are significantly increasing every year, especially in male age 40-70 years old. Tadalafil inhibit PDE5 enzyme 10.000 time more potent than PDE1, PDE2, PDE4 and PDE7; 700 time more potent than PDE6; 900 time more potent than PDE8, PDE9, PDE10, and also 14 time more potent than PDE11A1.In elderly erectile dysfunction commonly is caused by  aging process, hence in young adult can caused by physiologic factor or stress. Some studies report there is no significant difference of the tadalafil’s pharmacokinetic in young adult and elderly, and in patient with and without diabetes mellitus. The dose of tadalafil does not need to be reguleted in patient who have liver function disturbance, DM, elderly, renal function disturbance, patient who take medicine like erythromycin, ketoconazole, itraconazole, protease inhibitor, and medicine that inhibit the CYP3A4 system. Clinical study report that tadalafil can increase erection significantly and the patient able to do sex intercourse successfully.Tadalafil does not affect the blood pressure or heart rate, neither affect the concentration motility and morphology of the sperm and neither cause eye disturbance. There is no evidence of teratogenicity, embryotoxicity and foetotoxicity in rat that were given tadalafil 1000 mg/kg/day.

  20. Cardiovascular Disease Risk, Vascular Health, and Erectile Dysfunction among Middle-Aged, Clinically Depressed Men

    Science.gov (United States)

    Hoffman, Benson M.; Sherwood, Andrew; Smith, Patrick J.; Babyak, Michael A.; Doraiswamy, P. Murali; Hinderliter, Alan; Blumenthal, James A.

    2013-01-01

    Background Erectile dysfunction (ED) is especially common in men with major depressive disorder (MDD). This study examined the extent to which risk factors for cardiovascular disease (CVD) and vascular dysfunction were associated with ED severity in a series of MDD patients. Methods The sample included 46 middle-aged [M (SD) age = 53 (7)], sedentary men diagnosed with MDD. ED severity was assessed by the Arizona Sexual Experiences Scale (ASEX), item 3. Depression severity was measured by the Beck Depression Inventory (BDI). CVD risk factors were quantitated by the Framingham Cardiovascular Disease Risk Profile score. Vascular function was measured by flow-mediated dilation (FMD) of the brachial artery. Results The average ASEX score for this sample was 3.2 (SD = 1.2). Regression analysis revealed that ASEX scores were predicted by greater CVD risk factors (p = .008, β = .41) and lower FMD (p = .03, β = −.33). When FMD was included in the regression model, the relationship between CVD risk factors and ASEX scores was partially attenuated (p = .08, β = .28). Conclusions ED was associated with CVD risk and impaired vascular function, although it appears that CVD risk factors may affect ED through impairment of vascular functioning. PMID:19776749

  1. Prevalence and correlates of erectile dysfunction in men on chronic haemodialysis: a multinational cross-sectional study

    NARCIS (Netherlands)

    Vecchio, M.; Palmer, S.; Berardis, G. de; Craig, J.; Johnson, D.; Pellegrini, F.; Nicolucci, A.; Sciancalepore, M.; Saglimbene, V.; Gargano, L.; Bonifati, C.; Ruospo, M.; Navaneethan, S.D.; Montinaro, V.; Stroumza, P.; Zsom, M.; Torok, M.; Celia, E.; Gelfman, R.; Bednarek-Skublewska, A.; Dulawa, J.; Graziano, G.; Lucisano, G.; Gentile, G.; Ferrari, J.N.; Santoro, A.; Zucchelli, A.; Triolo, G.; Maffei, S.; Hegbrant, J.; Wollheim, C.; Cosmo, S. de; Manfreda, V.M.; Strippoli, G.F.; Steiner, K.

    2012-01-01

    BACKGROUND: Factors associated with erectile dysfunction in men on haemodialysis are incompletely identified due to suboptimal existing studies. We determined the prevalence and correlates of erectile dysfunction and identified combinations of clinical characteristics associated with a higher risk

  2. Is the chronic use of Ferula harmonis to enhance mice erectile function effective and safe? A histopathological study.

    Science.gov (United States)

    Ayuob, Nasra N; Al-Harbi, Mohammad S; Abdulhadi, Soad S

    2014-10-01

    Many studies are aimed towards a solution for erectile dysfunction which is a worldwide health problem. Medicinal and natural herbal medications have been prescribed but their long-term effects are not well known. This study aimed to investigate the impact of the chronic administration of F. hermonis root extract on the structure of the male mice reproductive organs and their fertility and to study the possible protective role of vitamin C. Sixty male albino mice were divided into 3 groups: the control, the experimental group that received F. hermonis root extract orally (6 mg/kg) for six weeks, and the treated group that received F. hermonis plus vitamin C for six weeks. Serum testosterone level and mice fertility were assessed. At the end of the experiment mice were sacrificed; testis, epididymis, and seminal vesicle were dissected and processed for routine histopathological and immunohistochemical examination. The chronic administration of F. hermonis extract significantly decreased the level of testosterone and partially impaired fertility. Histopathological degenerative changes and a significant reduction in estrogen receptor (ER)β expression were observed in testes, epididymis, and seminal vesicle. Vitamin C administration did not completely protect the testis from these harmful effects. Although F. hermonis roots are recommended to improve erectile and fertility problems, it should be used for short periods and with extreme caution. Further clinical studies to assess safety and efficacy are needed.

  3. Effect of sildenafil citrate (Viagra) on erectile dysfunction in a patient with familial amyloidotic polyneuropathy ATTR Val30Met.

    Science.gov (United States)

    Obayashi, K; Ando, Y; Terazaki, H; Yamashita, S; Nakagawa, K; Nakamura, M; Yamashita, T; Suga, M; Ishizaki, T; Uchino, M; Ando, M

    2000-04-12

    A 34-year-old male patient with familial amyloidotic polyneuropathy (FAP) amyloidogenic transthyretin (ATTR) Valine30Methionine (Val30Met), who underwent a liver transplantation in Sweden in 1994, was treated with sildenafil citrate (Viagra) to ameliorate his erectile dysfunction (ED). Some clinical symptoms and the examination data for autonomic functions were improved after liver transplantation, but ED was never improved after the operation. Five years after liver transplantation, he requested a sildenafil citrate therapy to enhance his erectile potential. One and a half hours after the administration of 25 mg of sildenafil citrate, the skin surface temperature around the pelvic area increased and the penis became erect, though the postdose hemodynamic parameters did not significantly change from the respective baseline or predose values. He was able to have sexual intercourse, though ejaculation did not occur. This case report appears to suggest that sildenafil citrate is an effective drug to treat ED in patients with an organic impairment of the autonomic nervous system without altering systemic circulation.

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

    Institute of Scientific and Technical Information of China (English)

    Ramazan Akdemir; Ekrem Yeter; (O)zlem Karakurt; Salih Orcan; Nihat Karakoyunlu; Mustafa Mucahit Balci; Levent Sa(g)nak; Hamit Ersoy; Mehmet Bulent Vatan; Harun Kilic

    2012-01-01

    Acute ST elevation myocarclial 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 angioplasty with stenting,and 26 were treated with thrombolytic agents.Erectile function was evaluated using the International Index of Erectile Function in the hospital to characterize each patient's sexual function before the acute myocardial infarction and 6 months after the event.The time required to restore blood flow to the artery affected by the infarct was found to be associated with the occurrence of erectile dysfunction after acute myocardial infarction.The increase in the prevalence of erectile dysfunction after acute myocardial infarction was 44.4% in the angioplasty group and 76.9% in the thrombolytic therapy group (P=0.008).In conclusion,this study has shown that reducing the time of reperfusion decreases the erectile dysfunction prevalence,and primary angioplasty is superior to thrombolytic therapy for decreasing the prevalence of erectile dysfunction after acute myocardial infarction.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Exploring the relationship between depression and erectile dysfunction in aging men.

    Science.gov (United States)

    Seidman, Stuart N

    2002-01-01

    Normal sexual function is a biopsychosocial process; sexual dysfunction almost always has organic and psychological components and requires multidisciplinary, goal-directed evaluation and treatment. Factors such as aging, declining testosterone levels, medical illness, certain medications. and comorbid depressive illness can contribute to sexual dysfunction. Erectile dysfunction is one of the more common male sexual dysfunctions encountered in the clinical setting. Comorbidity between erectile dysfunction and depressive illness is high, but the causal relationship is unclear. The psychosocial distress that often accompanies erectile dysfunction might stimulate the development of depressive illness, or, as some data suggest, depression might cause erectile dysfunction. This article reviews the literature on the relationship between depression and erectile dysfunction, as well as the design of a new study that may provide some answers, and concludes that erectile dysfunction is a common, treatable condition that may cause or be the result of depression. Recent data suggest that sildenafil is an effective treatment for erectile dysfunction in men with comorbid depression. Erectile dysfunction should be considered a multifactorial condition that may require a multidisciplinary approach to treatment, especially when depression is present.

  7. Impact of obesity on early erectile function recovery after robotic radical prostatectomy.

    Science.gov (United States)

    Uffort, Ekong E; Jensen, James C

    2011-01-01

    Studies are limited regarding the impact of obesity on early erectile functional outcomes after robotic radical prostatectomy. Our goal was to determine this impact using patient-reported validated questionnaires. International Index of Erectile Function (IIEF-6) scores were prospectively collected with institutional review board approval, for patients who underwent robotic radical prostatectomy with bilateral nerve sparing from February 2007 to October 2009. The data were categorized into nonobese and obese groups and subsequently into 2 subgroups based on risk for postprostatectomy erectile dysfunction. Low risk is preoperative IIEF-6 ≥19 and high risk is IIEF-6 function recovery rates between the groups (P=0.755). In both groups, patients with low risk of postoperative erectile dysfunction had statistically similar postoperative mean IIEF-6 scores at 6 and 12 months (P=0.580 and P=0.389, respectively), and no difference in erectile function recovery rates existed at 12 months (P=0.735). Obesity has no major contribution to the rate of early erectile function recovery after robotic radical prostatectomy. Preoperative erectile function remains the determining factor in postradical prostatectomy erectile dysfunction.

  8. The Impact of Medical and Surgical Treatment for Benign Prostatic Hypertrophy on Erectile Function.

    Science.gov (United States)

    Stearns, Gillian L; Sandhu, Jaspreet S

    2015-11-01

    There is a well-known link between treatment for lower urinary tract symptoms (LUTS) and erectile dysfunction. Surgical and medical management of LUTS all have side effect profiles which may affect erectile dysfunction, ejaculatory dysfunction, or libido. These should be taken into consideration during patient counseling. This article reviews the common side effects of the medical and surgical treatments of LUTS.

  9. Metabolic syndrome: An independent risk factor for erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Saran Sanjay

    2015-01-01

    Full Text Available Objective: The objective was to determine the role of various components of metabolic syndrome (MetS as independent risk factor for erectile dysfunction (ED. Materials and Methods: A total of 113 subjects of MetS, as recommended by recent IDF and AHA/NHLBI joint interim statement were selected for study who presented for ED. After doing Anthropometric examination, fasting laboratory assay for fasting plasma glucose (FPG, fasting insulin, hemoglobin A1c, triglyceride (TG, high-density lipoprotein (HDL, low-density lipoprotein (LDL, and 2 h oral glucose tolerance test (OGTT was done. Erectile function was assessed by completing questions one through five of the International Index of Erectile Function (IIEF-5. A multiple linear regression analysis was carried out on 66 subjects with IIEF-5 score as dependent variable and components of MetS FPG, 2 h OGTT, TG, HDL, and waist circumference as independent variables. Results: Using a multiple linear regression analysis, we observed that presence of the various components of MetS was associated with ED and a decrease IIEF-5 score and this effect was greater than the effect associated with any of the individual components. Of the individual components of the MetS, HDL (B = 0.136; P = 0.004 and FPG (B = −0.069; P = 0.007 conferred the strongest effect on IIEF-5 score. However, overall age had most significant effect on IIEF-5 score. Conclusion: It is crucial to formulate strategies and implement them to prevent or control the epidemic of the MetS and its consequences. The early identification and treatment of risk factors might be helpful to prevent ED and secondary cardiovascular disease, including diet and lifestyle interventions.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Does erectile dysfunction drug use contribute to risky sexual behavior?

    Institute of Scientific and Technical Information of China (English)

    Wayne J. G. Hellstrom

    2010-01-01

    @@ Erectile dysfunction (ED) is a common sexual problem affecting up to one-third of men through-out their lives. According to the Massachusetts Male Aging Study (MMAS), ED affects an estimated 52% of men between the ages of 40 and 70. With the approval of silde-nafil (USA in March 1998), the first phosphodiesterase type 5 (PDE-5) inhibitor to be made available for treatment of ED, and the subse-quent approval of vardenafil (USA in August 2003) and tadalafil (USA in November 2003), the PDE-5 inhibitor class of drugs has rapidly become the first-line therapy for ED of varying etiologies and se-verities.

  12. Is there a link between soft drinks and erectile dysfunction?

    Science.gov (United States)

    Adamowicz, Jan

    2011-01-01

    This review focuses on the potential role of soft drinks, particularly the sugar component, in the pathogenesis of erectile dysfunction (ED). We analyzed the hypothetical link between metabolic disorders, induced by sweetened soft drinks overconsumption, and ED. High caloric intake, high refined-carbohydrates, and high fructose corn syrup (HFCS) content and less satiety are main factors responsible for metabolic disorders contributing to ED development. Regular diet mistakes among human males, such as soft drink consumption, may lead to slow and asymptomatic progression of ED, finally resulting in full claimed manifestation of ED. PMID:24578881

  13. Leriche Syndrome Presenting as Depression with Erectile Dysfunction.

    Science.gov (United States)

    Bhatia, M S; Gautam, Priyanka; Saha, Rashmita

    2016-03-01

    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.

  14. Effectiveness of sildenafil citrate (Viagra) and tadalafil (Cialis) on sexual responses in Saudi men with erectile dysfunction in routine clinical practice

    National Research Council Canada - National Science Library

    Ali, Syed Tabrez

    2008-01-01

    ...), in the corpus cavernosum and therefore increases the penile response to sexual stimulation. Tadalafil (Cialis) is also a PDE5 inhibitor that increases the level of cyclic guanosine monophosphate...

  15. Combination therapy for erectile dysfunction: an update review

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

    The introduction of oral phosphodiesterase-5 inhibitors (PDE5ls) in the late 1990s and early 2000s revolutionized the field of sexual medicine and PDE5ls 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 thorough PubMed and Cochrane Library search was conducted focusing on the effectiveness of combination therapies for ED in therapeutic non-responders to PDE5I therapy. Journal articles spanning the time period between January 1990 and December 2010 were reviewed. Criteria included all pertinent review articles, randomized controlled trials, cohort studies and retrospective analyses. References from retrieved articles were also manually scanned for additional relevant publications. Published combination therapies include PDE5I plus vacuum erectile device (VED), intraurethral medication, intracavernosal injection (ICI), androgen supplement, a-blocker or miscellaneous combinations. Based on this review, some of these combination treatments appeared to be quite effective in preliminary testing. Caution must be advised, however, as the majority of combination therapy articles in the last decade have numerous limitations including study biases and small subject size. Regardless of limitations, present combination therapy research provides a solid foundation for future studies in complex ED management.

  16. Do lifestyle changes work for improving erectile dysfunction?

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Current and future standards in evaluation of erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Raymond W Pak

    2006-01-01

    Full Text Available Sexual dysfunction and more specifically erectile dysfunction (ED can be a harbinger of serious occult medical conditions. ED can be considered a clinical manifestation of generalized vascular disease and therefore shares similar risk factors: aging, hypertension, diabetes mellitus, hypercholesterolemia and smoking. The initial evaluation of men with ED should be thorough. Studies of normal and abnormal penile tumescence have led to the discovery of many important pathways. The greatest medical advance in the management of male sexual dysfunction since the identification of androgens have been the discoveries that nitric oxide (NO is the primary neuro-modulator of penile smooth muscle relaxation and that oral phosphodiesterase type 5 inhibitors enhance erection quality through the NO mechanism. As a consequence of oral pharmacotherapies, the role of invasive diagnostics has diminished. Most guidelines recommend only history, physical exam and limited laboratory testing prior to instituting oral therapies for ED. In 2006 we still have unanswered questions about ED and these will frame the role of future diagnosis and therapy: can lifestyle changes alone improve erectile function; is ED a marker for the development of atherosclerotic heart disease, do lower urinary tract symptoms of benign prostatic hypertrophy and ED share a common pathway?

  19. Effects of natural mineral-rich water consumption on the expression of sirtuin 1 and angiogenic factors in the erectile tissue of rats with fructose-induced metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Cidália D Pereira

    2014-08-01

    Full Text Available Consuming a high-fructose diet induces metabolic syndrome (MS-like features, including endothelial dysfunction. Erectile dysfunction is an early manifestation of endothelial dysfunction and systemic vascular disease. Because mineral deficiency intensifies the deleterious effects of fructose consumption and mineral ingestion is protective against MS, we aimed to characterize the effects of 8 weeks of natural mineral-rich water consumption on the structural organization and expression of vascular growth factors and receptors on the corpus cavernosum (CC in 10% fructose-fed Sprague-Dawley rats (FRUCT. Differences were not observed in the organization of the CC either on the expression of vascular endothelial growth factor (VEGF or the components of the angiopoietins/Tie2 system. However, opposing expression patterns were observed for VEGF receptors (an increase and a decrease for VEGFR1 and VEGFR2, respectively in FRUCT animals, with these patterns being strengthened by mineral-rich water ingestion. Mineral-rich water ingestion (FRUCTMIN increased the proportion of smooth muscle cells compared with FRUCT rats and induced an upregulatory tendency of sirtuin 1 expression compared with the control and FRUCT groups. Western blot results were consistent with the dual immunofluorescence evaluation. Plasma oxidized low-density lipoprotein and plasma testosterone levels were similar among the experimental groups, although a tendency for an increase in the former was observed in the FRUCTMIN group. The mineral-rich water-treated rats presented changes similar to those observed in rats treated with MS-protective polyphenol-rich beverages or subjected to energy restriction, which led us to hypothesize that the effects of mineral-rich water consumption may be more vast than those directly observed in this study.

  20. Evidence that the nitrergic neurotransmitter and endothelium-derived relaxing factor might be S-nitrosothiols in the mouse corpus cavernosum.

    Directory of Open Access Journals (Sweden)

    Büyükafşar K

    1999-10-01

    Full Text Available The effects of thimerosal, a sulfhydryl oxidizing agent on nitrergic, endothelium-dependent and -independent relaxations were investigated to examine the possibility that the nitrergic neurotransmitter and endothelium-derived relaxing factor (EDRF could be S-nitrosothiol or free nitric oxide (NO in the isolated mouse corpus cavernosum. Thimerosal (5 x 10(-6-2 x 10(-5 M inhibited or almost abolished electrical field stimulation--(EFS, 30V, 0.5 ms, 15 sec, 1, 2, 4, 8, 16 Hz, acetylcholine--(ACh, 5 x 10(-8-1.25 x 10(-6 M, glyceryl trinitrate--(GTN, 3 x 10(-7-3 x 10(-6 M, and S-nitrosoglutathione--(GSNO, 5 x 10(-6-1.25 x 10(-4 M induced relaxations. Thiomerosal inhibition seems to be specific to L-arginine NO pathways since it had no effect on acidified sodium nitrite--(10(-4-5 x 10(-4 M, photoactivated sodium nitrite--(2 x 10(-4 M, isoprenaline--(10(-6 M, or papaverine--(10(-4 M elicited relaxations. Moreover, the inhibitory effect of thimerosal on the nitrergic, ACh- or GTN-induced relaxations were partly reversed by sulfhydryl-containing compounds, L-cysteine (10(-3 M, dithiothreitol (10(-3 M, or glutathione (10(-3 M. However L-methionine (10(-3 M, which contains a methyl group on the sulphur atom, failed to restore the thimerosal inhibition. Thimerosal did not change the contraction produced by 10(-4 M NG-nitro-L-arginine methyl ester. These findings indicate that the nitrergic neurotransmitter as well as EDRF may not be free NO but NO-transferring molecules, probably S-nitrosothiols, in the mouse corpus cavernosum.

  1. Improvement in erectile function in a rat model of high cholesterol diet-induced atherosclerosis by atorvastatin in a manner that is independent of its lipid-lowering property.

    Science.gov (United States)

    Zhang, Z; Tang, L; Yu, W; Chen, Y; Dai, Y-T

    2017-03-10

    The purpose of the present study is to explore the effects of a lipid-lowering drug atorvastatin, a three-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor, in the treatment of erectile dysfunction (ED) in a rat model of atherosclerosis (AS) and the possible mechanisms underneath. A high-cholesterol diet was administrated to Sprague-Dawley rats in an attempt to induce an ASED model, which was later confirmed by abdominal aorta histopathology and erectile function evaluation. ASED rats were further assigned to non-treatment group, atorvastatin low-dose treatment group (5 mg kg(-1)  day(-1) ), high-dose group (10 mg kg(-1)  day(-1) ) and sildenafil (1.5 mg kg(-1)  day(-1) ) treatment group. Lipid profile, erectile function, oxidative stress biochemical markers, endothelial nitric oxide synthase (eNOS) and extracellular superoxide dismutase (SODEX ) mRNA expression were evaluated after 8-week treatment duration. Erectile function was impaired in AS rat model, which was preserved in atorvastatin and sildenafil intervention groups. The oxidative stress biochemical markers were attenuated, while eNOS and SODEX mRNA expression were restored in atorvastatin and sildenafil groups, which were found to be involved in ED pathogenesis. However, the lipid profile remained unaltered in the treatment group, and it was elevated in ASED rats. This kind of lipid-lowering agent, or atorvastatin, has the utilisation potential in ASED treatment, even before lipid profiles altered. This effect on erectile function preservation of atorvastatin was attributed to its preservation of endothelial function, possibly through amelioration of oxidative stress and improvement in eNOS expression.

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

    Directory of Open Access Journals (Sweden)

    Hamilton Z

    2014-05-01

    Full Text Available 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. Surgical technique, nerve sparing status, patient age, comorbid conditions, and pretreatment potency status all have an effect on post-surgical ED. Regardless of surgical technique, prostatectomy results in disruption of normal anatomy and nerve supply to the penis, which governs the functional aspects of erection. A variety of different treatment options are available for men who develop ED after prostatectomy, including vacuum erection device, oral phosphodiesterase 5 inhibitors (PDE5I, intracorporal injections, and penile prosthesis. The vacuum erection device creates an artificial erection by forming a vacuum via suction of air to draw blood into the penis. The majority of men using the vacuum erection device daily after prostatectomy, regardless of nerve-sparing status, have erections sufficient for intercourse. Phosphodiesterase 5 inhibitors remain a common treatment option for post-surgical ED and are the mainstay of therapy. They work through cyclic adenosine monophosphate and cyclic guanine monophosphate pathways and are recommended in all forms of ED. Intracorporal injections or intraurethral use of vasoactive substances may be a good second-line therapy in men who do not experience improvement with oral medications. Surgical placement of a penile prosthesis is typically the treatment strategy of choice after other options have failed. Semi-rigid and inflatable devices are available with high satisfaction rates. With careful patient counseling and proper

  3. Intracavernous pharmacotherapy for management of erectile dysfunction in multiple sclerosis patients.

    Science.gov (United States)

    Vidal, J; Curcoll, L; Roig, T; Bagunyá, J

    1995-01-01

    Intracavernous self-injection of vasoactive drugs is a well accepted therapy for the management of erectile dysfunction in neurogenic disorders. We present the results of a self-injection program in seven MS patients who were admitted in Institut Guttmann of Barcelona and who presented with an insufficient erection. All patients showed an excellent erectile response and had penile rigidity sufficient for sexual intercourse during acceptable time, with minimal complications. A patient reported improvement of erectile capacity so as not to need another cavernously injection for 2-3 months.

  4. Erectile dysfunction in patients with chronic pain treated with opioids.

    Science.gov (United States)

    Ajo, Raquel; Segura, Ana; Inda, María-Del-Mar; Margarit, César; Ballester, Pura; Martínez, Emi; Ferrández, Guillermina; Sánchez-Barbie, Ángel; Peiró, Ana M

    2017-07-21

    Chronic pain is associated with comorbidities that have an impact on the quality of life of patients and, among others, affect their sexual functioning. One of the most relevant side effects of opioid analgesics is erectile dysfunction (ED), due in part to the inhibition of the gonadal-pituitary-hypothalamic axis and the decline in testosterone levels. To evaluate ED and effectiveness of treatment in men with chronic pain treated with long-term opioids. Prospective observational study lasting 3 years, where the intensity of pain (visual analogue scale, 0-10cm), erectile function (IIEF-EF, range 1-30 points), quality of life (EQ-VAS, 0-100mm), quality of sexual life (MSLQ-QOL, 0-100 points), anxiety/depression (HAD, 0-21 points) and testosterone levels, was assessed in patients who reported sexual dysfunction (ED or libido modification). A 6-month follow-up was applied to each patient after administering the usual treatment in the Andrology Unit. The study was approved by the Clinical Research Ethics Committee and data were statistically analyzed with the GraphPad Prism 5 software. ED was observed in 27.6% of patients (n=105, 57±12.2 years, mean dose of morphine equivalent=107.1±107.9mg/day, 84.3% adjuvant analgesics). After 6 months, 42% of patients showed a significant improvement after being treated with iPDE5 (48.5%) and/or testosterone gel (81.8%), with a resolution rate of 31% (p=0.000). A positive correlation was observed between the improvement of IIEF and quality of sexual life (55.5±25.7 points, p=0.000), as well as anxiety (7.4±4.3 points, p=0.048). No significant changes were observed in the levels of testosterone, in the levels of pain nor in the quality of life, which remained moderate. Erectile function and quality of sexual life, as well as anxiety, improved in patients treated chronically with opioids after administering andrological treatment. The management of patients with pain should include a review of their sexual health history given the

  5. APPRAISAL OF MALE ERECTILE DYSFUNCTION IN PATIENTS WITH DIABETES MELLITUS

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    Rajendra Prasad Suram

    2016-07-01

    Full Text Available BACKGROUND One of the most common adverse effects of diabetes mellitus, erectile dysfunction (ED remains difficult to treat despite advances in pharmacotherapeutic approaches in the field. This unmet need has brought about a late re-focus on the pathophysiology, so as to comprehend the cellular and molecular mechanism prompting ED in diabetes. Diabetes-induced ED is a need to find focuses that may prompt novel approaches for a fruitful treatment. Present study was tried to understand role of vascular and neurogenic alterations in the pathophysiology of diabetic sexual dysfunction. SUBJECTS AND METHODS The study was carried out on 17 male impotent patients with Diabetes Mellitus: 5 patients (Aged 43-56 years; mean age 48.4 had insulin-dependent DM, and 13 patients (Aged 40-62; mean age 53.5 non-insulin-dependent DM. None of the patients were on medications known to interfere with male erectile sexual function. All patients were told to give informed consent. Every participant underwent a physical examination including complete medical and sexual history and routine laboratory tests. Penile vascular assessment and assessment of nocturnal penile erections investigation were assessed in the study. RESULTS As showed in Table I. alterations in the vascular system was found in 13 (61.5% participants. Out of which moderate alteration noticed in 8 (47% and severe alteration in 5 (16% patients. Among the patients with non-insulin-dependent DM, 7 (41.1% had showed Nocturnal Penile Erections abnormalities. According to the history and also to the normal responses to the Nocturnal penile tumescence monitoring (NPTM, patients were diagnosed as having impotence of psychogenic origin. CONCLUSION Initial involvement of both arterial supply and of the neurological pathways can be of some interest, suggesting the need for an early screening of neural and vascular status even in patients without penile erectile failure. As is the case for other degenerative

  6. Relation between histological prostatitis and lower urinary tract symptoms and erectile function

    Directory of Open Access Journals (Sweden)

    Taiki Mizuno

    2017-09-01

    Conclusion: We found a correlation only between histological prostatitis and LUTS, but not erectile dysfunction. Especially, the subscore of urinary symptoms (residual feeling and urinary frequency was associated with histological prostatitis.

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

    Directory of Open Access Journals (Sweden)

    E. A. Efremov

    2011-01-01

    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. 

  8. Phosphodiesterase type 5 inhibitor (Levitra: possibility of correction of erectile dysfunction in obese patients

    Directory of Open Access Journals (Sweden)

    A Yu Popova

    2008-03-01

    Full Text Available Obesity is the cause of a number of diseases such as type 2 diabetes, hypertension, atherosclerosis and coronary heart disease [1]. Obesity is associated with the development of a number of hormone-dependent tumors (breast cancer, uterine cancer and colon cancer [2]. Metabolic and hormonal disorders that accompany obesity and underlying a number of diseases, including may have an impact on erectile function. Despite the fact that in the literature there are few publications on the relationship of obesity and erectile dysfunction (ED, we could not find work on the effectiveness of treatment of patients with erectile dysfunction and obesity. These large-scale research on the role of weight loss in the treatment of other diseases, such as such as type 2 diabetes, hypertension, coronary heart disease, suggest that weight control and related metabolic disorders are able to provide a significant improvement in erectile quality function and effectiveness of the treatment of ED [3, 4, 5, 6].

  9. Sildenafil citrate (Viagra) treatment for erectile dysfunction: An updated profile of response and effectiveness.

    Science.gov (United States)

    Padma-Nathan, H

    2006-01-01

    In the 7 years since sildenafil citrate (VIAGRA) was introduced as the first oral phosphodiesterase type 5 inhibitor therapy for erectile dysfunction, it has been used to treat nearly 27 million men with erectile dysfunction worldwide. Patient populations with erectile dysfunction of varying etiologies and with diverse comorbidities have benefited from sildenafil treatment. This update focuses on relatively recent research that further defines the response and effectiveness profiles of sildenafil and provides additional insight into optimizing treatment. In addition to providing recent data on sildenafil efficacy and safety/tolerability, the update provides data on assessments of erection hardness, measures of psychosocial outcomes (e.g., emotional well-being and treatment satisfaction), and treatment approaches to maximize response and effectiveness (e.g., by titrating to the maximum tolerated dose). Increased understanding of the sildenafil response and effectiveness profiles and optimal sildenafil treatment are central to the appropriate management of erectile dysfunction using sildenafil.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. Cytokines profile changers after magnetic-heat-vibromassage in chronic abacterial prostatitis with erectile disfunction

    Directory of Open Access Journals (Sweden)

    D. G. Коren’kov

    2016-01-01

    Full Text Available The aim of the study was to examine the influence of magnetic-heat-vibromassage procedure in treatment of 27 patients with chronic abacterial prostatitis with erectile dysfunction, by mean of transrectal electrodes application of MAVIT® apparatus (ULP-01-“ELAT”. In the prostatic gland (PG media and blood plasma the pro-inflammatory cytokine concentrations was investigated. PG hemodynamic, and erectile dysfunction also was determined. Control group was presented by 10 healthy males (23–45 years old. Measurements were done before treatment, and after 10 procedures of PG massage, and 30 days after procedure.It was shown that chronic abacterial prostatitis with erectile dysfunction with low clinical performance is supported by pro-inflammatory cytokines produced by the PG. The usage of magnetic-heat-vibromassage procedure increased prostatic microcirculation, as well as testosterone level, and improved the erectile dysfunction in all 27 patients enrolled into the study

  12. Impact of obesity on early erectile function recovery after robotic radical prostatectomy

    National Research Council Canada - National Science Library

    Uffort, Ekong E; Jensen, James C

    2011-01-01

    .... International Index of Erectile Function (IIEF-6) scores were prospectively collected with institutional review board approval, for patients who underwent robotic radical prostatectomy with bilateral nerve sparing from February 2007 to October 2009...

  13. Erectile function post robotic radical prostatectomy: technical tips to improve outcomes?

    Science.gov (United States)

    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.

  14. Follow-up of vacuum and nonvacuum constriction devices as treatments for erectile dysfunction.

    Science.gov (United States)

    Schuetz-Mueller, D; Tiefer, L; Melman, A

    1995-01-01

    Of 20 men evaluated for erectile dysfunction (ED) for whom vacuum erection devices or constriction bands were recommended, only four experienced improvement of their erectile function by using the specific suggested method. Although use of a simple constriction band mechanism (e.g., a rubber band wound tightly around the penis) for men with brief erectile capacity has been described as a viable treatment, only one of five men who tried using it achieved any success. Three of six men who used a vacuum erection device were helped by it, particularly the men who suffered from only partial ED. Most patients did not follow through with the recommended treatment and stopped sexual activity, or belatedly returned for intracavernosal injections. The interviews revealed the pervasive influence of shame and demoralization regarding erectile problems, the importance of evaluation and treatment follow-up, and the necessity for careful, explicit, extensive, and concrete explanations and instructions regarding treatment options.

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

    Science.gov (United States)

    Brant, William O.

    2016-01-01

    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

  16. Erectile dysfunction as a complication of heart failure.

    Science.gov (United States)

    Baraghoush, Afshan; Phan, Anita; Willix, Robert D; Schwarz, Ernst R

    2010-12-01

    Erectile dysfunction (ED) is an increasingly common problem in the aging population and has been associated with chronic heart failure (HF), either as an epiphenomenon or even as an early marker for underlying cardiovascular disease. ED has a significant effect on patients' quality of life. This chapter reviews ED in patients with HF and prevention and treatment based on current data from the literature. Causes include physiologic changes resulting in decreased cardiac function and exercise capacity, intrinsic vascular and neurohormonal abnormalities, and extrinsic factors such as medication side effects and psychological issues. Physicians should address these issues with patients and begin treatment by optimizing HF management and minimizing medications with ED side effects. Use of phosphodiesterase-5 inhibitors provides significant improvement of ED and quality of life. Further research still is needed regarding long-term effects of ED treatment, investigation of newer medications, and preventive measures in this patient population.

  17. [The study of arteriogenic erectile impotence by noninvasive methods].

    Science.gov (United States)

    Ley Pozo, J; Aldama Figueroa, A; Vega Gómez, M E; Perera González, F

    1992-01-01

    With the development of noninvasive haemodynamic methods, recognition of arterial insufficiency signs is possible also in cases in which, in old times, we just could suspect a psychogenic cause. Although this advance, discrimination permitted by this method can be improved. Eighty-eight supposed healty patients and eighty-four patients with arteriogenic erectile impotency (tested by arteriography) were included into an study, which results are presented in here. Analysis made, avoided the effect of envelleiment on haemodynamic parameters interpretation. For identification of patients which obstructive arterial defect can be cause of sexual disfunction, combination of systolic pressure determination and arterial flow velocity curves (by Doppler ultrasonography) is proposed. We recommend this method as a part of the multifactorial examen required by such type of patients.

  18. Acute macular edema following intracorporeal prostaglandin injection for erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Asahi MG

    2015-07-01

    Full Text Available Masumi G Asahi, Calvin Chou, Ron P Gallemore Retina Macula Institute, Torrance, CA, USA Purpose: We aimed to describe the first case of macular edema following intracorporeal injection of alprostadil, a prostaglandin E1. Methods: This was a retrospective case report followed with optical coherence tomography, fundus photos, and fluorescein angiography images. Results: A patient developed bilateral cystoid macular edema following intracorporeal injection of alprostadil, a prostaglandin E1 for treatment of erectile dysfunction. The edema resolved following treatment with nonsteroidal anti-inflammatory drugs (NSAIDs and corticosteroids, with subsequent recovery in visual acuity. Discussion: Systemic prostaglandin administration can cause macular edema and vision loss, indicating that elevated systemic prostaglandin levels may affect visual function. This has potential implications for other systemic disorders and treatments that could affect macular function. Keywords: alprostadil, inflammation

  19. A New Approach for the Patient with Erectile Dysfunction

    Directory of Open Access Journals (Sweden)

    Ian Eardley

    2015-05-01

    Full Text Available This satellite symposium was held in two sessions. The first session was offered in a traditional format where invited experts reviewed and discussed the latest concepts and developments on the management of erectile dysfunction (ED. During the second session, experts discussed clinical cases from their real-life practice in an interactive format, to facilitate discussions with the audience, and to provide participants with the most relevant aspects of ED. The symposium objectives were to review and discuss the current status of the management of ED and treatment needs for patients with ED, and to explore the latest evidence on the use of topical alprostadil cream (Vitaros®, Virirec®, Vytaros®1 – who benefits the most?

  20. Erectile dysfunction among hypertensive men in a rapidly developing country

    Directory of Open Access Journals (Sweden)

    Abdulbari Bener

    2007-01-01

    Full Text Available Background: Previous studies have supported the association between hypertension and erectile dysfunction (ED. In addition, a significant correlation between hypertension in men and ED has been well established. Objectives: The aim of this study was to investigate the prevalence of ED, its severity and other sexual function domains in hypertensive patients in Qatar. Design and Setting: Cross-sectional study conducted between January and December 2006 at the Hamad General Hospital. Subjects: Qatari and nonQatari nationals 25 to 75 years of age were approached to participate in this study, 642 (75.5% gave their consent. Materials and Methods: Qatari and nonQatari men aged 25 to 75 years who gave consent were interviewed face-to-face. Sexual function was evaluated with the International index of erectile function. Results: A total of 642 (75.5% men responded, mean age of subjects was 57.1 ± 11.9 years. The prevalence of ED in hypertensive patients was 58.3%. 21.2% of hypertensive men reported severe ED, 20.7% moderate ED and 16.4% mild ED. The comorbidities and risk factors were significantly more prominent in ED patients than in those with normal ED for hypercholesterolemia ( P =0.009, diabetes ( P =0.022 for hypertriglyceridemia ( P =0.033 and myocardial ischemia ( P =0.042. Conclusions: Our results have shown a greater prevalence of ED in the hypertensive men in the population of Qatar. The presence of another risk factor in addition to elevated blood pressure can increase the likelihood of ED.

  1. New insights on arthropod toxins that potentiate erectile function.

    Science.gov (United States)

    Nunes, Kenia P; Torres, Fernanda S; Borges, Marcia H; Matavel, Alessandra; Pimenta, Adriano M C; De Lima, Maria E

    2013-07-01

    The use of natural substances for the treatment of diseases or injuries is an ancient practice of many cultures. According to folklore, natural aphrodisiacs may help to raise libido and increase desire. The supposed aphrodisiacs mainly include a plethora of preparations of plants, among other substances. However, the real boundary between myth and reality has not been established yet in most cases and such boundaries must be drawn by scientific methods. A growing interest of the scientific community has been focused on animal venoms, especially those from arthropods, i.e. spiders and scorpions, which cause priapism, a prolonged and painful erection. This review highlights the studies that have been performed with venoms and toxins from arthropods known to cause priapism, among other toxic symptoms, pointing out some pharmacological approaches for better understanding this effect. To date, the venom of some spiders, mainly Phoneutria nigriventer, and scorpions, such as the yellow South American scorpion Tityus serrulatus, among others, have been known to cause priapism. Since erectile dysfunction (ED) is a growing health problem in the world, more common in patients with vascular diseases as diabetes and hypertension, the use of animal venoms and toxins as pharmacological tools could not only shed light to the mechanisms involved in erectile function, but also represent a possible model for new drugs to treat ED. Unfortunately, attempts to correlate the structure of those priapism-related toxins were unfruitful. Such difficulties lie firstly on the poor data concerning purified priapism-related toxins, instead of whole venoms and/or semi-purified fractions, and secondly, on the scarce available primary sequences and structural data, mainly from spider toxins. It has been shown that all these toxins modify the sodium (Na(+)) channel activity, mostly slowing down its inactivation current. Improving the knowledge on the tertiary structure of these toxins could provide

  2. Radiation-induced erectile dysfunction: Recent advances and future directions

    Directory of Open Access Journals (Sweden)

    Javed Mahmood, PhD

    2016-07-01

    Full Text Available Prostate cancer is one of the most prevalent cancers and the second leading cause of cancer-related deaths in men in the United States. A large number of patients undergo radiation therapy (RT as a standard care of treatment; however, RT causes erectile dysfunction (radiation-induced erectile dysfunction; RiED because of late side effects after RT that significantly affects quality of life of prostate cancer patients. Within 5 years of RT, approximately 50% of patients could develop RiED. Based on the past and current research findings and number of publications from our group, the precise mechanism of RiED is under exploration in detail. Recent investigations have shown prostate RT induces significant morphologic arterial damage with aberrant alterations in internal pudendal arterial tone. Prostatic RT also reduces motor function in the cavernous nerve which may attribute to axonal degeneration may contributing to RiED. Furthermore, the advances in radiogenomics such as radiation induced somatic mutation identification, copy number variation and genome-wide association studies has significantly facilitated identification of biomarkers that could be used to monitoring radiation-induced late toxicity and damage to the nerves; thus, genomic- and proteomic-based biomarkers could greatly improve treatment and minimize arterial tissue and nerve damage. Further, advanced technologies such as proton beam therapy that precisely target tumor and significantly reduce off-target damage to vital organs and healthy tissues. In this review, we summarize recent advances in RiED research and novel treatment modalities for RiED. We also discuss the possible molecular mechanism involved in the development of RiED in prostate cancer patients. Further, we discuss various readily available methods as well as novel strategies such as stem cell therapies, shockwave therapy, nerve grafting with tissue engineering, and nutritional supplementations might be used to

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

    Science.gov (United States)

    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.

  4. Evaluation of High Sensitive Troponin in Erectile Dysfunction

    Science.gov (United States)

    Barassi, Alessandra; Pezzilli, Raffaele; Morselli-Labate, Antonio Maria; Dozio, Elena; Ghilardi, Francesca; Damele, Clara Anna Linda; Colpi, Giovanni Maria; Melzi d'Eril, Gian Vico; Corsi Romanelli, Massimiliano Marco

    2015-01-01

    Background. Evidence is accumulating in favour of a link between erectile dysfunction (ED) and coronary artery diseases. We investigated the presence of cardiac injury in patients who have had arteriogenic and nonarteriogenic ED using the hs-Tn levels. Methods. The diagnosis of ED was based on the International Index of Erectile Function 5-questionnaire (IIF-5) and patients were classified as arteriogenic (A-ED, n = 40), nonarteriogenic (NA-ED, n = 48), and borderline (BL-ED, n = 32) patients in relation to the results of echo-color-Doppler examination of cavernous arteries. The level of hs-TnT and hs-TnI was measured in 120 men with a history of ED of less than one year with no clinical evidence of cardiac ischemic disease. Results. The levels of both hs-TnT and hs-TnI were within the reference range and there was no significant (P > 0.05) difference between patients of the three groups. The hs-CRP values were higher in A-ED men compared with NA-ED (P = 0.048) but not compared with BL-ED (P = 0.136) and negatively correlated with IIF-5 (r = −0.480; P = 0.031). Conclusions. In ED patients of the three groups the measurement of hs-Tn allows us to exclude the presence of cardiac involvement at least when the history of ED is less than one year and the men are without atherosclerotic risk factors. PMID:25960595

  5. Intracavernous injection in the treatment of erectile dysfunction after radical prostatectomy: an observational study

    OpenAIRE

    Joaquim de Almeida Claro; José Elêrton de Aboim; Marcelo Maríngolo; Enrico Andrade; Wilson Aguiar; Marcos Nogueira; Archimedes Nardozza Júnior; Miguel Srougi

    2001-01-01

    CONTEXT: Despite the recent improvements in performing radical retropubic prostatectomy that have led to a considerable decrease in the complication rate, erectile dysfunction still represents a major problem. Moreover, less invasive treatment options that are emerging for erectile dysfunction have not shown satisfactory results in managing these patients. OBJECTIVE: To study the efficacy and side effects of self-injection therapy in the treatment of men who had become impotent after undergoi...

  6. Erectile dysfunction: on the efficacy of a phosphodiesterase inhibitor in patients with multiple risk factors

    Institute of Scientific and Technical Information of China (English)

    HarveyA.Rosenstock; SamuelD.Axelrad

    1999-01-01

    With the 1998 introduction of sildenafil(Viagra),the first available oral phosphodiesterase inhibitor, therehas been an increased interest in the treatment of erectiledysfunction (ED), the most common sexual dysfunctionof males. Most experts estimate that 25 to 30 millionmen in the United States experience erectile dysfunc-tion. The incidence of erectile dysfunction increaseswith age such that 52 % of all men at some time can

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

    OpenAIRE

    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 ...

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

    Directory of Open Access Journals (Sweden)

    Ashraf V

    2005-01-01

    Full Text Available 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 of Erectile Function-5 were classified as with erectile dysfunction and with a score of more than 21 as without erectile dysfunction. Clinical neurophysiological studies done were Sympathetic Skin Response from limbs, posterior tibial sensory evoked potential, pudendal sensory potential and bulbocavernous reflex. STATISTICAL ANALYSES: Chi-square test. RESULTS: Among 40 subjects 26 had erectile dysfunction. The frequency of abnormalities in clinical neurophysiological studies were: pudendal sensory evoked potentials - 16, posterior tibial sensory evoked potentials - 26, bulbocavernous reflex - 5, sympathetic skin response from sole - 24 and, sympathetic skin response from palm - 18. Significant associations were noted between erectile dysfunction and abnormal pudendal sensory evoked potentials (P=0.0479, and absent sympathetic skin response from palm (P=0.0279 and sole (PP=0.133 or bulbocavernous reflex (P=0.418. Sympathetic skin response from sole was most sensitive (80.8% and had best positive (87.5% and negative predictive (68.8% values. The specificity of these three tests was 78.6%. CONCLUSIONS: Sympathetic skin response from the sole of the foot was the most sensitive and specific clinical neurophysiological test for erectile dysfunction in spinal cord disorders.

  9. Observation on lower urinary tract symptoms and erectile dysfunction in Chinese middle-aged men

    Institute of Scientific and Technical Information of China (English)

    JingLeng; Xu-YuanHuang; Xian-ShengZhang; Yi-RanHuang

    2004-01-01

    Aim: To observe the incidence of lower urinary tract symptoms(LUTS) and erectile dysfunction (ED) in Chinese middle-aged men in Shanghai. Methods: In annual medical physical examination,681 Chinese men over 50 years old were evaluated. Each men completed an International Prostate Symptoms Score (IPSS), Quality of Life Assessment (QoL) and International Index for Erectile Funtion (I]EF-5).

  10. Association between Cigarette Smoking and Erectile Tumescence: The Mediating Role of Heart Rate Variability

    Science.gov (United States)

    Harte, Christopher B.; Meston, Cindy M.

    2012-01-01

    Cigarette smoking deleteriously affects erectile function, and conversely, quitting smoking improves erectile hemodynamics. Underlying mechanisms by which smoking (or reduction of smoking frequency) may affect erectile physiology are not well understood. This study examined the mediating role of heart rate variability (HRV; a marker of sympathovagal balance) among a sample of male chronic smokers from the United States. Sixty-two healthy men (Mage = 38.27 years; SD = 10.62) were assessed at baseline (while smoking regularly), at mid-treatment (while using a nicotine patch), and at follow-up, four weeks after patch discontinuation. Cigarette use, frequency-domain parameters of HRV (low frequency [LF], high frequency [HF], LF/HF ratio), and physiological sexual arousal responses (via penile plethysmography) were assessed at each visit. Results were consistent with mediation, in that greater reductions in cigarette use from baseline to follow-up were associated with longitudinal increases in LF, which in turn showed positive relations with across-time changes in erectile tumescence. Neither HF or LF/HF ratio mediated the relationship between smoking and erection. In conclusion, HRV mediated the inverse relationship between reductions in smoking and enhancements in erectile tumescence. Results underscore the possibility that cigarette use may deleteriously affect erectile function peripherally, in part, by disrupting cardiac autonomic function. PMID:23303335

  11. Erectile Dysfunction is Common among Men with Acromegaly and is Associated with Morbidities Related to the Disease.

    Science.gov (United States)

    Lotti, Francesco; Rochira, Vincenzo; Pivonello, Rosario; Santi, Daniele; Galdiero, Mariano; Maseroli, Elisa; Balestrieri, Antonio; Faustini-Fustini, Marco; Peri, Alessandro; Sforza, Alessandra; Colao, Annamaria; Maggi, Mario; Corona, Giovanni

    2015-05-01

    The prevalence of erectile dysfunction (ED) and its correlates in men with acromegaly has never been investigated. The aim of this study was to evaluate sexual function in men with acromegaly. Multicenter-based, retrospective analysis of a nonselected series of 57 acromegalic subjects (mean age: 52.7 ± 14.2 years) was performed. Acromegalic subjects reporting ED (n = 24) were compared with matched ED patients without acromegaly or pituitary disease (controls), selected from a cohort of more than 4,000 subjects enrolled in the Florence Sexual Medicine and Andrology Unit. Patients were interviewed using Structured Interview on Erectile Dysfunction (SIEDY) structured interview, a 13-item tool for the assessment of ED-related morbidities. Several clinical and biochemical parameters were taken. Penile color Doppler ultrasound (PCDU) was performed in a subgroup of 37 acromegalic subjects. ED was reported by 42.1% of acromegalic subjects. After adjusting for age and testosterone, acromegalic subjects with ED had a higher prevalence of hypertension and more often reported an impairment of sleep-related erections and a longer smoking habit. Accordingly, acromegaly-associated ED was characterized by a higher organic component and worse PCDU parameters. No relationship between ED and testosterone levels or other acromegaly-related parameters was found. However, acromegalic subjects with severe ED reported a longer disease duration. In a case-control analysis, comparing acromegalic subjects with ED-matched controls free from acromegaly (1:5 ratio), acromegalic men had a worse ED problem and a higher organic component of ED, as derived from SIEDY score. In line with these data, acromegalic patients with ED had a higher prevalence of major adverse cardiovascular events history at enrollment and lower PCDU parameters. Subjects with complicated acromegaly are at an increased risk of developing ED, especially those with cardiovascular morbidities. Our data suggest

  12. The administration of folic acid improves erectile function and reduces intracavernosal oxidative stress in the diabetic rabbit.

    Science.gov (United States)

    Shukla, Nilima; Hotston, Matthew; Persad, Raj; Angelini, Gianni D; Jeremy, Jamie Y

    2009-01-01

    To test the possibility that folic acid (FA) may be a means of treating erectile dysfunction (ED) in diabetes mellitus (DM), by studying the effect of FA administration to DM rabbits on cavernosal function and intrapenile oxidative stress. To investigate the effect of administering FA to DM rabbits on erectile function and oxidative stress the formation of superoxide (O(2)(-)), 8-isoprostane F(2 alpha) (8-IPF(2 alpha)) and prostacyclin (as 6-keto-PGF(1 alpha)) were assessed, as well as carbachol- and electrical field stimulated (EFS) relaxation and p47(phox) content (active component of NADPH oxidase complex). Non-ketotic DM was induced in New Zealand rabbits with alloxan and FA administered orally daily for 1 month. Rabbits were killed, penises excised and segments prepared. These were mounted in an organ bath and relaxation elicited with carbachol or EFS. O(2)(-) release was measured spectrophotometrically, p47(phox) expression by Western blotting and 8-IPF(2 alpha) and 6-keto-PGF(1 alpha) formation by enzyme-linked immunosorbant assay. Blood was collected for measurement of homocysteine, red blood cell (RBC) folate and glucose. In cavernosal tissue from DM rabbits, carbachol-and EFS-induced relaxation was significantly impaired compared with the untreated controls. O(2)(-) release, p47(phox) expression and 8-IPF(2 alpha) formation were all enhanced and 6-keto-PGF(1 alpha) formation reduced compared with the controls. All these effects were reversed by FA. Plasma total homocysteine was reduced and RBC folate elevated. The administration of FA may constitute a strategy for reducing ED in patients with DM.

  13. AB008. The link between erectile dysfunction (ED) and cardiovascular disease (CVD): what a urologist needs to know

    OpenAIRE

    Hassan, Tarek A.

    2015-01-01

    Background and Objective Erectile dysfunction (ED), or male impotence, is defined as the consistent inability to achieve and/or maintain an erection sufficient for satisfactory sexual activity, according to the National Institutes of Health (NIH). With the rapidly aging population, it has been projected to have 322 million men with erectile dysfunction by 2025 and the largest increase will happen in the developing world; Asia, Africa and South America. To describe the link between erectile dy...

  14. Fasudil improves erectile function of hypertensive rats%法舒地尔对高血压大鼠勃起功能的影响

    Institute of Scientific and Technical Information of China (English)

    马志鹏; 姜睿; 程勇; 杨海帆; 陈枫

    2012-01-01

    Objective: To investigate the effect of fasudil, an inhibitor of Rho kinase, on the erectile function of hypertensive rats and its action mechanism. Methods: Twenty 12-week-old healthy male Sprague-Dawley rats were randomly divided into groups A (control), B (hypertension) and C (fasudil treatment). After establishment of the hypertension model, group C received intraperito-neal injection of fasudil at 30 mg/(kg·d) , while A and B normal saline only. At 10 weeks after surgery, we measured the corpus cavernosum pressure / mean carotid arterial pressure (ICPmax / MAP), and the expression levels of ROCK1 and ROCK2 proteins in the corpus cavernosum of the rats by Western-blot. Results-. The systolic blood pressure (mmHg) and the expressions of ROCK1 and ROCK2 proteins were significantly increased in group B (190. 39 ± 5.07, 0. 048 ± 0. 002 and 0. 143 ± 0. 011) as compared with A (124.81 ±4.01, 0.036 ±0.001 and 0.101 ±0.011) (P <0.05), but markedly decreased in group C (182.03 ±4. 32, 0. 044 ± 0.001 and 0.126 ±0.007) in comparison with B ( P < 0.05). ICPmax / MAP was significantly lower in group B (36. 82 ± 5.47) than in A (59.99 ±5.69) (P <0.05), but remarkably higher in group C (51. 1 ±5. 63) than in B (P <0. 05). Conclusion-. Fasudil can improve erectile function in hypertensive rats by inhibiting the expression of RhoA / Rho kinase signaling and its possible attenuating effect on hypertension.%目的:探讨Rho激酶抑制剂法舒地尔对高血压大鼠勃起功能的影响及其机制.方法:12周龄雄性SD大鼠随机分成对照组(A组)、高血压组(B组)、法舒地尔治疗组(C组),建立高血压大鼠模型后,C组给予法舒地尔[30 mg/(kg·d)]腹腔注射,A组、B组给予等量生理盐水腹腔注射,术后10周测量大鼠阴茎海绵体内压/平均颈动脉压(ICPmax/MAP),Western印迹法测定ROCK1、ROCK2蛋白在阴茎海绵体的表达水平.结果:B组收缩压(mmHg)、ROCK1、ROCK2蛋白表达(190.39±5.07、0.048±0.002、0

  15. Endothelin-1-induced modulation of contractile responses elicited by an alpha 1-adrenergic agonist on human corpus cavernosum smooth muscle.

    Science.gov (United States)

    Kim, D C; Gondré, C M; Christ, G J

    1996-03-01

    The goal of these studies was to examine endothelin-1 (ET-1)-induced modulation of contractile responses elicited by the selective alpha 1-adrenergic agonist, phenylephrine (PE), on isolated human corporal tissue strips. Pharmacological studies were conducted on human corporal tissue strips obtained from 22 patients undergoing implantation of penile prostheses for erectile dysfunction. For the purposes of statistical analysis, the patients were stratified into two age groups: A, age or = 60 y (n = 12). The patients were further sub-divided into two diagnostic categories, diabetics (DM, n = 9) and nondiabetics (ND, n = 13). Cumulative concentration-response curves (CRCs) were constructed to the alpha 1-adrenergic agonist, PE, prior to constructing a CRC to a single mixture of PE and ET-1 on the same tissue. A previously described fixed molar ratio (FMR) protocol was used to generate CRCs to mixtures of PE and ET-1. In all cases, for the PE:ET-1 FMRs of 90:10, 80:20 and 70:30, the partial substitution of PE with ET-1 resulted in an approx 3-fold leftward shift in the EC50 of the PE alone CRC with an approx 4% concomitant increase in Emax and a decrease in the slope factor value. There were no significant age- or disease-related differences in any of the logistic parameter estimates that describe the FMR CRC, indicating that there are no detectable age- or disease-related alterations in ET-1-induced amplification of alpha 1-adrenergic-mediated contractions in these studies. In addition, the location of the FMR CRC was precisely predicted by the theoretical CRC for simple additivity of agonist effects. In conclusion, since relatively small increases in ET-1 concentrations were associated with significant increases in alpha 1-adrenergic-mediated contractile responses, these data provide further testimony to the importance of ET-1 in modulating corporal smooth muscle tone, and moreover, establish a conceptual framework for understanding the mechanism of its action(s).

  16. Hypercholesterolemia-induced erectile dysfunction: endothelial nitric oxide synthase (eNOS) uncoupling in the mouse penis by NAD(P)H oxidase

    Science.gov (United States)

    Musicki, Biljana; Liu, Tongyun; Lagoda, Gwen A.; Strong, Travis D.; Sezen, Sena F.; Johnson, Justin M.; Burnett, Arthur L.

    2010-01-01

    INTRODUCTION Hypercholesterolemia induces erectile dysfunction (ED) mostly by increasing oxidative stress and impairing endothelial function in the penis, but the mechanisms regulating reactive oxygen species (ROS) production in the penis are not understood. AIMS We evaluated whether hypercholesterolemia activates nicotinamide adenine dinucleotide phosphate (NAD[P]H) oxidase in the penis, providing an initial source of ROS to induce endothelial nitric oxide synthase (eNOS) uncoupling and endothelial dysfunction resulting in ED. METHODS Low-density-lipoprotein receptor (LDLR)–null mice were fed Western diet for 4 weeks to induce early-stage hyperlipidemia. Wild type (WT) mice fed regular chow served as controls. Mice received NAD(P)H oxidase inhibitor apocynin (10 mM in drinking water) or vehicle. Erectile function was assessed in response to cavernous nerve electrical stimulation. Markers of endothelial function (phospho [P]-vasodilator-stimulated-protein [VASP]-Ser-239), oxidative stress (4-hydroxy-2-nonenal [HNE]), sources of ROS (eNOS uncoupling and NAD[P]H oxidase subunits p67phox, p47phox, and gp91phox), P-eNOS-Ser-1177, and eNOS were measured by Western blot in penes. MAIN OUTCOME MEASURES Molecular mechanisms of ROS generation and endothelial dysfunction in hypercholesterolemia-induced ED. RESULTS Erectile response was significantly (Phypercholesterolemia increased (Phypercholesterolemia. CONCLUSION Activated NAD(P)H oxidase in the penis is an initial source of oxidative stress resulting in eNOS uncoupling, thus providing a mechanism of eNOS uncoupling and endothelial dysfunction in hypercholesterolemia-induced ED. PMID:20626609

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

    Directory of Open Access Journals (Sweden)

    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.

  18. AB028. Current status of pharmacotherapy for erectile dysfunction

    Science.gov (United States)

    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

  19. Visual Impairment

    Science.gov (United States)

    ... Surgery? Choosing the Right Sport for You Shyness Visual Impairment KidsHealth > For Teens > Visual Impairment Print A A ... with the brain, making vision impossible. What Is Visual Impairment? Many people have some type of visual problem ...

  20. Physical activity and exercise for erectile dysfunction: systematic review and meta-analysis.

    Science.gov (United States)

    Silva, André B; Sousa, Nelson; Azevedo, Luís F; Martins, Carlos

    2017-10-01

    A growing body of evidence suggests that physical activity and exercise may improve erectile function. To conduct a systematic review and meta-analysis evaluating the effects of physical activity modalities and exercise on erectile function in erectile dysfunction trials. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) statement. We searched 6 electronic databases between January 1990 and July 2016 and hand-searched reference lists for randomised controlled trials. Only patients with a diagnosis of erectile dysfunction were included. The mean differences between intervention and control groups were calculated for meta-analysis. 7 studies were eligible, including 478 participants allocated to aerobic, pelvic or combined exercise interventions. Follow-up ranged from 8 weeks to 2 years. The risk of bias in the trials was deemed moderate to high mainly due to impossible blinding of patients and personnel, as well as questionable blinding of outcome assessors. Random-effects meta-analyses were performed. Pooled data showed a statistically significant improvement in erectile function score (mean difference 3.85, 95% CI 2.33 to 5.37). A benefit was still demonstrable after a sensitivity analysis because the mean difference in International Index of Erectile Function (IIEF) score ranged from 3.39 (95% CI 1.92 to 4.87) to 4.28 (95% CI 2.54 to 6.02). A benefit was also detected in short-term and long-term interventions as well as in trials evaluating physical activity and exercise alone or in addition to usual care. The present study suggests that physical activity and exercise interventions improve patient-reported erectile dysfunction, particularly aerobic exercise with moderate-to-vigorous intensity. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. Oral phentolamine: an alpha-1, alpha-2 adrenergic antagonist for the treatment of erectile dysfunction.

    Science.gov (United States)

    Goldstein, I

    2000-03-01

    Phentolamine mesylate is an alpha-1 and alpha-2 selective adrenergic receptor antagonist which has undergone clinical trials for erectile dysfunction treatment. Biochemical and physiological studies in human erectile tissue have revealed a high affinity of phentolamine for alpha-1 and alpha-2 adrenergic receptors. Based on pharmacokinetic studies, it is suggested that 30-40 min following oral ingestion of 40 or 80 mg of phentolamine (Vasomax), the mean plasma phentolamine concentrations are sufficient to occupy the alpha-1 and -2 adrenergic receptors in erectile tissue and thereby result in inhibition of adrenergic-mediated physiologic activity. In large multi-center, placebo-controlled pivotal phase III clinical trials, the mean change in the erectile function domain of the International Index of Erectile Function scores (Questions 1-5 and 15) from screening to the end of treatment was significantly higher following use of active drug (40 mg and 80 mg) compared to placebo. Three to four times as many patients receiving phentolamine reported being satisfied or very satisfied compared with those receiving placebo. At doses of 40 mg and 80 mg respectively, 55% and 59% of men were able to achieve vaginal penetration with 51% and 53% achieving penetration on 75% of attempts. The correction of erectile dysfunction or improvement to a less severe category of dysfunction was experienced by 53% of men with the 80 mg dose and 40% with the 40 mg dose of phentolamine. All trends of response were the same regardless of any concomitant medication. There were no severe adverse events. At 40 mg, 7.7% experienced rhinitis and fewer than 3.1% experienced any other side effect of treatment. Phentolamine is safe, well tolerated and efficacious for the treatment of erectile dysfunction.

  2. Influential factors in the appearance of Erectile Dysfunction

    Directory of Open Access Journals (Sweden)

    Ángel Celada Rodríguez

    2016-08-01

    Full Text Available Objectives: Determine erectile dysfunction (ED prevalence in patients with cardiovascular risk factors (CVRF. Assess ED incidence in relation to the extent of controlling CVRF. Methodology: An observational, descriptive, analytical, cross-sectional study. Resulting in a sample of 210 people, of which 31 could not complete the study for various reasons (change of address, death, refused to complete questionnaire, etc.. Variables analysis. We analysed: Age, Level of education, Civil status, Height, Weight and Body mass index (BMI, SBP, DBP, Smoking habit, No. cigarettes/day, year smoking began, ex-smoker, year smoking stopped, Alcohol consumption, grams alcohol/week. Consumption of other drugs, frequency and type. Blood test: glucose, haemoglobin glycated haemoglobin, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, artherogenic index, creatinine, urea, GOT, GPT, gamma-GT and PSA. Urine test: microalbuminuria, proteinuria and creatinine clearance. ECG. Diabetes diagnosed at least one year ago and prescribed drugs to treat it. High blood pressure diagnosed at least one year ago and prescribed drugs to treat it. Dyslipidaemia (hypercholesterolaemia diagnosed at least one year ago and prescribed drugs to treat it. Concomitant diseases of at least one year and drugs (up to 3 . Results: Of the 210 selected people, 179 completed the questionnaire (85.2%. The mean age was 64.5 ± 11.6 years. When analysing all the study variables in relation to the main variable, presence or absence of ED, age is seen to play an important role in ED appearing as ED incidence rises with age. Blood pressure had no significant relationship with the studied variable, and the same can be said of BMI and its subdivision into normal weight and obesity. As regards toxic habits, neither cigarette smoking nor alcohol consumption influenced the presence of ED. The same may be said of the sociological-type variables (civil states, level of education. Regarding the

  3. Effect of vacuum therapy for vasculogenic erectile dysfunction:a report of 42 cases%阴茎负压吸引治疗血管性勃起功能障碍42例疗效观察

    Institute of Scientific and Technical Information of China (English)

    龙海; 刘良华; 邓程恩; 伍运筹

    2016-01-01

    Objective To study the efficiency of vacuum negative pressure aspiration for treating vascular male erectile dysfunction (ED). Methods Forty-two cases of vascular ED patients admitted to our hospital from Janu-ary 2013 to May 2015 were selected, of which 17 cases were artery (arterial ED group) and 25 cases were vein (venous ED group). All of them were treated for 6 months with vacuum negative pressure aspiration, and the likely improvements of erectile dysfunction (ED) before and after the treatment were measured by the International Index of Erectile Function (IIEF-5). Moreover, peak systolic vebcity (PSV), end diastolic velocity (EDV), resistive index (RI) of corpus cavernosum artery were also inspected with color Doppler ultrasound before and after the treatment. Results The rating of left and right sides PSV, PI and IIEF-5 of arterial ED group was improved after treatment and the difference was of statistical sig-nificance (P0.05). Treatment efficiency as well as sexual satisfaction rate were both 64.7%(11/17). Compare with before treatment, there was no statistical significance for left and right sides PSV of venous ED group after treatment (P>0.05). EDV of venous ED group after treatment was significantly lower than before treatment (P0.05),治疗有效率及对性生活满意率均为64.7%(11/17);静脉性ED组经治疗后左右两侧PSV与治疗前比较差异无统计学意义(P>0.05),EDV较治疗前降低,差异有统计学意义(P<0.05),RI及IIEF-5评分较治疗前提高,差异有统计学意义(P<0.05),治疗有效率及对性生活满意率分别为52%(13/25)和48%(12/25);此外,治疗后动脉性ED组患者的IIEF-5评分为(17.47±3.97)分,高于静脉性ED组的(14.35±3.98)分,差异有统计学意义(P<0.05)。结论阴茎真空负压吸引治疗血管性勃起功能障碍有效,其中治疗动脉性ED效果更好,患者对性生活的满意度更高。

  4. Acupuncture for erectile dysfunction: a systematic review protocol.

    Science.gov (United States)

    Cui, Xiaoming; Li, Xiaoli; Peng, Weina; Zhou, Jing; Yu, Jinna; Ye, Yongming; Liu, Zhishun

    2015-03-24

    This systematic review protocol aims to provide a protocol for assessing the safety and effectiveness of acupuncture for the treatment of erectile dysfunction(ED). Previous systematic reviews did not draw convincing conclusions owing to high heterogeneity and few included randomised controlled trials, so it is necessary to reassess the efficacy and safety of acupuncture for ED. Eight electronic databases will be searched: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PubMed, EMBASE, PsycInfo, the Chinese Biomedical Literature Database (CBM), the Chinese Medical Current Content (CMCC) and the China National Knowledge Infrastructure (CNKI). Related Chinese literature will be searched in other Chinese databases. All relevant randomised controlled trials in English or Chinese without any restrictions of publication type will be included. The main outcome measure will be improvements in sexual activity assessed by validated questionnaires. Assessment of risk of bias, data synthesis and subgroup analysis will be carried out using Review Manager 5.3. The results of the systematic review will be disseminated via publication in a peer-reviewed journal and presented at a relevant conference. The data we will use do not include individual patient data, so ethical approval is not required. PROSPERO CRD42014013575. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Growth factors for therapeutic angiogenesis in hypercholesterolemic erectile dysfunction

    Institute of Scientific and Technical Information of China (English)

    Donghua Xie; Brian H. Annex; Craig F. Donatucci

    2008-01-01

    The past decade has seen an explosion of new information on the physiology of penile erection, and pathophysiology of erectile dysfunction (ED). Hypercholesterolemia is a chronic condition that can lead to degeneration in the vasculature bed and can result in ED if the penile vasculature is involved. Angiogenesis is the growth of new blood vessels from preexisting vasculature. Therapeutic angiogenesis seeks to harness the mechanisms of vascular growth to treat disorders of inadequate tissue perfusion, such as coronary artery disease and ED. There have been tremendous changes in the field of therapeutic angiogenesis over the past decade, and there is much promise for the future.Initial preclinical work with cytokine growth factor delivery resulted in a great deal of enthusiasm for the treatment of ischemic heart and/or peripheral vascular disease, though clinical studies have not achieved similar success. With an increased understanding of the complex mechanisms involved in angiogenesis, novel therapies which target multiple different angiogenic pathways are also being developed and tested. The penis is a convenient tissue target for gene therapy because of its external location and accessibility, the ubiquity of endothelial lined spaces, and low level of blood flow, especially in the flaccid state. Therapeutic angiogenesis is an exciting field that continues to evolve. This review will focus on the development of growth factors for hypercholesterolemic ED, the use of various growth factors for ED therapy, their routes of delivery, and the results in animal studies.

  6. Management of erectile dysfunction: barriers faced by general practitioners

    Institute of Scientific and Technical Information of China (English)

    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.

  7. Efficacy of sildenafil on erectile dysfunction of newlyweds.

    Science.gov (United States)

    He, Q; Yang, J-R; Liu, L-F

    2009-12-01

    To explore the efficacy of sildenafil on erectile dysfunction (ED) of newlyweds, the author studied 60 outpatients within a month of marriage, who suffered from sexual intercourse (SI) failure caused by ED and showed no improvement after receiving sex education and psychological consultation. The patients were given oral sildenafil, 100 mg for the first and second times, 50 mg for the third and fourth times, no more than once every day, with a 1- to 3-day break between every two times. Four times of sildenafil administration formed one course of treatment. Sildenafil was taken 1 h before SI and was aided with adequate sexual stimulation. The rates of successful SI due to improved erection during and after a course of sildenafil treatment were 93.3% (56/60) and 85% (51/60), both P > 0.05. In the groups with one and more than one SI failure the successful SI rates after a sildenafil treatment course were 93.1% (27/29) and 77.4% (24/31), both P > 0.05. Oral sildenafil with psychological therapy in the treatment of ED of newlyweds proves to be effective in restoring the patients' sexual function and relieving their mental pressure or stress.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  9. Topical alprostadil cream for the treatment of erectile dysfunction.

    Science.gov (United States)

    Becher, Edgardo

    2004-03-01

    Erectile dysfunction (ED) has serious negative consequences on both sexual experience and emotional well being and affects a broad range of age groups. The prevalence of ED is associated with increasing age and has been reported to be as high as 70%. Although the disorder is common and underdiagnosed, its treatment can significantly improve patients' quality of life. Systemic treatment with oral phosphodiesterase type-5 (PDE-5) inhibitors is the current standard of care for patients with ED. Some patients, however, have absolute contraindications for PDE-5 inhibitors. In addition, these agents can be associated with adverse effects. Furthermore, because PDE-5 inhibitors are not as effective in patients who have undergone radical prostatectomy or who have severe vascular disease, a substantial unmet medical need exists among patients who have ED as a result of these conditions. Consequently, PDE-5 inhibitor therapy is associated with a high rate of discontinuation, as are intracavernosal or transurethral therapies, which are inconvenient and invasive. Several studies, including four double-blind, placebo-controlled, Phase II trials, show that alprostadil topical cream is efficacious and well-tolerated in ED in patients with mild-to-severe symptoms, in those undergoing treatment for cardiovascular diseases and diabetes and in otherwise healthy ED patients. Thus, alprostadil topical cream is a potential first-choice alternative for ED in patients who do not respond or who cannot tolerate or do not accept PDE-5 inhibitor therapy.

  10. Urinary and erectile dysfunction in multiple system atrophy (MSA).

    Science.gov (United States)

    Papatsoris, A G; Papapetropoulos, S; Singer, C; Deliveliotis, C

    2008-01-01

    Multiple system atrophy (MSA) is a neurodegenerative disease of undetermined etiology that occurs sporadically and manifests itself as a combination of parkinsonian, autonomic, cerebellar, and pyramidal signs. Despite the lack of effective therapies, some of the symptoms may be, at least temporarily, improved with adequate symptomatic therapies. Urinary and erectile dysfunction (ED) symptoms are prominent early features in male MSA patients. Lower urinary tract infections (UTIs) are a major cause of morbidity and mortality in this disorder. More than 50% of MSA patients suffer from recurrent lower UTIs and a significant number (approximately 25%) die of complications related to them. Urogenital symptoms in MSA are usually due to a complex mixture of central and peripheral nervous abnormalities, sometimes superimposed on previous local pathological conditions such as benign prostatic hyperplasia and perineal laxity. There have been instances were MSA-related urological symptoms were confused with symptoms of benign prostatic hyperplasia, leading to unnecessary urological surgery. In this review, we present the phenotypic range and therapeutic approaches for common storage and voiding urological symptoms and ED, in patients with MSA.

  11. [Stress, anxiety, depression and erectile dysfunction in patients with diabetes mellitus].

    Science.gov (United States)

    Mekhtiev, T V

    2013-01-01

    It was studied the erectile dysfunction (ED), the severity of depression and stress in patients with diabetes mellitus (DM) in the stage of compensation and decompensation, also investigated the relationship between the duration of the disease and the clinical manifestation of the various forms of ED. On a material of 293 male patients aged 17-60 years. The duration of diabetes ranged from 6 months to 30 years (at avarage - 17,4±17,5 years). Performed routine and special methods of investigation (pharmacodopplerography), also fixed psychogenic, organic and mixed forms of erectile dysfunction in correlation with the clinical form of the current CD according International index of Erectile function (EF) and the tables of Juneman et al. Found that in patients with type I and II diabetes anxiety and depression were found in 32.1 % of cases, and were accompanied by ED. In the state of decompensation of diabetes mellitus manifestation of anxiety, depression and erectile dysfunction were observed more often than in a state of long-term compensation. Between the increase in the period of limitation of the DM and the incidence of organic and mixed forms of ED there is a direct correlation, and between the increase of diabetes duration and the frequency of occurrence of psychogenic form of erectile dysfunction - inversly relationship.

  12. High Triglycerides Predicts Arteriogenic Erectile Dysfunction and Major Adverse Cardiovascular Events in Subjects With Sexual Dysfunction.

    Science.gov (United States)

    Corona, Giovanni; Cipriani, Sarah; Rastrelli, Giulia; Sforza, Alessandra; Mannucci, Edoardo; Maggi, Mario

    2016-09-01

    The atherogenic role of triglycerides (TG) remains controversial. The aim of the present study is to analyze the contribution of TG in the pathogenesis of erectile dysfunction (ED) and to verify the value of elevated TG in predicting major adverse cardiovascular events (MACE). An unselected series of 3,990 men attending our outpatient clinic for sexual dysfunction was retrospectively studied. A subset of this sample (n = 1,687) was enrolled in a longitudinal study. Several clinical, biochemical, and instrumental (penile color Doppler ultrasound; PCDU) factors were evaluated. Among the patients studied, after adjustment for confounders, higher TG levels were associated with arteriogenic ED and a higher risk of clinical and biochemical hypogonadism. Conversely, no association between TG and other sexual dysfunctions was observed. When pathological PCDU parameters-including flaccid acceleration (<1.17 m/sec(2)) or dynamic peak systolic velocity (PSV <35 cm/sec)-were considered, the negative association between impaired penile flow and higher TG levels was confirmed, even when subjects taking lipid-lowering drugs or those with diabetes were excluded from the analysis (OR = 6.343 [1.243;32.362], P = .026 and 3.576 [1.104;11.578]; P = .34 for impaired acceleration and PSV, respectively). Similarly, when the same adjusted models were applied, TG levels were associated with a higher risk of hypogonadism, independently of the definition criteria (OR = 2.892 [1.643;5.410], P < .0001 and 4.853 [1.965;11.990]; P = .001 for total T <12 and 8 nM, respectively). In the longitudinal study, after adjusting for confounders, elevated TG levels (upper quartile: 162-1686 mg/dL) were independently associated with a higher incidence of MACE (HR = 2.469 [1.019;5.981]; P = .045), when compared to the rest of the sample. Our data suggest an association between elevated TG and arteriogenic ED and its cardiovascular (CV) risk stratification. Whether the use of TG lowering drugs

  13. Penile rehabilitation: the evolutionary concept in the management of erectile dysfunction.

    Science.gov (United States)

    Hakky, Tariq S; Baumgarten, Adam S; Parker, Justin; Zheng, Yin; Kongnyuy, Mike; Martinez, Daniel; Carrion, Rafael E

    2014-04-01

    A compromise in erectile function is commonly experienced after radical prostatectomy and has been attributed to injury to vascular, neurogenic, and smooth muscle. The concept of rehabilitation after organ injury is not a novel concept and is one that has been applied to all aspects of medicine. Penile rehabilitation has been classically defined as the use of a device or pharmacologic agent to aid erectile function recovery after radical prostatectomy. Here we redefine penile rehabilitation as the use of any device, medication, or intervention to promote male sexual function as a primer before and after any insult to the penile erectile physiologic axis. We also review the epidemiology, rational and current literature on penile rehabilitation after prostatectomy.

  14. Evaluation of Crocus sativus L. (saffron) on male erectile dysfunction: a pilot study.

    Science.gov (United States)

    Shamsa, Ali; Hosseinzadeh, Hossein; Molaei, Mahmood; Shakeri, Mohammad Taghi; Rajabi, Omid

    2009-08-01

    In this study, the effect of Crocus sativus (saffron) was studied on male erectile dysfunction (ED). Twenty male patients with ED were followed for ten days in which each morning they took a tablet containing 200mg of saffron. Patients underwent the nocturnal penile tumescence (NPT) test and the international index of erectile function questionnaire (IIEF-15) at the start of the treatment and at the end of the ten days. After the ten days of taking saffron there was a statistically significant improvement in tip rigidity and tip tumescence as well as base rigidity and base tumescence. ILEF-15 total scores were significantly higher in patients after saffron treatment (before treatment 22.15+/-1.44; after treatment 39.20+/-1.90, pSaffron showed a positive effect on sexual function with increased number and duration of erectile events seen in patients with ED even only after taking it for ten days.

  15. Analysis of erectile responses to H2S donors in the anesthetized rat.

    Science.gov (United States)

    Jupiter, Ryan C; Yoo, Daniel; Pankey, Edward A; Reddy, Vishwaradh V G; Edward, Justin A; Polhemus, David J; Peak, Taylor C; Katakam, Prasad; Kadowitz, Philip J

    2015-09-01

    Hydrogen sulfide (H2S) is a biologically active endogenous gasotransmitter formed in penile tissue that has been shown to relax isolated cavernosal smooth muscle. In the present study, erectile responses to the H2S donors sodium sulfide (Na2S) and sodium hydrosulfide (NaHS) were investigated in the anesthetized rat. Intracavernosal injections of Na2S in doses of 0.03-1 mg/kg increased intracavernosal pressure and transiently decreased mean arterial pressure in a dose-dependent manner. Blood pressure responses to Na2S were rapid in onset and short in duration. Responses to Na2S and NaHS were similar at doses up to 0.3 mg/kg, after which a plateau in the erectile response to NaHS was reached. Increases in intracavernosal pressure in response to Na2S were attenuated by tetraethylammonium (K(+) channel inhibitor) and iberiotoxin (large-conductance Ca(2+)-activated K(+) channel inhibitor), whereas glybenclamide [ATP-sensitive K(+) (KATP) channel inhibitor] and inhibitors of nitric oxide (NO) synthase, cyclooxygenase, and cytochrome P-450 epoxygenase had no effect. These data indicate that erectile responses to Na2S are mediated by a tetraethylammonium- and iberiotoxin-sensitive mechanism and that KATP channels, NO, or arachidonic acid metabolites are not involved. Na2S did not alter erectile responses to sodium nitroprusside (NO donor) or cavernosal nerve stimulation, indicating that neither NO nor cGMP metabolism are altered. Thus, Na2S has erectile activity mediated by large-conductance Ca(2+)-activated K(+) channels. It is suggested that strategies that increase H2S formation in penile tissue may be useful in the treatment of erectile dysfunction when NO bioavailability, KATP channel function, or poor responses to PGE1 are present.

  16. Erectile Dysfunction in Male Adults With Atopic Dermatitis and Psoriasis.

    Science.gov (United States)

    Egeberg, Alexander; Hansen, Peter R; Gislason, Gunnar H; Skov, Lone; Thyssen, Jacob P

    2017-03-01

    Patients with psoriasis have increased risk of cardiovascular disease, but data on atopic dermatitis (AD) are less clear-cut. However, it is well-established that erectile dysfunction (ED) can serve as a risk marker for coronary disease. To investigate the incidence, prevalence, and risk of ED in men with psoriasis and AD. The sample included all Danish men at least 30 years old. In patients with AD and psoriasis, we determined disease severity based on use of systemic therapy. We performed a cross-sectional study (January 1, 2008) using logistic regression to estimate the prevalence and odds ratio of ED. Moreover, in a cohort study design, patients were followed from January 1, 2008 through December 31, 2012, and Cox regression models were used to estimate adjusted hazard ratios of new-onset ED. Models were adjusted for potential confounding factors, including age, socioeconomic status, health care consumption, smoking, alcohol abuse, diabetes, and cholesterol-lowering drug use. The outcome was initiation of pharmacotherapy used for treatment of ED. The sample consisted of 1,756,679 Danish men (age range = 30-100 years), of which 2,373 and 26,536 had adult AD (mild = 1,072; severe = 1,301) and psoriasis (mild = 21,775; severe = 4,761), respectively. Mean ages (SDs) were 53.0 (14.6), 46.7 (12.0), and 56.3 (13.8) years for the general population, patients with AD, and patients with psoriasis, respectively. Prevalences of ED were 8.7%, 6.7%, and 12.8% for the general population, patients with AD, and patients with psoriasis, respectively. Adjusted odds ratios (logistic regression) of ED were decreased in patients with AD (0.68; 0.57-0.80) but increased in those with psoriasis (1.15; 1.11-1.20). Adjusted odds ratios for mild and severe AD were 0.63 (0.48-0.82) and 0.72 (0.58-0.88), respectively, and those for psoriasis these were 1.16 (1.11-1.21) and 1.13 (1.03-1.23). Adjusted hazard ratios (Cox regression) were 0.92 (0.76-1.11) for AD and 1.14 (1.08-1.20) for

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  19. Medical treatment of erectile dysfunction: too many medical prescriptions?

    Science.gov (United States)

    Capogrosso, Paolo; Ventimiglia, Eugenio; Oreggia, Davide; Salonia, Andrea; Montorsi, Francesco

    2017-08-01

    Erectile dysfunction (ED) is a worldwide commonly reported condition; epidemiological data showed a prevalence ranging from 2.3 to 53.4% within different population subsets. In this context, the advent of phosphodiesterase type 5 inhibitors (PDE5is) in the second mid of 1990s has deeply changed the treatment scenario of this bothersome condition. Being user-friendly compounds with an excellent overall safety profile, PDE5is emerged as the first-line treatment for ED, thus overcoming topical alprostadil and intracavernous injections (ICIs). However, available data on treatment-utilization patterns and medical prescriptions of PDE5is showed a range of as wide as 22-78% of patients reporting to purchase PDE5is even without a proper medical prescription. Moreover, an increase in the recreational use of PDE5is among young men has been observed in the last decades, with a worrisome diffusion of potential health-risky behaviours associated with this habit. Indeed, treatment of ED should carefully follow internationally based clinical guidelines to avoid inappropriate drug prescriptions, which may eventually expose treated patients to drug-related side effects. Thereof, a careful assessment of the so-called modifiable and reversible ED risk factors along with a patient-tailored screening for potential contraindications to the treatment itself should be performed in every case. Lastly, although conclusive data still lack, the potential association between life-risky PDE5is side effects (i.e. cardiovascular adverse events, melanoma skin cancer and worsening of prostate cancer outcomes) should be carefully taken into account when counselling patients for ED treatment.

  20. Intraurethral alprostadil for erectile dysfunction: a review of the literature.

    Science.gov (United States)

    Costa, Pierre; Potempa, Axel-Juerg

    2012-12-03

    The global burden of erectile dysfunction (ED) is increasing. It is estimated that 8-19% of men in Europe have ED and that by 2025 the prevalence of ED worldwide will reach 322 million. The gold standard therapy for ED is an oral phosphodiesterase type 5 (PDE5) inhibitor, but they are not suitable for everyone; approximately 25% of patients do not respond to this therapy and it is contraindicated in others, e.g. those with vascular disease. When PDE5 inhibitors are not suitable, available options include intraurethral and intracavernosal alprostadil - a synthetic vasodilator chemically identical to the naturally occurring prostaglandin E(1) indicated for the treatment of ED. Intraurethral alprostadil is delivered by the Medicated System for Erection (MUSE).- a single-use pellet containing alprostadil suspended in polyethylene glycol administered using an applicator. It is recommended that intraurethral alprostadil be initiated at a dose of 500 μg, as it has a higher efficacy than the 250 μg dose, with minimal differences with regard to adverse events. Data from key clinical studies of intraurethral alprostadil show that it has a fast onset of effect and a good safety profile, with no occurrences of priapism, fibrosis (as seen with intracavernosal injection) or the typical systemic effects observed with oral ED pharmacological treatments. Intraurethral alprostadil has been associated with high patient preference, acceptance rates and quality of life versus intracavernosal injection due to its ease of administration. Evidence has shown that combination treatment with sildenafil may be a possible efficient alternative when single oral or local treatment has failed. Intraurethral alprostadil can be administered in all patients irrespective of ED origin and should be the first option in patients with ED for whom therapy with PDE5 inhibitors has failed or is contraindicated.

  1. Effect of Icariin on Cyclic GMP Levels and on the mRNA Expression of cGMP-binding cGMP-specific Phosphodiesterase (PDE5) in Penile Cavernosum

    Institute of Scientific and Technical Information of China (English)

    JIANG Zhaojian; HU Benrong; WANG Jialing; TANG Qiang; TAN Yan; XIANG Jizhou; LIU Juyan

    2006-01-01

    To further investigate the mechanisms of action of icariin (ICA), we assessed the effects of ICA on the in vitro formation of cGMP and cAMP in isolated rabbit corpus cavernosum. Isolated segments of rabbit corpus cavernosum were exposed to increasing concentrations of ICA and the dose-dependent accumulation of cGMP and cAMP was determined in the tissues samples by means of 125I radioimmunoassay. Responses of the isolated tissues preparations to ICA were compared with those obtained with the reference compounds sildenafil (Sild). Furthermore, the effects of ICA on the mRNA expression of specific cGMP-binding phosphodiesterase type V (PDE5) in rat penis were also observed. After incubation with ICA for 6 h or 14 h respectively, the levels of PDE5 mRNA were examined by reverse transcriptase polymerase chain reaction (RT-PCR). The results showed that ICA increased cGMP concentrations directly (P<0.05), but there was no significant effect on cAMP concentrations (P>0.05). In the presence of sodium nitroprusside (SNP), a stimulatory agent of cGMP,both ICA and Sild increased cGMP concentrations with increasing dose (P<0.01). Their EC50 was 4.62 (ICA) and 0.42 (Sild) μmol/L respectively. Under the same condition, ICA and Sild unaltered cAMP level significantly (P>0.05). There were PDE5A1 and PDE5A2 mRNA expressions in rat corpus cavernosum with PDE5A2 being the dominant isoform. ICA could obviously inhibit these two isoforms mRNA expression in rat penis, and decrease PDE5A1 more pronouncedly (P< 0.01). The present study indicated that the aphrodisiac mechanisms of icariin involved the NO-cGMP signal transduction pathway, with increasing cGMP levels in the corpus cavernosum smooth muscle. The inhibitory effect of icariin on PDE5 mRNA expression, especially on PDE5A1, might account for its molecular mechanisms for its long-term activity.

  2. Effects of a Topical Saffron (Crocus sativus L) Gel on Erectile Dysfunction in Diabetics: A Randomized, Parallel-Group, Double-Blind, Placebo-Controlled Trial.

    Science.gov (United States)

    Mohammadzadeh-Moghadam, Hossein; Nazari, Seyed Mohammad; Shamsa, Ali; Kamalinejad, Mohammad; Esmaeeli, Habibollah; Asadpour, Amir Abbas; Khajavi, Abdoljavad

    2015-10-01

    Erectile dysfunction is a man's persistent or recurrent inability to achieve and maintain erection for a satisfactory sexual relationship. As diabetes is a major risk factor for erectile dysfunction, the prevalence of erectile dysfunction among diabetic men has been reported as 35% to 90%. This randomized, parallel-group, double-blind, placebo-controlled trial investigated the effects of a topical saffron (Crocus sativus L) gel on erectile dysfunction in diabetic men. Patients were randomly allocated to 2 equal groups (with 25 patients each). The intervention group was treated with topical saffron, and the control received a similar treatment with placebo. The 2 groups were assessed using the International Index of Erectile Function Questionnaire before the intervention and 1 month after the intervention. Compared to placebo, the prepared saffron gel could significantly improve erectile dysfunction in diabetic patients (P saffron can be considered as a treatment option for diabetic men with erectile dysfunction.

  3. Intracavernous injection in the treatment of erectile dysfunction after radical prostatectomy: an observational study

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    Joaquim de Almeida Claro

    Full Text Available CONTEXT: Despite the recent improvements in performing radical retropubic prostatectomy that have led to a considerable decrease in the complication rate, erectile dysfunction still represents a major problem. Moreover, less invasive treatment options that are emerging for erectile dysfunction have not shown satisfactory results in managing these patients. OBJECTIVE: To study the efficacy and side effects of self-injection therapy in the treatment of men who had become impotent after undergoing radical prostatectomy due to prostate cancer, over a study period of 96 months. DESIGN: Observational study. SETTING: University Referral Center. PARTICIPANTS: 168 patients with erectile dysfunction, aged 43 to 78 years old, who underwent radical retropubic prostatectomy due to localized prostate cancer. PROCEDURES: The patients were treated with self-injection therapy using papaverine, phentolamine and prostaglandin E1, at home. RESULTS: This study showed an acceptable 94.6% success rate, with no life-threatening complications. In addition to this, our series presented a 13.1% cure rate with this therapy. CONCLUSION: Self-injection therapy with papaverine, phentolamine and prostaglandin E1 is effective and safe in the treatment of erectile dysfunction after radical prostatectomy.

  4. [Modernity in the treatment of erectile dysfunction: Levitra (vardenafil) in the form of oral dispersible tablet].

    Science.gov (United States)

    Gamidov, S I; Iremashvili, V V; Popova, A Iu

    2013-01-01

    Due to high efficiency, prompt action and low incidence of side effects, phosphodiesterase type 5 inhibitors are the drugs of first choice in the treatment of erectile dysfunction (ED). One of the most widely used drugs in this group currently is vardenafil. Vardenafil has a number of properties that distinguish it from other drugs in this group: high selectivity and the highest inhibitory activity. Recently, new form of this drug, an oral-dispersible tablet (Levitra ODT) was developed. It dissolves in the mouth for a few seconds and does not required to drink water. This feature Levitra ODT enables easy administration of the drug, which provides the desired effect at any time and in any circumstances. Studies have shown that of simplicity of drug intake is one of the most important characteristics of the "ideal" treatment for erectile dysfunction from the point of view of patients. Currently, Levitra ODT is available at a dose of 10 mg. Two large, randomized, double-blind placebo-controlled studies, POTENT I and POTENT II, with participation of more than 700 patients with erectile dysfunction divided into 2 age groups, have shown a high efficacy and good tolerability of Levitra ODT in both groups. Thus, Levitra ODT is a new and promising form of the drug vardenafil, more convenient to use. There is no doubt that Levitra ODT will occupy an important place in the arsenal of modern methods of treatment of erectile dysfunction due to its high efficacy, good tolerability and usability.

  5. Validation of the International Index of Erectile Function (IIFE) for Use in Brazil

    Energy Technology Data Exchange (ETDEWEB)

    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.

  6. Intracavernosal alprostadil is effective for the treatment of erectile dysfunction in diabetic men

    NARCIS (Netherlands)

    Heaton, JPW; Lording, D; Liu, SN; Litonjua, AD; Guangwei, L; Kim, SC; Kim, JJ; Zhi-Zhou, S; Israr, D; Niazi, D; Rajatanavin, R; Suyono, S; Benard, F; Casey, R; Brock, G; Belanger, A

    2001-01-01

    The efficacy and safety of intracavernosal alprostadil was evaluated for the treatment of erectile dysfunction in men with type I or type II diabetes mellitus. This was an open-label, flexible dose-escalating study involving 336 men (77% of whom were Asian/Oriental) enrolled by 15 centres in Austral

  7. Outcome and erectile function following treatment of priapism: An institutional experience

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    Dilip Kumar Pal

    2016-01-01

    Conclusion: Patients with late presentation and those patients requiring higher treatment modalities (e.g., proximal shunts for achieving detumescence will subsequently have a poor erectile function. These patients should be counseled about the early penile prosthesis placement during initial surgical management.

  8. Lower Urinary Tract Symptoms, Erectile Dysfunction, and Quality of Life in Poststroke Men

    DEFF Research Database (Denmark)

    Tibaek, Sigrid; Gard, Gunvor; Dehlendorff, Christian

    2017-01-01

    The aim of the current study was to compare lower urinary tract symptoms (LUTS), erectile dysfunction (ED), and quality of life (QoL) in poststroke and healthy men. Thirty poststroke men with stroke-related LUTS, and as controls, 96 healthy men participated in this controlled, cross-sectional stu...

  9. Perineal schwannoma: an unusual tumor and clinical presentation - first case with erectile dysfunction associated with this neoplasm.

    Science.gov (United States)

    Cecconi, Filippo; Maiolino, Giuseppe; Lanzi, Federico; Vittori, Gianni; Gentile, Filippo; Pizzirusso, Gerardo; Barbanti, Gabriele; Tripodi, Sergio

    2017-06-26

    Perineal schwannomas (PS) are very rare benign tumors with few cases reported in literature and none of these reports erectile dysfunction among clinical presentations. We report a case of PS with unusual clinical presentation showing erectile dysfunction associated with perineal pain and discomfort during defecation, and the postoperative residual pain and erectile dysfunction treatment. On the basis of a literature review of all cases reported and on our case reported, we have delineated a clinical, diagnostic, and therapeutic profile of PS, summarized in a useful table.

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

    Science.gov (United States)

    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.

  11. Neurturin enhances the recovery of erectile function following bilateral cavernous nerve crush injury in the rat

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    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

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

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    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.

  13. The interaction of l-cysteine/H2S pathway and muscarinic acetylcholine receptors (mAChRs) in mouse corpus cavernosum.

    Science.gov (United States)

    Aydinoglu, Fatma; Dalkir, Fatma Tugce; Demirbag, Hatice Oruc; Ogulener, Nuran

    2017-08-25

    The aim of this study was to investigate the possible interaction of l-cysteine/H2S pathway and muscarinic acetylcholine receptors (mAChRs) in the mouse corpus cavernosum (CC). l-cysteine (endogenous H2S substrate; 10(-6)-10(-3) M), sodium hydrogen sulfide (NaHS; exogenous H2S; 10(-6)-10(-3) M) and acetylcholine (10(-9)-10(-4) M) produced concentration-dependent relaxation in isolated mouse CC tissues. Relaxations to endogenous and exogenous H2S were reduced by non-selective mAChR antagonist atropine (5 × 10(-5) M), selective M1 mAChR antagonist pirenzepine (5 × 10(-5) M) and selective M3 mAChR antagonist 4-DAMP (10(-7) M) but not by selective M2 mAChR antagonist AF-DX 116 (10(-6) M). Also, acetylcholine-induced relaxations were reduced by atropine, pirenzepine, 4-DAMP and AF-DX 116, confirming the selective effects of mAChR antagonists. Furthermore, acetylcholine-induced relaxations were attenuated by cystathionine-gamma-lyase (CSE) inhibitor d,l-propargylglycine (PAG, 10(-2) M) and cystathionine-β-synthase inhibitor (CBS) aminooxyacetic acid (AOAA, 10(-3) M). l-nitroarginine, nitric oxide synthase inhibitor, augmented the inhibitory effects of mAChR antagonists and H2S enzyme inhibitors on acetylcholine-induced relaxations. In addition, the existence and localization of CSE, CBS and 3-MST were demonstrated in mouse CC. Furthermore, tissue acetylcholine release was significantly increased by l-cysteine but not by exogenous H2S. The increase in acetylcholine level was completely inhibited by AOAA and PAG. These results suggest that M1 and M3 mAChRs contributes to relaxant effect mediated by endogenous H2S but at same time l-cysteine triggers acetylcholine release from cavernosal tissue. Also, the role of NO in the interaction of l-cysteine/H2S pathway and muscarinic acetylcholine receptors (mAChRs) could not be excluded. Copyright © 2017. Published by Elsevier Inc.

  14. Functional Variations in the NOS3 Gene Are Associated With Erectile Dysfunction Susceptibility, Age of Onset and Severity in a Han Chinese Population.

    Science.gov (United States)

    Yang, Bo; Liu, Liangren; Peng, Zhufeng; Lu, Dongliang; Ren, Zhengju; Liu, Shengzuo; Yang, Xiling; Liao, Jian; Dong, Qiang

    2017-04-01

    Impaired function of endothelial nitric oxide synthase (eNOS) is involved in the pathologic processes of erectile dysfunction (ED), and three functional polymorphisms (G894T, T-786C, and a tandem repeat of 27 bp in intron 4) in the NOS3 gene, which encodes eNOS, are associated with the clinical characteristics of ED in several populations. To investigate the effect of these variations of NOS3 on ED phenotypes and the response to sildenafil in a Han Chinese population. This case-control study enrolled 112 patients with ED and 156 age-matched healthy men. Their medical history and laboratory data were collected. ED severity and response to sildenafil were assessed using the five-item International Index of Erectile Function (IIEF-5) score. Routine polymerase chain reaction and Sanger sequencing were used to genotype the three polymorphisms of NOS3. The frequencies of alleles, genotypes, and haplotypes of the loci in patients and controls; the IIEF-5 scores of patients carrying the risk and non-risk genotype; and the frequencies of risk and non-risk genotypes in patients with different ages at onset and responses to sildenafil were assessed. The frequencies of drinkers and diabetic and hyperlipidemic patients in the ED group were higher than those in the age-matched control group (P NOS3 polymorphisms were significantly different between patients with ED and controls. An increased risk for earlier onset of ED was observed in the G894T risk genotype carriers (odds ratio = 3.572; P NOS3 functional polymorphisms on ED suggests their application potential as a molecular biomarker in predicting ED susceptibility and severity in the Han Chinese population. This study provides strong evidence that NOS3 functional variation is an independent risk factor for ED in the Han Chinese population, which should be confirmed in larger cohorts considering the limited number of subjects in this study. These results are the first to identify a clear association between NOS3 functional

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

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    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.

  16. The opiorphin gene (ProL1) and its homologues function in erectile physiology.

    Science.gov (United States)

    Tong, Yuehong; Tar, Moses; Melman, Arnold; Davies, Kelvin

    2008-09-01

    To determine if ProL1, a member of the opiorphin family of genes, can modulate erectile physiology, as it encodes a peptide which acts as a neutral endopeptidase inhibitor, other examples of which (Vcsa1, hSMR3A) modulate erectile physiology. We cloned members of the opiorphin family of genes into the same mammalian expression backbone (pVAX); 100 microg of these plasmids (pVAX-Vcsa1, -hSMR3A, -hSMR3B and -ProL1) were injected intracorporally into retired breeder rats and the affect on erectile physiology assessed visually, by histology and by measuring the intracavernous pressure (ICP) and blood pressure (BP). As a positive control, rats were treated with pVAX-hSlo (expressing the MaxiK potassium channel) and as a negative control the empty backbone plasmid was injected (pVAX). We also compared the level of expression of ProL1 in corporal tissue of patients not reporting erectile dysfunction (ED), ED associated with diabetes and ED not caused by diabetes. Gene transfer of plasmids expressing all members of the opiorphin family had a similar and significant effect on erectile physiology. At the concentration used in these experiments (100 microg) they resulted in higher resting ICP, and histological and visual analysis showed evidence of a priapic-like condition. After electrostimulation of the cavernous nerve, rats had significantly better ICP/BP than the negative control (pVAX). Gene transfer of pVAX-hSlo increased the ICP/BP ratio to a similar extent to the opiorphin homologues, but with no evidence for a priapic-like condition. Corpora cavernosa tissue samples obtained from men with ED, regardless of underlying causes, had significant down-regulation of both hSMR3A and ProL1. All members of the human opiorphin family of genes can potentially modulate erectile physiology. Both hSMR3 and ProL1 are down-regulated in the corpora of men with ED, and therefore both genes can potentially act as markers of ED.

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

    Institute of Scientific and Technical Information of China (English)

    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

  18. Beneficial effects of switching from β-blockers to nebivolol on the erectile function of hypertensive patients

    Institute of Scientific and Technical Information of China (English)

    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.

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

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    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.

  20. The SSES-E: a measure of sexual self-efficacy in erectile functioning.

    Science.gov (United States)

    Libman, E; Rothenberg, I; Fichten, C S; Amsel, R

    1985-01-01

    The purpose of this study was to develop and validate the Sexual Self-Efficacy Scale (SSES-E) for erectile disorder. The subjects consisted of 15 heterosexual couples with nonproblematic sexual functioning (normal group) and a sexually dysfunctional sample consisting of nine heterosexual couples and eight heterosexual single males (dysfunctional group). Most of the males in the dysfunctional sample were diagnosed as suffering from erectile disorder. Reliability of the SSES-E, based on test-retest and split-half correlations and on item analyses, appears to be reasonable. Validity, measured in three different ways, is also acceptably high. Suggestions for the use of this instrument in clinical practice and for future research are made.

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

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    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.

  2. Advances in the treatment of erectile dysfunction: what’s new and upcoming?

    Science.gov (United States)

    Patel, Chintan K.; Bennett, Nelson

    2016-01-01

    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. PMID:27516878

  3. An open label, randomized, fixed-dose, crossover study comparing efficacy and safety of sildenafil citrate and saffron (Crocus sativus Linn.) for treating erectile dysfunction in men naïve to treatment.

    Science.gov (United States)

    Safarinejad, M R; Shafiei, N; Safarinejad, S

    2010-01-01

    Saffron (Crocus sativus Linn.) have been perceived by the public as a strong aphrodisiac herbal product. However, studies addressing the potential beneficial effects of saffron on erectile function (EF) in men with ED are lacking. Our aim was to evaluate the efficacy and safety of saffron administration on EF in men with ED. After a 4-week baseline assessment, 346 men with ED (mean age 46.6+/-8.4 years) were randomized to receive on-demand sildenafil for 12 weeks followed by 30 mg saffron twice daily for another 12 weeks or vice versa, separated by a 2-week washout period. To determine the type of ED, penile color duplex Doppler ultrasonography before and after intracavernosal injection with 20 microg prostaglandin E(1), pudendal nerve conduction tests and impaired sensory-evoked potential studies were performed. Subjects were assessed with an International Index of Erectile Function (IIEF) questionnaire, Sexual Encounter Profile (SEP) diary questions, patient and partner versions of the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire and the Global Efficacy Question (GEQ) 'Has the medication you have been taking improved your erections?' No significant improvements were observed with regard to the IIEF sexual function domains, SEP questions and EDITS scores with saffron administration. The mean changes from baseline values in IIEF-EF domain were +87.6% and +9.8% in sildenafil and placebo groups, respectively (P=0.08). We did not observe any improvement in 15 individual IIEF questions in patients while taking saffron. Treatment satisfaction as assessed by partner versions of EDITS was found to be very low in saffron patients (72.4 vs 25.4, P=0.001). Mean per patient 'yes' responses to GEQ was 91.2 and 4.2% for sildenafil and saffron, respectively (P=0.0001). These findings do not support a beneficial effect of saffron administration in men with ED.

  4. The International Index of Erectile Function: a methodological critique and suggestions for improvement.

    Science.gov (United States)

    Yule, Morag; Davison, Joyce; Brotto, Lori

    2011-01-01

    The International Index of Erectile Function is a well-worded and psychometrically valid self-report questionnaire widely used as the standard for the evaluation of male sexual function. However, some conceptual and statistical problems arise when using the measure with men who are not sexually active. These problems are illustrated using 2 empirical examples, and the authors provide recommended solutions to further strengthen the efficacy and validity of this measure.

  5. [Penile prosthesis for erectile dysfunction--long-term follow-up].

    Science.gov (United States)

    Gofrit, O N; Shenfeld, O Z; Katz, R; Shapiro, A; Landau, E H; Pode, D

    2000-09-01

    Our armamentarium for the treatment of erectile dysfunction has recently been expanded by addition of Viagra and the MUSE. However, their long-term results are still unknown. The insertion of a penile prosthesis is invasive, expensive, and irreversible, but under optimal condition provides an acceptable, definitive solution for erectile dysfunction. We evaluated our long-term results with penile prosthesis insertion (PPI). From 1987-1998, 57 patients underwent PPI in our department. Mean age was 55 years and the common causes of erectile dysfunction were atherosclerotic disease (23), radical pelvic surgery (15), and diabetes mellitus (14). Semirigid prostheses were inserted in 12 and inflatable prostheses in 45, including 42 single-component and 3 multi-component prostheses. Recently we interviewed these patients by telephone, using a standard questionnaire. Those not satisfied with the surgical results (83% of the living patients) were examined in our clinic. Mean follow-up was 53 months. In 37 (84%) the prosthesis was mechanically functional (rates after 1, 5 and 10 years were 87.8%, 80%, and 75%, respectively). In only 2 (2.5%) had serious complications led to prosthesis removal. All mechanical failures had occurred in those with inflatable prostheses after a mean of 48.5 months (range 4-113). At the time of the survey 68% were sexually active and 64% were satisfied with the surgical result. We conclude that PPI is safe treatment for erectile dysfunction. Although the rate of mechanically functioning prostheses decreases with time, modern multi-component prostheses may lead to better mechanical results.

  6. Flexibility in Men's Sexual Practices in Response to Iatrogenic Erectile Dysfunction after Prostate Cancer Treatment

    Directory of Open Access Journals (Sweden)

    Gary W. Dowsett, PhD

    2014-08-01

    Conclusions: Flexibility in sexual practice is possible for some men, both nonheterosexual and heterosexual, in the face of iatrogenic ED. Advising PCa patients of the possibilities of sexual strategies that include AI may help them in reestablishing a sex life that is not erection dependent. Dowsett GW, Lyons A, Duncan D, and Wassersug RJ. Flexibility in men's sexual practices in response to iatrogenic erectile dysfunction after prostate cancer treatment. Sex Med 2014;2:115–120.

  7. Testosterone improves erectile function through inhibition of reactive oxygen species generation in castrated rats

    Directory of Open Access Journals (Sweden)

    Rui Li

    2016-05-01

    Full Text Available Testosterone is overwhelmingly important in regulating erectile physiology. However, the associated molecular mechanisms are poorly understood. The purpose of this study was to explore the effects and mechanisms of testosterone in erectile dysfunction (ED in castrated rats. Forty male Sprague-Dawley rats were randomized to four groups (control, sham-operated, castration and castration-with-testosterone-replacement. Reactive oxygen species (ROS production was measured by dihydroethidium (DHE staining. Erectile function was assessed by the recording of intracavernous pressure (ICP and mean arterial blood pressure (MAP. Protein expression levels were examined by western blotting. We found that castration reduced erectile function and that testosterone restored it. Nitric oxide synthase (NOS activity was decrease in the castrated rats, and testosterone administration attenuated this decrease (each p < 0.05. The testosterone, dihydrotestosterone, cyclic guanosine monophosphate (cGMP and cyclic adenosine monophosphate (cAMP concentrations were lower in the castrated rats, and testosterone restored these levels (each p < 0.05. Furthermore, the cyclooxygenase-2 (COX-2 and prostacyclin synthase (PTGIS expression levels and phospho-endothelial nitric oxide synthase (p-eNOS, Ser1177/endothelial nitric oxide synthase (eNOS ratio were reduced in the castrated rats compared with the controls (each p < 0.05. In addition, the p40phox and p67phox expression levels were increased in the castrated rats, and testosterone reversed these changes (each p < 0.05. Overall, our results demonstrate that testosterone ameliorates ED after castration by reducing ROS production and increasing the activity of the eNOS/cGMP and COX-2/PTGIS/cAMP signaling pathways.

  8. Testosterone improves erectile function through inhibition of reactive oxygen species generation in castrated rats

    Science.gov (United States)

    Li, Rui; Meng, Xianghu; Zhang, Yan; Wang, Tao; Yang, Jun; Niu, Yonghua; Cui, Kai; Wang, Shaogang

    2016-01-01

    Testosterone is overwhelmingly important in regulating erectile physiology. However, the associated molecular mechanisms are poorly understood. The purpose of this study was to explore the effects and mechanisms of testosterone in erectile dysfunction (ED) in castrated rats. Forty male Sprague-Dawley rats were randomized to four groups (control, sham-operated, castration and castration-with-testosterone-replacement). Reactive oxygen species (ROS) production was measured by dihydroethidium (DHE) staining. Erectile function was assessed by the recording of intracavernous pressure (ICP) and mean arterial blood pressure (MAP). Protein expression levels were examined by western blotting. We found that castration reduced erectile function and that testosterone restored it. Nitric oxide synthase (NOS) activity was decrease in the castrated rats, and testosterone administration attenuated this decrease (each p < 0.05). The testosterone, dihydrotestosterone, cyclic guanosine monophosphate (cGMP) and cyclic adenosine monophosphate (cAMP) concentrations were lower in the castrated rats, and testosterone restored these levels (each p < 0.05). Furthermore, the cyclooxygenase-2 (COX-2) and prostacyclin synthase (PTGIS) expression levels and phospho-endothelial nitric oxide synthase (p-eNOS, Ser1177)/endothelial nitric oxide synthase (eNOS) ratio were reduced in the castrated rats compared with the controls (each p < 0.05). In addition, the p40phox and p67phox expression levels were increased in the castrated rats, and testosterone reversed these changes (each p < 0.05). Overall, our results demonstrate that testosterone ameliorates ED after castration by reducing ROS production and increasing the activity of the eNOS/cGMP and COX-2/PTGIS/cAMP signaling pathways. PMID:27168996

  9. Erectile dysfunction and the internet: drug company manipulation of public and professional opinion.

    Science.gov (United States)

    Read, John; Mati, Elizabeth

    2013-01-01

    Given that the Internet is now a major source of information regarding health and mental health problems, and that it is in the interest of the pharmaceutical industry to influence public and professional opinion, this study evaluated 70 websites about erectile dysfunction. The 31 drug company-funded websites (44%) were, compared with the 39 websites that are not industry funded, significantly more biased toward biological factors in general, and toward medication in particular (p public and professional opinion on the Internet.

  10. Erectile Dysfunction Among HIV Patients Undergoing Highly Active Antiretroviral Therapy: Dyslipidemia as a Main Risk Factor

    Directory of Open Access Journals (Sweden)

    Gustavo Romero‐Velez, MD

    2014-04-01

    Conclusions: ED is highly prevalent in HIV patients. Dyslipidemia should be considered as a risk factor for ED in HIV patients. Romero‐Velez G, Lisker‐Cervantes A, Villeda‐Sandoval CI, Sotomayor de Zavaleta M, Olvera‐Posada D, Sierra‐Madero JG, Arreguin‐Camacho LO, and Castillejos‐Molina RA. Erectile dysfunction among HIV patients undergoing highly active antiretroviral therapy: Dyslipidemia as a main risk factor. Sex Med 2014;2:24–30.

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

    OpenAIRE

    Nicolosi, Alfredo; Glasser, Dale B; Moreira Júnior, Edson Duarte; Villa, Marco; Erectile Dysfunction Epidemiology Cross National Study Group

    2003-01-01

    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...

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

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    Claro Joaquim A

    2003-01-01

    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

  13. Clinical use of alprostadil topical cream in patients with erectile dysfunction: a review

    OpenAIRE

    Anaissie J; Hellstrom WJG

    2016-01-01

    James Anaissie, Wayne JG Hellstrom Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA Abstract: Erectile dysfunction (ED) is a common and debilitating disorder seen in over 50% of men older than 70 years. Oral phosphodiesterase type 5 (PDE5) inhibitors are the mainstay of treatment for ED, but cannot be used by a significant subset of patients due to systemic side effects and drug–drug interactions. Second-line therapy may include intracaverno...

  14. Reasons for discontinuation of sildenafil citrate after successful restoration of erectile function

    Institute of Scientific and Technical Information of China (English)

    HwancheolSon; KwanjinPark; Soo-WoongKim; Jae-SeungPaick

    2004-01-01

    Aim: To investigate the reasons for discontinuations of sildenafil after the successful restoration of erectile function. Methods: One hundred fifty six patients, whose scores of erectile function domain of the 15-item International Index of Erectile Function (IIEF) increased to 26 or more after sildenafil medication, were included in this study. Six-months after the first sildenafil prescription, compliance to medication and the reason for discontinuity were reviewed by chart or surveyed by telephone. Results: Fifty-four (34.6%) of the 156 successfully treated patients discontinued sildenafil medication. The reasons for discontinuance were shortcomings in the partners' or patients' emotional readiness for the restoration of sexual life after long-term abstinence (37.0%), fear of possible side effects (18.5%), recovery of spontaneous erection (14.8%), postponement of ED treatment because of comorbid disease treatment (11.1%), unwillingness to accept drug-dependent erection (7.4%), high drug cost (3.7%),unacceptability of planned sexual activity (3.7%) and lack of sexual interest (3.7 %). Conclusion: The reasons for discontinuing sildenafil medication were primarily emotional or relationship-oriented, which indicates that simple recovery of a rigid erection is insufficient to restore sexual activity. More education about the effects of drug and the counseling of both partners is recommended to promote the successful recovery of sexual activity.

  15. High Chance of Late Recovery of Urinary and Erectile Function Beyond 12 Months After Radical Prostatectomy.

    Science.gov (United States)

    Mandel, Philipp; Preisser, Felix; Graefen, Markus; Steuber, Thomas; Salomon, Georg; Haese, Alexander; Michl, Uwe; Huland, Hartwig; Tilki, Derya

    2017-06-01

    Urinary incontinence (UI) and erectile dysfunction (ED) after radical prostatectomy (RP) can impose a strong burden. While most studies focus on certain time points after RP when analyzing functional outcome, there is paucity of evidence on late functional recovery in patients with UI or ED at 12 mo after RP. Using longitudinal patient data from a large European single-center, we show that the chance of regaining continence among patients (n=974) with UI (≥1 pad/24h) at 12 mo after RP was 38.6% after 24 mo and 49.7% after 36 mo. The corresponding rates for patients (n=1115) with ED (defined as International Index of Erectile Function-5 score <18) at 12 mo after RP were 30.8% at 24 mo and 36.5% at 36 mo after RP. Patients with postoperative UI or ED 12 mo after RP should be counseled about their good chance of achieving continence or potency in the course of time. We analyzed the probability of functional recovery among patients with urinary incontinence (UI) and erectile dysfunction (ED) 12 mo after radical prostatectomy. We found that up to 49.7% (36.5%) of patients with UI (ED) regain function within the next 24 mo and should be informed about these encouraging numbers. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

  16. Potent natural aphrodisiacs for the management of erectile dysfunction and male sexual debilities.

    Science.gov (United States)

    Pratap, Singh Akhand; Rajender, Singh

    2012-01-01

    The area of natural product research is rapidly progressing from traditional medicine to modern medicine having proper scientific basis of its usage. However, identifying the active constituent or the basis of its mechanism holds the key to synthesis of these drugs in the laboratory. Traditional Indian literature such as Ayurveda has listed several plant and animal based resources for treatment of almost every ailment. Erectile dysfunction and male sexual debilities are among the most explored areas in traditional medicine. A number of natural products, mostly plant based, have been claimed to cure erectile dysfunction and related male sexual debilities. These products often are aphrodisiac and have multi-fold effects on male reproductive system. This review aims at compiling the animal and plant based resources which bear promise of treating loss of libido and erectile dysfunction. A special emphasis is paid to find out scientific basis of their usage. The identification of potential resources could help undertake further studies to establish their possible mechanism of action; opening the doors to proper clinical trials for human use.

  17. Is epicardial adipose tissue, another measure of central obesity, correlated with erectile dysfunction?

    Directory of Open Access Journals (Sweden)

    Chih-Wei Tsao

    2016-01-01

    Full Text Available Background: This study investigated the correlation between epicardial adipose tissue (EAT, a measure of central obesity, and sexual function in males with vasculogenic erectile dysfunction (ED. Materials and Methods: The study was a cross-sectional study of selected males with ED aged <75 years who attended the Urology Outpatient Department of Tri-Service General Hospital. Sixty subjects were included in the study, which employed biochemical data, anthropometric indexes, echocardiography, and questionnaires. Biochemical lipid profiles and associated inflammation markers were recorded. The anthropometric indexes included general and central obesity and bioelectrical impedance analysis. Echocardiography results were assessed by a single experienced cardiologist and included epicardial and pericardial fat thickness measurements. Sexual function was evaluated using the International Index of Erectile Function-5 (IIEF-5 score. Results: According to the analysis of variance and multivariate logistic regression, only the erectile hardness score (EHS was statistically positively correlated with the IIEF-5 score. All other anthropometric indexes and echocardiography parameters, including EAT thickness, pericardial adipose tissue thickness, and ejection fraction (EF, were not significantly associated with sexual function. Conclusions: Only EHS was statistically associated with sexual function in the male subjects with ED. The anthropometric indexes and EAT thickness, a measure of central obesity, were not significantly correlated with sexual function in the male patients with ED.

  18. Clinical use of alprostadil topical cream in patients with erectile dysfunction: a review

    Directory of Open Access Journals (Sweden)

    Anaissie J

    2016-08-01

    Full Text Available James Anaissie, Wayne JG Hellstrom Department of Urology, Tulane University School of Medicine, New Orleans, LA, USA Abstract: Erectile dysfunction (ED is a common and debilitating disorder seen in over 50% of men older than 70 years. Oral phosphodiesterase type 5 (PDE5 inhibitors are the mainstay of treatment for ED, but cannot be used by a significant subset of patients due to systemic side effects and drug–drug interactions. Second-line therapy may include intracavernosal therapies, but are associated with poor compliance due to their invasive nature. Alprostadil has a mechanism of action different from that of PDE5 inhibitors. Clinical trials have shown topical alprostadil cream to be effective, increasing the erectile function (EF score of the International Index of EF by up to 13 points from baseline. It has also proven to be safe and well tolerated, with mild-to-moderate and transient treatment-related adverse events that are generally localized to the application site. Topical alprostadil cream is a safe and effective second-line therapy for ED, indicated for those who cannot tolerate, or are not satisfied with, oral PDE5 inhibitor therapy. Keywords: erectile dysfunction, topical cream, second-line treatment, alprostadil

  19. The Relationship between Neovascular Age-Related Macular Degeneration and Erectile Dysfunction

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    Harun Çakmak

    2013-01-01

    Full Text Available Purpose. To evaluate association between erectile dysfunction (ED and neovascular age-related macular degeneration (AMD. Methods. 195 men enrolled in this cross-sectional study. 90 of them had neovascular AMD and 105 of them were healthy volunteers. The International Index of Erectile Function (IIEF questionnaire’s erectile function (EF domain was used to assess ED. The patients in the study and control groups were statistically compared according to visual acuity, EF score, and body mass index. Results. The mean ages were 62 (54.5–73 and 60 (54–68, in the neovascular AMD and control groups, respectively. The total EF scores were 9 (6–16 in neovascular AMD and 18 (9.5–27 in control group. The results of IIEF questionnaire on neovascular AMD patients revealed that 85 men (94.4% had some degree of ED, whereas 68 men (64.8% had some degree of ED on control group. Patients with neovascular AMD had a significantly higher incidence of ED than control patients (. There was a significant association between ED and neovascular AMD (. Conclusions. Our results suggested that neovascular AMD has a high association with ED.

  20. Morphological association between ICC and signaling pathway of NO in guinea pig corpus cavernosum%豚鼠阴茎海绵体中ICC和NO信号通路的形态学关系

    Institute of Scientific and Technical Information of China (English)

    王宇卫; 王勤章; 王江平; 丁国富

    2012-01-01

    Objective To investigate the distribution of ICC and nNOS positive neurons in the corpus cavernosum of guinea pig and the histological association. Methods Using c-kit/nNOS immunofluorescence double staining of frozen sections of adult guinea pig corpus cavernosum, we observed the morphology and distribution of corpus cavernosum ICC and nNOS-posi-tive neurons under laser scanning confocal microscope(LSCM). Using c-kit/nNOS immunofluorescence double staining of cultured ICC by enzyme digestion, we observed the morphology and the expression of c-kit and nNOS under laser scanning confocal microscope. Results ICC were located near the boundaries of smooth muscle meshwork and interstice of smooth muscle, spindle-shaped, with long processes, round or oval-shaped cell body and expressed nNOS. ICC and nNOS-positive neurons were located on the boundaries of the smooth muscle meshwork and interstice of smooth muscle, and abundant ICC could be seen a-round nNOS-positive nerve trunk. Conclusions ICC are closely associated with nNOS-positive neurons in the corpus cavernosum of guinea pig, indicating that ICC may participate in the transduction of NO signal from nerves to smooth muscle cells.%目的 初步探讨豚鼠阴茎海绵体组织中cajal间质细胞 (ICC)和神经型一氧化氮合成酶(nNOS)阳性神经元的分布及两者的组织学关系.方法 ①制作成年豚鼠阴茎海绵体组织冰冻切片,利用c-kit/nNOS免疫荧光双染技术,激光共聚焦扫描显微镜(LSCM)下观察阴茎海绵体ICC及nNOS阳性神经元的形态及分布情况.②酶消化法体外培养阴茎海绵体ICC,c-kit/nNOS免疫荧光双染,LSCM下观察细胞形态及c-kit和nNOS的表达情况.结果 ICC分布在阴茎海绵体平滑肌小梁边缘及平滑肌肌间,纺锤形,具有长的突起,胞体呈圆形或椭圆形,并且表达nNOS;阴茎海绵体平滑肌小梁边缘及平滑肌肌间同时分布有ICC和nNOS阳性神经元,局部nNOS阳性神经主干附

  1. Visual Impairment

    Science.gov (United States)

    ... What Causes Visual Impairment? People rarely lose their eyesight during their teen years. When they do, it's ... inflammation in the eye. It's often found in poor rural countries that have overcrowded living conditions and ...

  2. Tribulus terrestris versus placebo in the treatment of erectile dysfunction: A prospective, randomized, double blind study.

    Science.gov (United States)

    Santos, C A; Reis, L O; Destro-Saade, R; Luiza-Reis, A; Fregonesi, A

    2014-05-01

    To evaluate the possible effects of Tribulus terrestris herbal medicine in the erectile dysfunction treatment and to quantify its potential impact on serum testosterone levels. Prospective, randomized, double-blind and placebo-controlled study including thirty healthy men selected from 100 patients who presented themselves spontaneously complaining of erectile dysfunction, ≥ 40 years of age, nonsmokers, not undergoing treatment for prostate cancer or erectile dysfunction, no dyslipidemia, no phosphodiesterase inhibitor use, no hormonal manipulation and, if present hypertension and/or diabetes mellitus should be controlled. International Index of Erectile Function (IIEF-5) and serum testosterone were obtained before randomization and after 30 days of study. Patients were randomized into two groups of fifteen subjects each. The study group received 800 mg of Tribulus terrestris, divided into two doses per day for thirty days and the control group received placebo administered in the same way. The groups were statistically equivalent in all aspects evaluated. The mean (SD) age was 60 (9.4) and 62.9 (7.9), P = .36 for intervention and placebo groups, respectively. Before treatment, the intervention group showed mean IIEF-5 of 13.2 (5-21) and mean total testosterone 417.1 ng/dl (270.7-548.4 ng/dl); the placebo group showed mean IIEF-5 of 11.6 (6-21) and mean total testosterone 442.7 ng/dl (301-609.1 ng/dl). After treatment, the intervention group showed mean IIEF-5 of 15.3 (5-21) and mean total testosterone 409.3 ng/dl (216.9-760.8 ng/dl); the placebo group showed mean IIEF-5 of 13.7 (6-21) and mean total testosterone 466.3 ng/dl (264.3-934.3 ng/dl). The time factor caused statistically significant changes in both groups for IIEF-5 only (P = .0004), however, there was no difference between the two groups (P = .7914). At the dose and interval studied, Tribulus terrestris was not more effective than placebo on improving symptoms of erectile dysfunction or serum total

  3. RhoA/Rho激酶信号通路导致高脂血症大鼠勃起功能障碍的机制%Mechanism of RhoA/Rho-kinase signal pathway-induced erectile dysfunction in hyperlipidemic rats

    Institute of Scientific and Technical Information of China (English)

    李瑞; 崔凯; 王涛; 王少刚; 杨为民; 刘继红; 饶可

    2016-01-01

    目的 观察高脂血症导致勃起功能障碍大鼠阴茎海绵体平滑肌RhoA/Rho激酶(ROCK)变化,探讨RhoA/ROCK导致高脂血症大鼠勃起功能障碍的机制.方法 将40只SD雄性大鼠按随机数字表法分为实验组20只(高脂饲料喂养24周)和对照组20只(正常饲料喂养24周).喂养前、后检测实验组和对照组大鼠血脂水平,检测喂养后实验组和对照组大鼠阴茎海绵体内压变化(△ICP)/平均动脉压(MAP)比值,应用Western印迹检测两组大鼠阴茎海绵体平滑肌总RhoA、ROCK1、ROCK2及平滑肌细胞膜RhoA、细胞质RhoA蛋白表达.结果 喂养24周后,实验组大鼠血胆固醇、三酰甘油和低密度脂蛋白明显高于喂养前及对照组(均P<0.01).喂养后实验组大鼠△ICP/MAP比值明显低于对照组(P<0.01).喂养后实验组大鼠阴茎海绵体平滑肌ROCK2蛋白表达明显高于对照组(0.77±0.10比0.27±0.08,P<0.01),两组总RhoA、ROCK1蛋白表达差异无统计学意义(均P>0.05).实验组大鼠阴茎海绵体平滑肌细胞胞质RhoA蛋白表达低于对照组(1.66±0.09比1.79±0.15,P<0.05);胞膜RhoA蛋白/胞质RhoA蛋白比值明显高于对照组(0.33±0.09比0.26±0.07,P<0.05).结论 RhoA/ROCK表达上调可能参与高脂血症大鼠勃起功能障碍的发生.%Objective To investigate the expression of RhoA/Rho-kinase (ROCK) in penile corpus cavernosum smooth muscles in rats of hyperlipidemia-induced erectile dysfunction and its molecular mechanism.Methods Forty male Sprague-Dawley rats were randomly divided into control and experimental groups using a random number table.Rats in the control group (n =20) were fed with regular diet for 24 weeks and those in the experimental group (n =20) with high-fat diet for the same period of time.The serum lipids profile was detected before and after the diet treatment.The ratio of intracavernosal pressure (△ICP)/mean arterial pressure (MAP) was measured,and Western blot was used to detect the

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

    Science.gov (United States)

    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.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  6. The herbal formula KH-204 is protective against erectile dysfunction by minimizing oxidative stress and improving lipid profiles in a rat model of erectile dysfunction induced by hypercholesterolaemia.

    Science.gov (United States)

    Jang, Hoon; Bae, Woong Jin; Kim, Su Jin; Cho, Hyuk Jin; Yuk, Seung Mo; Han, Dong Seok; Youn, Chang Shik; Kwon, Eun Bi; Hwang, Sung Yeoun; Kim, Sae Woong

    2017-02-24

    Hypercholesterolaemia (HC) is a major risk factor for ischemic heart disease and is also known to be a risk factor for erectile dysfunction (ED). ED caused by HC is thought to be related to HC-induced oxidative stress damage in the vascular endothelium and erectile tissue. KH-204 is an herbal formula with a strong antioxidant effect. We evaluated the effects of KH-204 on erectile function in a rat model of HC-induced ED. Male Sprague-Dawley rats (6 weeks old) were divided into normal control, high-fat and cholesterol diet (HFC), and HFC with KH-204 treatment (HFC + KH) groups (n = 12 each). Normal control group rats were fed normal chow diet. HFC and HFC + KH group rats were fed high-fat and cholesterol diets and treated with or without daily oral doses of KH-204 for 12 weeks. Subsequently, intracavernous pressure (ICP) and mean arterial pressure (MAP) were measured, and lipid profiles, expression of endothelial (eNOS) and neuronal (nNOS) nitric oxide synthase, oxidative stress (8-hydroxy-2-deoxyguanosine), and ratio of smooth muscle cells and collagen fibres were evaluated in the serum and corpora tissue. Compared to the HFC group, the HFC + KH group showed statistically significant increases in peak ICP and ICP/MAP ratio, expression of eNOS and nNOS, and ratio of smooth muscle cells and collagen fibres (p < 0.05). The HFC + KH group also showed statistically significant decreases in oxidative stress (p < 0.05). Further the lipid profiles of this group were ameliorated compared to those of the HFC group (p < 0.05). The current study shows that the antioxidant and hypolipidemic effects of KH-204 are effective in ameliorating ED by restoring endothelial dysfunction and suggests that KH-204 may be a potential therapeutic agent for ED by correcting the fundamental cause of ED.

  7. Combined sildenafil with vacuum erection device therapy in the management of diabetic men with erectile dysfunction after failure of first-line sildenafil monotherapy.

    Science.gov (United States)

    Sun, Lu; Peng, Fang-Li; Yu, Zhi-Ling; Liu, Cai-Ling; Chen, Jun

    2014-12-01

    To evaluate the efficacy and safety of combination therapy of sildenafil plus vacuum erection devices in men with type 2 diabetes mellitus with moderate to severe erectile dysfunction who are dissatisfied with the results of using sildenafil alone. The study included 66 diabetes mellitus patients presenting erectile dysfunction for at least 6 months and dissatisfied with the use of 100 mg sildenafil monotherapy. The patients were randomized in two groups. Those in group A (n = 33) were instructed to use a vacuum erection device only, whereas those in group B (n = 33) were treated with combination therapy, including sildenafil 100 mg and a vacuum erection device. Erectile function was evaluated subjectively using the International Index of Erectile Function, Sexual Encounter Profile questionnaire questions 2 and 3 at visit 1 (baseline; study entry), visit 2 (4 weeks after baseline), and visit 3 (12 weeks after baseline; study end). There were no significant differences in average patient age, duration of diabetes, duration of erectile dysfunction, baseline International Index of Erectile Function scores, hypertension, blood testosterone, smoking and alcohol consumption between two groups. Mean International Index of Erectile Function scores were significantly higher for group B at the 1-month (14.86 ± 2.17 vs 12.41 ± 2.63; P vacuum erection device therapy significantly enhances erectile function, and it is well tolerated by diabetes mellitus patients not responding to first-line sildenafil alone. © 2014 The Japanese Urological Association.

  8. Hearing Impairments

    Science.gov (United States)

    Cavender, Anna; Ladner, Richard E.

    For many people with hearing impairments, the degree of hearing loss is only a small aspect of their disability and does not necessarily determine the types of accessibility solutions or accommodations that may be required. For some people, the ability to adjust the audio volume may be sufficient. For others, translation to a signed language may be more appropriate. For still others, access to text alternatives may be the best solution. Because of these differences, it is important for researchers in Web accessibility to understand that people with hearing impairments may have very different cultural-linguistic traditions and personal backgrounds.

  9. All Vision Impairment

    Science.gov (United States)

    ... Home > Statistics and Data > All Vision Impairment All Vision Impairment Vision Impairment Defined Vision impairment is defined as the ... Ethnicity 2010 U.S. Age-Specific Prevalence Rates for Vision Impairment by Age and Race/Ethnicity Table for ...

  10. Long-term safety and efficacy of oral phentolamine mesylate (Vasomax) in men with mild to moderate erectile dysfunction.

    Science.gov (United States)

    Padma-Nathan, H; Goldstein, I; Klimberg, I; Coogan, C; Auerbach, S; Lammers, P

    2002-08-01

    The objectives of this study were to evaluate long-term safety and efficacy of phentolamine mesylate, an orally active, rapid-acting alpha-adrenergic receptor antagonist, for the treatment of men suffering from erectile dysfunction (ED). It was an open-label study involving more than 2000 patients. Men received phentolamine mesylate 40 mg or 80 mg (10 tablets/month) as needed for up to 13 months and self-assessed erectile performance using two validated questionnaires. Treatment with phentolamine mesylate was associated with increases in Erectile Function Domain score of the IIEF, successful vaginal penetrations, and in overall satisfaction. Most adverse events were mild or moderate in severity and consistent with the known pharmacodynamic properties of phentolamine. In conclusion, phentolamine mesylate is safe and effective in the long-term treatment of men with mild to moderate ED.

  11. A comparison of colour duplex ultrasonography after transurethral alprostadil and intracavernous alprostadil in the assessment of erectile dysfunction.

    Science.gov (United States)

    Ahn, H S; Lee, S W; Yoon, S J; Hann, H J; Hong, J M

    2004-01-01

    This study aimed to investigate whether transurethral alprostadil could be used for the diagnosis of erectile dysfunction using colour duplex ultrasound. The ultrasonography results were compared after transurethral and intracavernous alprostadil administration in 20 patients with erectile dysfunction. There were no significant differences in the mean peak systolic velocities (PSVs) between the two routes of administration, but the mean end diastolic velocities (EDVs) showed significant differences, with patients treated with transurethral alprostadil having higher EDVs. Linear regression analysis of the PSVs reached following the two routes of administration showed a moderate relationship, but linear regression analysis of the EDVs showed no relationship. We concluded that transurethral alprostadil was an inappropriate vasoactive drug to use with colour duplex ultrasonography for the evaluation of patients with erectile dysfunction because it required a longer scan time and it was less effective and less reliable than intracavernous alprostadil at stimulating complete corporeal smooth muscle relaxation.

  12. A systematic review of the psychosocial outcomes associated with erectile dysfunction: does the impact of erectile dysfunction extend beyond a man's inability to have sex?

    Science.gov (United States)

    McCabe, Marita P; Althof, Stanley E

    2014-02-01

    The aim of this study was to report and analyze the published data from randomized controlled trials (RCTs) for (i) the psychosocial outcomes associated with erectile dysfunction (ED) before treatment with a phosphodiesterase type 5 (PDE5) inhibitor; and (ii) the change in psychosocial outcomes after the use of a PDE5 inhibitor in men with ED. The method used was a prospectively designed systematic literature review of publications reported in MEDLINE via PubMed, EMBASE, the Cochrane Library, Science Citation Index Expanded, and PsychINFO from January 1, 1995 to May 14, 2012. The main outcome measures were scores on psychosocial measures in men who were treated for ED with a PDE5 inhibitor before and after treatment. A total of 1,714 publications were retrieved; 1,674 publications were excluded because they did not meet the design requirements of the review, and 40 publications (32 RCTs) were retained. Before treatment, men who participated in clinical trials reported relatively good quality of life and overall relationships, but poor sexual relationships and sexual satisfaction, diminished confidence, low self-esteem, and symptoms of depression. After treatment, there were significant improvements from baseline in most of these measures, except for overall life satisfaction and overall relationship satisfaction. ED and the treatment of ED are associated with substantially broader aspects of a man's life than just erectile functioning. This review demonstrates the importance of evaluating the psychosocial factors associated with ED and its treatment, and the importance of using standardized scales to conduct this evaluation. Further research is needed to better understand the mechanisms underlying the reciprocal relationships among physical and psychological functioning in men with ED. © 2013 International Society for Sexual Medicine.

  13. Risk of erectile dysfunction in transfusion-naive thalassemia men: a nationwide population-based retrospective cohort study.

    Science.gov (United States)

    Chen, Yu-Guang; Lin, Te-Yu; Lin, Cheng-Li; Dai, Ming-Shen; Ho, Ching-Liang; Kao, Chia-Hung

    2015-04-01

    Based on the mechanism of pathophysiology, thalassemia major or transfusion-dependent thalassemia patients may have an increased risk of developing organic erectile dysfunction resulting from hypogonadism. However, there have been few studies investigating the association between erectile dysfunction and transfusion-naive thalassemia populations. We constructed a population-based cohort study to elucidate the association between transfusion-naive thalassemia populations and organic erectile dysfunction. This nationwide population-based cohort study involved analyzing data from 1998 to 2010 obtained from the Taiwanese National Health Insurance Research Database, with a follow-up period extending to the end of 2011. We identified men with transfusion-naive thalassemia and selected a comparison cohort that was frequency-matched with these according to age, and year of diagnosis thalassemia at a ratio of 1 thalassemia man to 4 control men. We analyzed the risks for transfusion-naive thalassemia men and organic erectile dysfunction by using Cox proportional hazards regression models. In this study, 588 transfusion-naive thalassemia men and 2337 controls were included. Total 12 patients were identified within the thalassaemia group and 10 within the control group. The overall risks for developing organic erectile dysfunction were 4.56-fold in patients with transfusion-naive thalassemia men compared with the comparison cohort after we adjusted for age and comorbidities. Our long-term cohort study results showed that in transfusion-naive thalassemia men, there was a higher risk for the development of organic erectile dysfunction, particularly in those patients with comorbidities.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    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 1,457 men aged 20-69 who participated in a series of physical examination at the Medical Centre in Fangchenggang First People’s Hospital from September 2009 to December 2009. ED was identified by the five-item International Index of Erectile Function (IIEF-5) questionnaire. All participants were measured for plasma Hcy, vitamin B12, folic acid, systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), fasting plasma glucose, triglyceride and high-density lipoprotein cholesterol (HDL). Smoking, alcoholic drinking and physical activity were collected by face to face communication. Results A total of 691 (47.4%) men were identified as ED in this study, participants with ED were older or more likely to drink alcohol than the non-ED. It was higher Hcy (P=0.032), vitamin B12 (P=0.008) and fasting plasma glucose (P=0.014) in the participants with ED. There were significant positive correlation between ED status (none, mile, moderate and severe) and Hcy (P=0.024), vitamin B12 (P=0.015) and fasting plasma glucose (P=0.002). Logistic regression analysis showed that age, Hcy and vitamin B12 were the main determinants in ED. Hcy was positively associated with ED in the men more than 45, but vitamin B12 was positively related with ED in the men less than 45. Conclusions Hcy was positively associated with ED in elder, however, vitamin B12 was positively related with ED in younger.

  16. Socio-demographic and psychosocial correlates of erectile dysfunction among hypertensive patients.

    Science.gov (United States)

    Fadzil, Mohd Ariff; Sidi, Hatta; Ismail, Zaliha; Hassan, Muhamad Rahimi Che; Thuzar, Khin; Midin, Marhani; Nik Jaafar, Nik Ruzyanei; Das, Srijit

    2014-01-01

    The main aim of the study was to estimate the prevalence of ED and the associated socio-demographic and psychological correlates among hypertensive patients from a rural multiethnic community in Malaysia. A cross-sectional study was conducted among hypertensive patients attending rural primary care clinics. The socio-demographic, health characteristics, erectile function and levels of depression, anxiety and stress were recorded and analysed. The International Index of ErectileFunction-5 (IIEF-5) questionnaire and the Depression, Anxiety and Stress Scale (DASS-21) were used to assess erectile function and the levels of depression, anxiety and stress, respectively. A total of 253 hypertensive patients comprising 178 (70.4%) Malays, 56 (22.1%) Chinese and 18 (7.5%) Indians participated. The mean age of participants was 59.8 ± 10.62 years. Overall, the prevalence rate of ED was 62%: 90 (35%) with moderate and 69 (27%) with severe ED. The prevalence rate of ED among those aged 65 years or older (83.1%) was significantly higher than those less than 65 years (51.8%), (p<0.001). Higher prevalence rates were also noted among the Chinese (78.6%) compared to Malays (59.6%) and Indians (50%) (p=0.021); lower education level (69.1%) (p=0.026), among hypertensive patients with concomitant diabetes mellitus (70.6%) (p=0.026) and WHR ≥ 0.9 (31.3%) (p=0.021). However, no significant association was found between depression, anxiety and stress scores with IIEF-5 score. The prevalence rate of ED among Malaysian hypertensive patients is high. The rate increases significantly with age, Chinese ethnicity, concomitant diabetes mellitus, lower education level, WHR and the number of pack years of smoking. ED should be properly recognized and managed in hypertensive patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. 'Sex for life'? Men's counter-stories on 'erectile dysfunction', male sexuality and ageing.

    Science.gov (United States)

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

    2006-04-01

    Discourse on male sexuality in mid-to-later life has exploded in recent years (Gullette 1998). Attention to this topic has been spurred by the advent of (highly profitable) sexuopharmaceutical 'solutions' to erectile changes affecting older men. 'Success' stories abound in the media and in medical literature related to the restoration of faulty erections and ailing sex lives through drugs such as Viagra (sildenafil citrate), Uprima (apomorphine) and Cialis (tadalafil). In this paper we explore some of the ways in which notions about ageing and male sexuality are changing in popular cultural and medical texts in response to the advent of Viagra and the increasing authority of biomedicine in this area. We also demonstrate how the recent biomedical endorsement of 'sex for life' (the imperative to maintain an active youthful masculine [hetero]sexuality - defined in terms of male orgasm through penetrative sex) may be challenged by the very accounts of older men who are, or have been, affected by erectile difficulties and have used drugs like Viagra themselves. We present the perspectives of mid-to-late life heterosexual men in New Zealand whose stories question the contemporary biomedical privileging of erections and intercourse 'at any cost and at any age'. We argue that the current push to identify and treat so-called erectile dysfunction (and restore erections and penetrative sex to relationships) neglects some men's own experiences of alternative modes of relating sexually that they identify as 'normal', 'healthy', 'enjoyable' and 'satisfying' for them and their partners; and undermines their understanding of such changes as positive outcomes of ageing, experience and maturity.

  18. Irritable bowel syndrome is associated not only with organic but also psychogenic erectile dysfunction.

    Science.gov (United States)

    Hsu, C-Y; Lin, C-L; Kao, C-H

    2015-01-01

    This study investigated the correlation between irritable bowel syndrome (IBS) and organic erectile dysfunction (OED) and psychogenic erectile dysfunction (PED), and analyzed the influence of various comorbidities. Data were obtained from reimbursement claims of the National Health Insurance Program in Taiwan. We selected male patients aged >20 years, who were diagnosed with IBS during the 2000-2011 period as the IBS cohort. The index date for patients with IBS was the date of their first medical visit. We excluded patients with a diagnosis of OED and PED at baseline and those without information on age and sex. The IBS to non-IBS cohorts were estimated using univariable and multivariable Cox proportional hazards regression model. Adjusted hazard ratios were determined after adjusting for age and comorbidities. The Kaplan-Meier method was used to plot the cumulative incidence of OED and PED, and a log-rank test was used to compare the cohorts. A total of 15,533 IBS patients and 62,124 controls without IBS were enrolled in our study. Among the study participants, 48.2% were 49 years of age or younger. Patients with IBS were more likely to develop erectile dysfunction (ED) than those without IBS. Patients with IBS were 2.12 times more likely to develop OED and 2.38 times more likely to develop PED than the controls. There is an increased risk of both PED and OED in patients with IBS. Not only with organic but also PED should be considered when patients with IBS complain of ED.

  19. Association Among Metabolic Syndrome, Testosterone Level and Severity of Erectile Dysfunction

    Directory of Open Access Journals (Sweden)

    Hsin-Chih Yeh

    2008-05-01

    Full Text Available The purpose of this study was to determine the influence of metabolic syndrome (MS and serum testosterone in patients with erectile dysfunction (ED and their possible association. A total of 103 men with ED were enrolled. The International Index of Erectile Function (IIEF questionnaire was used to assess erectile condition. MS was defined according to the criteria formulated by the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III and the International Diabetes Federation (IDF. The mean age of the study population was 57.5 ± 10.7 years, with an average IIEF of 14.7 ± 6.7. The age and prevalence of MS using the NCEP ATP III criteria, but not the IDF criteria, were significantly different between mild and moderate/severe ED patients (p = 0.031 and 0.009, respectively. The percentage of hypertension (78.6% vs. 36.2%; p < 0.001 and raised fasting glucose levels (46.4% vs. 19.1%; p = 0.004 were significantly higher in the moderate/severe ED group, and both differences remained significant in multivariate analysis (p = 0.001 and 0.042, respectively. In addition, serum testosterone levels were significantly lower in ED patients with MS (p = 0.002. In summary, the presence of MS is associated with more severe ED. Among the components of MS, elevated blood pressure and fasting blood glucose were independent risk factors. NCEP ATP III criteria seem to correlate better with the degree of ED than the IDF definition. Our results also indicate that MS is associated with a lower testosterone level in patients with ED.

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

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    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.

  1. Relation between histological prostatitis and lower urinary tract symptoms and erectile function.

    Science.gov (United States)

    Mizuno, Taiki; Hiramatsu, Ippei; Aoki, Yusuke; Shimoyama, Hirofumi; Nozaki, Taiji; Shirai, Masato; Lu, Yan; Horie, Shigeo; Tsujimura, Akira

    2017-09-01

    Chronic prostatitis (CP) significantly worsens a patient's quality of life (QOL), but its etiology is heterogeneous. Although the inflammatory process must be associated with CP symptoms, not all patients with benign prostatic hyperplasia and histological prostatitis complain of CP symptoms. The relation between the severity of histological inflammation and lower urinary tract symptoms (LUTS) and erectile function is not fully understood. This study comprised 26 men with suspected prostate cancer but with no malignant lesion by pathological examination of prostate biopsy specimens. LUTS were assessed by several questionnaires including the International Prostate Symptom Score (IPSS), QOL index, Overactive Bladder Symptom Score (OABSS), and the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI), and erectile function was assessed by the Sexual Health Inventory for Men. Prostate volume (PV) measured by transabdominal ultrasound, maximum flow rate by uroflowmetry, and serum concentration of prostate-specific antigen were also evaluated. All data collections were performed before prostate biopsy. Histological prostatitis was assessed by immunohistochemical staining with anti-CD45 antibody as the Quick score. The relation between the Quick score and several factors was assessed by Pearson correlation coefficient and a multivariate linear regression model after adjustment for PV. The Pearson correlation coefficient showed a correlation between the Quick score and several factors including PV, IPSS, QOL index, OABSS, and NIH-CPSI. A multivariate linear regression model after adjustment for PV showed only the NIH-CPSI to be associated with the Quick score. The relation between the Quick score and each domain score of the NIH-CPSI showed only the subscore of urinary symptoms to be an associated factor. We found a correlation only between histological prostatitis and LUTS, but not erectile dysfunction. Especially, the subscore of urinary symptoms

  2. The role of statins in erectile dysfunction:a systematic review and meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Xiang Cai; Ye Tian; Tao Wu; Chen-Xi Cao; Si-Yuan Bu; Kun-Jie Wang

    2014-01-01

    To evaluate the effect of statins for erectile dysfunction (ED), a systematic review of the literature was conducted in the Cochrane Library, Embase and PubMed from the inception of each database to June 2013. Only randomized controlled trials (RCTs) comparing treatment for ED with statins were identiifed. Placebo RCTs with the International Index of Erectile Function (IIEF) as the outcome measure were eligible for meta-analysis. A total of seven RCTs including two statins with a total of 586 patients strictly met our criteria for systematic review and ifve of them qualiifed for the meta-analysis. A meta-analysis using a random effects model showed that statins were associated with a signiifcant increase in IIEF-5 scores (mean difference (MD):3.27;95%conifdential interval (CI):1.51 to 5.02;P<0.01) and an overall improvement of lipid proifles including total cholesterol (MD:-1.08;95%CI:-1.68 to-0.48;P<0.01), low-density lipoprotein (LDL) cholesterol (MD:-1.43;95%CI:-2.07 to-0.79;P<0.01), high-density lipoprotein (HDL) cholesterol (MD:0.24;95%CI:0.13 to 0.35;P<0.01) and triglycerides (TGs) (MD:-0.55;95%CI:-0.61 to -0.48;P< 0.01). In summary, our study revealed positive consequences of these lipid-lowering drugs on erectile function, especially for nonresponders to phosphodiesterase type 5 inhibitors (PDE5Is). However, it has been reported that statin therapy may reduce levels of testosterone and aggravate symptoms of ED. Therefore, larger, well-designed RCTs are needed to investigate the double-edged role of statins in the treatment of ED.

  3. Intracavernosal alprostadil is effective for the treatment of erectile dysfunction in diabetic men.

    Science.gov (United States)

    Heaton, J P; Lording, D; Liu, S N; Litonjua, A D; Guangwei, L; Kim, S C; Kim, J J; Zhi-Zhou, S; Israr, D; Niazi, D; Rajatanavin, R; Suyono, S; Benard, F; Casey, R; Brock, G; Belanger, A

    2001-12-01

    The efficacy and safety of intracavernosal alprostadil was evaluated for the treatment of erectile dysfunction in men with type I or type II diabetes mellitus. This was an open-label, flexible dose-escalating study involving 336 men (77% of whom were Asian/Oriental) enrolled by 15 centres in Australia, Canada and seven countries in Asia. The effective alprostadil dose, ie the dose producing penile rigidity adequate for intercourse and lasting up to 60 min, was established by titration at the clinic prior to entry into the 6 month self-treatment home phase. All men were fully trained in the self-injection technique before entry into the home phase. Efficacy and safety were assessed using patient and partner diaries and by interview at clinic visits during the titration phase and after 1, 3 and 6 months of treatment. An effective home dose was established by titration for 94% of the 336 men (median dose 20 microg, range 2.5-60 microg). Of 278 (83%) men who entered the home phase, 277 men (247 with type II diabetes and 30 with type I diabetes) had evaluable data for alprostadil dosage and clinical response. During the home phase, a satisfactory erectile response was achieved after 99% of injections, and the median alprostadil dose remained unchanged. The initial home dose and clinical response were similar in type I and type II diabetic men. Treatment was generally well tolerated with a low incidence of penile pain (24%) In conclusion, intracavernosal alprostadil was effective and well tolerated in type I and type II diabetic men with erectile dysfunction of mixed aetiology.

  4. Erectile dysfunction drugs and oxidative stress in the liver of male rats

    Directory of Open Access Journals (Sweden)

    Salah Sheweita

    2015-01-01

    Full Text Available Erectile dysfunction (ED affected the lives of more than 300 million men worldwide. Erectile dysfunction drugs (EDD, known as phosphodiesterase inhibitors (PDEIs, have been used for treatment of ED. It has been shown that oxidative stress plays an important role in the progression of erectile dysfunction. Oxidative stress can be alleviated or decreased by antioxidant enzymes. Therefore, the present study aims at investigating the changes in the activity of antioxidant enzymes such as superoxide dismutase, catalase, and glutathione reductase as well as protein expression of glutathione peroxidase and glutathione S-transferase after treatment of male rats with a daily dose of sildenafil (1.48 mg/kg, tadalafil (0.285 mg/kg and vardenafil (0.285 mg/kg for three weeks. In addition, levels of reduced glutathione and malondialdyhyde (MDA were assayed. The present study showed that sildenafil, vardenafil, and tadalafil treatments significantly decreased the levels of glutathione, MDA and the activity of glutathione reductase. In addition, vardenafil and sildenafil increased the activity of superoxide dismutase and catalase. Interestingly, western immunoblotting data showed that vardenafil induced the activity of glutathione peroxidase (GPX and its protein expression, whereas tadalafil and sildenafil inhibited such enzyme activity and its protein expression. In addition, the protein expression of GST π isozyme was markedly reduced after treatment of rats with sildenafil. It is concluded that ED drugs induced the activities of both SOD and catalase which consequently decreased MDA level. Therefore, decrement in MDA levels could increase nitric oxide–cGMP level which in turn promotes the erection mechanism.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    LENUS (Irish Health Repository)

    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.

  8. Low-intensity extracorporeal shockwave therapy in the treatment of postprostatectomy erectile dysfunction

    DEFF Research Database (Denmark)

    Frey, Anders; Sønksen, Jens; Fode, Mikkel

    2016-01-01

    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...... were included in the analysis at t1 and 15 patients were included in the analysis at t2. At baseline the median age was 62 years (range 51 to 70 years) and the median time since surgery was 24 months (range 12 to 54 months). The median preoperative IIEF-5 score was 25 (range 22 to 25) and the median...

  9. Low-Intensity Extracorporeal Shock Wave as a Novel Treatment for Erectile Dysfunction.

    Science.gov (United States)

    Pan, Michael M; Raees, Ayman; Kovac, Jason R

    2016-03-01

    The paradigm of erectile dysfunction (ED) treatment was fundamentally altered following the introduction of oral phosphodiesterase type 5 inhibitors. Unfortunately, a significant number of men exhibit a suboptimal response and require additional management strategies. One of the novel, minimally invasive strategies being developed is low-intensity extracorporeal shock wave therapy. Used in the hope of delaying placement of an inflatable penile prosthesis, the final phase of ED treatment, low-intensity extracorporeal shock wave therapy is a unique application of an established technology that may hopefully one day expand the medical options for patients with ED. This commentary will highlight the physiology underlying this technique and summarize the most recent studies.

  10. Biomarkers, erectile dysfunction, and cardiovascular risk prediction:the latest of an evolving concept

    Institute of Scientific and Technical Information of China (English)

    Charalambos Vlachopoulos; Nikolaos Ioakeimidis; Christodoulos Stefanadis

    2015-01-01

    A number of circulating and imaging biomarkers are robustly associated with cardiovascular (CV) risk. The overall expectation from a biomarker in the erectile dysfunction (ED) setting is to enhance the optimal management of a man with this disorder but no clinical atherosclerosis. Evidence demonstrating that these biomarkers enhance risk prediction for individuals with ED is at this stage still limited for most of them. A better identification of the subsets of the ED population that require further risk stratification, as well as the initiation of randomized trials that will formally test the ability of biomarkers to predict CV risk, could make biomarker‑guided prevention an attainable goal.

  11. Penile prosthesis implantation in the era of medical treatment for erectile dysfunction.

    Science.gov (United States)

    Montague, Drogo K

    2011-05-01

    Penile prosthesis implantation, the oldest of the modern treatments for erectile dysfunction (ED), still plays an important role despite the advent of less invasive alternatives. For some men with ED, penile prosthesis implantation is the only effective or acceptable treatment. Penile prosthesis implantation remains a viable option in the contemporary management of ED as evidenced by annual penile prosthesis implantation cases in the United States rising from 17,540 in 2000 to 22,420 in 2009. Improvements in prosthesis design and implantation techniques have resulted in significant increases in device survival and patient satisfaction.

  12. Effect of Low-Energy Linear Shockwave Therapy on Erectile Dysfunction

    DEFF Research Database (Denmark)

    Fojecki, Grzegorz L; Thiessen, Stefan; Osther, Palle Jørn Sloth

    2017-01-01

    MEASURES: The primary outcome measurement was an increase of at least five points on the IIEF-EF score. The secondary outcome measurement was an increased EHS score to at least 3 in men with a score no higher than 2 at baseline. Data were analyzed by linear and logistic regression. RESULTS: Mean IIEF......INTRODUCTION: Previous studies have shown that focal low-energy extracorporeal shockwave therapy (Li-ESWT) can have a positive effect in men with erectile dysfunction (ED). Linear Li-ESWT (LLi-ESWT) for ED has not been previously assessed in a randomized trial. AIM: To evaluate the treatment...

  13. Chronic administration of atorvastatin could partially ameliorate erectile function in streptozotocin-induced diabetic rats

    Science.gov (United States)

    Park, Juhyun; Kwon, Oh Seong; Cho, Sung Yong; Paick, Jae-Seung; Kim, Soo Woong

    2017-01-01

    The efficacy of statins is related to the ‘common soil’ hypothesis, which proposes oxidative stress and inflammation as main pathophysiologic processes in the disease group of diabetes and endothelial dysfunction. This study evaluated the recovery of erectile function after administration of chronic statin alone in streptozotocin (STZ)-induced diabetes mellitus (DM) rats, focusing on the anti-oxidative effects and consequentially recuperated endothelial function. A total of 45 male Sprague-Dawley rats (8 weeks old) were divided into three groups (n = 15 each): an age-matched normal control group (Control group), an uncontrolled DM group (DM group), and a statin-treated group (Statin group). The rats in the DM and Statin group received an injection of STZ (60 mg/kg). Beginning 10 weeks after the establishment of DM, the Statin group received daily treatment with atorvastatin (10 mg/kg) via oral gavage for four weeks. After 14 weeks, the results of the experiment were evaluated. The ratios of intracavernosal pressure (ICP) to mean arterial pressure (MAP) were recorded with cavernosometry (20 Hz, 3 V, 0.2 msec for 30 seconds) before and after the intravenous administration of udenafil (1 mg/kg). Expression of alpha-smooth muscle actin (α-SMA) was evaluated using cavernosal tissue. In addition, changes in RhoA translocation ratio and myosin phosphatase target subunit 1 (MYPT1) phosphorylation were evaluated with western blot. Superoxide dismutase (SOD) and malondialdehyde (MDA) levels were also analyzed as measurements of oxidative stress levels. The ICP/MAP and area under the curve (AUC)/MAP ratios of the Statin group were obviously superior to the DM group, but were not comparable to the Control group (PStatin group than in the DM group (P = 0.015), and was comparable to the Control group. In contrast, MDA levels were not considerably different among the groups (P = 0.217). The RhoA translocation ratio was not significantly different among the groups (P = 0

  14. [Directed clinical history and physical examination in patients with erectile dysfunction. Clinical features we cannot forget].

    Science.gov (United States)

    Tejero, Emilio José Emmanuel; Chicharro, Raul Vozmediano; Vargas, Eloy Vivas; Morales, Antonio Martín

    2010-10-01

    We aim in this work to establish directions for data collection in the chart of the patient with erectile dysfunction (ED), to characterize the presenting problem, reveal possible associated risk factors, evaluate the need of additional complementary tests, and decide if a multidisciplinary approach is necessary. Bibliographic review about directions and recommendations on initial and clinical management of ED. Sexual history is the most important part of the basic routine with a patient with ED, and the purpose of the andrologist is to identify the type of sexual dysfunction, time of start, severity, duration, and treatment expectations.

  15. The influence of different metabolic syndrome definitions in predicting vasculogenic erectile dysfunction: is there a role for the index of central obesity?

    Science.gov (United States)

    Carvalho, H N; Campos Costa, I M; Campos Costa, I N; Botelho, F; Tomada, N

    2013-09-01

    Analyze the capacity of ICO, the ratio of waist circumference (WC) and height, in predicting hemodynamic impairment in Erectile Dysfunction (ED) patients, independently and integrated in Metabolic Syndrome (MetS) definitions. Four hundred and eighty-five ED patients followed in Urology consult from January 2008 until March 2012 were evaluated by a standardized protocol: health questionnaire, anthropometric measurements (AM), blood pressure and analysis, and Penile Duplex Doppler Ultrasound (PDDU) exam. Associations between AM and MetS definitions, including ATPIII, IDF and a new definition replacing WC by ICO in ATPIII MetS definition (ModATPIII), and PDDU were calculated. ICO was the measure of obesity more strongly correlated with diminished mean Peak Systolic Velocity (mPSV) (r = -0.189, p ICO ≥ 0.60 (a nationally obtained ratio) in ATPIII MetS definition (ModATPIII). Patients with ModATPIII had lower mPSV when compared to non-MetS patients (30.8 versus 37.1, p ICO revealed potential value to predict PDDU changes in a MetS context. However, IDF definition presented a stronger correlation with arteriogenic ED. Although longitudinal studies are necessary to confirm this hypothesis, our study highlights the importance of different MetS definitions for ED assessment.

  16. Farnesoid X receptor activation improves erectile dysfunction in models of metabolic syndrome and diabetes.

    Science.gov (United States)

    Morelli, Annamaria; Vignozzi, Linda; Maggi, Mario; Adorini, Luciano

    2011-08-01

    The metabolic syndrome (MetS) is an insulin-resistant state characterized by a cluster of cardiovascular risk factors, including abdominal obesity, hyperglycemia, elevated blood pressure and combined dyslipidemia. In this review, we discuss the potential of farnesoid X receptor (FXR) agonists in the treatment of erectile dysfunction (ED), a multifactorial disorder often comorbid with MetS. FXR not only regulates lipid and glucose homeostasis but also influences endothelial function and atherosclerosis, suggesting a regulatory role for this hormone nuclear receptor in the cardiovascular complications associated with the MetS, including ED. MetS induces ED via several mechanisms, and in particular through endothelial dysfunction in penile vessels. In a high-fat diet rabbit model of MetS, a 3-month treatment with the potent and selective FXR agonist INT-747 restores endothelium-dependent relaxation in isolated cavernous tissue, normalizing responsiveness to acetylcholine and to electrical field stimulation. Accordingly, eNOS expression in the penis is greatly up-regulated by INT-747 treatment. Experiments in a rat model of chemically-induced type 1 diabetes further demonstrate that INT-747 treatment preserves erectile function induced by electrical stimulation of the cavernous nerve. These results add a new facet to the pleiotropic activities mediated by FXR, and reveal novel beneficial effects of FXR activation with potential clinical relevance. This article is part of a Special Issue entitled: Translating nuclear receptors from health to disease.

  17. Vacuum erection devices to treat erectile dysfunction and early penile rehabilitation following radical prostatectomy.

    Science.gov (United States)

    Zippe, Craig D; Pahlajani, Geetu

    2008-11-01

    Vacuum erection devices (VED) are becoming first-line therapies for erectile dysfunction and preservation (rehabilitation) of erectile function following treatment for prostate cancer. Currently, phosphodiesterase-5 inhibitors have limited efficacy in elderly patients or patients with moderate to severe diabetes, hypertension, and coronary artery disease. Alternative therapies, such as VED, have emerged as a primary option for patients refractory to oral therapy. VED has also been successfully used in combination treatment with oral therapy and penile injections. More recently, there has been interest in the use of VED in early intervention protocols to encourage corporeal rehabilitation and prevention of post-radical prostatectomy venoocclusive dysfunction. This is evident by the preservation of penile length and girth seen with the early use of the VED following radical prostatectomy. There are ongoing studies to help preserve penile length and girth with early use of VED following prostate brachytherapy and external beam radiation for prostate cancer. Recently, there has also been interest in VED to help maintain penile length following surgical correction of Peyronie's disease and to increase penile size before implantation of the penile prosthesis.

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

    Directory of Open Access Journals (Sweden)

    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

  19. The role of penile color-duplex ultrasound for the evaluation of erectile dysfunction.

    Science.gov (United States)

    Aversa, Antonio; Sarteschi, Lelio Mario

    2007-09-01

    In the era of orally active agents, dynamic penile color-duplex ultrasound (D-PCDU) is not considered a necessary first screening for all patients with erectile dysfunction (ED). Various parameters, such as peak systolic flow velocity, end diastolic velocity, resistance index, acceleration time, and degree of arterial dilatation, have been suggested for the diagnosis of vascular ED by D-PCDU. To highlight the clinical utility and evidence-based interpretation of D-PCDU criteria. Extensive, unsystematic PubMed literature search reviewing relevant data on D-PCDU in the evaluation of male ED. The advantage of ultrasound is the minimally invasive nature of the procedure and the ability to screen patients to identify a normal arterial response of cavernous arteries. Men with sexual dysfunctions above 55 years of age and comorbidities are more likely to have multi-organ vascular dysfunction and may necessitate further testing because erectile failure may be the first presenting symptom requiring investigation and treatment even in the absence of cardiovascular risk factors. All patients affected with Peyronie's disease and younger men with persistent ED, a history of pelvic traumas, or fractures of the penile shaft should be offered ultrasonographic penile blood flow studies before referral to surgery or more invasive vascular investigations. In the near future, D-PCDU may be used in preference to patients presenting with or without vascular risk factors, particularly those not responding to first-line orally active drugs and seeking an explanation as to why these agents failed.

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

    Science.gov (United States)

    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 exercise tolerance, depression and HF medications. Before treating HF patients with PDE-5 inhibitors, patients should be assessed for their risk of a cardiac event during sexual activity. PDE-5 inhibitors are safe and effective in treating ED in HF patients. An improvement in erectile function by PDE-5 inhibitors was associated with an improvement in quality of life and reduction in depression. Several studies demonstrated the effect of PDE-5 inhibitors on HF per se. PDE-5 inhibitors improved endothelial dysfunction, increased exercise tolerance, decreased pulmonary vascular resistance and pulmonary artery pressure, and increased cardiac index. Several mechanisms whereby PDE-5 inhibitors improve HF have been proposed. PDE-5 inhibitors already have a role in treating primary pulmonary hypertension; however additional studies are needed to determine if they will become a standard therapy for HF patients. PMID:19387454

  1. Erectile function in men with diabetes type 2: correlation with glycemic control.

    Science.gov (United States)

    Awad, H; Salem, A; Gadalla, A; El Wafa, N Abou; Mohamed, O A

    2010-01-01

    Men with diabetes have an increased risk for erectile dysfunction (ED) than those without diabetes. The diabetes control and complications trial clearly showed that better long-term control of blood glucose in diabetes type 1 is associated with decreased frequency and delayed the onset of microvascular complications. The aim of this study is to explore the role of glycemic control, and its correlation to sexual function in patients with diabetes type 2. One hundred patients were selected for the study according to the following criteria: all the cases were presenting with diabetes type 2 as a single risk factor for ED, age being between 35 and 50 years and free of liver and kidney failure, and blood dyscrasis. The selected patients were evaluated for sexual function by asking the patients to complete the abridged form of the International Index of Erectile Function (IIEF). The evaluation of glycemic control was based on the measurement of hemoglobin A(1c) (HbA(1c)) values. Our results showed that the level of HbA(1c) is significantly higher with declining degrees of potency (P-value=0.003). Also, there is an association between potency degree and glycemic control (P=0.002). We conclude that glycemic control is independently and inversely associated with ED in men with diabetes type 2.

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

    Directory of Open Access Journals (Sweden)

    Pierre Costa

    2009-04-01

    Full Text Available 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 phosphodiesterase 5 (PDE5 inhibitors. A PDE5 inhibitor is now widely recognized as the first-line therapy for the majority of men with ED. Currently, three PDE5 inhibitors – sildenafil, tadalafil and vardenafil – are approved to be taken as needed in anticipation of sexual activity, but only one of these, tadalafil, has been approved to be taken once daily. The primary aims of this review are to summarize the patients’ and partners’ viewpoints of ED management with PDE5 inhibitors, and to determine whether once-daily tadalafil can contribute to improving some psychological aspects of ED (such as sexual self-confidence, spontaneity and time concerns compared with on-demand tadalafil or other PDE5 inhibitors taken by patients with ED.Keywords: erectile dysfunction, once-daily treatment, patient and partner perspectives, phosphodiesterase 5 (PDE5 inhibitor

  3. Pathophysiology of visual disorders induced by phosphodiesterase inhibitors in the treatment of erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Moschos MM

    2016-10-01

    Full Text Available Marilita M Moschos, Eirini Nitoda 1st Department of Ophthalmology, Medical School, National & Kapodistrian University of Athens, Athens, Greece Aim: The aim of this review was to summarize the ocular action of the most common phosphodiesterase (PDE inhibitors used for the treatment of erectile dysfunction and the subsequent visual disorders.Method: This is a literature review of several important articles focusing on the pathophysiology of visual disorders induced by PDE inhibitors.Results: PDE inhibitors have been associated with ocular side effects, including changes in color vision and light perception, blurred vision, transient alterations in electroretinogram (ERG, conjunctival hyperemia, ocular pain, and photophobia. Sildenafil and tadalafil may induce reversible increase in intraocular pressure and be involved in the development of nonarteritic ischemic optic neuropathy. Reversible idiopathic serous macular detachment, central serous chorioretinopathy, and ERG disturbances have been related to the significant impact of sildenafil and tadalafil on retinal perfusion.Discussion: So far, PDE inhibitors do not seem to cause permanent toxic effects on chorioretinal tissue and photoreceptors. However, physicians should write down any visual symptom observed during PDE treatment and refer the patients to ophthalmologists. Keywords: erectile dysfunction, pathophysiological mechanisms, phosphodiesterase inhibitors, PDE5, visual disorders

  4. Hormonal Modulation in Aging Patients with Erectile Dysfunction and Metabolic Syndrome

    Directory of Open Access Journals (Sweden)

    Inês Campos Costa

    2013-01-01

    Full Text Available Erectile dysfunction (ED, metabolic syndrome (MetS, and hypogonadism are closely related, often coexisting in the aging male. Obesity was shown to raise the risk of ED and hypogonadism, as well as other endocrinological disturbances with impact on erectile function. We selected 179 patients referred for ED to our andrology unit, aiming to evaluate gonadotropins and estradiol interplay in context of ED, MetS, and hypogonadism. Patients were stratified into groups in accordance with the presence (or not of MetS and/or hypogonadism. Noticeable differences in total testosterone (TT and free testosterone (FT levels were found between patients with and without MetS. Men with MetS evidenced lower TT circulating levels with an increasing number of MetS parameters, for which hypertriglyceridemia and waist circumference strongly contributed. Regarding the hypothalamic-pituitary-gonadal axis, patients with hypogonadism did not exhibit raised LH levels. Interestingly, among those with higher LH levels, estradiol values were also increased. Possible explanations for this unexpected profile of estradiol may be the age-related adiposity, other estrogen-raising pathways, or even unknown mechanisms. Estradiol is possibly a molecule with further interactions beyond the currently described. Our results further enlighten this still unclear multidisciplinary and complex subject, raising new investigational opportunities.

  5. The vascular and neurogenic factors associated with erectile dysfunction in patients after pelvic fractures

    Directory of Open Access Journals (Sweden)

    Yong Guan

    2015-10-01

    Full Text Available ABSTRACT Erectile dysfunction (ED is a common complication of pelvic fractures. To identify the vascular and neurogenic factors associated with ED, 120 patients admitted with ED after traumatic pelvic fracture between January 2009 and June 2013 were enrolled in this study. All patients answered the International Index of Erectile Function (IIEF-5 questionnaire. Nocturnal penile tumescence (NPT testing confirmed the occurrence of ED in 96 (80% patients on whom penile duplex ultrasound and neurophysiological testing were further performed. Of these ED patients 29 (30% were demonstrated only with vascular abnormality, 41 (42.7% were detected only with neural abnormality, 26 (27.1% revealed mixed abnormalities. Of the 55 patients (29+26 with vascular problems, 7 patients (12.7% with abnormal arterial response to intracavernous injection of Bimix (15mg papaverine and 1mg phentolamine, 31 (56.4% with corporal veno-occlusive dysfunction and 17 (30.9% had both problems. Of the 67 (41+26 patients with abnormal neurophysiological outcomes, 51 (76.1% with abnormal bulbocavernosus reflex (BCR, 20 (29.9% with pathological pudendal nerve evoked potentials (PDEPs and 25 (37.3% with abnormal posterior tibial somatosensory nerve evoked potentials (PTSSEPs. Our observation indicated that neurogenic factors are important for the generation of ED in patients with pelvic fracture; venous impotence is more common than arteriogenic ED.

  6. [IIEF-5 cannot be used as a tool for differential diagnosis of vasculogenic erectile dysfunction].

    Science.gov (United States)

    Chen, Bin; Lu, Yong-ning; Han, Yin-fa; Huang, Xu-yuan; Hu, Kai; Wang, Yi-xin; Huang, Yi-ran

    2007-02-01

    To evaluate the 5-item version of the international index of erectile function (IIEF-5) as a method to differentiate the causes of vasculogenic erectile dysfunction (ED). In all, 103 ED patients (mean age 46.8 +/- 18.7) were reviewed by IIEF-5. Penile blood flow was also assessed in each patient after an intracavernosal injection (ICI) and audio-visual sex stimulation by duplex Doppler ultrasonography. The 99mTc-(113m)In dual radioisotope test was performed to confirm specific vascular causes in the vasculogenic ED cases. Kruskal-Wallis TEST was employed to compare the scores of IIEF-5 with the results of ICI, duplex Doppler ultrasonography and the 99mTC-(113m)In dual radioisotope test. Of the total number of ED cases, 37 (37/103, 35.9%) were nonvasculogenic, 18 (18/103, 17.5%) arteriogenic, 35 (35/103, 34.0%) venogenic and 13 (13/103, 12.6%) combined vasculogenic. There was no significant difference in the IIEF-5 scores either between the vasculogenic group and the non-vasculogenic one (P = 0.253) or among different groups of the vasculogenic ED patients. IIEF-5 cannot be used as a tool for differential diagnosis of vasculogenic ED, or to compare its specific vascular causes, nor can the scores of IIEF-5 reflect penile vascular conditions.

  7. Assessment of sexual function in patients undergoing vasectomy using the international index of erectile function

    Directory of Open Access Journals (Sweden)

    Eduardo Bertero

    2005-10-01

    Full Text Available INTRODUCTION: The present study aims to prospectively compare the sexual function in males before and after vasectomy surgery using the international index of erectile function (IIEF. MATERIALS AND METHODS: From October to December 2002, sixty-four patients who were candidates for male sterilization in the vasectomy program of the Urology Section at the General Hospital of the University of São Paulo were included. The same investigator applied the IIEF before and 90 days after the surgery. The mean scores obtained on pre and postoperative visits for all domains of sexual function were analyzed and compared with the Wilcoxon test. RESULTS: The mean patient age was 35 years (range from 25 to 48 years and the mean number of children per man was 3. The total mean score of the IIEF was 64.06 before surgery and 65.64 after the procedure, with this difference considered statistically significant (p < 0.001. Sixty-seven per cent of the patients improved their scores, versus 17% and 16% who showed worsening or no change at all in IIEF scores following surgery, respectively. Of the 5 sexual function domains, desire and sexual satisfaction presented statistically significant improvement. CONCLUSION: This study showed that vasectomy caused a positive impact on sexual function, especially on desire and sexual satisfaction, in the majority of men undergoing surgery. There was no case of surgery-related erectile dysfunction.

  8. Erectile dysfunction post-radical prostatectomy – a challenge for both patient and physician

    Science.gov (United States)

    Bratu, O; Oprea, I; Marcu, D; Spinu, D; Niculae, A; Geavlete, B; Mischianu, D

    2017-01-01

    Post-radical prostatectomy erectile dysfunction (post RP ED) is a major postoperative complication with a great impact on the quality of life of the patients. Until present, no proper algorithm or guideline based on the clinical trials has been established for the management of post RP ED. According to literature, it is better to initiate a penile rehabilitation program as soon as possible after surgery than doing nothing, in order to prevent and limit the postoperative local hypoxygenation and fibrosis. The results of numerous clinical trials regarding the effectiveness of the phosphodiesterase 5 inhibitors therapy on post RP ED have made them the gold standard treatment. Encouraging results have been achieved in studies with vacuum erectile devices, intraurethral suppositories with alprostadil and intracavernosal injections, but due to their side effects, especially in the cases of intracavernosal injections and intraurethral suppositories, their clinical use was limited therefore making them a second line option for the post RP ED treatment. What should not be forgotten is that penile implant prosthesis has proven very effective, numerous studies confirming high rates of satisfaction for both patients and partners. PMID:28255370

  9. Clinical use of alprostadil topical cream in patients with erectile dysfunction: a review.

    Science.gov (United States)

    Anaissie, James; Hellstrom, Wayne Jg

    2016-01-01

    Erectile dysfunction (ED) is a common and debilitating disorder seen in over 50% of men older than 70 years. Oral phosphodiesterase type 5 (PDE5) inhibitors are the mainstay of treatment for ED, but cannot be used by a significant subset of patients due to systemic side effects and drug-drug interactions. Second-line therapy may include intracavernosal therapies, but are associated with poor compliance due to their invasive nature. Alprostadil has a mechanism of action different from that of PDE5 inhibitors. Clinical trials have shown topical alprostadil cream to be effective, increasing the erectile function (EF) score of the International Index of EF by up to 13 points from baseline. It has also proven to be safe and well tolerated, with mild-to-moderate and transient treatment-related adverse events that are generally localized to the application site. Topical alprostadil cream is a safe and effective second-line therapy for ED, indicated for those who cannot tolerate, or are not satisfied with, oral PDE5 inhibitor therapy.

  10. Oral treatment of erectile dysfunction: from herbal remedies to designer drugs.

    Science.gov (United States)

    Guirguis, W R

    1998-01-01

    The erect penis has always been a symbol of power, virility, and fertility. Inability to obtain or maintain an erection, known clinically as erectile dysfunction, is a major health problem. It can cause considerable distress, unhappiness, and relationship problems. The search has therefore continued from time immemorial to find an effective safe, and easy to administer treatment for erectile problems. Although a number of these treatments became available in the last two decades, they all had problems with efficacy, safety, or ease of administration. Clinicians in this field often are told at the end of an assessment interview, "I wish you have a magic pill". An effective and safe oral treatment is, no doubt, the most acceptable and easy to use option. Finding such a treatment has always been the dream of many scientists, and many attempts have been made over the years. These ranged from herbal remedies used by native healers, mostly in Eastern countries, to the more sophisticated designer drugs, which are based on a better understanding of the physiological mechanism of erection. This article describes some of these attempts.

  11. Tadalafil once daily and extracorporeal shock wave therapy in the management of patients with Peyronie's disease and erectile dysfunction: results from a prospective randomized trial.

    Science.gov (United States)

    Palmieri, A; Imbimbo, C; Creta, M; Verze, P; Fusco, F; Mirone, V

    2012-04-01

    Extracorporeal shock wave therapy improves erectile function in patients with Peyronie's disease. However, erectile dysfunction still persists in many cases. We aimed to investigate the effects of extracorporeal shock wave therapy plus tadalafil 5 mg once daily in the management of patients with Peyronie's disease and erectile dysfunction not previously treated. One hundred patients were enrolled in a prospective, randomized, controlled study. Patients were randomly allocated to receive either extracorporeal shock wave therapy alone for 4 weeks (n = 50) or extracorporeal shock wave therapy plus tadalafil 5 mg once daily for 4 weeks (n = 50). Main outcome measures were: erectile function (evaluated through the shortened version of the International Index of Erectile Function), pain during erection (evaluated through a Visual Analog Scale), plaque size, penile curvature and quality of life (evaluated through an internal questionnaire). Follow-up evaluations were performed after 12 and 24 weeks. In both groups, at 12 weeks follow-up, mean Visual Analog Scale score, mean International Index of Erectile Function score and mean quality of life score ameliorated significantly while mean plaque size and mean curvature degree were unchanged. Intergroup analysis revealed a significantly higher mean International Index of Erectile Function score and quality of life score in patients receiving the combination. After 24 weeks, intergroup analysis revealed a significantly higher mean International Index of Erectile Function score and mean quality of life score in patients that received extracorporeal shock wave therapy plus tadalafil. In conclusion extracorporeal shock wave therapy plus tadalafil 5 mg once daily may represent a valid conservative strategy for the management of patients with Peyronie's disease and erectile dysfunction.

  12. Erectile Dysfunction and Low Sex Drive in Men with Type 2 DM: The Potential Role of Diabetic Pharmacotherapy

    Science.gov (United States)

    Al-Gareeb, Ali I.

    2016-01-01

    Introduction Diabetic men with erectile dysfunction have not been widely studied. They have low testosterone levels, causing low sex drive and erectile dysfunction. Aim To assess the erectile dysfunction and sex drive in relation to testosterone serum levels in type 2 Diabetes Mellitus (DM) patients. Materials and Methods A total of 64 patients with type 2 DM were enrolled in this cross-sectional study, according to the treatment types they were divided into three groups, group (A): 34 patients treated with metformin, group (B): 30 patients treated with sulfonylurea and group (C): 27 healthy normal non-diabetic men are taken as control. Total testosterone (TT), Free Testosterone (FT), Free Androgenic Index (FAI), Sex Hormone Binding Globulin (SHBG), lipid profile and anthropometric parameters in metformin and sulfonylurea treated patients were compared to normal healthy men along with Sexual Health Inventory for Men (SHIM). Results Total testosterone serum levels were high in sulfonylurea treated patients as compared to metformin treated patients’ p elevation in testosterone levels, sex drive and erectile function. PMID:28208875

  13. Initial experience with linear focused shockwave treatment for erectile dysfunction: a 6-month follow-up pilot study.

    Science.gov (United States)

    Reisman, Y; Hind, A; Varaneckas, A; Motil, I

    2015-01-01

    Low-intensity shockwaves (LISW) are known to produce revascularization and have been in evaluation and in use to treat erectile dysfunction (ED). The present single-arm pilot study is aimed to assess the safety and efficacy of a dedicated shockwave device (Renova) on vasculogenic ED patients. Fifty-eight patients with mild to severe ED were treated by LISW and their erectile function was evaluated by the International Index of Erectile Function-Erectile Function Domain (IIEF-EF), Sexual Encounter Profile and Global Assessment Questions questionnaires, at baseline and at 1, 3 and 6 months post treatment. The average IIEF-EF increased significantly from 14.78 at baseline to 21.93 at 3 months post treatment and stabilized at 22.26 at 6 months post treatment. Out of 58 patients, 47 (81%) had a successful treatment. No adverse events were reported during the treatment and the follow-up duration. In conclusion, it suggests that the performance of LISW could add a new advanced treatment for ED.

  14. Comparison of the efficacy and safety of sildenafil citrate (Viagra) and oral phentolamine for the treatment of erectile dysfunction.

    Science.gov (United States)

    Ugarte, F; Hurtado-Coll, A

    2002-08-01

    This open-label, multi-center study from Mexico compared the efficacy and safety of oral sildenafil and phentolamine in men with erectile dysfunction. Patients received sildenafil (25-100 mg; n=123) or phentolamine (40 mg; n=119) for 8 weeks, and efficacy was assessed using the International Index of Erectile Function (IIEF) as well as two global efficacy questions. Mean scores for the erectile function domain of the IIEF were significantly higher for sildenafil (27.23 +/- 0.62; P=0.0001) than for phentolamine (19.35 +/- 0.66). Approximately twice as many men receiving sildenafil had successful attempts at sexual intercourse (88% vs 42%), improved erections (95% vs 51.1%), and improved ability to have sexual intercourse (94.4% vs 46.4%) compared with phentolamine. The most common adverse events included rhinitis, headache, tachycardia, and nausea, with a higher frequency reported in patients receiving phentolamine than sildenafil (41% vs 33%), with the exception of headache, which was reported more frequently in sildenafil users. Overall, sildenafil was more effective and appeared to be better tolerated than phentolamine for the treatment of erectile dysfunction.

  15. Prevalence and predictors of concomitant low sexual desire/interest and new-onset erectile dysfunction - a picture from the everyday clinical practice.

    Science.gov (United States)

    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

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Science.gov (United States)

    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.

  18. Outcome of implanting penile prosthesis for tr eating erectile dysfunction: experience with 42 cases%阴茎假体植入术治疗勃起功能障碍:42例报告

    Institute of Scientific and Technical Information of China (English)

    X. J.Xuan; D.H. Wang; P. Sun; H. Mei

    2007-01-01

    Aim: To report a short-time result of three-piece inflatable penile prosthesis (IPP) implantation on treating patients with organic erectile dysfunction (ED). Methods: Three-piece IPPs were implanted in 42 Chinese patients with ED refractory to systemic treatment between May 2002 and May 2004. The etiologies of ED were neurogenic (28 with paraplegia and seven with traumatic nervi-erigentes injury); congenital venous leakage (5 cases), fibrosis of corpus cavernosum (lcase) and Klinefelter's syndrome (1 case). The follow-up period ranged from 24 to 57 months.Results: Implantation procedures were successfully performed upon all 42 patients. The length of implanted prosthesis was from 13 cm to 18 cm, and the diameter was 1 cm. The implanted prosthesis was made by the Medical Instrumentation Company of Muping (Muping, Shandong, China). Localized infection occurred in only one patient and mechanical complications occurred in five patients. Coitus could be performed in 41 cases (97.6%). Three patients with congenital venous leakage made their spouses pregnant after implantation. Conclusion: Implantation of patients because of its efficacy. (Asian J Androl 2007 Sep; 9: 716-719)%目的:探讨中国产(中华人民共和国医疗器械注册证国药管械准字2002第3460989号)三件套可膨胀性阴茎假体植入术治疗器质性勃起功能障碍疗效.方法:2002年5月至2004年5月,42例非手术治疗无效的勃起功能障碍的中国病人进行了三件套可膨胀阴茎假体植入术治疗.勃起功能障碍的病因包括相关神经损伤(28例瘫痪患者和7例外伤性神经损伤患者)、先天性静脉漏(5例)、海绵体纤维化(1例)、以及Klinefelter综合征(1例).随访时间为24-57个月.结果:42例病人的假体植入术均获成功.植入假体的长度在13-18厘米之间,直径为1厘米.术后1例病人发生了局部感染,有5例病人出现了机械故障.41例病人(97.6%)可以进行满意的性生活.假体植入后有3例

  19. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  20. The efficacy and safety of udenafil [Zydena] for the treatment of erectile dysfunction in hypertensive men taking concomitant antihypertensive agents.

    Science.gov (United States)

    Paick, Jae-Seung; Kim, Sae Woong; Park, Yoon Kyu; Hyun, Jae Seog; Park, Nam Cheol; Lee, Sung Won; Park, Kwanjin; Moon, Ki Hak; Chung, Woo Sik

    2009-11-01

    Erectile dysfunction (ED) and hypertension are frequent comorbid conditions. The vasodilating properties of type 5 phosphodiesterase inhibitor (PDE5I) are the major concerns for the treatment of ED patients on antihypertensive medications. To evaluate the efficacy and safety of Udenafil [Zydena] (Dong-A, Seoul, Korea), a newly developed PDE5I, for the treatment of ED patients on antihypertensive medication. It was a multicentered, randomized, double-blind, placebo-controlled, fix-dosed clinical trial among 165 ED patients receiving antihypertensive medications. The subjects treated with placebo, 100 mg or 200 mg of Udenafil for 12 weeks were asked to complete the Sexual Encounter Profile (SEP) diary, the International Index of Erectile Function (IIEF), and the Global Assessment Question (GAQ) during the study period. Primary parameter: the change from baseline for IIEF erectile function domain (EFD) score; Secondary parameters: the IIEF Question 3 and 4, SEP Question 2 and 3, the rate of achieving normal erectile function (EFD > or = 26) and the response to GAQ. Compared to placebo, patients receiving both doses of Udenafil showed significantly improved the IIEF-EFD score. The least squares means for the change from baseline in IIEF-EFD scores were 8.4 and 9.8 for 100 mg and 200 mg Udenafil groups, respectively; those values were significantly higher than that of placebo (2.4, P treatment-emergent adverse events, which were transient and mild-to-moderate in nature. No parameters of efficacy and safety were affected among the subsets stratified according to either the number of antihypertensive medication received or the previous experience of PDE5Is treatment. Udenafil significantly improved erectile function among ED patients with hypertensive symptom treated with concomitant antihypertensive medication. The treatment did not increase the frequency or severity of adverse events.

  1. Preparation and clinical evaluation of nano-transferosomes for treatment of erectile dysfunction

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    Ali MFM

    2015-04-01

    Full Text Available Maha Fadel M Ali,1 Heba F Salem,2 Hany F Abdelmohsen,3 Sameh K Attia4 1Pharmaceutical Technology Unit, Medical Applications of Lasers Department, National Institute of Laser Enhanced Science, Cairo University, Cairo, Egypt; 2Pharmaceutics and Industrial Pharmacy Department, 3Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt; 4Dermatology and Andrology Department, Faculty of Medicine, Minia University, Minia, Egypt Objective: The goal of the present study was to formulate topical nanocarriers of the low-cost vasodilator, papaverine hydrochloride (PH, as an alternative to the painful penile injections. The injections are used for both diagnosis and treatment of erectile dysfunction. Transdermal nano-transferosome (T, the ultraflexible nanoliposome, was used as a nanocarrier to enhance the penetration of the papaverine to the penis. Methods: Different nano formulas were prepared and characterized for their encapsulation efficiency, particle size, zeta potential, and cumulative drug release. The formula acquired the best characteristics was incorporated into 2% (w/v hydroxypropyl methylcellulose hydrogel base. The gel containing transferosomal papaverine hydrochloride (PH and that containing free PH were clinically compared using color flow Doppler measurements. Results: The results revealed that transferosome 3 (T3 had the highest entrapment efficiency approaching 72%, low particle size of 220 nm, and zeta potential of -33.4 mV. The formula released 73% of its initial drug content within 2 hours. The clinical evaluation showed the increase in the cavernous artery diameter from 0.53 mm to 0.78 mm and the increase in the peak systolic flow velocity from 5.95 cm/second to 12.2 cm/second, both of which were found to be significant at P<0.05. Conclusion: It is evident from the study that the transferosomes can be used as a carrier of papaverine hydrochloride for both diagnosis and treatment of the

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

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    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

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

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    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

  4. The GAy MEn Sex StudieS erectile dysfunction among Belgian gay men

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    Vansintejan J

    2013-07-01

    Full Text Available Johan Vansintejan, Jan Vandevoorde, Dirk Devroey Department of Family Medicine, Vrije Universiteit Brussel (VUB, Brussels, Belgium Aim: To determine the prevalence of erectile dysfunction (ED in a sample of the Belgian men who have sex with men (MSM population, and to assess the relevance of major predictors such as age, relationship, and education. We investigated the use of phosphodiesterase type 5 (PDE5 inhibitors among Belgian MSM. Methods: An internet-based survey on sexual behavior and sexual dysfunctions, called GAy MEn Sex StudieS (GAMESSS, was administered to MSM, aged 18 years or older, between the months of April and December 2008. The questionnaire used was a compilation of the Kinsey's Heterosexual–Homosexual Rating Scale, Erection Quality Scale (EQS, and the shortened version of the International Index of Erectile Function (IIEF-5. Results: Of the 1752 participants, 45% indicated having some problems getting an erection. In this group of MSM, 71% reported mild ED; 22% mild to moderate ED; 6% moderate ED; and 2% severe ED. Independent predictors for the presence of ED were: age (odds ratio [OR] = 1.04, P < 0.0001, having a steady relationship (OR = 0.59, P < 0.0001, frequency of sex with their partner (OR = 1.22, P < 0.0001, versatile sex role (OR = 1.58, P = 0.016, passive sex role (OR = 3.12, P < 0.0001, problems with libido (OR = 1.15, P = 0.011, ejaculation problems (OR = 1.33, P < 0.0001, and anodyspareunia (OR = 0.87, P < 0.0001. Ten percent of the Belgian MSM used a PDE5 inhibitor (age 43 ± 11 years; mean ± standard deviation and 83% of them were satisfied with the effects. "Street drugs" were used by 43% of MSM to improve ED. Conclusion: Forty-five percent of participating Belgian MSM reported some degree of ED and 10% used a PDE5 inhibitor to improve erections. Older MSM reported more ED. MSM, who were in a steady relationship or frequently had sex with a partner, reported less ED. MSM with ejaculation problems

  5. Lower urinary tract symptoms, benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction: are these conditions related to vascular dysfunction?

    Science.gov (United States)

    Shimizu, Shogo; Tsounapi, Panagiota; Shimizu, Takahiro; Honda, Masashi; Inoue, Keiji; Dimitriadis, Fotios; Saito, Motoaki

    2014-09-01

    Although the pathogenesis of lower urinary tract symptoms, benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction is poorly understood and thought to be multifactorial, it has been traditionally recognized that these conditions increase with age. There is increasing evidence that there is an association between cardiovascular disease and lower urinary tract symptoms as well as benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction in elderly patients. Age might activate systemic vascular risk factors, resulting in disturbed blood flow. Hypertension, diabetes, hyperlipidemia and atherosclerosis are also linked to the etiology of lower urinary tract symptoms, benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction. In the present review, we discuss the relationship between decreased pelvic blood flow and lower urinary tract symptoms, benign prostatic hyperplasia/benign prostatic enlargement and erectile dysfunction. Furthermore, we suggest possible common mechanisms underlining these urological conditions.

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

    Science.gov (United States)

    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.

  7. Endothelium-specific gene and stem cell-based therapy for erectile dysfunction

    Institute of Scientific and Technical Information of China (English)

    Travis D. Strong; Milena A. Gebska; Arthur L. Burnett; Hunter C. Champion; Trinity J. Bivalacqua

    2008-01-01

    Erectile dysfunction (ED) commonly results from endothelial dysfunction of the systemic vasculature. Although phosphodiesterase type 5 (PDE-5) inhibitors are effective at treating most cases of ED, they must be taken routinely and are ineffectual for a meaningful number of men. In recent years gene and stem cell-based therapies targeted at the penile endothelium have been gaining momentum in preclinical studies. These early studies reveal that gene and stem cell-based therapies may be both enduring and efficacious, and may eventually lead to a cure for ED. The following review will highlight our current understanding of endothelial-specific gene and stem cell-based therapies performed to date in a number of experimental animal models.

  8. Emerging neuromodulatory molecules for the treatment of neurogenic erectile dysfunction caused by cavernous nerve injury

    Institute of Scientific and Technical Information of China (English)

    Anthony J. Bella; Guiting Lin; Ilias Cagiannos; Tom F. Lue

    2008-01-01

    Advances in the neurobiology of growth factors, neural development, and prevention of cell death have resulted in a heightened clinical interest for the development of protective and regenerative neuromodulatory strategies for the cavernous nerves (CNs), as therapies for prostate cancer and other pelvic malignancies often result in neuronal damage and debilitating loss of sexual function. Nitric oxide released from the axonal end plates of these nerves within the corpora cavernosa causes relaxation of smooth muscle, initiating the haemodynamic changes of penile erection as well as contributing to maintained tumescence; the loss of CN function is primarily responsible for the development of erectile dysfunction (ED) after pelvic surgery and serves as the primary target for potential neuroprotective or regenerative strategies. Evidence from pre-clinical studies for select neuromodulatory approaches is reviewed, including neurotrophins, glial cell line-derived neurotrophic factors (GDNF), bone morphogenic proteins, immunophilin ligands,erythropoetin (EPO), and stem cells.

  9. Erectile dysfunction in urethral stricture and pelvic fracture urethral injury patients: diagnosis, treatment, and outcomes.

    Science.gov (United States)

    Sangkum, P; Levy, J; Yafi, F A; Hellstrom, W J G

    2015-05-01

    Urethral stricture disease, pelvic fracture urethral injury (PFUI), and their various treatment options are associated with erectile dysfunction (ED). The etiology of urethral stricture disease is multifactorial and includes trauma, inflammatory, and iatrogenic causes. Posterior urethral injuries are commonly associated with pelvic fractures. There is a spectrum in the severity of both conditions and this directly impacts the treatment options offered by the surgeon. Many published studies focus on the treatment outcomes and the relatively high recurrence rates after surgical repair. This communication reviews the current knowledge of the association between ED and urethral stricture disease, as well as PFUI. The incidence, pathophysiology, and clinical ramifications of both conditions on sexual function are discussed. The treatment options for ED in those patients are reviewed and summarized. © 2015 American Society of Andrology and European Academy of Andrology.

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

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    Anna Tarantini

    2012-01-01

    Full Text Available 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.

  11. Bilateral external and internal pudendal veins embolization treatment for venogenic erectile dysfunction

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    Daniel Lee, BBA, BS

    2017-03-01

    Full Text Available Erectile dysfunction (ED or impotence is estimated to affect around 20-30 million men in the United States (Rhoden et al, 2002. Vascular etiology is purported to be the most prevalent cause of ED in the elderly population, with venogenic ED being the most common subtype (Shafik et al, 2007; Rebonato et al, 2014. A patient, who developed severe venogenic ED, was referred to interventional radiology after ineffective pharmaceutical treatments. Selective embolization of bilateral external and internal pudendal veins was performed through accessing the deep dorsal vein of penis. Subsequent venogram verified successful embolization with stasis within the outflow of the deep dorsal vein of penis. Close to 6 weeks after the procedure, the patient purports to be able to achieve approximately 65% of full penile erection and complete penile erection with penile stimulation and 0.25 mL injection of alprostadil after 25 minutes.

  12. Erectile Dysfunction

    Science.gov (United States)

    ... and vardenafil (Levitra), relax the muscles in the penis, allowing blood to rapidly flow in. On average, the drugs take about an hour to begin ... MUSE is a medicated pellet about half the size of a grain of rice that is ... at the tip of the penis using a disposable plastic applicator. Like the oral ...

  13. Erectile Dysfunction

    Science.gov (United States)

    ... replacement therapy can be delivered via injection, patch, gel, gum and cheek (buccal cavity), intranasal, subcutaneous pellet, ... FDA) has issued warnings about several types of "herbal viagra" because they contain potentially harmful drugs not ...

  14. Erectile Dysfunction

    Science.gov (United States)

    ... uses a pump to draw blood into your penis to create an erection. This hand- or battery-powered device is simple to operate and has a low risk of problems. If a vacuum-constriction device is a good ...

  15. [Treatment of erectile dysfunction in patients with chronic prostatitis using vibromagnetic lazer].

    Science.gov (United States)

    Tereshin, A T; Sosnovskiĭ, I B; Dmitrenko, G D; Tret'iakov, A A

    2012-01-01

    The study was aimed to evaluation of the effectiveness of vibromagnitic lazer therapy (VMLT) of erectile dysfunction (ED) in patients with chronic prostatitis (CP). The study included 40 patients with CP, aged 22 to 45 years. CP duration ranged from 6 months to 9 years, ED--from 6 months to 7 years. All the patients underwent a survey on "Chart of sexological examination of man" with the calculation of sex constitution index, an transrectal ultrasonography of prostate gland (PG), uroflowmetry, clinical and functional assessment of components of the copulatory interval, and assessment of blood plasma concentrations of peptide and steroid hormones. All patients underwent a psychotherapeutic correction of sexual disadaptation, sex therapy using Masters-Johnson, Kaplan, and Lo Piccolo methods, and VMLT using "Matrix-Urologist" device. The control group included 20 healthy men aged 22 to 45 years. All studies were performed Before and 30 days after the end of the last VMLT session. As a result of the treatment, integral IIEF indicators were normalized in 60% of patients, the volume of the prostate--in 70%, hemodynamics in the phase of relaxation and erection--in 70%, venous blood flow in the PG--in 70%, dorsal artery hemodynamics in the phase of relaxation and erection--in 60%, and penile hemodynamics--in 60% of patients. Voiding bladder function was optimized in 75% of patients. The functional activity of the pituitary-adrenal-testicular system returned to normal level in 60% of patients. 1 year after treatment, sexual function was maintained at attained levels in 47.5% of patients. As a matter of findings, it was concluded that VMLT is high effective method of combined non-pharmacological correction of erectile dysfunction in CP patients with strong and medium sex constitution.

  16. The relationship between vitamin D level and erectile dysfunction in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Basat, Sema; Sivritepe, Rıdvan; Ortaboz, Damla; Sevim Çalık, Ecem; Küçük, Eyüp Veli; Şimşek, Berkan; Atay, Sabri; Çalışgan, Arzu

    2017-09-23

    Recent studies have suggested that a relationship could exist between 25-hydroxyvitamin D [25(OH)D] deficiency and erectile dysfunction (ED). The present study evaluated the relationship between 25(OH)D levels and ED in male patients with type 2 diabetes mellitus (DM). The study included 98 patients with type 2 DM aged between 18-80 years. The International Index of Erectile Function (IIEF-5) Questionnaire was administered. The patients were divided into three groups according to IIEF-5 scoring: IIEF-5 score between 5-10, severe ED; IIEF-5 score between 11-20, moderate ED; IIEF-5 score between 21-25, no ED. Biochemical parameters, 25(OH)D and hormonal analysis tests were obtained in all patients. All parameters were compared between these three groups. Of 98 patients included in the study, 32 had severe ED, 45 had moderate ED and 21 had no ED. The mean age was 55.12 ± 9.39 years and the mean 25(OH)D level was 13.69 ± 8.15 ng/ml. When the three groups were compared, 25(OH)D levels were significantly lower in patients with the IIEF-5 score between 5-10 (p = 0.020). There was a moderate positive relationship between IIEF-5 score and 25(OH)D level (r = 0.21, p = 0.038). The patients with severe ED have considerably lower 25(OH)D levels.

  17. Common approach to managing lower urinary tract symptoms and erectile dysfunction

    Institute of Scientific and Technical Information of China (English)

    Jennifer M. Taylor; Rowena DeSouza; Run Wang

    2008-01-01

    The present paper serves as a review of the associations between lower urinary tract symptoms (LUTS) and erectile dysfunction (ED), with a focus on common and combined pathways for treatment. LUTS and ED are common conditions seen in general urologic practice. Research has started to establish epidemiologic and pathophysiologic links between the two conditions and a strong association confirmed across multiple studies. Men seeking care for one condition should always be interviewed for complaints of the other condition. Proposed common pathways include α-1 adrenergic receptor imbalance, Rho-kinase overactivity, endothelial cell dysfunction and atherosclerosis-induced ischemia. Medical therapy has replaced surgery as the first-line treatment for LUTS in most patients, with the incorporation of α-adrenergic receptor antagonists (α-ARAs) and 5-α-reductase inhibitors (5-ARIs) into everyday practice. Treatment with α-ARAs contributes to some improvement in ED, whereas use of 5-ARIs results in worsened sexual function in some patients. Phosphodiesterase-5 (PDE-5) inhibitors have revolutionized the treatment of ED with a simple oral regimen, and new insights demonstrate a benefit of combined use of PDE-5 inhibitors and α-ARAs. The mechanisms of action of these medications support these observed benefits, and they are being studied in the basic science and clinical settings. In addition, novel mechanisms for therapy have been proposed based on clinical and research observations. The minimally invasive and surgical treatments for LUTS are known to have adverse effects on ejaculatory function, while their effects on erectile function are still debated. Much remains to be investigated, but it is clear that the associations between LUTS and ED lay the foundation for future therapies and possible preventative strategies.

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

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    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. .

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

    Energy Technology Data Exchange (ETDEWEB)

    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

  20. Association of psychological factors, patients’ knowledge, and management among patients with erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Huri HZ

    2016-05-01

    Full Text Available Hasniza Zaman Huri,1,2 Nurul Diyana Mat Sanusi,1 Azad Hassan Abdul Razack,3 Raymond Mark1 1Department of Pharmacy, 2Clinical Investigation Center, University of Malaya Medical Centre, 3Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Background: Erectile dysfunction (ED is one of the most common health problems in men. ED can significantly affect a man’s psychological well-being and overall health. Purpose: To investigate the association of psychological factors, patients’ knowledge, and management among ED patients. Patients and methods: A total of 93 patients with an age range from 31 to 81 years who have undergone treatment for ED were included in this study. Results: It was found that the feeling of blame (P=0.001, guilt (P=0.001, anger or bitterness (P=0.001, depression (P=0.001, feeling like a failure (P=0.001, and the feeling of letting down a partner during intercourse (P=0.001 were significantly associated with ED. Age was also found to be significantly associated with patients’ psychological scale (P=0.004. In addition, the majority of patients in this study practice the right method of administration of ED therapy. However, no significant correlation was found between patients’ knowledge of ED therapy and demographic characteristics. Conclusion: This study concluded that ED does affect psychological well-being of people. In addition, patient’s knowledge about ED and its management is also crucial in ensuring that the patient achieves optimal therapeutic outcomes from ED therapy. Keywords: erectile dysfunction, psychological factors, patients’ knowledge, management

  1. What is the current role of intracavernosal injection in management of erectile dysfunction?

    Science.gov (United States)

    El-Sakka, A I

    2016-05-01

    The emerging of intracavernosal injection (ICI) of vasoactive materials was a major breakthrough in the treatment of erectile dysfunction (ED). However, the current state and future direction of ICI role in the armamentarium of diagnosis, prevention and treatment of ED are not well defined. The aim of this study was to address the current place of ICI in the armamentarium of ED diagnosis and treatment. An English-language MEDLINE review for the utilization of 'intracavernosal injection & erectile dysfunction' was performed from 1990 to present time. Four hundred forty-eight articles were analyzed and classified according to the current utilization of ICI in the following conditions; diagnosis of ED, phosphodiesterase-5 inhibitor (PDE5I) non-responders, diabetes, post radical prostatectomy (RP), stem cells and gene therapy, new intracavernosal drugs, adverse effects and couple satisfaction. This paper is not a standard systematic review; it is eventually a literature review of original peer-reviewed manuscripts and clinical trials reported in Medline. The comprehensive analyses of all the reviewed data were not possible as the level of evidence for utility of ICI in each topic was not available. Current date have established the role of ICI of vasoactive materials as a very common alternative domain in treatment of severe ED particularly in diabetic patients, post-RP, PDE5I non-responders. Further, new studies have denoted the potential future role of intracavernosal treatment for ED in the era of stem cells and gene therapy. ICI of vasoactive material continues to be a highly effective and safe treatment tool for men with wide varieties of ED etiologies. Several experimental and clinical studies are currently investigating new ICI materials. Hopefully in the near future, we might witness evolved molecules and innovative strategies that could help to treat ED patients with different etiologies.

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

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    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.

  3. Urinary tract symptoms and erectile function in patients at risk of prostate cancer.

    Science.gov (United States)

    Ramírez-Backhaus, M; González-Tampán, J; Ortiz-Rodríguez, I M; Gómez-Ferrer, Á; Rubio-Briones, J; Collado-Serra, A; Calatrava, A; Rodríguez-Torreblanca, C; Solsona-Narbón, E

    2015-01-01

    We estimate that more tan 63000 prostate biopsies are performed in our country each year. There are no functional status data of those patients and if there is a relationship between biopsy result and functional status. In order to solve that question we have performed this study. 1,128 prostate biopsies were included. Patients fill in the IPSS, IIEF-5 and ICIQ-SF questionnaires before the prostate biopsy was performed. A prospective data collection of clinical, pathological and questionnaires results was done. A descriptive analysis was carried out. IPSS and IIEF-5 results were categorized. Results were compared depending on the biopsy result. In the subgroup of patients with prostate cancer, questionnaires results were stratify according to the clinical risk group. The mean age of the sample was 65. Prostate cancer detection rate was 32,71%, 52,2% of the sample had mild lower urinary tract symptoms (LUTS) and 13,4% had severe LUTS at the time of the biopsy. Regarding the impact of LUTS on quality of life (QOL), only 12,6% showed a perfect QOL. More than 50 percent of patients suffered from some degree of erectile dysfunction at the time of the biopsy. According to ICIQ-SF, 24% of the sample experienced some kind of urinary incontinence, although it is true that most of them classified it as small amount. Patients with a positive biopsy had a lower IPSS and IIEF-5 average score. There were no differences in the prostate cancer detection rate stratified by the severity of LUTS. Patients undergoing prostate biopsy have, with a high probability, LUTS. Approximately 50% suffer from some degree of erectile dysfunction and 24% had some kind of urinary leakage. Copyright © 2014 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Usefulness of electromyography of the cavernous corpora (CC EMG) in the diagnosis of arterial erectile dysfunction.

    Science.gov (United States)

    Virseda-Chamorro, M; Lopez-Garcia-Moreno, A M; Salinas-Casado, J; Esteban-Fuertes, M

    2012-01-01

    Electromyography (EMG) of the corpora cavernosa (CC-EMG) is able to record the activity of the erectile tissue during erection, and thus has been used as a diagnostic technique in patients with erectile dysfunction (ED). The present study examines the usefulness of the technique in the diagnosis of arterial ED. A cross-sectional study was made of 35 males with a mean age of 48.5 years (s.d. 11.34), referred to our center with ED for >1 year. The patients were subjected to CC-EMG and a penile Doppler ultrasound study following the injection of 20 μg of prostaglandin E1 (PGE1). The patients were divided into three groups according to their response to the intracavernous injection of PGE1: Group 1 (adequate erection and reduction/suppression of EMG activity); Group 2 (insufficient erection and persistence of EMG activity); and Group 3 (insufficient erection and reduction/suppression of EMG activity). Patient classification according to response to the intracavernous injection of PGE1 was as follows: Group 1: six patients (17%), Group 2: 18 patients (51%), and Group 3: 11 patients (31%). Patients diagnosed with arterial insufficiency according to Doppler ultrasound (systolic arterial peak velocity EMG activity showed a sensitivity of 66.7% (confidence interval between 50 and 84%) and a specificity of 92.9% (confidence interval between 84 and 100%) in the diagnosis of arterial ED. Owing to the high specificity of CC-EMG response to the injection of PGE1, this test is considered useful as a screening technique in the diagnosis of arterial ED.

  5. Problems in understanding the Turkish translation of the international index of erectile function.

    Science.gov (United States)

    Serefoglu, Ege Can; Atmaca, Ali Fuat; Dogan, Bayram; Altinova, Serkan; Akbulut, Ziya; Balbay, M Derya

    2008-01-01

    The objective of our study is to analyze the impact of patient age, education level, and household income on the understanding of the International Index of Erectile Function (IIEF) and to determine the patient characteristics that make this questionnaire less reliable. All men older than 18 years presenting to our clinic were asked to complete the Turkish translation of IIEF upon arrival. Self-reported information related to age, education level, and household income of the patients was also recorded from the questionnaire. The patients were requested to complete the questionnaires once again during their second visit, which was not earlier than 5 hours and no later than 5 days. The patients were requested to complete the questionnaire by themselves; however, those who were unable to do so themselves were allowed to receive the assistance of their companions. The answers of the questions that were replied to properly were defined as "appropriate," and the unanswered questions or those replied to with more than one answer were defined as "inappropriate." A total of 430 patients were included in this study. Only 289 patients (67.2%) were able to respond to all of the questions properly at first visit. The percentage of improper completion increased as age increased, whereas it decreased parallel to the increase in educational level and household income (respectively, P = .027, P translation of the IIEF needs further validations for the self-administered mode in order to improve its comprehension as well as its reliability, validity, and specificity, especially in older patients with lower educational levels and household income status, among whom the prevalence and the severity of erectile dysfunction is higher.

  6. Neuromedin B Restores Erectile Function by Protecting the Cavernous Body and the Nitrergic Nerves from Injury in a Diabetic Rat Model.

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    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.

  7. Cortical Visual Impairment

    Science.gov (United States)

    ... Frequently Asked Questions Español Condiciones Chinese Conditions Cortical Visual Impairment En Español Read in Chinese What is cortical visual impairment? Cortical visual impairment (CVI) is a decreased visual ...

  8. Efficacy and safety of sildenafil citrate (Viagra) for the treatment of erectile dysfunction in men in Egypt and South Africa.

    Science.gov (United States)

    Levinson, I P; Khalaf, I M; Shaeer, K Z M; Smart, D O

    2003-04-01

    The efficacy of sildenafil citrate (Viagra), an oral agent for the treatment of erectile dysfunction (ED), has been demonstrated in global studies. This 12-week randomized, double-blind, placebo-controlled, parallel-group, flexible-dose study assessed the efficacy and safety of sildenafil to treat ED in men in Egypt and South Africa. Men with ED of varied etiology were randomized to receive sildenafil 50 mg (n=128) or placebo (n=126); doses could be adjusted to 100 or 25 mg. Questions from the International Index of Erectile Function (IIEF) assessing the ability to achieve (Q3) and maintain (Q4) erections demonstrated a significant improvement with sildenafil compared with placebo (PEgypt and South Africa.

  9. Levels of l-arginine and l-citrulline in patients with erectile dysfunction of different etiology.

    Science.gov (United States)

    Barassi, A; Corsi Romanelli, M M; Pezzilli, R; Damele, C A L; Vaccalluzzo, L; Goi, G; Papini, N; Colpi, G M; Massaccesi, L; Melzi d'Eril, G V

    2017-03-01

    Nitric oxide is a physiologic signal essential to penile erection. l-citrulline (l-Cit) is converted into l-arginine (l-Arg), the precursor from which nitric oxide is generated. The level of l-Arg and l-Cit in the field of male sexual function remains relatively underexplored. The aim of the study was to evaluate the level of serum l-Arg and of l-Cit in a group of patients with erectile dysfunction. Diagnosis and severity of erectile dysfunction was based on the IIEF-5 and its etiology was classified as arteriogenic (A-ED), borderline (BL-ED), and non-arteriogenic (NA-ED) with penile echo-color-Doppler in basal condition and after intracaversous injection of prostaglandin E1. Serum l-Arg and l-Cit concentrations were measured by a cation-exchange chromatography system. l-Arg and l-Cit levels of men with A-ED were compared with those of male with BL-ED and NA-ED. Median level of l-Arg and l-Cit in 122 erectile dysfunction patients (41 A-ED, 23 ED-BL, 58 NA-ED) was 82.7 and 35.4 μmol/L, respectively. l-Arg and l-Cit levels in control patients were not significantly different (p = 0.233 and p = 0.561, respectively) than in total erectile dysfunction patients. l-Arg and l-Cit levels in control patients were significantly higher (p  0.50) was observed in controls and in both BL-ED and NA-ED patients. Patients with severe/complete-erectile dysfunction (IIEF-5 l-Arg or l-Cit level significantly lower (-17%, p L) than those with mild-erectile dysfunction (IIEF-5 = 16-20). l-Arg and l-Cit levels in A-ED were significantly lower (p l-Arg under 82.7 μmol/L or l-Cit under 35.4 μmol/L and in the same population, the median peak systolic velocity values were lower in l-Arg deficient (29 vs. 35; p l-Cit deficient (31 vs. 33, p > 0.3) but without reaching the statistical significance. Our study shows that a significant proportion of erectile dysfunction patients have low l-Arg or l-Cit level and that this condition is more frequent in patients with arteriogenic

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

    Directory of Open Access Journals (Sweden)

    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.

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

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    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

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

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    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.

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

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    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.)

  14. Effects of oral phentolamine, taken before sleep, on nocturnal erectile activity: a double-blind, placebo-controlled, crossover study.

    Science.gov (United States)

    Hatzichristou, D G; Apostolidis, A; Tzortzis, V; Hatzimouratidis, K; Kouvelas, D

    2001-10-01

    The objective of this study was to determine the effects of oral phentolamine, administered before sleep, on nocturnal penile erectile activity of men with mild to moderate erectile dysfunction (ED). We studied five patients with mild to moderate ED (mean age 34.8 +/- 8.13 and mean duration of ED 31.8 +/- 23.5 months), in a double-blind, placebo-controlled, crossover study. All patients received oral phentolamine (Vasomax) at a dose of 40 mg and placebo for three consecutive nights respectively and were submitted to nocturnal penile tumescence and rigidity monitoring (NPTR) with the Rigiscan device. NPTR parameters of the two 3-night recordings were evaluated and compared. Administration of oral phentolamine before sleep was associated with a statistically significant increase in the number of erectile events with rigidity > or = 60% lasting > or = 10 min (P = 0.02), as well as the rigidity activity units (RAU) value per hour sleep, both at the base (P = 0.023) and the tip of the penis (P = 0.019). The number of events as measured by Rigiscan software (20% change in circumference), as well as tumescence activity units (TAU)/h values did not show any statistical difference. No adverse effects were recorded. It is concluded that oral phentolamine administered before sleep enhanced NPTR parameters associated with the quality of the erectile events. Such results provide a pathway for the development of a prevention strategy for ED. Future studies will elucidate whether vasoactive agents taken on a regular basis before sleep, can prevent ED in men at risk, protecting also minimally and moderately impotent patients to become moderately and severely impotent respectively.

  15. Emotional changes in men treated with sildenafil citrate for erectile dysfunction: a double-blind, placebo-controlled clinical trial.

    Science.gov (United States)

    Moncada, Ignacio; Martínez-Jabaloyas, José M; Rodriguez-Vela, Luis; Gutiérrez, Pedro R; Giuliano, Francois; Koskimaki, Juha; Farmer, Ian S; Renedo, Virginia Pascual; Schnetzler, Gabriel

    2009-12-01

    Erectile dysfunction (ED) has been associated with several comorbidities and can cause significant loss of quality of life and self-esteem. In men with ED, to use the validated Self-Esteem and Relationship (SEAR) questionnaire to evaluate changes in self-esteem associated with sildenafil treatment of ED and to assess changes dependent on concomitant comorbid conditions. This was a 14-week, international, randomized, parallel-group, double-blind, flexible-dose (25, 50, or 100 mg), placebo-controlled study of sildenafil in men aged >or=18 years with a clinical diagnosis of ED (score Self-Esteem subscale score from baseline to the end of treatment. Secondary outcomes were the change in SEAR component scores stratified by ED comorbidity, the change in the International Index of Erectile Function (IIEF) domain scores and in the intercourse success rate, and the response to the global efficacy assessment and to the global satisfaction assessment. A total of 841 patients were included in the intent-to-treat efficacy analysis (559 sildenafil, 282 placebo). Patients randomized to sildenafil had significantly greater change scores from baseline to the end of treatment on all components of the SEAR and all domains of the IIEF (P Self-Esteem subscale score correlated with improvements in the mean Erectile Function domain score (r = 0.6338, P depression. Using both the IIEF and the SEAR questionnaires provides a more complete assessment of ED.

  16. Predictors of Erectile Dysfunction in Men with Type 2 Diabetes Mellitus Referred to a Tertiary Healthcare Centre

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    Theophilus Ugwu

    2016-01-01

    Full Text Available Background. The frequency of erectile dysfunction (ED complicating diabetes mellitus (DM is reportedly high. However, its risk factors have not been well studied. Methods. This was a cross-sectional study of 160 male type 2 DM adults, aged 30–70 years, attending a tertiary healthcare clinic. Demographic and relevant clinical information was documented. Erectile function was assessed using an abridged version of the International Index of Erectile Function (IIEF-5. All subjects were evaluated for central obesity, glycemic control, peripheral arterial disease (PAD, autonomic neuropathy, dyslipidemia, and testosterone deficiency. Results. 152 (95% patients with a mean age of 60.3 ± 8.8 years completed the study. 71.1% had varying degrees of ED, while 58.3% suffered from a moderate-to-severe form. Independent predictors of ED [presented as adjusted odds ratio (95% confidence interval] were longer duration of DM, 1.14 (1.02–1.28, PAD, 3.87 (1.28–11.67, autonomic neuropathy, 3.51 (1.82–6.79, poor glycemic control, 7.12 (2.49–20.37, and testosterone deficiency, 6.63 (2.61–16.83. Conclusion. The prevalence of ED and its severe forms was high in this patient population. Poor glycemic control and testosterone deficiency were the strongest risk factors for ED, making it possibly a preventable condition.

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

    Institute of Scientific and Technical Information of China (English)

    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)

  18. Diagnosis and treatment of erectile dysfunction in patients with benign prostatic hyperplasia

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    S. N. Kalinina

    2016-01-01

    Full Text Available The efficacy and safety of the Russian phosphodiesterase type 5 inhibitor sildenafil-C3 in combination with a natural complex of the Russian multicomponent dietary supplement (DS Erectogenon were investigated in 75 patients with erectile dysfunction (ED and benign prostatic hyperplasia (BPH. Clinical and Doppler ultrasound examinations revealed moderate ED in 34 study group patients who had received combined treatment with sildenafil and the DS Erectogenon for 4 weeks. In the same perod, 21 patients from a comparative group (Group 2 had taken sildenafil only and 20 patients from a comparative group (Group 3 had used the natural biocomplex DS Erectogenon only. The investigation revealed mild ED in the patients from Groups 2 and 3. The immediate and late treatment results were assessed 4 and 12 weeks after the end of treatment, respectively. Combined therapy with sildenafil + Erectogenon was found to statistically significantly enhance its efficiency and to improve quality of sexual life in 85.3 % of the study group patients who had moderate ED. This patient group had a more marked positive clinical effect (a mean increase in erection quality by 7.0 scores by the International Index of Erectile Function, a rise in penile blood flow by 3.5 times, and a reduction in the International Prostatitis Symptom Index by 5 scores. Sildenafiil-C3 or Erectogenon monotherapy provided a lower effect in the comparative groups. The findings confirm that combined therapy with the Russian drugs sildenafil-C3 and DS Erectogenon is effective, safe, and well-compatible and causes no adverse reactions and the synergism of the components of the biocomplex DS Erectogenon prolongs the effect of daily low-dose sildenafil. The combined treatment may be recommended for the treatment of ED in patients with BPH, for this affects the pathogenesis of the disease, alleviates the progression of ED, and improves their quality of life. The treatment should be used in moderate

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

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    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

  20. [Intraurethrally applicated alprostadil for the treatment of organic erectile dysfunction in practice: a multicenter clinical monitoring study (noninterventional investigation)].

    Science.gov (United States)

    Potempal, Axel-Jürg; Potempa, Dirk M; Görlich, Hans Diether; Stolpmann, Rainer M

    2007-01-01

    In a multicenter clinical monitoring study (observation of use investigation according to 67.6 of the German Drug Law), which was conducted between 2003 and 2005 in 105 urological practices in 314 patients with organic erectile dysfunction (ED), efficacy, safety, convenience and acceptance of intraurethral administered alprostadil (CAS 745-65-3; MUSE - Medicated Urethral System for Erection) was studied. 306 patients could statistically be evaluated. The patients were 61.3 +/- 9.2 years old (median+/- SD) (181 patients between 60 and 80 y). The time of ED was from 2 to 120 months with a mean duration of 21.5 +/- 22 months (median+/-SD. Genesis of the ED was in 55 % of the patients a local damage, which followed in 42.8 % a prostate cancer surgery. 46 % of the patients had vascular, 28 % metabolic diseases including diabetes and 11% neural damages. In 51.3% of the patients drugs, which were known to induce ED, were suspected to have caused or partially caused the impairment. The degree of the disturbance was in 93 % of the cases moderate to severe. Alprostadil (MUSE) was applicated three times in doses of 250, 500 or 1000 microg. The dosage of 1000 microg was used for the third application by 65 % of the patients. Very good and good efficacy increased from 45.8% of the patients after the first through 63.7 % after the second to 69.3 % after the third application. In patients after surgery because of prostate cancer very good and good efficacy improved in comparison to the first application about 20% and concerned 53.9 % of the patients after the third application. Sexual intercourse was possible by 67% of the patients after the first, 83 % after the second and 87 % after the third use. Tolerability of alprostadil (MUSE) was very good and good in 90% of the patients. 81.1% intended to continue the treatment. The handling of alprostadil (MUSE) was assessed very good and good by 75%, the acceptance was very good and good in 96% of the patients. In a retrospective

  1. Masculinity and emotion in Mexican men's understandings of erectile dysfunction aetiology and treatment.

    Science.gov (United States)

    Wentzell, Emily

    2014-01-01

    This paper investigates the role that emotions related to local gender norms play in urban Mexican men's understandings of erectile dysfunction (ED) aetiology and drug treatment by analysing semi-structured interviews with 28 male urology patients. Analysing narrative data from our interviews, the paper examines how these men drew differently from locally intelligible ways of understanding health and masculinity to develop context-specific understandings of causes and potential treatment outcomes. Study participants' feelings of success or failure in life areas relating to the performance of 'responsible' masculinity, especially work and romance, strongly influenced understandings of ED aetiology and goals for drug treatment. Those who felt successful at being men collaborated with loved ones to adopt purely biological understandings of ED causation, while those who expressed negative emotions about their performances of masculinity viewed these feelings, as well as the structural and interpersonal problems that caused them, as key causes and consequences of dysfunction. I discuss how these different emotional experiences led to different ways of using medication, and the relevance of these findings for clinical practice.

  2. Cerebral Activity Changes in Different Traditional Chinese Medicine Patterns of Psychogenic Erectile Dysfunction Patients

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    Qi Liu

    2015-01-01

    Full Text Available Background. Pattern differentiation is the foundation of traditional Chinese medicine (TCM treatment for erectile dysfunction (ED. This study aims to investigate the differences in cerebral activity in ED patients with different TCM patterns. Methods. 27 psychogenic ED patients and 27 healthy subjects (HS were enrolled in this study. Each participant underwent an fMRI scan in resting state. The fractional amplitude of low-frequency fluctuation (fALFF was used to detect the brain activity changes in ED patients with different patterns. Results. Compared to HS, ED patients showed an increased cerebral activity in bilateral cerebellum, insula, globus pallidus, parahippocampal gyrus, orbitofrontal cortex (OFC, and middle cingulate cortex (MCC. Compared to the patients with liver-qi stagnation and spleen deficiency pattern (LSSDP, the patients with kidney-yang deficiency pattern (KDP showed an increased activity in bilateral brainstem, cerebellum, hippocampus, and the right insula, thalamus, MCC, and a decreased activity in bilateral putamen, medial frontal gyrus, temporal pole, and the right caudate nucleus, OFC, anterior cingulate cortex, and posterior cingulate cortex (P<0.005. Conclusions. The ED patients with different TCM patterns showed different brain activities. The differences in cerebral activity between LSSDP and KDP were mainly in the emotion-related regions, including prefrontal cortex and cingulated cortex.

  3. The dangers of sexual enhancement supplements and counterfeit drugs to “treat” erectile dysfunction

    Science.gov (United States)

    Chiang, Jason; Yafi, Faysal A.; Dorsey, Philip J.

    2017-01-01

    Counterfeit phosphodiesterase-5 inhibitors (PDE-5i) are an increasing problem. Already in widespread use, the market for PDE-5i is steadily growing as the population ages. Counterfeiters are taking advantage of this growing market by developing illicit and counterfeit PDE-5i products. Many factors are contributing to the rapid growth of the illicit market, such as the low risk of prosecution, potentially high financial reward, and ease of distribution via Internet pharmacies. Consumers of illicit PDE-5i often do not realize they are using counterfeit products and placing themselves at an unnecessary health risk. Others seek to bypass the legitimate healthcare system due to either embarrassment of the underlying condition or desire for cheaper alternatives. However, taking illicit PDE-5i may harm consumers directly, as many illicit products contain detrimental contaminants and inaccurate amounts of the active ingredient without the appropriate warnings. Bypassing the legitimate healthcare system also endangers consumers indirectly, as erectile dysfunction (ED) is often associated with other medical comorbidities that patients should be screened for. Furthermore, PDE-5i can have potentially dangerous interactions with other pharmaceuticals that are rarely warned against with counterfeit PDE-5i. This communication reviews the literature regarding counterfeit PDE-5i, and summarizes both the scope and dangers of the illicit PDE-5i market. PMID:28217446

  4. The dangers of sexual enhancement supplements and counterfeit drugs to "treat" erectile dysfunction.

    Science.gov (United States)

    Chiang, Jason; Yafi, Faysal A; Dorsey, Philip J; Hellstrom, Wayne J G

    2017-02-01

    Counterfeit phosphodiesterase-5 inhibitors (PDE-5i) are an increasing problem. Already in widespread use, the market for PDE-5i is steadily growing as the population ages. Counterfeiters are taking advantage of this growing market by developing illicit and counterfeit PDE-5i products. Many factors are contributing to the rapid growth of the illicit market, such as the low risk of prosecution, potentially high financial reward, and ease of distribution via Internet pharmacies. Consumers of illicit PDE-5i often do not realize they are using counterfeit products and placing themselves at an unnecessary health risk. Others seek to bypass the legitimate healthcare system due to either embarrassment of the underlying condition or desire for cheaper alternatives. However, taking illicit PDE-5i may harm consumers directly, as many illicit products contain detrimental contaminants and inaccurate amounts of the active ingredient without the appropriate warnings. Bypassing the legitimate healthcare system also endangers consumers indirectly, as erectile dysfunction (ED) is often associated with other medical comorbidities that patients should be screened for. Furthermore, PDE-5i can have potentially dangerous interactions with other pharmaceuticals that are rarely warned against with counterfeit PDE-5i. This communication reviews the literature regarding counterfeit PDE-5i, and summarizes both the scope and dangers of the illicit PDE-5i market.

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

    Science.gov (United States)

    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.

  6. Lichen Simplex Chronicus Associated With Erectile Dysfunction: A Population-Based Retrospective Cohort Study.

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    Chao-Kuei Juan

    Full Text Available An association between lichen simplex chronicus (LSC and sexual dysfunction was explored. However, no data are available from investigations into the relationship between erectile dysfunction (ED and LSC.This retrospective population-based cohort study aimed to clarify the risk of ED associated with LSC.By using the Taiwan National Health Insurance Research dataset, we identified 5611 male patients who had been newly diagnosed with LSC from 2000 to 2004. The date of diagnosis was identified as the index date. LSC patients with incomplete demographic information or with a history of ED before the index date were excluded. In total, 22444 age-matched patients without LSC were randomly selected as the non-LSC group based on a 1:4 ratio. Subsequence occurrence of ED was measured until 2011. The association between LSC and the risk of developing ED was estimated using Cox proportional hazard regression model.After adjusting for age and comorbidities, patients with LSC had a 1.74-fold greater risk of developing ED compared with those without LSC (95% confidence interval=1.44-2.10. LSC patients with comorbidities including diabetes, hyperlipidemia, hypertension, cardiovascular disease, peripheral arterial disease, chronic obstructive pulmonary disease, chronic kidney disease, depression, and anxiety were at a higher risk of ED compared with the non-LSC patients without comorbidities.LSC confers a greater risk in the development of ED. Physicians should be aware of the potential of ED occurrence in LSC patients.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  8. Complex beam diagnostics erectile dysfunction of the venoocclusive apparatus of a penis

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    V. I. Mustafina

    2012-01-01

    Full Text Available Erectile dysfunction – it disability to reach and support an erection, sufficient for sexual intercourse carrying out.A research objective – to use complex beam diagnostics with application of ultrasonic research with Doppler techniques (color, power and spectral Doppler, regimen Dynamic flow, a pharmacological and visual induction of an erection, a computer tomography (СТ, MR-tomographies (MRT, dynamic cavernosography to estimate opportunities and to lead the comparative analysis. 47 men have been surveyed. The control group was made by 8 volunteers at the age from 25 till 55 years without complaints to erection disturbances. The basic group was made by 39 patients at the age from 30 till 60 years with suspicion of dysfunction of the venoocclusive apparatus of a penis. In the basic group at 39 men have been found out sonographic signs of dysfunction of the venoocclusive apparatus of a penis. The referential estimation was spent with dynamic cavernosography, МRT, СТ.

  9. Complex beam diagnostics erectile dysfunction of the venoocclusive apparatus of a penis

    Directory of Open Access Journals (Sweden)

    V. I. Mustafina

    2014-11-01

    Full Text Available Erectile dysfunction – it disability to reach and support an erection, sufficient for sexual intercourse carrying out.A research objective – to use complex beam diagnostics with application of ultrasonic research with Doppler techniques (color, power and spectral Doppler, regimen Dynamic flow, a pharmacological and visual induction of an erection, a computer tomography (СТ, MR-tomographies (MRT, dynamic cavernosography to estimate opportunities and to lead the comparative analysis. 47 men have been surveyed. The control group was made by 8 volunteers at the age from 25 till 55 years without complaints to erection disturbances. The basic group was made by 39 patients at the age from 30 till 60 years with suspicion of dysfunction of the venoocclusive apparatus of a penis. In the basic group at 39 men have been found out sonographic signs of dysfunction of the venoocclusive apparatus of a penis. The referential estimation was spent with dynamic cavernosography, МRT, СТ.

  10. Erectile dysfunction in patients with plaque psoriasis: the relation of depression and cardiovascular factors.

    Science.gov (United States)

    Ji, S; Zang, Z; Ma, H; Gu, M; Han, Y; Wang, L; Jia, S; Yang, B

    2016-05-01

    Psoriasis is a chronic inflammatory skin disease and seems to be associated with erectile dysfunction (ED). ED is a predictor of future cardiovascular disease. It is important to identify ED early and investigate cardiovascular problems in psoriasis patients. The sample consisted of 191 psoriasis patients and 191 healthy men. One hundred and one of 191 (52.9%) patients with psoriasis were indicative of ED, compared with 40.3% in control group, reflecting an age-adjusted odds ratio of 1.965 in favor of the psoriasis group. A univariate analysis in the psoriasis group indicated that age, hypertension, hyperlipidemia, diabetes mellitus and depressive symptoms were the risk factors for ED. The multivariate logistic regression model indicated that increasing age, hypertension, hyperlipidemia and depressive symptoms were independent risk factors for ED in psoriasis. The more severe depressive symptoms increased the risk of ED and especially moderate-severe ED. The diagnosis of ED may help prevent emotional and physical discomfort in men and aid in identifying reversible cardiovascular risk factors. Screening of ED may become a part of routine care in the management of psoriasis patients.

  11. Usage of neck circumference as novel indicator of erectile dysfunction: a pilot study in Turkish population.

    Science.gov (United States)

    Akin, Y; Gulmez, H; Bozkurt, A; Nuhoglu, B; Usta, M F

    2014-01-01

    Erectile dysfunction (ED) is the most common male sexual problem worldwide. The association between ED and components of metabolic syndrome (MtS) is well established. This study examined neck circumference (NC) as a possible indicator of MtS and also of ED. Ninety-two patients were included and divided into two groups. Group 1 consisted of 47 patients with ED and Group 2 consisted of 45 healthy volunteers. Questionnaires, differences in anthropometric and laboratory measurements between patients with ED and the control group, and a cut-off value for NC were investigated. The mean NC in ED patients was higher in Group 1 than in Group 2 (P = 0.001), and Group 1 also demonstrated more MtS criteria than Group 2 (P circumference for ED and MtS were 105.5 and 102.5 cm respectively. In the light of these findings, NC may be a new component of MtS in ED patients. Additionally, NC may be a novel indicator of central obesity and ED. We suggest that NC values of 35 cm and over may predict ED in patients with MtS.

  12. Pathophysiology of visual disorders induced by phosphodiesterase inhibitors in the treatment of erectile dysfunction

    Science.gov (United States)

    Moschos, Marilita M; Nitoda, Eirini

    2016-01-01

    Aim The aim of this review was to summarize the ocular action of the most common phosphodiesterase (PDE) inhibitors used for the treatment of erectile dysfunction and the subsequent visual disorders. Method This is a literature review of several important articles focusing on the pathophysiology of visual disorders induced by PDE inhibitors. Results PDE inhibitors have been associated with ocular side effects, including changes in color vision and light perception, blurred vision, transient alterations in electroretinogram (ERG), conjunctival hyperemia, ocular pain, and photophobia. Sildenafil and tadalafil may induce reversible increase in intraocular pressure and be involved in the development of non-arteritic ischemic optic neuropathy. Reversible idiopathic serous macular detachment, central serous chorioretinopathy, and ERG disturbances have been related to the significant impact of sildenafil and tadalafil on retinal perfusion. Discussion So far, PDE inhibitors do not seem to cause permanent toxic effects on chorioretinal tissue and photoreceptors. However, physicians should write down any visual symptom observed during PDE treatment and refer the patients to ophthalmologists. PMID:27799745

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

    Science.gov (United States)

    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.

  14. Ultrastructural changes of corpora cavernosa in men with erectile dysfunction and chronic renal failure.

    Science.gov (United States)

    Bellinghieri, Guido; Santoro, Giuseppe; Santoro, Domenico; Lo Forti, Bruno; Savica, Vincenzo; Favazzi, Pietro; Magaudda, Ludovico; Cohen, Arthur H

    2004-09-01

    Erectile dysfunction (ED) is a common and often distressing side effect of renal failure. Uremic men of different ages report a high variety of sexual problems, including sexual hormonal pattern alterations, reduced or loss of libido, infertility, and impotence, thereby influencing their well-being. The pathogenic mechanisms include physiologic, psychologic, and organic causes. To determine the contribution of morphologic factors to impotence we studied the ultrastructure of the corpora cavernosa in 20 patients with end-stage renal disease who were treated with chronic dialysis and compared the findings with 6 individuals with no clinical history of impotence. Our results indicated that in male uremic patients with sexual disturbances there were major changes in smooth muscle cells. This was characterized by reduction of dense bodies in the cytoplasm, thick basement membranes, and increased interstitial collagen fibers with resultant reduction of cell-to-cell contact. In addition, there was thickening and lamination of basement membranes of endothelial cells and increased accumulation of collagen between nerve fibers. These alterations were more evident in patients with longer time on dialysis and were independent of type of primary renal disease. We hypothesize that ED in dialysis patients is not related to the primary disease but to the uremic state.

  15. Vasoactive intestinal polypeptide/phentolamine for intracavernosal injection in erectile dysfunction.

    Science.gov (United States)

    Dinsmore, W Wallace; Wyllie, Michael G

    2008-09-01

    Erectile dysfunction (ED) is becoming an increasingly common problem and although oral therapies offer first-line treatment for many men, they are contraindicated or ineffective in substantial groups of patients. Intracavernosal injection (ICI) therapy is the most effective nonsurgical treatment for ED and offers an effective alternative to oral therapy. Sufficient arterial blood supply and a functional veno-occlusive mechanism are prerequisites in the attainment and maintenance of a functional erection. Invicorp (Plethora Solutions, London, UK) is a combination of vasoactive intestinal polypeptide (VIP) 25 microg and phentolamine mesylate 1 or 2 mg for ICI in the management of moderate to severe ED. The two active components have complementary modes of action; VIP has a potent effect on the veno-occlusive mechanism, but little effect on arterial inflow, whereas phentolamine increases arterial blood flow with no effect on the veno-occlusive mechanism. Clinical studies showed that Invicorp is effective in >or=80% of men with ED, including those who have failed to respond to other therapies and, unlike existing intracavernosal therapies, is associated with a very low incidence of penile pain and virtually negligible risk of priapism. We estimate that there are >5.9 million men in the USA alone for whom oral ED drugs are not a viable treatment option, and for whom Invicorp might offer a safe and effective alternative.

  16. [Normal connective tissue in penis and its changes in patients with erectile dysfunction and Peyronie's disease].

    Science.gov (United States)

    Neĭmark, A I; Klimachev, V V; Gerval'd, V Ia; Bobrov, I P; Avdalian, A M; Muzalevskaia, N I; Gerval'd, I V; Aliev, R T; Kazymov, M A

    2009-01-01

    The aim of this study was to examine the connective tissue of penis in normal individuals and in patients with erectile dysfunction (ED) and Peyronie's disease (PD) using computer methods of image analysis. Penis tissues were obtained from 20 males aged 20-40 years who died in accidents, penis biopsies were taken from 23 patients with ED and 9 patients with PD (average age: 51 +/- 11.5 years). In both groups of patients, the volumetric fraction of collagen fibers in the tunica albuginea and corpora cavernosa was increased, while that one of elastic fibers was decreased. At the same time, the changes of elastic fibers were noted: the fibers become thinner and formed "rods". The reduction of the amplitude and the wavelength in the collagen fibers of the tunica albuginea in patients with ED and the presence of fibrous plaques in corpora cavernosa in in patients with PD were registered. The methods of computer image analysis may improve the morphologic diagnosis of ED and PD.

  17. Sildenafil citrate vs intracavernous alprostadil for patients with arteriogenic erectile dysfunction: a randomised placebo controlled study.

    Science.gov (United States)

    Mancini, M; Raina, R; Agarwal, A; Nerva, F; Colpi, G M

    2004-02-01

    We compared the effectiveness of sildenafil citrate and alprostadil in improving arterial penile inflow (peak systolic velocity (PSV)) and penile rigidity in 55 patients with erectile dysfunction caused by atherosclerosis. A total of 35 patients with pure vasculogenic impotency were randomly assigned to alprostadil (Av group; n=11), sildenafil (Sv group; n=12), or placebo (P group; n=12), and 20 patients with nonvasculogenic impotency were randomly assigned to alprostadil (A group; n=10) or Sildenafil (S group; n=10): Av and A used alprostadil injection (capable of giving a full erection) once a week for 1 month, Sv and S took daily oral sildenafil (25 mg) for 1 month, and P took daily oral placebo for one month. The PSV was measured with Duplex sonography and penile rigidity was assessed using the IIEF-15 questionnaire, both of which were administered before and after treatment. Although both treatments improved penile rigidity, they increased PSV only in the Av and Sv groups. Our results suggest that alprostadil and oral therapy should be the starting therapy in men with vasculogenic impotency, whereas alprostadil should be avoided as the first-line approach in men with nonvasculogenic impotency.

  18. [Sildenafil and alprostadil in the combined drug therapy of erectile dysfunction].

    Science.gov (United States)

    Mazo, E B; Dmitriev, D G; Gamidov, S I; Ovchinnikov, R I

    2002-01-01

    Forty-four patients with erectile dysfunction (ED) aged 21-72 years aged 21-72 years (mean age 61 years) were examined and treated with sildenafil and alprostadil monotherapy or combined therapy. ED was psychogenic in 9(20.5%), arterial in 12(27.2%), vein occlusive in 9(20.5%) and neurogenic in 14(31.8%) patients. Monotherapy was most effective in psychogenic ED (alprostadil--100%, sildenafil--88.9%), least effective in vein occlusive ED (alprostadil--33.3%, sildenafil--22.2%). Alprostadil was more effective in arterial and neurogenic ED (83.3 vs 66.7 and 78.6 vs 57.1%, respectively). Combination of the two drugs produced much high response: 100, 85.7 and 55.5% in arterial, neurogenic and vein occlusive ED, respectively. Thus, combined treatment with sildenafil and alprostadil is a method of choice in the treatment of ED in failure of monotherapy with these drugs or in vein occlusive ED. In the combined treatment dose of the drugs, number of side effects and cost of therapy are lower.

  19. Combination of low-energy shock-wave therapy and bone marrow mesenchymal stem cell transplantation to improve the erectile function of diabetic rats.

    Science.gov (United States)

    Shan, Hai-Tao; Zhang, Hai-Bo; Chen, Wen-Tao; Chen, Feng-Zhi; Wang, Tao; Luo, Jin-Tai; Yue, Min; Lin, Ji-Hong; Wei, An-Yang

    2017-01-01

    Stem cell transplantation and low-energy shock-wave therapy (LESWT) have emerged as potential and effective treatment protocols for diabetic erectile dysfunction. During the tracking of transplanted stem cells in diabetic erectile dysfunction models, the number of visible stem cells was rather low and decreased quickly. LESWT could recruit endogenous stem cells to the cavernous body and improve the microenvironment in diabetic cavernous tissue. Thus, we deduced that LESWT might benefit transplanted stem cell survival and improve the effects of stem cell transplantation. In this research, 42 streptozotocin-induced diabetic rats were randomized into four groups: the diabetic group (n = 6), the LESWT group (n = 6), the bone marrow-derived mesenchymal stem cell (BMSC) transplantation group (n = 15), and the combination of LESWT and BMSC transplantation group (n = 15). One and three days after BMSC transplantation, three rats were randomly chosen to observe the survival numbers of BMSCs in the cavernous body. Four weeks after BMSC transplantation, the following parameters were assessed: the surviving number of transplanted BMSCs in the cavernous tissue, erectile function, real-time polymerase chain reaction, and penile immunohistochemical assessment. Our research found that LESWT favored the survival of transplanted BMSCs in the cavernous body, which might be related to increased stromal cell-derived factor-1 expression and the enhancement of angiogenesis in the diabetic cavernous tissue. The combination of LESWT and BMSC transplantation could improve the erectile function of diabetic erectile function rats more effectively than LESWT or BMSC transplantation performed alone.

  20. Erectile function and assessments of erection hardness correlate positively with measures of emotional well-being, sexual satisfaction, and treatment satisfaction in men with erectile dysfunction treated with sildenafil citrate (Viagra).

    Science.gov (United States)

    Montorsi, Francesco; Padma-Nathan, Harin; Glina, Sidney

    2006-09-01

    We aimed to determine whether erectile function (EF) and assessments of erection hardness correlate positively with measures of psychosocial outcomes (ie, emotional well-being, sexual satisfaction, and satisfaction with erectile dysfunction [ED] treatment) in men treated with sildenafil citrate (Viagra; Pfizer Inc, New York, NY). Data were collected from 33 worldwide phase 2, 3, and 4 sildenafil clinical trials, which included almost 10,000 men with ED. Most of these trials were randomized, double-blind, and placebo-controlled (n = 27) and were undertaken to assess doses of 50 mg adjustable to 25 mg or 100 mg, depending on efficacy and tolerability (n = 32). Doses were taken approximately 1 hour before anticipated sexual activity but not more often than once daily. EF was assessed with use of the EF domain of the International Index of Erectile Function (IIEF) and with assessments of erection hardness (Erection Hardness Grading Scale [EHGS] and IIEF Q2 [the frequency of erections hard enough for penetration]). Change (baseline to end point) in emotional well-being in men treated for ED was assessed with the Self-Esteem and Relationship (SEAR) questionnaire, which consisted of the Confidence domain (ie, the Self-Esteem subscale and Overall Relationship subscale) and the Sexual Relationship domain. End point treatment satisfaction (overall, speed of onset, and duration of action) was assessed with the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS). The IIEF was used to assess change and end point sexual satisfaction by means of the Intercourse Satisfaction domain, Q7 (frequency of satisfactory sexual intercourse), and the Overall Satisfaction domain (ie, Q13, satisfaction with sex life, and Q14, satisfaction with sexual relationship). In men treated with sildenafil for ED, scores for measures of EF (IIEF EF domain, IIEF Q2) and the percentage of erections graded completely hard and fully rigid (EHGS grade 4) correlated positively with scores for

  1. The history of ginseng in the management of erectile dysfunction in ancient China (3500-2600 BCE).

    Science.gov (United States)

    Nair, Rajesh; Sellaturay, Senthy; Sriprasad, Seshadri

    2012-01-01

    Emperor Shen-Nung was the second of China's mythical emperors (3500-2600 BCE). Widely considered the father of Chinese medicine, he catalogued over 365 species of medicinal plants which he personally tasted. Through his treatise 'Shen Nung Benchau Jing', we relive Emperor Shen-Nung's contribution to urology with reference to his management of erectile dysfunction. Time-related sources in medical and historical literature were reviewed, including the 'Shen Nung Benchau Jing' (The medicine book of Emperor Shen-Nung), archives and manuscripts at the Wellcome History of Medicine Collection, the Royal Society of Medicine, London, The Hong Kong Museum of Medical Sciences, and The Museum of Medical History, Shanghai, China. Chinese traditional herbal medicine began approximately 5000 years ago. Agricultural clan leader, Emperor Shen-Nung, was said to have a 'crystal-like belly' to watch the reactions in his own stomach of the herbs he collected. Ginseng was among of Shen Nung's contributions to herbal medicine. He experienced a warm and sexually pleasurable feeling after chewing the root. He advocated this as a treatment for erectile dysfunction and used it to stimulate sexual appetite. The reputation of ginseng as an aphrodisiac is based on the doctrine of signatures, since the adult root has a phallic shape. Shen-Nung believed that ginseng's resemblance to the human form is proof of its rejuvenative and aphrodisiac properties. It was believed that the closer the similarity to the human figure, the more potent the root. The use of ginseng for erectile dysfunction by Emperor Shen-Nung was unique for its time. It continues to hold parallels as a modern-day herbal aphrodisiac 5000 years on.

  2. The history of ginseng in the management of erectile dysfunction in ancient China (3500-2600 BCE

    Directory of Open Access Journals (Sweden)

    Rajesh Nair

    2012-01-01

    Full Text Available Emperor Shen-Nung was the second of China′s mythical emperors (3500-2600 BCE. Widely considered the father of Chinese medicine, he catalogued over 365 species of medicinal plants which he personally tasted. Through his treatise ′Shen Nung Benchau Jing′, we relive Emperor Shen-Nung′s contribution to urology with reference to his management of erectile dysfunction. Time-related sources in medical and historical literature were reviewed, including the ′Shen Nung Benchau Jing′ (The medicine book of Emperor Shen-Nung, archives and manuscripts at the Wellcome History of Medicine Collection, the Royal Society of Medicine, London, The Hong Kong Museum of Medical Sciences, and The Museum of Medical History, Shanghai, China. Chinese traditional herbal medicine began approximately 5000 years ago. Agricultural clan leader, Emperor Shen-Nung, was said to have a ′crystal-like belly′ to watch the reactions in his own stomach of the herbs he collected. Ginseng was among of Shen Nung′s contributions to herbal medicine. He experienced a warm and sexually pleasurable feeling after chewing the root. He advocated this as a treatment for erectile dysfunction and used it to stimulate sexual appetite. The reputation of ginseng as an aphrodisiac is based on the doctrine of signatures, since the adult root has a phallic shape. Shen-Nung believed that ginseng′s resemblance to the human form is proof of its rejuvenative and aphrodisiac properties. It was believed that the closer the similarity to the human figure, the more potent the root. The use of ginseng for erectile dysfunction by Emperor Shen-Nung was unique for its time. It continues to hold parallels as a modern-day herbal aphrodisiac 5000 years on.

  3. Visual Impairment, Including Blindness

    Science.gov (United States)

    ... Who Knows What? Survey Item Bank Search for: Visual Impairment, Including Blindness Links updated, April 2017 En ... doesn’t wear his glasses. Back to top Visual Impairments in Children Vision is one of our ...

  4. Speech and Language Impairments

    Science.gov (United States)

    ... impairment. Many children are identified as having a speech or language impairment after they enter the public school system. A teacher may notice difficulties in a child’s speech or communication skills and refer the child for ...

  5. Erectile Dysfunction Treatment Following Radical Cystoprostatectomy: Analysis of a Nationwide Insurance Claims Database.

    Science.gov (United States)

    Chappidi, Meera R; Kates, Max; Sopko, Nikolai A; Joice, Gregory A; Tosoian, Jeffrey J; Pierorazio, Phillip M; Bivalacqua, Trinity J

    2017-06-01

    To improve care for patients after radical cystoprostatectomy (RCP), focus on survivorship issues such as sexual function needs to increase. Previous studies have demonstrated the burden of erectile dysfunction (ED) after RCP to be as high as 89%. To determine the rates of ED treatment use (phosphodiesterase type 5 inhibitors, injectable therapies, urethral suppositories, vacuum erection devices, and penile prosthetics) in patients with bladder cancer before and after RCP to better understand current patterns of care. Men with bladder cancer undergoing RCP were identified in the MarketScan database (2010-2014). ED treatment use was assessed at baseline (during the 1 year before RCP) and at 6-month intervals (0-6, 7-12, 13-18, 19-24 months) after RCP. Multivariable logistic regression models were used to identify predictors of ED treatment use at 6-month intervals after RCP. ED treatment rates and predictors of ED treatment at 0-6, 7-12, 13-18, 19-24 month follow-up after RCP. At baseline, 6.5% of patients (77 of 1,176) used ED treatments. The rates of ED treatment use at 0 to 6, 7 to 12, 13 to 18, and 19 to 24 months after RCP were 15.2%, 12.7%, 8.1%, and 10.1% respectively. Phosphodiesterase type 5 inhibitors were the most commonly used treatment at all time points. In the multivariable model, predictors of ED treatment use at 0 to 6 months after RCP were age younger than 50 years (odds ratio [OR] = 3.17, 95% CI = 1.68-6.01), baseline ED treatment use (OR = 5.75, 95% CI = 3.08-10.72), neoadjuvant chemotherapy (OR = 1.72, 95% CI = 1.13-2.61), and neobladder diversion (OR = 2.40, 95% CI = 1.56-3.70). Baseline ED treatment use continued to be associated with ED treatment use at 6 to 12 months (OR = 5.63, 95% CI = 2.42-13.10) and 13 to 18 months (OR = 8.99, 95% CI = 3.05-26.51) after RCP. While the burden of ED following RCP is known to be high, overall ED treatment rates are low. These findings suggest either ED treatment is low priority for RCP patients

  6. Erectile function following brachytherapy, external beam radiotherapy, or radical prostatectomy in prostate cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Putora, P.M.; Buchauer, K.; Plasswilm, L. [Kantonsspital St. Gallen, Department of Radiation Oncology, St. Gallen (Switzerland); Engeler, D.; Schmid, H.P. [Kantonsspital St. Gallen, Department of Urology, St. Gallen (Switzerland); Haile, S.R.; Graf, N. [Kantonsspital St. Gallen, Clinical Trials Unit, St. Gallen (Switzerland)

    2016-03-15

    For localized prostate cancer, treatment options include external beam radiotherapy (EBRT), radical prostatectomy (RP), and brachytherapy (BT). Erectile dysfunction (ED) is a common side-effect. Our aim was to evaluate penile erectile function (EF) before and after BT, EBRT, or RP using a validated self-administered quality-of-life survey from a prospective registry. Analysis included 478 patients undergoing RP (n = 252), EBRT (n = 91), and BT (n = 135) with at least 1 year of follow-up and EF documented using IIEF-5 scores at baseline, 6 weeks, 6 months, 1 year, and annually thereafter. Differences among treatments were most pronounced among patients with no or mild initial ED (IIEF-5 ≥ 17). Overall, corrected for baseline EF and age, BT was associated with higher IIEF-5 scores than RP (+ 7.8 IIEF-5 score) or EBRT (+ 3.1 IIEF-5 score). EBRT was associated with better IIEF-5 scores than RP (+ 4.7 IIEF-5 score). In patients undergoing EBRT or RP with bilateral nerve sparing (NS), recovery of EF was observed and during follow-up, the differences to BT were not statistically significant. Overall age had a negative impact on EF preservation (corrected for baseline IIEF). In our series, EF was adversely affected by each treatment modality. Considered overall, BT provided the best EF preservation in comparison to EBRT or RP. (orig.) [German] Die externe Radiotherapie (EBRT), die radikale Prostatektomie (RP) sowie die Brachytherapie (BT) stellen Behandlungsoptionen fuer das lokalisierte Prostatakarzinom dar. Die erektile Dysfunktion (ED) ist eine haeufige Nebenwirkung dieser Therapien. Unser Ziel war es, die penile erektile Funktion (EF) vor und nach BT, EBRT und RP mit Hilfe eines validierten, vom Patienten ausgefuellten Lebensqualitaetsfragebogens aus einer prospektiven Datenbank zu beurteilen. Mit einer minimalen Nachbeobachtungszeit von einem Jahr wurden 478 Patienten analysiert, die eine RP (n = 252), EBRT (n = 91) oder BT (n = 135) erhalten hatten und deren EF mit

  7. Prevalence and influential factors of erectile dysfunction in male renal transplant recipients: a multiple center survey

    Institute of Scientific and Technical Information of China (English)

    TIAN Ye; DU Lin-dong; AO Jian-hua; MA Lin-lin; CHEN Li-sheng; XU Yuan-cheng; JI Zheng-guo; TANG Ya-wang; ZHANG Lei; L(U) Wen-cheng; LIN Jun; GUO Hong-bo; XIE Ze-lin; SUN Wen

    2008-01-01

    Background Renal transplants can improve the quality of life for recipients, but the quality of their sexual life might not be improved. This study was conducted to research the prevalence of erectile dysfunction (ED) and the influential factors in male renal transplant recipients (RTRs).Methods A cross-sectional survey was conducted in three renal transplantation centers. Structured questionnaires were administrated by trained interviewers to 824 male renal transplant patients, who had active sexual lives in the last 6 months.Results Complaints of ED were reported by 75.5% of the 809 RTRs (age range 19-75 years, mean age (45±10) years),whose questionnaires were completed. Mild, moderate and severe ED were reported at 53.6%, 8.3% and 13.6%,respectively. The mean age and the graft duration were significantly higher in male RTRs with ED compared to potent graft recipients (P=-0.00 and 0.04, respectively). The prevalence of ED increased with the increase in age. It was 60.7%, 65.8%,75.2%, 87.5% and 92.2% in patients with age below 30 years, 31-40 years, 41-50 years, 51-60 years and over 60 years,respectively (P=0.000). Moreover, the severity of ED increased with aging. The percentage of moderate and severe cases of ED increased from 6.7% in patients below 40 years to 28.9% in those over 40 years (P=0.000). The prevalence of ED in the RTR who had no occupation was higher than in those who were holding a position (P=0.001). The prevalence of ED decreased with the increase in the education level. The prevalence of ED was 94.3%, 86.4%, 74.0% and 67.8% in men with elementary school or lower, middle school, high school, and college or higher degrees, respectively (P=0.000). Patients,whose distal end of arteria iliaca interna was interrupted and underwent iterative transplantation, worried transplanted kidney function was impacted by sexual life, and received cyclosporine (CsA)-based immunosuppressive regimens, were more likely to have ED (P=0.000, 0.001, 0.000, 0

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    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...... their erectile function and were able to accomplish sexual intercourse. Post-hoc stratification according to urinary continence status was performed. Accordingly, for continent men (median IIEFinclusion = 7 (95% CI 5-12), 8 out of 11 men recovered erectile function (IIEF6months = 17 (6-23)), corresponding...

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

    Science.gov (United States)

    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. Copyright © 2015 Longwoods Publishing.

  10. Identification of counterfeit medicines for erectile dysfunction from an illegal supply chain.

    Science.gov (United States)

    Tomić, Sinisa; Milcić, Neven; Sokolić, Milenko; Martinac, Adrijana Ilić

    2010-03-01

    The appearance of counterfeit medicines in supply chains is a global public health problem that may seriously affect patients. Counterfeit drugs do not meet quality standards and do not declare their real composition and/or source for the purposes of fraud. They may be generic or innovative, they may contain genuine constituents in a fake packaging, or wrong ingredients, or inactive ingredients, or an incorrect quantity of the active substance. In Croatia, no cases of counterfeit medicines have been detected so far, but the Agency for Medicinal Products and Medical Devices has received 34 samples of medicines and other products for testing from Zagreb City Police. The samples included medicines for erectile dysfunction: sildenafil, tadalafil, and vardenafil. Twenty-three samples of tablets without marketing authorisation in Croatia were tested with high-performance liquid chromatography (HPLC) for the declared sildenafil and tadalafil content. Samples labelled 1 (batch T/33), 3 (batch T/33), 5 (batch 4), 6 (batch M0016J), 10 (batch T-070235), 12 (batch T-070544), 15 (batch 314833201), 16 (batch 832718474), and 17 (batch 504830028) containing sildenafil and samples labelled 20 (batch 070356), 21 (batch 05668), and 22 (batch T 378 5) containing tadalafil did not contain the active substance within the acceptable 95 % to 105 % margin of deviation from the declared content. While most samples cannot be described as fake with a reasonable amount of certainty, there is still a suspicion of counterfeit. A correct conclusion can be drawn only with the assistance of the manufacturers and by conducting additional laboratory tests.

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  14. Nanoethosomal transdermal delivery of vardenafil for treatment of erectile dysfunction: optimization, characterization, and in vivo evaluation

    Directory of Open Access Journals (Sweden)

    Fahmy UA

    2015-11-01

    Full Text Available Usama A Fahmy Department of Pharmaceutics & Industrial Pharmacy, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia Abstract: Vesicular drug delivery systems have recently gained attention as a way of improving dosing accuracy for drugs with poor transdermal permeation. The current study focuses on utilization of the natural biocompatible vesicles to formulate vardenafil nanoethosomes (VRD-NE, for the enhancement of their transdermal permeation and bioavailability. Fifteen formulations were prepared by thin-layer evaporation technique according to Box–Behnken design to optimize formulation variables. The effects of lipid composition, sonication time, and ethanol concentration on particle size and encapsulation efficiency were studied. The diffusion of vardenafil (VRD from the prepared nanoethosomes specified by the design was carried out using automated Franz diffusion cell apparatus. The optimized formula was investigated for in vivo pharmacokinetic parameters compared with oral VRD suspension. Confocal laser scanning microscopy images were used to confirm enhanced diffusion release of VRD in rat skin. The results showed that the optimized formula produced nanoethosomes with an average size of 128 nm and an entrapment efficiency of 76.23%. VRD-NE provided a significant improvement in permeation with an enhancement ratio of 3.05-fold for a film made with optimally formulated VRD-NE compared with a film made with VRD powder. The transdermal bioavailability of VRD from the nanoethosome film was approximately twofold higher than the oral bioavailability from an aqueous suspension. VRD-NE thus provide a promising transdermal drug delivery system. As a result, management of impotence for a longer duration could be achieved with a reduced dosage rate that improves patient tolerability and compliance for the treatment of erectile dysfunction.Keywords: Box–Behnken design, impotence, vesicles, nanoparticles

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

    Directory of Open Access Journals (Sweden)

    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

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

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    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.

  17. Evaluation of tetrahydrobiopterin (BH4) as a potential therapeutic agent to treat erectile dysfunction

    Institute of Scientific and Technical Information of China (English)

    Frank Sommer; Theodor Klotz; Dirk Steinritz; Wilhelm Bloch

    2006-01-01

    Aim: Nitric oxide (NO)-mediated smooth muscle relaxation causes penile erections. The endothelial NO synthase (eNOS) coenzyme tetrahydrobiopterin (BH4) converts eNOS-mediated catalytic activity from oxygen radical to NO production, improving endothelial function and vascular smooth muscle relaxation. Methods: Using quantitative immunohistochemistry, 8-isoprostane and nitrotyrosine concentrations were compared in cavernosal tissue from 17potent and 7 impotent men, and the effect of single oral doses of BH4 on penile rigidity and tumescence was investigated.The pharmacodynamic effect of single oral doses of BH4 on penile rigidity and tumescence was investigated in a randomized, placebo-controlled, double-blind cross-over fashion in 18 patients with erectile dysfunction (ED) while receiving visual sexual stimulation. Results: 8-isoprostane content in endothelium and smooth muscle was significantly higher in impotent patient samples; the level of nitrotyrosine was unchanged in ED patients. Relative to placebo,a single dose of 200 mg BH4 led to a mean increase in duration of > 60% penile rigidity (33.5 min [95% confidence interval (CI): 13.1-49.3] at base and 29.4 min [95% CI: 8.9-42.2] at tip). A 500-mg dose increased the relative duration of>60% penile rigidity by 36.1 min (95% CI: 16.3-51.8) at the base and 33.7 min (95% CI: 11.4-43.9) at the tip. Treatments were well tolerated. Conclusion: BH4 treatment is suggested to switch eNOS catalytic activity from super-oxide to NO formation, leading to a reduced formation of free radical reaction product 8-isoprostane without alteration of nitrotyrosine. The observed results make BH4 a suitable candidate as an ED treatment through reconstitution of altered catalytic activity of the eNOS.

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

    Institute of Scientific and Technical Information of China (English)

    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.

  19. Measurement of endothelial dysfunction via peripheral arterial tonometry predicts vasculogenic erectile dysfunction

    Science.gov (United States)

    Kovac, Jason R.; Gomez, Lissette; Smith, Ryan P.; Coward, Robert M.; Gonzales, Marshall A.; Khera, Mohit; Lamb, Dolores J.; Lipshultz, Larry I.

    2014-01-01

    Introduction Endothelial cell dysfunction is associated with cardiovascular disease and vasculogenic erectile dysfunction (ED). Measured via Peripheral Artery Tonometry (PAT), endothelial dysfunction in the penis is an independent predictor of future cardiovascular events. Aim Determine whether measurement of endothelial dysfunction differentiates men with vasculogenic ED identified by duplex ultrasound from those without. Methods A total of 142 men were retrospectively assessed using patient history, penile duplex ultrasonography (US) and PAT (EndoPAT 2000). ED was self reported and identified on history. Vasculogenic ED was identified in men who exhibited a peak systolic velocity (PSV) of ≤25 cm/s obtained 15 minutes following vasodilator injection. The reactive hyperemia index (RHI), a measurement of endothelial dysfunction in medium/small arteries and the Augmentation Index (AI), a measurement of arterial stiffness, were recorded via PAT. Results Penile duplex US separated men into those with ED (n=111) and without (n=31). The cohort with ED had a PSV of 21±1 cm/s (left cavernous artery) and 22±1 cm/s (Right). The control group without ED had values of 39±2 cm/s (Left) and 39±2 (Right). Given the potential for altered endothelial function in diabetes mellitus, we confirmed that hemoglobin A1c, urinary microalbumin, and vibration pulse threshold were not different in men with vasculogenic ED and those without. RHI in patients with ED (1.85±0.06) was significantly decreased compared to controls (2.15±0.2) (p<0.05). The AI was unchanged when examined in isolation, and when standardized to heart rate. Conclusions Measurement of endothelial function with EndoPAT differentiates men with vasculogenic ED from those without. RHI could be used as a non-invasive surrogate in the assessment of vasculogenic ED and to identify those patients with higher cardiovascular risk. PMID:24784889

  20. Sildenafil (Viagra for male erectile dysfunction: a meta-analysis of clinical trial reports

    Directory of Open Access Journals (Sweden)

    McQuay HJ

    2002-05-01

    Full Text Available Abstract Background Evaluation of company clinical trial reports could provide information for meta-analysis at the commercial introduction of a new technology. Methods Clinical trial reports of sildenafil for erectile dysfunction from September 1997 were used for meta-analysis of randomised trials (at least four weeks duration and using fixed or dose optimisation regimens. The main outcome sought was an erection, sufficiently rigid for penetration, followed by successful intercourse, and conducted at home. Results Ten randomised controlled trials fulfilled the inclusion criteria (2123 men given sildenafil and 1131 placebo. NNT or NNH were calculated for important efficacy, adverse event and discontinuation outcomes. Dose optimisation led to at least 60% of attempts at sexual intercourse being successful in 49% of men, compared with 11% with placebo; the NNT was 2.7 (95% confidence interval 2.3 to 3.3. For global improvement in erections the NNT was 1.7 (1.6 to 1.9. Treatment-related adverse events occurred in 30% of men on dose optimised sildenafil compared with 11% on placebo; the NNH was 5.4 (4.3 to 7.3. All cause discontinuations were less frequent with sildenafil (10% than with placebo (20%. Sildenafil dose optimisation gave efficacy equivalent to the highest fixed doses, and adverse events equivalent to the lowest fixed doses. Conclusion This review of clinical trial reports available at the time of licensing agreed with later reviews that had many more trials and patients. Making reports submitted for marketing approval available publicly would provide better information when it was most needed, and would improve evidence-based introduction of new technologies.

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

    Science.gov (United States)

    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

  2. [Cytoflavin in the treatment of patients with chronic abacterial prostatitis and erectile dysfunction].

    Science.gov (United States)

    Churakov, A A; Kolesnikov, A I; Bliumberg, B I; Popkov, V M

    2012-01-01

    The problem of chronic prostatitis (CP) and erectile dysfunction (ED) involves not only their high prevalence, but also the insufficient effectiveness of their treatments. In this regard, there is need for administration the pathogenetic drugs with antihypoxic, antioxidant and neuroprotective effects and improving blood flow to the genitals. The study included 60 men with CP associated with ED, aged 22 to 60 years. Patients were randomized into 2 groups of 30 people. Patients of comparison group received baseline therapy (alpha1-adrenoblockers, non-specific anti-inflammatory drugs, digital prostate massage and vacuum phallostimulation). Antibiotics were applied on the basis of their potential effectiveness in chronic abacterial prostatitis. In addition to the above treatment, patients of main group received step-down therapy with cytoflavin (in infusion, then oral administration). Positive dynamics was noted in both groups of patients; however, according to the indicators of the severity of pain and dysuria, as well as quality of life, positive dynamics in the main group of patients was more significant. Similarly, the dynamics of objective criteria for inflammation in the prostate gland was more pronounced when using cytoflavin. After treatment, the rigid phase of erection during vacuum fallotest occurred within 2-3 min from the beginning of the procedure in 16 (53.3%) patients of main group and only in 9 (30%) patients of comparison group. During follow-up examination at 6 months after treatment, stable remission was found in 75% of patients of main group. Thus, the inclusion of cytoflavin in the scheme of complex treatment of patients with abacterial CP associated with ED is pathogenetically justified, makes it more efficient and provides good DFS.

  3. Penile prosthesis implantation in Chinese patients with severe erectile dysfunction: 10-year experience.

    Science.gov (United States)

    Song, Wei-Dong; Yuan, Yi-Ming; Cui, Wan-Shou; Wu, Alex K; Zhu, Yi-Chen; Liu, Jing; Wang, Lin; Bai, Guang-Yi; Peng, Jing; Zhang, Zhi-Chao; Gao, Bing; Guo, Ying-Lu; Lue, Tom F; Xin, Zhong-Cheng

    2013-09-01

    We retrospectively evaluated the clinical outcome of penile prosthesis implantation (PPI) in Chinese patients with severe erectile dysfunction (SED). From July 2000 to December 2011, 224 patients (mean age: 35.9±11.8 years, range: 20-75 years) with SED underwent PPI by experienced surgeon according to standard PPI procedure at our centre. A malleable prosthesis (AMS 650) was implanted in 45 cases (20.1%), and a three-piece inflatable prosthesis (AMS 700 CXM or AMS 700 CXR) was implanted in 179 cases (79.9%). Surgical outcomes, including postoperative complications, clinical efficacy and couple satisfaction, were evaluated over than 6 months postoperatively using medical record abstraction, IIEF-5, quality of life (QoL) scores, and the patient/partner sexual satisfaction score proposed by Bhojwani et al. Of the 224 patients eligible for the study, 201 subjects (89.7%) completed follow-up. All of patients could perform sexual intercourse post PPI with the mean postoperative IIEF-5 and QoL scores were 20.02±2.32 and 5.28±0.76, respectively, which were significantly improved compared with the preoperative scores (6.29±1.5 and 2.13±0.84, PPatient satisfaction in the three-piece inflatable prosthesis group was higher than in the malleable prosthesis group (Ppatients with SED and experienced surgeon perform PPI according to standard PPI procedure could reduce the postoperative complications of PPI and could improve patient satisfaction ratio and QoL.

  4. Alprostadil cream in the treatment of erectile dysfunction: clinical evidence and experience.

    Science.gov (United States)

    Cuzin, Béatrice

    2016-08-01

    Erectile dysfunction (ED) is a very common disorder with a deep impact on quality of life on both patients and partners. Several options are available for treating ED: oral pharmacotherapy with phosphodiesterase 5 (PDE5) inhibitors currently represents the first-line option for many patients with ED. Alprostadil, a prostaglandin, has been marketed for many years as a urethral stick and an intracavernous injection for the treatment of ED. It is now available in the form of a cream (Vitaros/Virirec), a noninvasive treatment which combines an active drug (alprostadil, a synthetic prostaglandin E1) with a skin enhancer improving its local absorption directly at the site of action. Alprostadil has a favourable pharmacodynamic profile and is poorly absorbed in systemic circulation, which makes it suitable in a lot of circumstances and results in a reduced risk of adverse effects (AEs). Systemic AEs are reported in only 3% of the treated population. Clinical efficacy has been demonstrated in both phase II and III trials, showing a global efficacy up to 83% with the 300 μg dose in patients with severe ED, significantly better than placebo. Its fast onset of action and lack of interactions with other drugs makes alprostadil cream a possible first-line therapeutic option for some patients with ED: individuals who are reluctant to take systemic treatments or have AEs, patients who do not respond, cannot tolerate, or do not accept PDE5 inhibitor therapy, and patients treated with nitrates. Therefore, this new treatment for ED can be offered to patients and could help address the needs unmet by other treatments.

  5. Socioeconomic factors and incidence of erectile dysfunction: findings of the longitudinal Massachussetts Male Aging Study.

    Science.gov (United States)

    Aytaç, I A; Araujo, A B; Johannes, C B; Kleinman, K P; McKinlay, J B

    2000-09-01

    Despite the well-documented relationship of socioeconomic factors (SEF) to various health problems, the relationship of SEF to erectile dysfunction (ED) is not well understood. As such, the goals of this paper are: (1) to determine whether incident ED is more likely to occur among men with low SEF; and (2) to determine whether incident ED varies by SEF after taking into consideration other well-established ED risk factors that are also associated with SEF such as smoking, diabetes, and high blood pressure. We used data from 797 participants in the longitudinal population-based Massachusetts Male Aging Study (baseline 1987-1989, follow-up 1995-1997) who were free of ED at baseline and had complete data on ED and all risk factors. ED was determined by a self-administered questionnaire and its relationship to SEF was assessed using logistic regression. We first analyzed the age-adjusted relationship of education, income, and occupation to incidence of ED. The results show that men with low education (O.R. = 1.46, 95% C.I. = 1.02-2.08) or men in blue-collar occupations (O.R. = 1.68, 95% C.I. = 1.16-2.43) are significantly more likely to develop ED. For the multivariate model, due to multicollinearity among education, income, and occupation, we ran three separate models. After taking into consideration all the other risk factors--age, lifestyle and medical conditions--the effect of occupation remained significant. Men who worked in blue-collar occupations were one and a half times more likely to develop ED compared to men in white-collar occupations (O.R. = 1.55, 95% C.I. = 1.06-2.28).

  6. 海绵体肌电信号分析的相关技术的应用%Application of correlation techniques in the analysis of corpus cavernosum electromyographic signals

    Institute of Scientific and Technical Information of China (English)

    Xiao-Gang Jiang; Jan Holsheimer; Ljubomir Manola; Gorm Wagner; Hessel Wijkstra; Ben Knipscheer; Eric J. H. Meuleman

    2007-01-01

    Aim: To establish an objective, easy-to-use and comprehensive method to analyze corpus cavernosum electromyographic signals (CC-potentials). Methods: CC-potentials were recorded during flaccidity in 23 young healthy volunteers,with surface electrodes placed on the penile shaft bilaterally. Based on the correlation function of Matlab software, an application program for the analysis of CC-potentials was developed. Individual CC-potentials and their autocorrelation function were evaluated, yielding parameters amplitude (A), duration (D), and dominant frequency (DF). The crosscorrelation function of both longitudinal and bilateral pairs of adjacent electrodes was calculated to assess the similarity and mutual delay of CC-potentials recorded simultaneously from different parts of the CC. The parameters derived were squared maximum cross-correlation coefficient (Rmax) and delay (τ). Based on the absolute value of τ and the corresponding inter-electrode distance, propagation velocity (PV) was calculated. Results: The values of the parameters were determined automatically. No significant difference related to the locations of the electrodes for parameters A, D, and DF was detected. The cross-correlation showed that both longitudinal and bilateral CC-potential pairs had highly similar waveforms (the absolute values of Rmax were 0.80 ± 0.05 and 0.87 ± 0.06, respectively). PV of longitudinal pairs was estimated as 6.15 ± 3.98 cm/s. Conclusion: The application program for correlation analysis of CC-potentials is a comprehensive and versatile method to analyze corpus cavernosum electromyographic recordings.Its objectiveness makes multi-center application possible.%目的:建立一种客观、简便、全面的分析海绵体肌电信号(CC-信号)的方法.方法:在23名年轻健康志愿者中,将表面电极放在阴茎轴的两侧,在未勃起的情况下记录CC-电压.根据Matlab软件的相关函数,我们设计了一种分析CC-电压的应用程序.对每个个

  7. An investigation of sexual dysfunction in female partners of men with erectile dysfunction: how interviews expand on questionnaire responses.

    Science.gov (United States)

    Conaglen, H M; O'Connor, E J; McCabe, M P; Conaglen, J V

    2010-01-01

    Using the Female Sexual Function Index (FSFI) for investigating female sexual function has become widespread. A score of 26.5 has been suggested as delineating 'functional' from 'dysfunctional' women. This study aimed to understand in greater detail what contributes to changes in women's FSFI scores while their partners are taking oral erectile medications for erection problems. Couples randomized to receive two erectile medications for two 3-month phases, completed questionnaires. FSFI scores were augmented by individual interviews at baseline, 3 and 6 months, in order to better understand what the scores meant in the context of ED medication use. In all, 50% of the women scored dysfunctional' women recorded low FSFI scores solely as a result of their partner's ED. Overall, 22% were still 'dysfunctional' at 6 months, but one third of these appeared 'functional' at 3 months. A further group of women continued to record low scores despite reporting much improved sexual satisfaction. The women's interviews elaborate on their FSFI results, with five themes emerging to provide more clarity about the relative changes seen in a prospective study situation, and potentially in clinical practise contexts. The increasing use of questionnaires to determine sexual function should be supplemented with good clinical interviewing. The interview details explain how FSFI fluctuations occurred and contain clinical implications for research and practise in the area of couple's sexuality.

  8. Predicting erectile dysfunction in sexually active patients seeking prostate health screening: proposal for a multivariable risk stratification.

    Science.gov (United States)

    Favilla, V; Russo, G I; Reale, G; Leone, S; Castelli, T; La Vignera, S; Condorelli, R A; Calogero, A E; Cimino, S; Morgia, G

    2015-01-01

    To address the severity of erectile dysfunction (ED) in consecutive sexually active men seeking a prostate health screening through a multivariable risk stratification including comorbidities and lower urinary tract symptoms (LUTS). Four hundred and twenty five consecutive subjects with stable sexual relationship with normal testosterone levels were enrolled. The International Index of Erectile Function (IIEF-5) and the International Prostate Symptom Score (IPSS) questionnaires were collected and health-significant comorbidities were scored with the Charlson comorbidity index (CCI). All the independent predictors of ED were combined to form four different risk categories of ED: low (age⩽65 years and IPSS65 years, IPSS⩾8 or CCI⩾1), high (two of the following: age>65 years, IPSS⩾8 or CCI⩾1) and very high (age >65 years, IPSS⩾8 and CCI⩾1). The prevalence of ED increased with increase of CCI (χ(2) likelihood ratio: 40.85, P=0.001). The median of the IIEF-5 significantly reduced with the increase of the CCI (P<0.001) and with the worsening of our risk group stratification (P<0.001). At univariate logistic regression analysis very high risk was significantly associated with of ED (odds ratio: 26.85, P<0.001). Very high-risk group predicted ED with 88% and 56% of specificity and sensitivity, respectively. Combining these risk factors through our risk stratification may be usefulness in revealing an underling ED.

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

    Science.gov (United States)

    Djordjevic, Miroslav L; Kojovic, Vladimir

    2013-05-01

    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 were inserted in 49 and 13 cases, respectively. Penile prostheses were inserted into the corpora cavernosa using the standard ventral approach. After lifting the neurovascular 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 without additional grafting.

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

    Institute of Scientific and Technical Information of China (English)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  12. Chromatographic analysis of some drugs employed in erectile dysfunction therapy: qualitative and quantitative studies using calixarene stationary phase.

    Science.gov (United States)

    Hashem, Hisham; Ibrahim, Adel Ehab; Elhenawee, Magda

    2014-10-01

    In this study, the effect of change in chromatographic process variables on the retention behavior of four drugs employed in erectile dysfunction therapy on a calixarene stationary phase is described. Three of these drugs are known to treat erectile dysfunction, namely, sildenafil citrate, tadalafil, and apomorphine hydrochloride, and one drug that is used as opioid analgesic, tramadol hydrochloride, which is quiet widely misused to treat premature ejaculation. The results indicate the importance of considering the structure and pKa values of drugs to be separated along with mobile phase composition. A new optimized, rapid, and accurate liquid chromatography method is also established for simultaneous determination of sildenafil citrate, tadalafil, and apomorphine hydrochloride in pharmaceutical preparations and bulk powders. The chromatographic separation of the three pharmaceuticals was achieved on a calixarene column in less than 10 min using a binary mobile phase of 35% acetonitrile and 65% 50 mM sodium perchlorate pH2.5 at 1 mL/min flow rate. The method was validated for system efficiency, linearity, accuracy, precision, limits of detection and quantitation, specificity, stability, and robustness. Statistical analysis proved that the method enabled reproducible and selective quantification of all three analytes in bulk drugs and in pharmaceutical preparations.

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

    Directory of Open Access Journals (Sweden)

    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.

  14. Diabetic peripheral neuropathy and prevalence of erectile dysfunction in Japanese patients aged diabetes mellitus: The Dogo Study.

    Science.gov (United States)

    Furukawa, S; Sakai, T; Niiya, T; Miyaoka, H; Miyake, T; Yamamoto, S; Maruyama, K; Ueda, T; Senba, H; Todo, Y; Torisu, M; Minami, H; Onji, M; Tanigawa, T; Matsuura, B; Hiasa, Y; Miyake, Y

    2017-01-01

    Only limited epidemiological evidence exists regarding the relationship between diabetic neuropathy and erectile dysfunction (ED) among Japanese patients with type 2 diabetes mellitus. To investigate the relationship between diabetic neuropathy and ED among Japanese patients with type 2 diabetes mellitus, a multicenter cross-sectional study was conducted in 287 male Japanese patients with type 2 diabetes mellitus, age (19-65 years). Diabetic neuropathy was diagnosed if the patients showed two or more of the following three characteristics: neuropathic symptoms, decreased or disappeared Achilles tendon reflex and/or abnormal vibration perception. ED, moderate to severe ED, and severe ED were defined as present when a subject had a Sexual Health Inventory for Men score diabetic neuropathy and severe ED were 47.0 and 39.0%, respectively. Diabetic neuropathy was independently positively associated with severe ED, but not ED and moderate ED: the adjusted odds ratio was 1.90 (95% confidence interval: 1.08-3.38). No relationships were found between diabetic retinopathy or diabetic nephropathy and ED. Diabetic neuropathy is positively associated with severe erectile dysfunction among Japanese type 2 diabetes mellitus patients aged <65 years.

  15. Efficacy of sildenafil citrate (Viagra) for the treatment of erectile dysfunction in men in remission from depression.

    Science.gov (United States)

    Tignol, Jean; Furlan, Pier Maria; Gomez-Beneyto, Manuel; Opsomer, Reinier; Schreiber, Wolfgang; Sweeney, Mike; Wohlhuter, Claire

    2004-07-01

    Erectile dysfunction (ED) and depression are highly prevalent and frequently comorbid. Sildenafil effectively treats ED in men with depression and in men taking antidepressants. We evaluated the efficacy of sildenafil in men with depression in remission and ED. Patients with a history of ED when major depressive disorder (MDD) was diagnosed, which persisted after MDD was treated to remission, were randomized to 12 weeks of treatment with sildenafil (50 mg, flexible) or placebo. Efficacy was assessed using intercourse success rates, a global efficacy question (Has treatment improved your erections?), the International Index of Erectile Function (IIEF) and Life Satisfaction Checklist (LSC). By week 12, intercourse success rates were significantly higher among sildenafil- (74%) compared to placebo-treated patients (29%; P=0.0001). About 83% and 34% of sildenafil- and placebo-treated patients, respectively, reported improved erections (odds ratio=9.4, P=0.0001). IIEF scores in the sildenafil group (n=83) were significantly improved compared to those in the placebo group (n=85; P <0.0001). LSC sexual life item improved significantly among sildenafil- versus placebo-treated patients. The most frequently reported adverse events were transient and mild-to-moderate. Sildenafil is an effective and well-tolerated treatment for ED in patients with a history of ED at the time of MDD diagnosis, and which persisted after the MDD was treated to remission.

  16. [Determination of apomorphine, sildenafil and alprostadil in medicines for erectile dysfunction by high performance liquid chromatography-mass spectrometry].

    Science.gov (United States)

    Xu, Yuanjin; Xu, Guiping

    2005-11-01

    A high performance liquid chromatography-mass spectrometry (LC-MS) analytical method for illicit drugs, apomorphine, sildenafil and alprostadil, in medicines for erectile dysfunction has been developed. The samples were extracted with methanol using ultrasound-assisted extraction. The chromatographic separation was performed on a Zorbax Eclipse XDB-C18 column using acetonitrile-0.5% formic acid aqueous solution as mobile phase. The three compounds were identified by retention time and m/z and quantified by peak area. The results demonstrated that the linear ranges were 50.0 - 5 000.0 microg/L, 10.0 - 1 000.0 microg/L, 40.0 - 4 000.0 microg/L, with detection limits of 20.0, 4.0, 10.0 microg/L for apomorphine, sildenafil and alprostadil, respectively. The average recoveries and the relative standard deviations were 89% - 95% and 9.5% - 11%. The method is simple, rapid, accurate and suitable for the simultaneous determination of these drugs in medicines for erectile dysfunction.

  17. 闭合性阴茎海绵体白膜破裂伤的高频彩色多普勒超声诊断%Closed corpus cavernosum penis albuginea rupture of high freQuency color Doppler ultrasound in the diagnosis of trauma

    Institute of Scientific and Technical Information of China (English)

    邓连桂; 王晓波

    2014-01-01

    Objective:To investigate the diagnostic value of high frequency color Doppler ultrasound rupture injury in closed corpus cavernosum penis albuginea. Methods:Retrospective analysis of two-dimensional and color Doppler flow imaging features,summarize 9 cases of clinically proven closed corpus cavernosum penis albuginea rupture. Results:Diag-nosis of high frequency color Doppler ultrasonography on 9 cases of closed rupture of albuginea penis accuracy rate is 100%. The diagnosis mainly with 2D sonogram:(1)tunica albuginea penis surface linear hyperechoic discontinuity;(2) rupture of albuginea export occurs in the corpus cavernosum penis right,found in the proximal 1/3 segment;(3)with sponge body damage,damage is not homogeneous low echo.(4)penile subcutaneous effusion(hematoma). Color Doppler flow imaging showed no arteriovenous fistula or pseudoaneurysm,dorsal penile move,vein and cavernous artery blood flow. Conclusions:High frequency color Doppler ultrasound in closed corpus cavernosum penis albuginea rupture of albuginea rupture interrupt clear diagnosis,location and cavernous injury and hematoma location accurate judgment,is the preferred method of examination of closed rupture of albuginea penis sponge,can provide reliable information for the clinical treat-ment of.%目的:探讨高频彩色多普勒超声在闭合性阴茎海绵体白膜破裂伤中的诊断价值。方法回顾分析、总结经临床证实的9例闭合性阴茎海绵体白膜破裂的二维及彩色多普勒血流显像特征。结果高频彩色多普勒超声对9例闭合性阴茎海绵体白膜破裂的诊断准确率达100%。其诊断主要以二维声像图特征为主:(1)阴茎海绵体表面白膜呈线状高回声连续性中断;(2)白膜破裂口一般发生于右侧海绵体,多见于阴茎近端1/3段;(3)合并海绵体损伤,损伤处见不均匀低回声。(4)阴茎皮下积液(血肿)。彩色多普勒血流显像未见动静脉瘘及假性动脉

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

    Science.gov (United States)

    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.

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

    Institute of Scientific and Technical Information of China (English)

    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

  20. Evaluation of a progressive treatment program for erectile dysfunction in patients with diabetes mellitus.

    Science.gov (United States)

    Israilov, S; Shmuely, J; Niv, E; Engelstein, D; Livne, P; Boniel, J

    2005-01-01

    The aim was to evaluate the effectiveness of a progressive program, starting with simple methods and, when not effective, moving to more complex methods, to treat erectile dysfunction (ED) in patients with diabetes mellitus. A total of 284 diabetic patients with ED entered into a 6-phase program starting with sildenafil citrate (Viagra). Those with contraindications, side effects, or negative response (erection insufficient for vaginal penetration) were switched to the vacuum erection device (VED), and then progressively (for failures) to intracavernous injection (ICI), sildenafil citrate+ICI, ICI+VED, and penile prosthesis. Patients were followed for 2 y. Of the 284 patients 276 patients were eligible for sildenafil citrate and 147 (53.3%) responded positively, but 25 (9.1%) patients stopped it soon due to adverse effects. Of 162 patients (129 nonresponders, eight noneligible for the sildenafil and 25 patients who dropped out due to adverse effects), treated with VED, 114 (70.4%) responded well, however, only 19 (11.7%) patients agreed to continue its use. Of the remaining 143 patients (nonresponders, noneligible for the previously mentioned treatments and patients who dropped out due to adverse effects), 103/143 (72%) responded to ICI, 27/40 (67.5%) to sildenafil+ICI, and 9/13 (69.2%) to ICI+VED. Four patients received a penile implant. At the 2 y follow-up, 81 of 284 patients who entered the study (28.5%) were still responding to sildenafil, seven (2.5%) to VED, 113 (39.8%) to ICI, 24 (8.5%) to sildenafil+ICI, two (0.7%) to ICI+VED; 15 (5.3%) had a penile implant. In all 17 (6%) patients reported spontaneous erections, 11 (3.9%) stopped the treatment due to family reasons and 14 (4.9%) failed the treatment. In conclusion, the progressive treatment program for ED seems to be very effective for diabetic patients, yielded a complete response for short-term and 91.2% rate of success at the end of 2 y follow-up.

  1. Aging related erectile dysfunction—potential mechanism to halt or delay its onset

    Science.gov (United States)

    Gonzalez-Cadavid, Nestor F.; Rajfer, Jacob

    2017-01-01

    Erectile dysfunction (ED) will visit every man at some time in his life. The age at when that knock on the door is heard is totally dependent on one’s genetics as well as other extrinsic factors. Unlike guests who come for a visit and then leave, once ED shows up it tends to hang around forever. To add insult to injury, the longer ED hangs around, the worse it will get. It is estimated that by the time a man is in his 40’s, he has about a 40% chance of having some form of ED and this prevalence increases about 10% per decade thereafter. This suggests that the aging related process that leads to ED begins early in life. It turns out that the most common cause of ED, regardless of the patient’s age, is due to a problem with the vascular system of the penis. However, this specific aging related vascular problem is not caused by arterial disease but due to a dysfunction and/or loss of the corporal smooth muscle cells (SMC), the main constituent of the corporal sinusoids. As one gets older, these SMC continue to degrade and disappear. When approximately 15% of these cells have been impacted, it results in an inability of the corporal tissue to retain and/or prevent the blood from “leaking” out of the corporal sinusoids into the systemic veins. However, the corporal SMC themselves begin to combat this aging process by expressing the inducible nitric oxide synthase (iNOS) enzyme to make nitric oxide (NO) in an attempt to quench the high intracellular oxidative stress responsible for the SMC apoptosis. When this iNOS pathway is then pharmacologically upregulated, reversal of these aging related changes in the corpora with correction of the venous leakage is observed. Since we believe that aging related ED is pathologically the same disorder as essential hypertension, the development of a therapeutic regimen that can halt, delay or possibly reverse the cellular processes that lead to aging related ED should also be applicable to those patients diagnosed with

  2. 体外培养的豚鼠阴茎海绵体ICC表达nNOS的实验研究%Study on expression of nNOS in cultured ICC of guinea pig corpus cavernosum.

    Institute of Scientific and Technical Information of China (English)

    王宇卫; 王江平; 丁国富; 王勤章

    2012-01-01

    目的 探索成年豚鼠阴茎海绵体中Cajal间质细胞(ICC)的分离、培养和鉴定方法以及神经型一氧化氮合酶(nNOS)的表达情况.方法 ①取豚鼠阴茎海绵体组织,采用酶消化法分离细胞,差速帖壁法纯化ICC,将细胞接种于DMEM培养基中培养,48 h后进行c-kit特异性抗体免疫荧光染色法鉴定ICC并用c-kit/nNOS特异性抗体免疫荧光双重染色法观察nNOS的表达情况.结果 培养24 h后细胞帖壁良好,倒置显微镜下显示ICC呈纺锤形,有两个或多个长的突起,48 h后细胞形态趋于稳定,免疫荧光染色可见ICC呈c-kit抗体染色阳性,c-kit/nNOS特异性抗体免疫荧光双重染色显示培养的ICC表达nNOS.结论 用混合酶消化法可以成功分离和培养出豚鼠阴茎海绵体ICC,豚鼠阴茎海绵体ICC可能参与一氧化氮(NO)的分泌和传导,在阴茎勃起中发挥重要作用.%Objective To explore the method for isolation, culture and identification of interstitial cells of Cajal ( ICC ) from corpus cavernosum of guinea pigs and to observe the expression of nJNOS in ICCs. Methods (1)The corporal tissue was obtained from adult guinea pig. These ICCs were isolated by enzyme digestion and purified through differential attachment technique, then cell suspensions were inoculated onto culture dishes and cultured in DMEM medium. After 48 hours, these cells were identified by using c - kit of immunofluorescence staining and the expression of nJNOS in ICCs was observed by c - kit and nJNOS immunofluorescence double staining. Results ICCs adhered well after cultured for 24 hours, and ICCs were spindle - shaped with two or more long processes under phase contrast microscopy. The morphological features of ICCs were stabilized, immunofluorescence staining showed these cultured cells were c -kit positive, and c -kit and nJNOS immunofluorescence double staining showed these c - kit positive cells were nJNOS positive. Conclusion Enzyme digestion method can

  3. Superoxide dismutase analog (TEMPOL: 4-hydroxy-2, 2, 6, 6-tetramethylpiperidine 1-oxyl) treatment restores erectile function in diabetes-induced impotence

    Science.gov (United States)

    Kawakami, Toshifumi; Urakami, Shinji; Hirata, Hiroshi; Tanaka, Yuichiro; Nakajima, Koichi; Enokida, Hideki; Shiina, Hiroaki; Ogishima, Tatsuya; Tokizane, Takashi; Kawamoto, Ken; Miura, Kazukiyo; Ishii, Nobuhisa; Dahiya, Rajvir

    2014-01-01

    We hypothesized that administration of the superoxide dismutase (SOD) mimetic Tempol (4-hydroxy-2, 2, 6, 6-tetramethylpiperidine 1-oxyl) may reverse diabetes induced ED(erectile dysfunction). To test this hypothesis, ROS related genes (SOD1, SOD2, GPx1, CAT, NOS2, NOS3), erectile functional studies, and immunohistochemical analysis were performed in diabetic rats treated with or without Tempol. Thirty Sprague-Dawley (3–4 months old) rats were divided into 3 groups (n=10 each), 20 with diabetes (diabetic control and Tempol treatment) and 10 healthy controls. Twelve weeks after induction of diabetes by streptozotocin and Tempol treatment, all groups underwent in vivo cavernous nerve stimulation. Rat crura were harvested and expression of antioxidative defense enzymes examined by semi-quantitative RT-PCR. To confirm the RT-PCR results, we performed immunohistochemistry (IHC) for catalase (CAT) and iNOS (NOS2). Nitration of tyrosine groups in proteins was also examined by IHC. Mean intracavernous pressure in the diabetic group was significantly lower than in healthy controls (p<0.001) and was reversed by Tempol treatment (p<0.0108). NOS2 protein expression was significantly increased in diabetic animals compared to healthy controls and Tempol restored NOS2 protein level. Nitrotyrosine was also higher in diabetic animals and though Tempol treatment decreased its formation, it remained higher than that found in healthy controls. This study suggests that Tempol treatment increased erectile function through modulating oxidative stress related genes in diabetic rats. This is the first report about the relationship between diabetes induced erectile dysfunction and oxidative stress, and anti-oxidative therapy using the superoxide dismutase mimetic, Tempol to restore erectile function. PMID:19554009

  4. The Involvement of Corin in the Progression of Diabetic Erectile Dysfunction in a Rat Model by Down-Regulating ANP /NO/cGMP Signal Pathway.

    Science.gov (United States)

    Wang, Jian; Mi, Yuanyuan; Yuan, Fenglai; Wu, Sheng; You, Xiaoming; Dai, Feng; Huang, Yi; Cao, Jia; Zhu, Jin; Xue, Boxin; Zhu, Lijie

    2017-01-20

    This study was aimed to analyze the potential role of Corin in the procession of diabetic ED and to explore the underlying mechanism. Diabetic ED rat model was constructed and the characteristics of diabetic ED and control rats were recorded at 4, 8, 12 and 16 weeks. qRT-PCR and Western bloting were used to detected the mRNA and protein levels. Intracellular cGMP detection was accomplished using a commercial radioimmunoassay method. Vascular endothelial cell from rat corpus cavernosum spiral artery was isolated and transfected with si- Corin to analyzed the potential role of Corin. Cell viability was assessed using crystal violet. The results showed that diabetic ED rats showed significantly higher glucose level, and lower body weight, ICP level and ICP/MAP ratio at 12 and 16 weeks in diabetic ED rats compared with control rats. The protein levels of Corin, atrial natriuretic peptide (ANP)and eNOS, and the level of cGMP were significantly down-regulated in corpus cavernosum in diabetic ED rats, revealing the potential role of Corin in NO-associated diabetic ED. Further studies proved that defect of Corin not only inhibited the vascular endothelial cell viability in high-glucose condition, but also suppressed ANP, eNOS and cGMP expression in vascular endothelial cells. To sum up, Corin contributes to the progression of diabetic ED and the underlying mechanism is associated with the down-regulation of ANP /NO/cGMP signal pathway. This article is protected by copyright. All rights reserved.

  5. Imbalanced low-grade inflammation and endothelial activation in patients with type 2 diabetes mellitus and erectile dysfunction.

    Science.gov (United States)

    Araña Rosaínz, Manuel de J; Ojeda, Miriam Ojeda; Acosta, Janet Rodriguez; Elías-Calles, Lizet Castelo; González, Neraldo Orlandi; Herrera, Omaida Torres; García Álvarez, Caridad T; Rodríguez, Elvira Maciquez; Báez, Mario Estevez; Seijas, Eduardo Álvarez; Valdés, Ramiro Fragas

    2011-07-01

    Erectile dysfunction (ED) is highly prevalent among type 2 diabetes mellitus patients (T2DM). Although a link among systemic inflammation, endothelial dysfunction, and ED is described in clinical situations mainly related with coronary heart disease (CHD) risk, evidences of this link in T2DM patients are rather limited. To evaluate the association between endothelial dysfunction and balance of pro-/anti-inflammatory mediators with ED presence and severity in T2DM. We conducted a cross-sectional study of 190 T2DM patients without symptomatic CHD, 150 out of them with ED and 40 without ED. Serum levels of E-selectin, intercellular adhesion molecule-1, tumor necrosis factor-α (TNF-α), and interleukin (IL)-10 were measured using specific enzyme-linked immunosorbent assays (ELISAs). ED presence and severity were tested by the five-item version of the International Index of Erectile Function questionnaire. Differences in circulating levels of endothelial dysfunction (ICAM-1, E-selectin) and inflammatory/anti-inflammatory (TNF-α, IL-10, TNF-α : IL-10 ratio) markers between T2DM patients with and without ED, and assessment of biomarkers ED predictive value while adjusting for other known ED risk factors. Patients with ED were older and had longer duration of diabetes than patients without ED. E-selectin serum levels were significantly increased, while IL-10 were lower in patients with ED; because TNF-α levels tend to be higher, TNF-α : IL-10 ratio was more elevated in ED patients. No significant differences of ICAM-1 levels were observed between study groups. Endothelial activation markers and TNF-α, as well as diabetes duration, were negatively correlated with erectile function. On multivariate analysis including age, duration of diabetes, insulin treatment, hypertension, insulin resistance, fair-to-poor glycemic control, and metabolic syndrome, increments in E-selectin levels and TNF-α : IL-10 ratio predicted independently ED presence, while IL-10 increases

  6. Cavernous nerve reconstitution with the use of bone marrow stem cells and erectile function evaluation: an experimental animal study

    Directory of Open Access Journals (Sweden)

    Oskar Grau Kaufmann

    2009-12-01

    Full Text Available Objective: To assess the influence of adult stem cells from bone marrow of rats in the regeneration of cavernous nerve, taking the return of erectile function as a parameter in animals subjected to the apomorphine-induced test of erection. Methods: Forty-eight male Wistar-EPM rats, aged between nine and ten weeks, and weighing approximately 250 g were used. They were randomly divided into four study Groups containing 12 animals each, as follows: Group I: surgical exposure of the cavernous nerves bilaterally without injury; Group II: bilateral surgical injury of the cavernous nerve of approximately 3 mm, without reconstruction; Group III: bilateral surgical injury of the cavernous nerves of approximately 3 mm, and bilateral reconstruction with silicone guiding tubes containing saline solution inside; Group IV: bilateral surgical injury of the cavernous nerves of approximately 3 mm, and bilateral reconstruction with silicone guiding tubes filled with adult stem cells. Four weeks after surgery, the animals were injected with apomorphine for induction of erection. Rresults: In Group I there was complete erectile response in all animals (100% – 12 out of 12. On the other hand, none of the animals in Group II presented erection after the use of apomorphine. Five of the twelve animals of Group III (41.7% and nine of the 12 animals of Group IV (75% had erections after the stimulus. When we compared the frequency of restoration of erection in the four Groups, Group IV was shown to have a similar performance to Group I (p = 0.217, while Group III animals had a frequency of erections inferior to those in Group I (p = 0.005. Moreover, comparison of results of Groups III and IV versus Group II showed that the frequency of erections was statistically higher in the first two Groups (p = 0.037 and p < 0.001, respectively. Finally, Group IV presented a tendency to a larger number of erections when compared to Group III (75 versus 41.7% but this difference was

  7. 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

    Directory of Open Access Journals (Sweden)

    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.

  8. 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.

    Science.gov (United States)

    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.

  9. Development or Impairment?

    Science.gov (United States)

    Hakansson, Gisela

    2010-01-01

    Joanne Paradis' Keynote Article on bilingualism and specific language impairment (SLI) is an impressive overview of research in language acquisition and language impairment. Studying different populations is crucial both for theorizing about language acquisition mechanisms, and for practical purposes of diagnosing and supporting children with…

  10. Development or Impairment?

    Science.gov (United States)

    Hakansson, Gisela

    2010-01-01

    Joanne Paradis' Keynote Article on bilingualism and specific language impairment (SLI) is an impressive overview of research in language acquisition and language impairment. Studying different populations is crucial both for theorizing about language acquisition mechanisms, and for practical purposes of diagnosing and supporting children with…

  11. Pathophysiology and treatment of diabetic erectile dysfunction%糖尿病勃起功能障碍的病理生理学和治疗

    Institute of Scientific and Technical Information of China (English)

    Charles R. Moore; Run Wang

    2006-01-01

    The pathophysiology of diabetes is multifactorial and no single etiology is at the forefront. The proposed mechanisms of erectile dysfunction (ED) in diabetic patients includes elevated advanced glycation end-products (AGEs) and increased levels of oxygen free radicals, impaired nitric oxide (NO) synthesis, increased endothelin B receptor binding sites and ultrastructural changes, upregulated RhoA/Rho-kinase pathway, NO-dependent selective nitrergic nerve degeneration and impaired cyclic guanosine monophosphate (cGMP)-dependent kinase-1 (PKG-1). The treatment of diabetic ED is multimodal. Treatment of the underlying hyperglycemia and comorbidities is of utmost importance to prevent or halt the progression of the disease. The peripherally acting oral phosphodiesterase type 5 (PDE5) inhibitors are the mainstay of oral medical treatment of ED in diabetics. Vacuum erection devices are an additional treatment as a non-invasive treatment option. Local administration of vasoactive medication via urethral suppository or intracorporal injection can be effective with minimal side-effects. Patients with irreversible damage of the erectile mechanism are candidates for penile implantation. Future strategies in the evolution of the treatment of ED are aimed at correcting or treating the underlying mechanisms of ED. With an appropriate vector, researchers have been able to transfect diabetic animals with agents such as neurotrophic factors and nitric oxide synthase (NOS). Further studies in gene therapy are needed to fully ascertain its safety and utility in humans. (Asian J Androl 2006 Nov; 8: 675-684)%糖尿病在病理生理学上的原理是多因素的,所以没有任何一种病理学可以独立解释这种疾病.有关研究已经提出一些对糖尿病患者勃起功能障碍发病机制的解释,这些机制涉及到以下因素:晚期糖基化终产物升高(AGEs)、氧化自由基水平增加、一氧化氮(NO)合成酶受损、内皮素B受体结合位点增加和

  12. 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)

    National Research Council Canada - National Science Library

    Luis Valero Aguayo; Jonatán Bernet Carrero

    2015-01-01

    ... (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 relationship to improve the sexual problem...

  13. [TECAR therapy for Peyronie’s disease: a phase-one prospective study. Great evidence in patients with erectile dysfunction].

    Science.gov (United States)

    Pavone, Carlo; Castrianni, Davide; Romeo, Salvatore; Napoli, Enrica; Usala, Manuela; Gambino, Giuseppa; Scaturro, Dalila; Letizia Mauro, Giulia

    2013-01-01

    Our phase-one prospective study wants to evaluate the safety and tolerability of TECAR therapy in the treatment of Peyronie’s disease. From June 2011 to September 2012 we enrolled 70 patients. Each patient had been previously subjected to andrological examination, to a questionnaire for the evaluation of IPP and ED, and the SF-36 (V1) for the evaluation of the general state of health. The evaluation of pain was made using the VAS scale of pain. Every patient was subjected to TECAR treatment of the fibrotic plaque (both in resistive mode and in capacitive mode) for a total of three sessions carried out on consecutive days. We recorded a good compliance by patients; none of them reported side effects. Pain was decreased by the technique in 80% of the cases.The whole sample completed the study. Surprisingly enough those patients who complained also of erectile dysfunction, reported an improvement in sexual potency.

  14. Understanding the cellular basis and pathophysiology of Peyronie’s disease to optimize treatment for erectile dysfunction

    Science.gov (United States)

    Alzubaidi, Raidh

    2017-01-01

    Erectile dysfunction (ED) is a common condition that significantly impacts a man’s physical and psychological well-being. ED is often associated with Peyronie’s disease (PD), which is an abnormal curvature of the penis. Delayed treatment of or surgical invention for PD often results in ED and therefore unsatisfied patients. The pathophysiology of PD is incompletely understood, but has been studied extensively and based on our current understanding of PD physiology, many medical treatment options have been proposed. In this paper, we will review what is known about the pathophysiology of PD and the medical treatment options that have been trialed as a result. More investigations in regards to the basic science of PD need to be carried out in order to elucidate the exact mechanisms of the fibrosis, and propose new, more successful treatment options which should be implemented prior to the onset of ED. PMID:28217450

  15. Bilateral Synchronous Granulomatous Orchitis in a Patient with