WorldWideScience

Sample records for preventing erectile dysfunction

  1. Erectile Dysfunction

    Science.gov (United States)

    ... rigid. Medications The oral medications for erectile dysfunction, sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra), relax the muscles ... to begin working; the erection helping effects of sildenafil and vardenafil last for about 8 hours and ...

  2. Erectile Dysfunction

    Science.gov (United States)

    ... cut out alcohol. Excess alcohol can contribute to erectile dysfunction. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for men older than age 65, and up to two drinks ...

  3. Prevention of erectile dysfunction after radiotherapy for prostate cancer

    Directory of Open Access Journals (Sweden)

    Izak Faiena

    2014-12-01

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

  4. Erectile Dysfunction (ED)

    Science.gov (United States)

    ... men older than 75 years of age. Is erectile dysfunction just a part of old age? ED doesn’t have to be a part of getting older. It’s true that as you get older, you may need more ... Symptoms of erectile dysfunction The primary symptom of ED is not ...

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

    NARCIS (Netherlands)

    L. Incrocci (Luca)

    2014-01-01

    textabstractA recently published paper addressed the interesting topic of prevention of erectile dysfunction (ED) with tadalafil, a phosphodiesterase-type 5 inhibitor (PDE5i) in patients undergoing radiation therapy for localized prostate cancer. [1]Tadalafil 5 mg or placebo was

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Luca Incrocci

    2014-10-01

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

  8. [Testosterone and erectile dysfunction].

    Science.gov (United States)

    Diemer, T

    2010-01-01

    Primary hypogonadism represents a classic but rare cause of erectile dysfunction (ED) in men. Therapy with testosterone as monotherapy is therefore unlikely to cure ED in the typical ED patient. However, recent developments indicate a much greater role of testosterone in erectile function than has been supposed in the past. Serum testosterone levels decline in men with increasing age. Aging men might develop late-onset hypogonadism (LOH) associated with characteristic symptoms. Typical symptoms of LOH are represented by decreased libido and sexual function, osteoporosis, altered distribution of body fat, overall reduction in physical strength, and alterations in the general mood. Experimental and clinical studies over the last few years have also pointed out that hypogonadism results in characteristic alterations of the erectile tissue of the penis. These alterations might be reversible in response to hormone therapy with testosterone. Particularly testosterone might be a helpful supportive therapy in cases where PDE-5 antagonists have tended to lose their effectiveness on the erectile tissue in the treatment of ED.

  9. PREVENTION AND TREATMENT OF ERECTILE DYSFUNCTION IN PATIENTS AFTER RADICAL NERVESPARING PROSTATECTOMY

    Directory of Open Access Journals (Sweden)

    P. A. Karnaukh

    2015-01-01

    Full Text Available The purpose of our research is to improve the quality of life of patients undergoing radical prostatectomy. With the increasing frequency of prostate cancer and determining the effectiveness of surgical treatment significantly increased the number of radical prostatectomy. Surgical treatment is definitely in much greater extent when compared to radiation treatments related to the development of impotence, erectile dysfunction and urinary incontinence.The incidence of erectile dysfunction after prostatectomy ranges from 10 to 50%. Therefore, the development of new programmes for the rehabilitation of patients can improve their quality of life, due to the greater likelihood of recovery of erectile function after the operation. In our study we observed 84 patient. The incidence of erectile dysfunction was 76%. After applying one of the existing methods of stimulation: FDÈ5 inhibitors, intracavernose injections of prostaglandin, physical therapy, we were able to increase the effectiveness of treatment up to 54.8%, 40% and 70% respectively.

  10. Effects of Biofeedback in Preventing Urinary Incontinence and Erectile Dysfunction after Radical Prostatectomy

    Directory of Open Access Journals (Sweden)

    Fabiana S. B. Perez

    2018-02-01

    Full Text Available In this study, we present a biofeedback method for the strengthening of perineal muscles during the preoperative procedures for radical prostatectomy, and we evaluate this technique as a prevention measure against complications such as urinary incontinence (UI and erectile dysfunction (ED, which affect prostatectomy patients after surgery. In the experimental protocol, the patients performed specific exercises with the help of a device that provided the patient with visual biofeedback, based on a plot of the anal pressure. For the experimental protocol, we selected 20 male patients, with an average age of 64.0 years, and submitted them to ten therapeutic sessions each. A control group consisting of 32 men with an average age of 66.3 years, who were treated with the same surgical procedure but not with the preoperative procedures, also took part in the experiment. To evaluate UI and ED after the surgery in both control and experimental groups, we used two validated questionnaires—to assess UI, we used the King’s Health Questionnaire (KHQ and, for ED, we used the International Index of Erectile Function (IIEF-5 Questionnaire. We compared the variables associated with UI and ED after the surgery for the control and experimental groups. The occurrence of UI after radical prostatectomy in the control group (100% of the patients was higher than that for the experimental group (5% of the patients, with p < 0.0001. Likewise, the occurrence of erectile dysfunction after prostatectomy in the control group (48.6% of the patients was higher than that for the experimental group (5% of the patients, with p < 0.0001. The number of nocturia events also decreased as a consequence of the intervention (p < 0.0001, as did the number of disposable underwear units for urinary incontinence (p < 0.0001. Furthermore, we compared, only for the experimental group, the anal pressure before the biofeedback intervention and after the surgery, and we

  11. Pattern of erectile dysfunction in Jeddah city.

    Science.gov (United States)

    Al Helali, N S; Abolfotouh, M A; Ghanem, H M

    2001-01-01

    The aim of this study was to determine the demographic features of erectile dysfunction patients attending different specialized clinics in Jeddah city, and to identify possible risk factors associated with erectile dysfunction problem. All newly erectile dysfunction patients (n=388) who attended 6 andrology and urology clinics within a period of 3 months were subjected to a modified structural interview questionnaire to collect demographic data and risk factors for erectile dysfunction. The study revealed the following results among erectile dysfunction patients; Saudi patients constituted (81%). The age ranged from 20-86 years with mean age of 43.23+12.56 years, 73% were married with one wife, 23.5% married with two wives, and 8% were single. About one-half (43%) were less than secondary education level. Retired patients constituted (13%) of all patients. Lack of exercise was the most frequent risk factor among 82% of patients, followed by smoking (56%), use of regular medication (44%), diabetes (30%), hypertension (15%), history of pelvic surgery (14%) alcoholism (13%), and drug addict (8%). Erectile dysfunction is a problem of not only old age but also of middle and young age. This might be attributed to the high frequency of some risk factors such as diabetes mellitus, hypertension, smoking, alcohol consumption, and drug addiction. This finding may reflect the necessity for construction of prevention strategies.

  12. Oral health and erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Vijendra P Singh

    2017-01-01

    Full Text Available Ample evidence strongly supports the fact that periodontal disease is a major risk factor for various systemic diseases namely cardio-vascular disease, diabetes mellitus, etc. Recently, investigators focussed on exploring the link between chronic periodontitis (CP and erectile dysfunction (ED by contributing to the endothelial dysfunction. Both the diseases share common risk factors. Various studies conducted in different parts of the world in recent years reported the evidence linking this relationship as well as improvement in ED with periodontal treatment. Systemic exposure to the periodontal pathogen and periodontal infection-induced systemic inflammation was thought to associate with these conditions. The objective of this review was to highlight the evidence of the link between CP and ED and the importance of oral health in preventing the systemic conditions.

  13. 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.

  14. Postprostatectomy Erectile Dysfunction: A Review

    Directory of Open Access Journals (Sweden)

    Paolo Capogrosso

    2016-08-01

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

  15. Erectile dysfunction among men attending surgical outpatients ...

    African Journals Online (AJOL)

    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 ...

  16. Motorcycling as a Risk Factor for Erectile Dysfunction: Implications ...

    African Journals Online (AJOL)

    Conclusion: It is concluded that motorcyclists, physicians and policy makers need to know the inherent danger in motorcycle operation with respect to erectile dysfunction, with a view to working out appropriate intervention and prevention strategies. Keywords: Erectile Dysfunction, Motorcycling, Family Physician.

  17. Erectile dysfunction and amatorial cycling.

    Science.gov (United States)

    Colpi, Giovanni Maria; Contalbi, Gianfranco; Ciociola, E; Mihalca, Radu

    2008-09-01

    Today cycling is considered a useful form of exercise for reducing cardiovascular risk, but it may also represent a risk factor for erectile dysfunction and perineal-genital paresthesia. These disorders are attributed to the local reduction of oxygen in the perineal-genital area, secondary to the perineal compression. Numerous studies have been carried out measuring the penile oxygen pressure or penile blood flow by echo-colour-Doppler: a reduced inflow of blood and oxygen to the cavernous tissue was demonstrated. The attention of the specialist is therefore concentrated on the compression of the perineum on the bicycle saddle and how to reduce this through the position of the cyclist on the bicycle (i.e. height and tilt of the saddle), the different shapes of saddle available (i.e. noseless, grooved, wide, etc.) and the padding materials of the saddle. In order to reduce perineal compression, the posterior part of the saddle should be as wide as the distance between the two ischiatic tuberosities. In addition, the saddle should be studied on the basis of the biotype of the cyclist: ectomorphic, mesomorphic or endomorphic. However, in the genesis of the erectile dysfunction of the cyclist, apart from the above-mentioned factors, an "individual predisposition to developing erectile dysfunction" linked to the perineal-genital anatomy (i.e. type of insertion of the perineum into the root of the penis, number of layers of the tunica albuginea of the corpus cavernosum) cannot be excluded.

  18. Erectile dysfunction in haemodialysis patients

    International Nuclear Information System (INIS)

    Mumtaz, A.; Hussain, S.; Nazir, M.

    2009-01-01

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

  19. Bicycle riding and erectile dysfunction: a review.

    Science.gov (United States)

    Sommer, Frank; Goldstein, Irwin; Korda, Joanna Beate

    2010-07-01

    For many years, reports in the literature have implicated bicycle riding as causing increased risk of erectile dysfunction (ED). Perineal compression during cycling has been associated with the development of sexual complications. To review current literature on the rationale for ED from bicycle riding and outcome of bicycle riding on erectile function and to present available research on preventative measures specifically regarding bicycle riding. A systematic comprehensive literature review. There is a significant relationship between cycling-induced perineal compression leading to vascular, endothelial, and neurogenic dysfunction in men and the development of ED. Research on female bicyclists is very limited but indicates the same impairment as in male bicyclists. Preventative measures including use of a properly fitted bicycle, a riding style with a suitable seat position and an appropriate bicycle seat can help prevent impairment of erectile function. There is a need for further research on safe bicycle and bicycle seat design and investigations that address the underlying mechanisms leading to cycling-related sexual dysfunction in both male and female bicyclists.

  20. Imaging for evaluation of erectile dysfunction

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-03-15

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

  1. 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.

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

    International Nuclear Information System (INIS)

    Ahmed, I.; Anwar, E.; Ali, S.S.; Ali, A.

    2013-01-01

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

  3. Sildenafil inhibits superoxide formation and prevents endothelial dysfunction in a mouse model of secondhand smoke induced erectile dysfunction.

    Science.gov (United States)

    Bivalacqua, Trinity J; Sussan, Thomas E; Gebska, Melina A; Strong, Travis D; Berkowitz, Dan E; Biswal, Shyam; Burnett, Arthur L; Champion, Hunter C

    2009-02-01

    We determined the effect of passive secondhand cigarette smoke on 1) erectile function in vivo, 2) molecular mechanisms involved in penile vascular function, and 3) erectile function and penile molecular signaling in the presence of phosphodiesterase type 5 inhibitor therapy. Four groups of mice were used, including group 1--controls, group 2--mice exposed to 3 weeks of secondhand smoke (5 hours per day for 5 days per week), group 3--control plus sildenafil (100 mg/kg per day) and group 4--smoke exposed plus sildenafil (100 mg/kg per day). Cavernous nerve electrical stimulation and intracavernous injection of acetylcholine were done to assess erectile function. Constitutive and inducible nitric oxide synthase activity, reactive oxygen species generation, nitrotyrosine formation and superoxide anion levels were assessed. Decreased erectile responses to cavernous nerve electrical stimulation and impaired endothelium dependent erectile responses to ACh in mice exposed to secondhand smoke were observed. Superoxide anion was increased in endothelial and corporeal smooth muscle cells of smoking mouse penises. In mice exposed to secondhand smoke constitutive nitric oxide synthase activity was decreased, and inducible nitric oxide synthase activity, reactive oxygen species generation and nitrotyrosine formation increased. Sildenafil therapy restored constitutive nitric oxide synthase activity in the penis of smoking mice, decreased inducible nitric oxide synthase activity, reactive oxygen species generation and nitrotyrosine formation, and improved erectile responses to cavernous nerve electrical stimulation and acetylcholine. Short-term exposure to secondhand smoke impairs erectile function through excessive penile reactive oxygen species signaling and inducible nitric oxide synthase activity. Decreased penile constitutive nitric oxide synthase activity may be attributable to the decreased endothelial nitric oxide synthase activity resulting from increased oxidative

  4. Erectile Dysfunction: Viagra and Other Oral Medications

    Science.gov (United States)

    Erectile dysfunction: Viagra and other oral medications By Mayo Clinic Staff Oral medications are often the first line of treatment for ... medications work well and cause few side effects. Sildenafil (Viagra), vardenafil (Levitra, Staxyn), tadalafil (Cialis) and avanafil ( ...

  5. Erectile Dysfunction in Males on Hemodialysis

    International Nuclear Information System (INIS)

    Haider, E.; Iftikhar, R.; Ghazanfar, A.; Afzal, M.; Mir, A. W.; Mansoor, K.; Taj, R.; Samiullah, R.

    2013-01-01

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

  6. 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

    reports, although to our knowledge the pathophysiological mechanisms remain unclear. Estimating the strength of the association of erectile dysfunction with distinct risk factors in terms of odds ratios enabled us to identify the factors to pursue when seeking to prevent erectile dysfunction. Furthermore, the relationship of tobacco with erectile dysfunction, which has been controversial in previous series, was well characterized in our study.

  7. Prevalence and risk factors of erectile dysfunction in Niger delta ...

    African Journals Online (AJOL)

    Background: Erectile Dysfunction (ED) is one of the major social problems causing significant distress in men. Despite the increasing difficulty in management, knowledge, and understanding of factors responsible for its development are important for prevention and care. Objectives: To assess the prevalence and risk ...

  8. Linking erectile dysfunction and coronary artery disease.

    Science.gov (United States)

    Rodriguez, J J; Al Dashti, R; Schwarz, E R

    2005-12-01

    Coronary artery disease (CAD) and erectile dysfunction (ED) are both highly prevalent conditions that frequently coexist. Additionally, they share mutual vascular risk factors, suggesting that they are both manifestations of systemic vascular disease. The role of endothelial dysfunction in CAD is well established. Normal erectile function is primarily a vascular event that relies heavily on endothelially derived, nitric oxide-induced vasodilation. Accordingly, endothelial dysfunction appears to be a common pathological etiology and mechanism of disease progression between CAD and ED. The risk factors of diabetes mellitus, hypertension, hyperlipidemia, obesity and tobacco abuse contribute to endothelial dysfunction. This article reviews the role of vascular endothelium in health, the abnormalities resulting from vascular risk factors, and clinical trials evaluating the role of endothelial dysfunction in ED.

  9. Characteristics of patients with erectile dysfunction in a family physician-led erectile dysfunction clinic: Retrospective case series

    OpenAIRE

    Lap Kin Chiang; Cheuk-Wai Kam; Kin-Chung Michael Yau; Lorna Ng

    2017-01-01

    Objectives: 1. To examine the characteristics of patients with erectile dysfunction in a family physician led erectile dysfunction clinic; 2. To review association of chronic disease spectrum and erectile dysfunction; 3. To review initial treatment pattern and outcome. Design: Retrospective case series review. Subjects: All consecutive patients seen in a regional hospital family physician led erectile dysfunction clinic from April 2014 to March 2015. Main outcome measures: 1. The severity of ...

  10. Erectile dysfunction | Smith | South African Family Practice

    African Journals Online (AJOL)

    Erectile dysfunction (ED) is a medical term that describes the inability to achieve and/or maintain an erect penis adequate for sexual function. This condition is one of the most common sexual problems for men and increases with age, but it's not a natural part of ageing. Approximately one half of men aged 40 years and ...

  11. Prevalence of anxiety and depressive erectile dysfunction

    African Journals Online (AJOL)

    The primary illness is that of depression, with ED a symptom of the depressive disorder. Prevalence of anxiety and depressive symptoms in men with erectile dysfunction. K Pankhurst, MB ChB. G Joubert, BA, MSc. P J Pretorius, MB ChB, MMed (Psych). Departments of Psychiatry and Biostatistics,. University of the Free State ...

  12. 01 Erectile Dysfunction Original 1.pmd

    African Journals Online (AJOL)

    Pierre Marais

    To estimate the prevalence of erectile dysfunction (ED) among users of primary care in a Black and Mixed Race urban population in the ... Correspondence: Prof PJT de Villiers, Department of Family Medicine and Primary Care,. University of Stellenbosch, PO Box .... 3. refusal of the patient to give consent. Data collection.

  13. Prevalence and determinants of erectile dysfunction in Santos, southeastern Brazil

    OpenAIRE

    Moreira Júnior,Edson Duarte; Bestane,Walter Jorge; Bartolo,Elaine Bestane; Fittipaldi,João Antônio Saraiva

    2002-01-01

    CONTEXT: Recent population-based surveys suggest that the prevalence of erectile dysfunction is between 30% and 56% among men over the age of 40. Most of these studies, however, are from the United States or Europe. We need estimates of erectile dysfunction from samples of Brazilian populations, as societies that differ ethnically, culturally, and economically may also differ with respect to potential risk factors for erectile dysfunction. OBJECTIVE: To determine the prevalence of erectile dy...

  14. AB62. Age-related differences of erectile function in erectile dysfunction patients

    OpenAIRE

    Zhang, Kai; Jiang, Hui; Wang, Xiaofeng

    2014-01-01

    Objectives To investigate the age-related differences of erectile function and erectile hardness in erectile dysfunction (ED) patients. Methods The data is retrieved in the baseline database of a study on ED management which was performed in 46 urological clinics in China. The patients are stratified on the basis of every 10 years (yrs) old. The evaluation questionnaires of ED are the erectile function domain of the International Index of Erectile Function (IIEF-EF) and the Erection Hardness ...

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

    Science.gov (United States)

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

    2006-09-20

    Erectile dysfunction is associated with, and may be the first sign of coronary artery disease. We aimed to assess whether men with erectile dysfunction but without cardiovascular disease have reduced coronary flow reserve, as a sign of early coronary atherosclerosis. We investigated 12 men aged 68-73 years with erectile dysfunction, and 12 age-matched controls. Erectile function was evaluated using the validated IIEF-5 questionnaire. A score or = 21 was considered normal. Patients with neurological or psychological reasons for erectile dysfunction were excluded, as were patients with symptoms of or prescribed medication for cardiovascular disease, hypertension or diabetes. Coronary flow velocity reserve was measured non-invasively by Doppler in the left anterior descending artery, before and during adenosine infusion. Coronary flow velocity reserve was significantly reduced in subjects with erectile dysfunction: 2.36 versus 3.19; P=0.024. In logistic regression analysis, compared to control subjects, men with erectile dysfunction had significantly increased risk of reduced coronary flow velocity reserve (reduced coronary flow velocity reserve, P=0.016. Men with erectile dysfunction but without diabetes or clinical cardiovascular disease have early signs of coronary artery disease. Our findings suggest that a cardiac risk evaluation may be indicated in men with suspected vasculogenic erectile dysfunction, and these individuals should be considered for primary prevention measures regarding cardiovascular disease risk factors.

  16. 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.

  17. AB019. Erectile dysfunction: analysis based on age stratification

    OpenAIRE

    Kai, Zhang

    2015-01-01

    Objective To establish the profile of erectile dysfunction in different age groups, and analysis the effect of sildenafil based on age stratification. Subjects and Methods From 2007 to 2008, a total of 4,507 men diagnosed with erectile dysfunction (ED) were enrolled from 46 centers in China; 4,039 of these patients were treated with sildenafil and asked to complete the Erectile Function domain of the International Index of Erectile Function, Erection Hardness Score, and Quality of Erection Qu...

  18. Management of erectile dysfunction post-radical prostatectomy

    Directory of Open Access Journals (Sweden)

    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. 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.

  20. Erectile Dysfunction in the Older Adult Male.

    Science.gov (United States)

    Mola, Joanna R

    2015-01-01

    Erectile dysfunction (ED) in the older adult male is a significant problem affecting more than 75% of men over 70 years of age in the United States. Older men have an increased likelihood of developing ED due to chronic disease, comorbid conditions, and age-related changes. Research has demonstrated that while the prevalence and severity of ED increases with age, sexual desire often remains unchanged. This article discusses the clinical picture of ED, including relevant pathophysiology, clinical presentation, and evaluation and treatment options.

  1. Endovascular treatment of vasculogenic erectile dysfunction

    OpenAIRE

    O. B. Zhukov; S. N. Shcherbinin; V. A. Ukolov

    2014-01-01

    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 i...

  2. [Obesity--significant risk factor for erectile dysfunction in men].

    Science.gov (United States)

    Skrypnik, Damian; Bogdański, Paweł; Musialik, Katarzyna

    2014-02-01

    The obesity affects around 312 million people over the world. In The United States it causes more than 300 000 deaths per year. It leads to many complications, such as ischemic heart disease, hypertension, dyslipidemia, atherosclerosis and abnormal carbohydrate metabolism. It was proven recently that obesity is also an independent risk factor for erectile dysfunction in men. 79% of men presenting erectile disorders have BMI of 25 kg/m2 or greater. BMI in the range 25-30 kg/m2 is associated with 1,5 times, and in the range of over 30 kg/m2 with 3 times greater risk of sexual dysfunction. The occurrence of erectile dysfunction in patients with obesity is caused by a number of complications which are characteristic for an excessive amount of fat tissue, in example: cardiovascular diseases, diabetes or dyslipidemia. In the United States diabetes and obesity are responsible for 8 million cases of erectile dysfunction. Scientific evidence indicates that excessive body weight should be considered as an independent risk factor for erectile dysfunction. This risk increases with increasing BMI. Erectile disorders correlate with the occurrence of obesity at any time during the patient's life. Obesity leads to erectile dysfunction in a considerably greater extent than aging. Mechanisms responsible for the independent influence of obesity on the erectile dysfunction are: hormonal imbalance, endothelial dysfunction, insulin resistance, psychological factors and physical inactivity. The basis for erectile dysfunction treatment in obesity is body weight loss. Erectile disorders in obese men are significantly more frequent than in general population. Obesity is beyond any doubts an independent risk factor of erectile dysfunction.

  3. The pharmacological management of erectile dysfunction – Update ...

    African Journals Online (AJOL)

    Erectile dysfunction (ED) is a trivial condition with a prevailing incidence worldwide. Phosphodiesterase-5 inhibitors ... Keywords: cardiovascular disease, erectile dysfunction, phosphodiesterase-5 inhibitors, prostaglandin, testosterone. South African Family ..... among older adults in the United States. N Engl J Med. 2007 ...

  4. Prevalence of erectile dysfunction and possible risk factors among ...

    African Journals Online (AJOL)

    Introduction: Erectile dysfunction (ED) is currently one of the most common sexual dysfunctions worldwide but it is usually underestimated because it is not a life threatening condition. The associated stigma makes men who have it to suffer in silence. This study was conducted to determine the prevalence of erectile ...

  5. 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...

  6. 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

  7. 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.

  8. Sexual dysfunction in women partners of men with erectile dysfunction.

    Science.gov (United States)

    Greenstein, A; Abramov, L; Matzkin, H; Chen, J

    2006-01-01

    We evaluated 113 female partners of men with erectile dysfunction (ED) attending a sexual dysfunction clinic in order to define sexual dysfunction among these women. In all, 51 (45%) women denied having any sexual dysfunction. The other 62 (55%) responded to questions classifying their complaint(s) according to the international classification of female sexual dysfunction (FSD) in the following topics (40/62, 65%, reported having more than one problem): decreased sexual desire (n=35, 56%), sexual aversion (none), arousal (n=23, 37%) and orgasmic disorders (n=39, 63%), dyspareunia (n=19, 31%), vaginismus (n=3, 5%), and noncoital sexual pain (none). Many female partners of men with ED report having some form of sexual disorder, mostly orgasmic problems and decreased sexual desire. Therefore, for optimal outcome of ED treatment, evaluation and treatment of male and FSD should be addressed as one unit within the context of the couple, and be incorporated into one clinic of sexual medicine.

  9. Penile prosthesis surgery in the management of erectile dysfunction

    Science.gov (United States)

    Sadeghi-Nejad, Hossein; Fam, Mina

    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’, ‘complications’ and ‘infection’. Results We describe the novel indications for the use of penile prostheses, the significant advances in implant designs with improved mechanical reliability, the changing landscape of device infection, and the current management of complications. Sixty-eight publications with a grade A, B and C level of evidence are cited. Conclusion The clinical indications to implant a penile prosthesis have expanded beyond organic erectile dysfunction. With the many different devices currently available, the choice of which device to implant can be tailored based on an individual’s unique medical conditions, manual dexterity and expectations, and surgeon preference. There must be a conscious effort to prevent device infection, in the light of the development of increasingly virulent organisms. Penile prosthesis surgery is an integral part of the treatment of erectile dysfunction when non-surgical options fail or are contraindicated. PMID:26558089

  10. [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.

  11. Erectile Dysfunction in 101 Consecutive Hypertensive Patients and ...

    African Journals Online (AJOL)

    In a 6 month prospective questionnaire study of 101 consecutive newly referred hypertensive patients and 86 normotensive volunteers, the relationship of erectile dysfunction and hypertension in these patients was studied using a modified international index of erectile function (IIEF). The mean age of the hypertensive ...

  12. Correlation between prevalence of erectile dysfunction and length of ...

    African Journals Online (AJOL)

    Even stationary bikes can cause trauma to the blood supply to the penis, resulting in erectile dysfunction (22). Objective: To evaluate the effects of long hours of bicycle riding/week on erectile function among bicycle taxi (boda boda) riders in Bungoma town. Design: A Cross-sectional survey. Setting: Bungoma town, part of ...

  13. Erectile Dysfunction Herbs: A Natural Treatment for ED?

    Science.gov (United States)

    ... is a common problem. You've likely seen advertisements for erectile dysfunction herbs or supplements to "increase ... is used for premature ejaculation. Panax ginseng contains many active ingredients. It appears to be safe used ...

  14. Possible Association between Erectile Dysfunction and Osteoporosis in Men

    Directory of Open Access Journals (Sweden)

    Murat Dursun

    2015-01-01

    Full Text Available Sexual dysfunction in general and erectile dysfunction (ED in particular significantly affect men’s quality of life. Some patients who have ED, also develop osteoporosis. So, in this study we investigated the relationship between erectile dysfunction and osteoporosis in men. 95 men with erectile dysfunction and 82 men with normal sexual function were included in the study. The men’s sexual functions were evaluated by International Index of Erectile Function-5 items (IIEF-5. All men received a Dual Energy X-ray Absorptiometry (DEXA; Hologic scan to measure bone mineral density (BMD for osteoporosis. Chi-square test was used for statistical analysis. Mean age was 53.5 (38–69 in ED group and 50.1 (31–69 in control group. In ED group the men have lower T score levels than those of the control group. In conclusion, the men who have erectile dysfunction were at more risk for osteoporosis. The results of the present study demonstrate that the men with erectile dysfunction have low bone mineral density and they are at higher risk for osteoporosis. Because of easy and noninvasive evaluation of osteoporosis, patients with ED should be checked for bone mineral density and osteoporotic male subjects should be evaluated for ED.

  15. Prevalence and Predictors of Erectile Dysfunctions among Men on ...

    African Journals Online (AJOL)

    viral therapies (ART) and different degrees of sexual dysfunction in men.[1-3] The highest rates of dysfunction are associated with Indinavir and the lowest with Nevirapine.[2] ... Abstract. Background: Erectile dysfunctions (EDs) are common presentations among men on ..... of old age could also explain this phenomenon.

  16. Obesity, low testosterone levels and erectile dysfunction.

    Science.gov (United States)

    Diaz-Arjonilla, M; Schwarcz, M; Swerdloff, R S; Wang, C

    2009-01-01

    Obesity is an important risk factor for many common diseases including cardiovascular disease (CVD), type 2 diabetes, cancer and erectile dysfunction (ED). Adipose tissues produce a number of adipokines and cytokines, which affect endothelial and metabolic function resulting in insulin resistance and the metabolic syndrome (risks factors for CVD). Both ED and metabolic syndrome improve with a reduction in body mass index (BMI). The relationships among obesity, metabolic syndrome, ED, sex hormone-binding globulin (SHBG) and serum total and free testosterone levels are complex and often confusing to the physician. It is known that BMI is inversely proportional to serum total testosterone concentrations; low serum SHBG levels in obesity contribute to the low serum total testosterone. Recent studies show that BMI is also inversely proportional to free testosterone concentration. The characteristic low serum testosterone concentrations observed in obese men are also present in men with the metabolic syndrome and type 2 diabetes mellitus. A small proportion of men with ED have hypogonadism; however, the proportion increases if these men are obese with manifestations of the metabolic syndrome or type 2 diabetes mellitus. ED is a common symptom in patients with type 2 diabetes who also have low testosterone levels. This review describes the relationships between low serum testosterone concentrations and ED in obese patients and those with metabolic syndrome and type 2 diabetes mellitus.

  17. Erectile dysfunction management options in Nigeria.

    Science.gov (United States)

    Afolayan, Anthony Jide; Yakubu, Musa Toyin

    2009-04-01

    In Nigeria, the prevalence of erectile dysfunction (ED) among patients attending primary care clinics, age-standardized to the U.S. population in 2000 is 57.4%. This is considered high enough to warrant the attention of scientist for critical studies and analysis. The high ED prevalence is associated with etiologies such as psychosexual factors, chronic medical conditions, and some lifestyles. ED constitutes a major public health problem, influencing the patient's well-being and quality of life. It also leads to broken homes and marriages, psychological, social, and physical morbidity. To give an account of various ED management options in Nigeria. Review of peer-reviewed literature, questionnaire, and ethnobotanical survey to some indigenous herb sellers and herbalists. Cross cultural perspectives of ED management in Nigeria. The review suggests that traditional (phytotherapy, zootherapy, and occultism) and nontraditional, orthodox practice (drug therapy, psychological, and behavioral counseling) are applicable to ED management in Nigeria. This review should help in creating awareness into various options available for managing ED in the country, but does not recommend self medication of any form, be it the use of orthodox or herbal remedy.

  18. Treatment of Erectile Dysfunction in Type 2 Diabetic Men

    Directory of Open Access Journals (Sweden)

    V.Ye. Luchytskyi

    2015-11-01

    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.

  19. Non-steroidal anti-inflammatory drug (NSAID) use is not associated with erectile dysfunction risk: results from the Prostate Cancer Prevention Trial.

    Science.gov (United States)

    Patel, Darshan P; Schenk, Jeannette M; Darke, Amy; Myers, Jeremy B; Brant, William O; Hotaling, James M

    2016-03-01

    To evaluate the associations of non-steroidal anti-inflammatory drug (NSAID) use with risk of erectile dysfunction (ED), considering the indications for NSAID use. We analysed data from 4 726 men in the placebo arm of the Prostate Cancer Prevention Trial (PCPT) without evidence of ED at baseline. Incident ED was defined as mild/moderate (decrease in normal function) or severe (absence of function). Proportional hazards models were used to estimate the covariate-adjusted associations of NSAID-related medical conditions and time-dependent NSAID use with ED risk. Arthritis (hazard ratio [HR] 1.56), chronic musculoskeletal pain (HR 1.35), general musculoskeletal complaints (HR 1.36), headaches (HR 1.44), sciatica (HR 1.50) and atherosclerotic disease (HR 1.60) were all significantly associated with an increased risk of mild/moderate ED, while only general musculoskeletal complaints (HR 1.22), headaches (HR 1.47) and atherosclerotic disease (HR 1.60) were associated with an increased risk of severe ED. Non-aspirin NSAID use was associated with an increased risk of mild/moderate ED (HR 1.16; P = 0.02) and aspirin use was associated with an increased risk of severe ED (HR 1.16; P = 0.03, respectively). The associations of NSAID use with ED risk were attenuated after controlling for indications for NSAID use. The modest associations of NSAID use with ED risk in the present cohort were probably attributable to confounding indications for NSAID use. NSAID use was not associated with ED risk. © 2015 The Authors BJU International © 2015 BJU International Published by John Wiley & Sons Ltd.

  20. Frequency and determinants of erectile dysfunction in Turkish ...

    African Journals Online (AJOL)

    2014-06-03

    Jun 3, 2014 ... Erectile dysfunction (ED) or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance.[1] Although ED may occur at a younger age, it is a disorder most frequently seen in middle‑aged and ‑elderly men. ED in diabetic men is ...

  1. Frequency and determinants of erectile dysfunction in Turkish ...

    African Journals Online (AJOL)

    Background: Erectile dysfunction (ED) or impotence is a sexual dysfunction characterized by the inability to develop or maintain an erection of the penis during sexual performance. ED is observed more frequently and manifests earlier in diabetic patients compared to the normal population. Material and Methods: One ...

  2. Cardiovascular drugs and erectile dysfunction - a symmetry analysis

    DEFF Research Database (Denmark)

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

    2015-01-01

    for erectile dysfunction (NNTH). RESULTS: We identified 20 072 males with a median age of 64 years (IQR 60-70) who initiated a cardiovascular drug and a 5-phosphodiesterase inhibitor within a 6 month interval. Sequence ratios showed minor asymmetry in prescription orders after adjustment for trends......AIM: Erectile dysfunction is a common problem among patients with cardiovascular diseases and the influence of cardiovascular drugs is much debated. The aim of this study was to evaluate the short term potential for different cardiovascular drugs to affect the risk of being prescribed a drug...... against erectile dysfunction. METHODS: We employed a symmetry analysis design and included all Danish male individuals born before 1950 who filled their first ever prescription for a cardiovascular drug and a 5-phosphodiesterase inhibitor within a 6 month interval during 2002-2012. If the cardiovascular...

  3. [Erectile dysfunction as a result of spinal trauma].

    Science.gov (United States)

    Dolan, I; Srámková, T; Filipenský, P; Sramková, K

    2014-01-01

    Erectile dysfunction (ED) is one of many consequences of spinal trauma. Its extent is influenced by several factors, depending mainly on the height of spinal injuries as well as the premorbid state. The incidence of spinal cord injuries in the Czech Republic and around the world has a slightly upward trend. Epidemiological statistics include mostly young people for whom sexual activity has a reproductive function. Disorders in the intimate area seriously and significantly reduce the quality of life. The article presents current theoretical knowledge of erectile dysfunction, according to epidemiological data on spinal cord injuries in the Czech Republic, and an overview of up-to-date therapeutic modalities for erectile dysfunction in men after spinal trauma.

  4. 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

  5. Erectile dysfunction is strongly linked with decreased libido in diabetic men.

    Science.gov (United States)

    Nakanishi, S; Yamane, K; Kamei, N; Okubo, M; Kohno, N

    2004-06-01

    Erectile dysfunction frequently occurs with diabetes mellitus. A survey of diabetic men was conducted by anonymous questionnaire to investigate the associations of erectile dysfunction with various predictive factors. A total of 112 diabetic males without an obvious history of erectile dysfunction were available for analyses. The mean age and duration of diabetes were 53.7 +/- 12.2 years and 10.2 +/- 8.6 years (mean +/- standard deviation), respectively. The questionnaire included questions on the presence or absence of smoking, hypertension, libido and subjective symptoms of diabetic neuropathy that may be associated with erectile dysfunction. Analysis of the answers to the questionnaire revealed that 40% of the patients complained of erectile dysfunction (erection 'always insufficient'). Erectile dysfunction was significantly correlated with age (p = 0.005), but not with duration of diabetes (p = 0.25), adjusted for age. Erectile dysfunction was also associated with sensory neuropathy and reduced libido, independently of age. The logistic regression analysis revealed that erectile dysfunction was positively associated with reduced libido and age. The odds ratio of erectile dysfunction for reduced compared to unreduced libido was 18.21, suggesting that psychogenic factors have a marked influence on erectile dysfunction. It is concluded that the presence of erectile dysfunction should be considered when symptoms related to diabetic neuropathy are observed; psychological approaches, such as sexual counseling, could be applied for the treatment of erectile dysfunction.

  6. Intravenous Infusion of Bone Marrow–Derived Mesenchymal Stem Cells Reduces Erectile Dysfunction Following Cavernous Nerve Injury in Rats

    OpenAIRE

    Yohei Matsuda, MD; Masanori Sasaki, MD, PhD; Yuko Kataoka-Sasaki, MD, PhD; Akio Takayanagi, MD, PhD; Ko Kobayashi, MD, PhD; Shinichi Oka, MD, PhD; Masahito Nakazaki, MD, PhD; Naoya Masumori, MD, PhD; Jeffery D. Kocsis, PhD; Osamu Honmou, MD, PhD

    2018-01-01

    Introduction: Intravenous preload (delivered before cavernous nerve [CN] injury) of bone marrow–derived mesenchymal stem cells (MSCs) can prevent or decrease postoperative erectile dysfunction (J Sex Med 2015;12:1713–1721). In the present study, the potential therapeutic effects of intravenously administered MSCs on postoperative erectile dysfunction were evaluated in a rat model of CN injury. Methods: Male Sprague-Dawley rats were randomized into 2 groups after electric CN injury. Intrave...

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

    Directory of Open Access Journals (Sweden)

    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.

  8. The pharmacological management of erectile dysfunction

    African Journals Online (AJOL)

    The International Index of Erectile Function (IIEF) and the Sexual. Health Inventory for ... parasympathetic and somatic outflow mechanisms, and is considered to .... Multiple sclerosis. • Epilepsy. • Parkinson's disease. • Alzheimer's disease. • A stroke. • Spinal cord injury. • Pelvic surgery. • Testosterone deficiency syndrome.

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

    African Journals Online (AJOL)

    1 or type 2 diabetes mellitus, but it is often missed by treating physicians.1–3. It occurs at a younger age and with greater frequency in men with diabetes mellitus compared to non- diabetic men.1–3 The prevalence of erectile dysfunction in the general adult population in the USA was found to be between. 18% and 31% ...

  10. Historical approach to the surgical treatment of erectile dysfunction.

    Science.gov (United States)

    Jara, J; Lledó, E

    2013-01-01

    Throughout human history, erectile dysfunction has represented one of the most omnipresent health problems. This has resulted in a search for solutions that, one after the other, have been shown to be fruitless. In this context, the emergence of possible surgical solutions at the start of the 20th century represented a revolution that, even then, would take several decades to demonstrate their effectiveness. We performed a literature review that shows the process in the development of potential surgical treatments for hormonal restoration for erectile dysfunction, followed by the sudden emergence of vascular surgery, with new anastomosis techniques, and in the future, the development of penile prosthetic implants as alternative treatments. The publication of results from erectile dysfunction surgery has been lagging for decades due to a lack of objectivity, given that sexual function is a topic restricted by patients' privacy. This situation has led to a reliance on results reported by various authors whose actual credibility could not be verified, with subsequent demonstrations showing that some of these results were not reproducible. This article reviews some of the most important milestones in the progress of surgeries designed to treat erectile dysfunction. The achievements and apparent failures provide a reason for reflection on how we far we have come and how far we can go in the near future. Copyright © 2012 AEU. Published by Elsevier Espana. All rights reserved.

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

    DEFF Research Database (Denmark)

    Fløe, Andreas; Hilberg, Ole; Wijsenbeek, Marlies

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

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

    African Journals Online (AJOL)

    Pharmaceutical Sciences, Universiti Sains Malaysia, Pulau Pinang, Malaysia, 3Faculty of Pharmacy, The University of Lahore,. Lahore, Pakistan ... on the prevalence of sexual/erectile dysfunction in hypertensive men taking antihypertensive drugs and risk factors ..... knowledge of side effects produce anxiety that may affect ...

  13. The prevalence of erectile dysfunction at a primary healthcare clinic ...

    African Journals Online (AJOL)

    Objectives: The objectives of this study were to determine the prevalence of erectile dysfunction (ED) in men attending a primary healthcare (PHC) clinic in Durban, KwaZulu-Natal, and to document any relationship between ED and age, smoking, economic status and co-morbid conditions. Design: An observational ...

  14. Erectile Dysfunction in patients with Sickle Cell Anaemia | Ibidapo ...

    African Journals Online (AJOL)

    Background: Sickle cell disorder is characterized by a reduced haemoglobin solubility and consequent polymerization, leading to an increased haemolysis as well as vaso-occlusive complications including priapism. Priapism occurs frequently amongst SCD patients in LUTH, and can be associated with erectile dysfunction ...

  15. The pharmacological management of erectile dysfunction – Update ...

    African Journals Online (AJOL)

    Erectile dysfunction (ED) is a trivial condition with a prevailing incidence worldwide. Phosphodiesterase-5 inhibitors (PDE-5) have revolutionised the treatment of ED and are regarded as one of the most successful drug groups in modern medicine. Generally PDE-5 inhibitors are well tolerated and the incidence of ...

  16. The patient who complains of erectile dysfunction | Levinson | South ...

    African Journals Online (AJOL)

    South African Journal of Psychiatry. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 11, No 2 (2005) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. The patient who complains of erectile dysfunction.

  17. Dynamic and morphologic evaluation of erectile dysfunction on ...

    African Journals Online (AJOL)

    Background: Penile erection is a complex phenomenon that involves coordinated interaction of the psychologic, hormonal, nervous, arterial, venous, and sinusoidal systems. Erectile dysfunction (ED) is the persistent inability to attain or maintain penile erection sufficient for sexual intercourse. This study aims to determine ...

  18. Erectile dysfunction is a common problem in interstitial lung diseases

    DEFF Research Database (Denmark)

    Fløe, Andreas; Hilberg, Ole; Wijsenbeek, Marlies

    2017-01-01

    Introduction: Erectile dysfunction (ED) is related to chronic diseases, including COPD. The patho- genesis may involve chronic hypoxia, which is common in interstitial lung disease (ILD). We aimed to study the relationship between ILD and ED. Method: Male patients with ILD detected by high-resolu...

  19. Biochemical Pattern Of Erectile Dysfunction in Nigerians Living in ...

    African Journals Online (AJOL)

    Endocrine disorders were observed in 48.7% of the subjects. These include primary hypogonadism (10.4%), hypogonadotropins (26.1%) and isolated low FSH (12.2%). No endocrine pathologies were observed in 51.3% of the subjects. Endocrine disorders are common in patients with erectile dysfunction referred to the ...

  20. Prevalence and characteristics of erectile dysfunction in black and ...

    African Journals Online (AJOL)

    Prevalence and characteristics of erectile dysfunction in black and mixed race primary care populations of the Cape Flats and Helderberg Basin area of the Western Cape, South Africa. ... Significantly associated diseases: hypertension, diabetes, gastrointestinal and heart disease. Alcohol consumption (younger patients), ...

  1. Management of erectile dysfunction: perceptions and practices of ...

    African Journals Online (AJOL)

    2003-08-23

    Aug 23, 2003 ... Background. Erectile dysfunction (ED) is a prevalent health problem in many societies, but the diagnosis is seldom documented in primary ..... Other risk factors implicated include depression, cigarette smoking, caffeine consump- tion, inactivity and obesity.21. Primary care physicians need to be aware that.

  2. Effect of sildenafil on erectile dysfunction in spinal Cord injured ...

    African Journals Online (AJOL)

    Effect of sildenafil on erectile dysfunction in spinal Cord injured patients. ... Trauma was the etiology in 87.5% of the cases (44% were road accidents). 12/16 patients were paraplegics (10 above ... in SCI patients. This approach is compatible with the efforts to improve the quality of life and rehabilitation of these patients.

  3. Obstructive sleep apnea syndrome and erectile dysfunction: does ...

    African Journals Online (AJOL)

    Conclusion: It is not certainly possible to say that OSAS is clearly associated with ED. However, after 3 months of regular CPAP usage, ED complaints in patients with OSAS might improve positively. Trials with larger series may give more conclusive data. Key Words: Sleep disorder, erectile dysfunction, obstructive sleep ...

  4. New insights into androgen treatment of erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Louis Gooren

    2006-01-01

    Full Text Available Erectile response in mammals is centrally and peripherally regulated by androgens. Severe hypogonadism in men usually results in loss of libido and potency which can be restored by androgen administration. The original insights into the mechanisms of action of androgens on sexual function indicated that androgens particularly exert effects on libido and that sleep-related erections were androgen-sensitive but erections in response to erotic stimuli were relatively androgen-independent. There are a number of recent developments which shed new light on testosterone treatment of erectile dysfunction in aging men. There is growing insight that testosterone has profound effects on tissues of the penis involved in the mechanism of erection and that testosterone deficiency impairs the anatomical and physiological/biochemical substrate of erectile capacity, reversible upon androgen treatment. Several studies have indicated that the administration of PDE-5-inhibitors is not always sufficient to restore erectile potency in men and that administration of testosterone improves the therapeutical response to PDE-5-inhibitors considerably. There is increasing insight not to view erectile dysfunction (ED as a single entity but as part of the aging process. Circulating levels of testosterone are closely related to manifestations of other etiological factors in ED, such as atherosclerotic disease and diabetes mellitus. The latter are correlated with lower-than-normal testosterone levels.

  5. Occupational cycling is a risk factor for erectile dysfunction in east ...

    African Journals Online (AJOL)

    Logistic regression indicated that the odds of reporting Erectile Dysfunction were 9.1 (95% CI: 5.4-15.5) times higher in cyclists compared to noncyclists controls. Conclusion: In East Africa, occupational cycling is associated with lower International Index of Erectile Function scores and higher rates of Erectile Dysfunction.

  6. Current approaches to erectile dysfunction and testosterone deficiency.

    Science.gov (United States)

    Wespes, E

    2010-12-01

    Androgens are essential for the development of the penis and it is well known that testosterone play a critical role in the physiology of erectile function. From animal studies, testosterone insufficiency disrupts cellular-signaling pathways and induces pathologic alterations in penile tissues leading to erectile dysfunction. In human, the testosterone threshold for maintaining erection is low which explains the reason why some contracted men still have an erection due to the androgens produced by the adrenal gland. Testosterone alone can improve erectile function in hypogonadic patients. Associated with PDE5-I, testosterone supplementation is a treatment for the hypogonadic patients non responders to therapy. The article reviews the different aspects of the testosterone role in the pathophysiology of erection.

  7. 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.

  8. Is there any relationship between serum levels of total bilirubin and the severity of erectile dysfunction?

    Science.gov (United States)

    Keskin, Ercüment; Karabakan, Mehmet; Bozkurt, Aliseydi; Hirik, Erkan; Karabulut, İbrahim; Gunay, Murat; Çakan, Murat

    2018-04-01

    Recent studies have shown that atherosclerosis is associated with erectile dysfunction and the serum bilirubin level. In this study, the serum total bilirubin levels of patients with erectile dysfunction were measured to investigate the relationship between the levels of erectile dysfunction and total bilirubin. A total of 94 patients with erectile dysfunction were divided into three groups; severe erectile dysfunction (33 patients), moderate erectile dysfunction (31 patients), and mild erectile dysfunction (30 patients). In addition, a control group was formed with 31 healthy men. The International Index of Erectile Function-5 Questionnaire was used to measure the quality of erection in all the groups. The body mass index was calculated for all the participants. The serum glucose, low-density lipoprotein and high-density lipoprotein, cholesterol, triglyceride, total bilirubin, and total testosterone levels were also determined. No statistically significant difference was observed between the groups in terms of the mean age, hypertension, smoking status, alcohol use, cardiovascular diseases, hepatobiliary disease, diabetes mellitus, and levels of total testosterone, low-density lipoprotein-cholesterol, and triglyceride. However, high-density lipoprotein, body mass index, and total bilirubin were significantly lower compared to the control group (p < 0.001). The serum total bilirubin level was found to be 0.41 ± 0.21 ng/dL in the severe erectile dysfunction, 0.43 ± 0.19 ng/dL in the moderate erectile dysfunction, and 0.48 ± 0.11 ng/dL in the mild erectile dysfunction groups (p < 0.001). Considering the significant differences between the erectile dysfunction and control groups in terms of serum total bilirubin levels, a low level of bilirubin may have a role in the etiology of erectile dysfunction.

  9. eNOS-uncoupling in age-related erectile dysfunction

    OpenAIRE

    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 ...

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

    OpenAIRE

    Ashwin Saxena; Pawan Prakash; Mayur Porwal; Neeraj Sissodia; Pravesh Sharma

    2012-01-01

    Erectile dysfunction (ED) or male impotence is defined as the inability to have or sustain an erection long enough to have a meaningful sexual intercourse. ED tends to occur gradually until the night time or early morning erections cease altogether or are so flaccid that successful intercourse does not occur. Sexual health is an important determinant of quality of life. Today, millions of men, young and old, suffer from ED due to high levels of synthetic hormones (known as Xenoestrogens) in o...

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Maria Ida Maiorino

    2015-02-01

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

  13. Biofeedback and facilitation of erection in men with erectile dysfunction.

    Science.gov (United States)

    Reynolds, B S

    1980-04-01

    Thirty men with psychogenic erectile dysfunction were instructed to concentrate on cognitions that facilitate erection during one baseline and four training sessions. The subjects were divided into three groups that received either continuous feedback of erection changes plus segments of erotic film delivered contingent on erection increases, contingent film segments without continuous feedback, or noncontingent film segments. Although subjects who received noncontingent film segments initially showed greater erection increase than did subjects in the contingent feedback groups, the groups did not differ by the final training session. However, when subjects were instructed to facilitate erection without the aid of feedback or film segments during evaluation trials that followed each training session, subjects who had received contingent film without continuous feedback showed greater erectile responsivity than subjects in other groups. The groups did not differ in the amount of clinical improvement shown on self-report measures concerning erectile functioning during a 1-month follow-up period. Although these results indicate that the provision of erotic film feedback enhances the voluntary facilitation of erection in the laboratory, the therapeutic value of erectile feedback remains undemonstrated.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. Relationships between erectile dysfunction, depression, and anxiety in Japanese subjects.

    Science.gov (United States)

    Sugimori, Hiroki; Yoshida, Katsumi; Tanaka, Toshiaki; Baba, Katsuyuki; Nishida, Takayasu; Nakazawa, Ryuto; Iwamoto, Teruaki

    2005-05-01

    This study aimed to elucidate the relationships between erectile dysfunction (ED) and depression or anxiety. Subjects were 1,419 Japanese men aged 40-64 years. ED was assessed by the International Index of Erectile Function 5 (IIEF-5) score (Japanese version), and depression and anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale (HADS). In this study ED cases were defined as those whose IIEF-5 value was less than 12, and a score of 8 or higher was used to classify a subject as suffering from depression or anxiety, respectively. The prevalence odds ratio (OR) of ED was calculated with confidence interval (CI) estimated by the Woolf's method by five age groups (40-44, 45-49, 50-54, 55-59, 60-64 years). To control for age, body mass index, smoking, and alcohol drinking factors, we conducted the multivariate logistic regression analysis for calculating adjusted ORs and 99% CIs. ED was significantly associated with depression in age groups 45-49 (OR 3.42, 99% CI 1.51-7.76) and 50-54 years (OR 2.43, 99% CI 1.11-5.35). After using multivariate analysis, adjusted OR also showed statistical significance. (OR 2.02, 99% CI 1.32-3.08). ED was significantly associated with anxiety in the 50-55-year-old age group (OR 2.48, 99% CI 1.12-5.47). After using multivariate analysis, adjusted OR also showed statistical significance (OR 1.77, 99% CI 1.15-2.72). The concomitant depression and anxiety group (A+D+) had significantly higher prevalence of ED than the control group (A-D-) in both the 45-49 and 50-54 age groups. (P < 0.01) ED associated significantly with depression and anxiety status only in late 40s to early 50s (45-55 years) in male Japanese. Furthermore, comorbidities of depression and anxiety strengthen this association. Our results might be useful in furthering understanding of ED etiology and determining a target population for prevention in ED subjects.

  16. [Erectile Dysfunction in Diabetic Men - Current Diagnostics and Therapy].

    Science.gov (United States)

    Zitzmann, M; Kliesch, S

    2015-07-01

    Sexual functional dysfunctions represent a multidimensional nosological entity. Apart from the directly measurable pathophysiological parameters, psychological and dynamic partnership aspects are almost always involved. These can exert a triggering and a potentiating influence. Similarly, sociocultural factors have to be taken into account. In men the problem most frequently has a physiological focus and the main symptom within the complex of sexual difficulties, especially for diabetic patients, is erectile dysfunction. Disorders of ejaculation and orgasm may also occur. Testosterone production in men may be impaired due to obesity-related dysfunctions of the hypothalamic-pituitary-gonadal axis and this can lead to a clinically significant androgen deficit and thus also to a decline of libido. © Georg Thieme Verlag KG Stuttgart · New York.

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

    Directory of Open Access Journals (Sweden)

    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. Psychosomatic aspects in the diagnosis and treatment of erectile dysfunction.

    Science.gov (United States)

    Beutel, M

    1999-01-01

    After a critical review of prevalence data, psychosocial determinants and psychosomatic aspects in the diagnosis and treatment of erectile dysfunction are discussed (with reference to age-related changes). Widely used laboratory assessments are responsive to psychological factors (e.g. anxiety). Inclusion of the partner in the diagnostic process may change the clinical picture and the treatment recommendations considerably. As illustrated by penile prosthetis treatment and self-injection of vasoactive substances, acceptance and success of widely used surgical and medical treatments depend largely upon the patient's expectations, and the adaptation of the couple to the procedure. Even in cases with a clear organic pathology, fluctuations in erectile functioning may be attributable to psychological influences. As recent psychotherapeutic and psychoeducational approaches underscore, erectile failure is best conceived as a final common pathway of somatic, lifestyle, psychological and partnership determinants. These should be taken into account in comprehensive diagnostic and treatment formulations if the goal of therapy is not only to produce rigid erections, but to increase sexual satisfaction.

  19. Effect of cardiac resynchronization therapy on libido and erectile dysfunction.

    Science.gov (United States)

    Vural, Ahmet; Agacdiken, Aysen; Celikyurt, Umut; Culha, Melih; Kahraman, Goksel; Kozdag, Guliz; Ural, Dilek

    2011-07-01

    Chronic heart failure (HF) is a common, complex clinical syndrome characterized by dyspnea, fatigue and exercise intolerance. HF patients experience decreased libido and erectile dysfunction (ED). The effects of cardiac resynchronization therapy (CRT) on libido and erectile function have not been previously evaluated. We aimed to investigate the effects of CRT on libido and ED. Cardiac resynchronization therapy improves libido and ED. Thirty-one male patients with advanced HF, scheduled for implantation of a CRT device, were included in the study. Left ventricular systolic function, New York Heart Association (NYHA) class, libido, and ED were assessed before and 6 months after CRT. Libido and ED were evaluated with the Aging Male Symptoms (AMS) rating scale and internationally validated Sexual Health Inventory for Men (SHIM) questionnaire, respectively. At the 6-month follow-up, the mean NYHA class improved from 3.4 ± 0.5 to 2.1 ± 0.6 (Plibido and erectile function in patients with congestive HF. This improvement is related to the improvements in the LVEF and functional capacity. . © 2011 Wiley Periodicals, Inc.

  20. Low-intensity shockwave therapy for erectile dysfunction

    DEFF Research Database (Denmark)

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

    2017-01-01

    Erectile dysfunction (ED) affects ∼30% of all men above the age of 40 years and its prevalence steadily increases with age. Current nonsurgical treatment options, including phosphodiesterase type 5 inhibitors (PDE5I), provide temporary relief but have failed to provide a permanent improvement...... of the condition. Low-intensity extracorporeal shockwave therapy (Li-ESWT) is noninvasive and uses acoustic waves, which can pass through tissue and be focussed to target specific areas or organs to induce the desired effects. The use of Li-ESWT has previously been described in other disease contexts...

  1. Alprostadil plus Vacuum (VITARUM) in severe erectile dysfunction (ED).

    Science.gov (United States)

    Mantovani, Franco

    2017-06-30

    Severe erectile dysfunction (ED) is not uncommon, as can be seen from the epidemiological literature, and there are several possible causes, which are not always known, or leastways evident. Having ascertained the ineffectiveness, intolerance to or rejection of pharmacological aids, the option of prosthetic surgery remains, but before this, it may be wise when feasible to use Alprostadil cream in association with Vacuum device. 12 patients, aged between 55 and 65 years, with severe erectile dysfunction without palpable cavernous fibrosis, were instructed to self-insert into the urethral meatus, 3 mg of Alprostadil cream, sufficient to make it easy to place the Vacuum device over the penis. In the cases observed, the preliminary use of Alprostadil cream fast produced an erection with enough rigidity to place the Vacuum. A sufficient erection was maintained, obviously using an elastic ring at the base of the penis, to achieve penetration. The reproducibility of the use of Alprostadil cream with Vacuum device was then confirmed at home, to the satisfaction of the patients.

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

    Science.gov (United States)

    Srilatha, B; Adaikan, P G

    2003-12-01

    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.

  3. Avanafil for treatment of erectile dysfunction: review of its potential

    Directory of Open Access Journals (Sweden)

    Burke RM

    2012-08-01

    Full Text Available Ryan M Burke,1 Jeffery D Evans21The University of Louisiana at Monroe College of Pharmacy, Monroe, LA, 2The University of Louisiana at Monroe College of Pharmacy, Shreveport, LA, USAAbstract: Avanafil is a medication that was recently approved by the US Food and Drug Administration for the management of erectile dysfunction. Avanafil is a new phosphodiesterase type 5 inhibitor similar to sildenafil and tadalafil. Avanafil was studied in over 1300 patients during clinical trials, including patients with diabetes mellitus and those who had undergone radical prostatectomy, and was found to be more effective than placebo in all men who were randomized to the drug. The medication was studied with on-demand dosing that may occur after food and/or alcohol. Avanafil is dosed as 50 mg, 100 mg, or 200 mg tablets. Avanafil may differentiate itself from the other phosphodiesterase type 5 inhibitors with its quicker onset and higher specificity for phosphodiesterase type 5 versus other phosphodiesterase subtypes, but may lead to complications of therapy.Keywords: avanafil, safety, efficacy, erectile dysfunction

  4. 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.

  5. Relationship between Chronic Periodontitis and Erectile Dysfunction: A Narrative Review

    Directory of Open Access Journals (Sweden)

    Jaffer A. Shariff

    2016-01-01

    Full Text Available Objective. To conduct a descriptive literature review on research studies investigating the association between chronic periodontitis (CP and erectile dysfunction (ED. Methods. Cohort studies, case-control studies, cross-sectional studies, randomized control trials, and animal studies up to July 2015 that studied the relationship between CP and ED were reviewed and reported. Data sources included PubMed, EMBASE, Cochrane Library, and Clinicaltrials.gov. The themes “periodontal disease” and “erectile dysfunction” and the role of periodontal therapy were identified and discussed throughout the narrative review. Results. After reviewing the literature, it was found that an association between CP and vasculogenic ED likely exists. Inflammation resulting from CP promotes endothelial dysfunction by increasing the systemic levels of inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α. Periodontal therapy attempts to decrease the release of TNF-α and could act to restore endothelial function, particularly in the penile vasculature. Conclusion. Although the literature reported a positive association between CP and ED, the studies were few and possess several methodological limitations. Large-scale cohort studies and confounder analysis are recommended. Dentists and physicians should collaborate to manage patients with either CP or ED because of their potential association not only with each other but also with other serious systemic comorbidities.

  6. 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.

  7. Using Statistics and Data Mining Approaches to Analyze Male Sexual Behaviors and Use of Erectile Dysfunction Drugs Based on Large Questionnaire Data.

    Science.gov (United States)

    Qiao, Zhi; Li, Xiang; Liu, Haifeng; Zhang, Lei; Cao, Junyang; Xie, Guotong; Qin, Nan; Jiang, Hui; Lin, Haocheng

    2017-01-01

    The prevalence of erectile dysfunction (ED) has been extensively studied worldwide. Erectile dysfunction drugs has shown great efficacy in preventing male erectile dysfunction. In order to help doctors know drug taken preference of patients and better prescribe, it is crucial to analyze who actually take erectile dysfunction drugs and the relation between sexual behaviors and drug use. Existing clinical studies usually used descriptive statistics and regression analysis based on small volume of data. In this paper, based on big volume of data (48,630 questionnaires), we use data mining approaches besides statistics and regression analysis to comprehensively analyze the relation between male sexual behaviors and use of erectile dysfunction drugs for unravelling the characteristic of patients who take erectile dysfunction drugs. We firstly analyze the impact of multiple sexual behavior factors on whether to use the erectile dysfunction drugs. Then, we explore to mine the Decision Rules for Stratification to discover patients who are more likely to take drugs. Based on the decision rules, the patients can be partitioned into four potential groups for use of erectile dysfunction: high potential group, intermediate potential-1 group, intermediate potential-2 group and low potential group. Experimental results show 1) the sexual behavior factors, erectile hardness and time length to prepare (how long to prepares for sexual behaviors ahead of time), have bigger impacts both in correlation analysis and potential drug taking patients discovering; 2) odds ratio between patients identified as low potential and high potential was 6.098 (95% confidence interval, 5.159-7.209) with statistically significant differences in taking drug potential detected between all potential groups.

  8. Levels of uric acid in erectile dysfunction of different aetiology.

    Science.gov (United States)

    Barassi, Alessandra; Corsi Romanelli, Massimiliano Marco; Pezzilli, Raffaele; Dozio, Elena; Damele, Clara Anna Linda; Vaccalluzzo, Liborio; Di Dario, Marco; Goi, Giancarlo; Papini, Nadia; Massaccesi, Luca; Colpi, Giovanni Maria; Melzi d'Eril, Gian Vico

    2018-01-12

    Erectile dysfunction is a common disease characterized by endothelial dysfunction. The aetiology of ED is often multifactorial but evidence is being accumulated in favor of the proper function of the vascular endothelium that is essential to achieving and maintaining penile erection. Uric acid itself causes endothelial dysfunction via decreased nitric oxide production. This study aims to evaluate the serum uric acid (SUA) levels in 180 ED patients, diagnosed with the International Index of Erectile Function-5 (IIEF-5) and 30 non-ED control. Serum uric acid was analyzed with a commercially available kit using ModularEVO (Roche, Monza, Italy). Within-assay and between-assay variations were 3.0% and 6.0%, respectively. Out of the ED patients, 85 were classified as arteriogenic (A-ED) and 95 as non-arteriogenic (NA-ED) with penile-echo-color-Doppler. Uric acid levels (median and range in mg/dL) in A-ED patients (5.8, 4.3-7.5) were significantly higher (p uric acid levels in patients with mild A-ED (IIEF-5 16-20) and severe/complete A-ED (IIEF-5 ≤ 10) that were 5.4 (range 4.3-6.5) mg/dL and 6.8 (range 6.4-7.2) mg/dL, respectively. There was no difference between the levels of uric acid in patients with different degree of NA-ED. Our findings reveal that SUA is a marker of ED but only of ED of arteriogenic aetiology.

  9. 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

  10. Association between erectile dysfunction and cardiovascular risk in individuals with type-2 diabetes without overt cardiovascular disease

    OpenAIRE

    Meena, Babu Lal; Kochar, Dhanpat Kumar; Agarwal, Tulsi Das; Choudhary, Raghvendra; Kochar, Abhishek

    2009-01-01

    Background: Erectile dysfunction in type-2 diabetes may be an independent marker for coronary artery disease. Present study was undertaken to investigate whether type-2 diabetic patients with erectile dysfunction without having overt cardiovascular disease had increased cardiovascular risk. Aim: To find out correlation between ED and cardiovascular risk in diabetic patients. Methods: Fifty type-2 diabetic patients were assessed for erectile dysfunction using international index of erectile dy...

  11. [Erectile dysfunction in patients treated for bladder and prostate cancer].

    Science.gov (United States)

    Tkocz, Michał T; Kupajski, Maciej T

    2009-01-01

    The disorders of the erectile dysfunction are well-known complication connected with the operating interventions of abdominal and pelvic surgery. Radical treatment of the malignancy, vascular operations and transurethral resection can lead to the rise of these disorders. The majority of these interventions is carried out at patients in the old age at which the disorders of the erection already existed about the various degree of intensification before treating operating how also the presence of the illnesses of the leaders to their rise or intensification after finishing the treatment (diabetes, arterial hypertension, arteriosclerosis). Patients in the young aged wait not only curing from the malignancy from second side, but also the behaviour of the quality of the life (QOL - quality of life), which the correct erection enabling is one of elements satisfying living together.

  12. 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

  13. 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

  14. The Patient's Comorbidity Burden Correlates with the Erectile Dysfunction Severity.

    Science.gov (United States)

    García-Cruz, E; Carrión, A; Ajami, T; Álvarez, M; Correas, M Á; García, B; García, J V; González, C; Portillo, J A; Romero-Otero, J; Simón, C; Torremadé, J; Vigués, F; Alcaraz, A

    To explore the potential relationship between erectile dysfunction (ED), low testosterone levels, and the Charlson Comorbidity Index (CCI). Cross-sectional study on patients referred to the andrology unit in 7 Spanish centers. The ED was diagnosed and graded using the International Index of Erectile Function (IIEF-5) score. Total testosterone, the prevalence of each comorbidity, and the CCI were compared between patients with different grades of ED. Besides, the correlation between total testosterone and the CCI score, the influence of each comorbidity, and the ED severity on the CCI was assessed in a multiple linear regression. The study included 430 men with a mean age of 61 years. The mean CCI was 3.5, and mean total testosterone 15.2 nmol/L; 389 (91%) subjects had some grade of ED: 97 (23%) mild, 149 (35%) mild-to-moderate, 86 (20%) moderate, and 57 (13%) severe. The increase in ED severity was significantly associated with a decrease in total testosterone (P=.002), and an increase in the CCI score (P<.001). Testosterone levels were significantly lower in patients with obesity, diabetes, hypercholesterolemia, and hypertriglyceridemia (P<.05). However, only the prevalence of diabetes and hypertension was significantly associated with the severity of ED. The multivariate analysis including variables related to all assessed comorbidities, total testosterone levels, and the DE severity significantly predicted the CCI score (P<.001, R 2 =.426). The severity of ED significantly contributed to this model (P=.011), but total testosterone did not (P=.204). The CCI is significantly associated with the ED severity, but it shows a weak correlation with the testosterone levels. Copyright © 2017 AEU. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Erectile dysfunction and correlated factors in Brazilian men aged 18-40 years.

    Science.gov (United States)

    Martins, Fernando Gonini; Abdo, Carmita Helena Najjar

    2010-06-01

    Few population-based studies in erectile dysfunction (ED) included subjects less than 40 years old and analyzed the several factors and consequences potentially associated with this condition. Evaluation of the prevalence of erectile dysfunction (ED) and associated factors in a sample of Brazilian men aged 18 to 40 years old. Cross-sectional study in which subjects were contacted in public places of 18 major Brazilian cities and interviewed using an anonymous questionnaire. Survey data were submitted to chi-squared, student's t-test and logistic regression analyses. The data were collected by means of a self-administered questionnaire with 87 questions about sociodemographic variables, general health, habits and lifestyle-related factors, sexual behavior and sexual difficulties, including ED which was assessed by a single question. Prevalence of ED in 1,947 men was 35.0% (73.7% mild, 26.3% moderate/complete). Greater frequency of ED was seen in subjects that never had information about sex, experienced difficulties in the beginning of sexual life and have never masturbated. ED was associated to lower level of education, but not to race, sexual orientation, employment or marital status. Also, no association was found between ED and smoking, alcoholism, obesity, sedentary life, diabetes, hypertension, cardiovascular disease, hyperlipidemia, depression or anxiety. ED caused negative impact in men's self-esteem, interpersonal relationships, work and leisure activities, and in sexual life satisfaction. Less than 10% of men with ED had received medical treatment for this problem. Prevalence of ED in this young population was high, mostly of mild severity. Low education and psychosocial problems were associated to ED and, due probably to the sample subjects' young age, no association was found with organic problems. Measures in the fields of education and psychosocial difficulties prevention would have a positive impact in the control of erectile dysfunction in the young

  16. Cardiovascular and metabolic syndrome risk among men with and without erectile dysfunction: case-control study

    OpenAIRE

    Zambon, João Paulo; Mendonça, Rafaela Rosalba de; Wroclawski, Marcelo Langer; Karam Junior, Amir; Santos, Raul D.; Carvalho, José Antonio Maluf de; Wroclawski, Eric Roger

    2010-01-01

    CONTEXT AND OBJECTIVE: Erectile dysfunction has been associated with cardiovascular diseases. The aim here was to evaluate cardiovascular risk through the Framingham Risk Score (FRS) criteria, C-reactive protein (CRP) assays and presence of metabolic syndrome (MS) in men with and without erectile dysfunction diagnosed within a healthcare program. DESIGN AND SETTING: A retrospective case-control study was conducted. The patients were selected from a healthcare program at the Hospital Israelita...

  17. 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

  18. Increased risk of erectile dysfunction in men with multiple sclerosis: an Italian cross-sectional study.

    Science.gov (United States)

    Balsamo, Raffaele; Arcaniolo, Davide; Stizzo, Marco; Illiano, Ester; Autorino, Riccardo; Natale, Franca; Costantini, Elisabetta; Damiano, Rocco; De Sio, Marco

    2017-01-01

    Sexual dysfunctions (SDs) are common, but often underestimated symptoms in men with multiple sclerosis (MS). The most common sexual complaint in a multiple sclerosis male is erectile dysfunction (ED). The aim of this observational, cross-sectional study was to assess the prevalence of erectile dysfunction (ED) and its relationship with neurological disability, depression, urodynamic findings and lower urinary tract symptoms (LUTS) in these patients. From January 2014 to January 2016, there were 101 consecutive male patients with a diagnosis of Multiple Sclerosis according to the McDonald revised criteria and stable sexual relationships were included. Patients were evaluated with the International Index of Erectile Function (IIEF-15), Sexual Quality of Life Questionnaire-Male version (SQoL-M), International Prostate Symptom Score (I-PSS) and the Beck Depression Inventory-II (BDI-II). Neurological impairment was assessed using the Expanded Disability Status Scale (EDSS). The presence of Detrusor Overactivity (DO), Detrusor Underactivity (DU) and Detrusor Sphincter Dyssynergia (DSD), was defined by International Continence Society (ICS) criteria. Erectile dysfunction (ED) defined according to the erectile function (EF)-subdomain score ≤25 was present in 75 patients (74.25%). Univariate regression analysis showed that Sexual Quality of Life Questionnaire-Male version (P Status Scale score (P = 0.001), Beck Depression Inventory-IIscore (P = 0.001),International Prostate Symptom Score (P = 0.001), Detrusor Underactivity (P = 0.002), Multiple Sclerosis-Secondary Progressive (P = 0.002) was significantly associated with erectile dysfunction. All significant findings in univariate analysis were then entered into a multiple logistic regression model. The results indicated that the Beck Depression Inventory-II score (P = 0.011) and International Prostate Symptom Score (P = 0.043) were the only independent predictive factors of erectile dysfunction onset in these patients

  19. Evaluation of arterial stiffness and cardiac function in patients with vascular erectile dysfunction : Acute effects of phosphodiesterase-5 inhibitor tadalafil

    NARCIS (Netherlands)

    Özdabakoglu, O.; Güllülü, S.; Sag, S.; Sentürk, T.; Kilicarslan, H.; Tütüncü, A.; Kecebas, M.; Baran, Ismet; Aydinlar, A.

    2017-01-01

    This study aimed to detect endothelial dysfunction in erectile dysfunction (ED) patients free from cardiovascular diseases or atherosclerotic risk factors and to evaluate acute effects of phosphodiesterase-5 inhibitor tadalafil on endothelial dysfunction and cardiac function. Thirty ED patients and

  20. [Treatment of erectile dysfunction with penile prothesis. Our experience].

    Science.gov (United States)

    Rodríguez Faba, O; Martín Benito, J L; Escaf Barmadah, S; Rodríguez Martínez, J J; Jalón Monzón, A; Regadera Sejas, J

    2004-09-01

    The aim of this study was to review the current situation of penile prosthesis in the treatment of erectile dysfunction and to analyze the indications, degree of acceptability and complications in our experience. From 1984 to 2003, 48 implants were inserted in men suffering from impotence due to different etiologies. The mean age was 55 years. Vascular disease, Diabetes and pelvic surgery were the most common pathologies recorded. The type of prothesis inserted were malleable inactive in 7 cases (14.58%), Jonas6, Acu-form1. Inflable active with 3 components in 19 cases (39.58%), AMS 700 plus17, Alpha2. Inflable active integrated in 5 cases (10.41%) Hydroflex4, Dynaflex1. Inflable active with 2 components in 17 cases (35.4%), Ambicor2, Mark II15. Infection of the prosthesis was observed in 6.25% of the cases. This infectious complication required removal of the prosthesis. 4.16% of the cases complained of mechanical failure that required change of the prosthesis. 80% of the patients were satisfied with the results. Penile prostheses continue to be an effective and valid therapeutic alternative in impotent. Although the complication rate is low, adequate information must be provided to the patient.

  1. The dosimetry of brachytherapy-induced erectile dysfunction

    International Nuclear Information System (INIS)

    Merrick, Gregory S.; Butler, Wayne M.

    2003-01-01

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

  2. The role of dietary polyphenols in the management of erectile dysfunction-Mechanisms of action.

    Science.gov (United States)

    Eleazu, Chinedum; Obianuju, Nwite; Eleazu, Kate; Kalu, Winner

    2017-04-01

    The incidence of erectile dysfunction (ED) is on the increase and it is estimated that it will affect about 322 million men globally by the year 2025 if adequate measures are not taken to curb it. Natural polyphenols in plant based diets have gained public interest in recent times due to their roles in the prevention of various disease that implicate free radicals/reactive oxygen species and recently on ED. However, the role of polyphenols in the management of ED has not been explored due perhaps to limited data available. Hence this study which reviewed the role of dietary polyphenols in the management of ED and their mechanisms of action. Literature search was carried out in several electronic data bases such as Pubmed, Google Scholar, Medline, Agora and Hinari from1972 to 2016 to identify the current status of knowledge on the role of polyphenols in the management of erectile dysfunction. Progress made so far in this direction suggests inhibition of arginase, acetylcholinesterase, angiotensin converting enzyme, rho-kinase II; activation of endothelial and neuronal NO synthase; decreased synthesis of luteinizing hormone and testosterone reduction; activation of silent information regulator 2-related enzymes (sirtuin1) as well as free radical/reactive oxygen species inhibition as the mechanisms through which the polyphenols identified in this review exert beneficial roles in the management of ED. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  3. Treatment of radiation-induced erectile dysfunction with low-intensity extracorporeal shock wave: A case report

    Directory of Open Access Journals (Sweden)

    Chun Wai Chan

    2017-10-01

    Full Text Available Low-intensity extracorporeal shock wave therapy is a new treatment in treating vasculogenic erectile dysfunction. We report a case of low-intensity extracorporeal shock wave therapy used for treating radiation-induced erectile dysfunction. A 66-year-old gentleman with dyslipidemia and smoking presented with radiation-induced erectile dysfunction. Six sessions of low-intensity extracorporeal shock wave therapy were administered. Pre-treatment IIEF- 5 score was 10 and post-treatment IIEF-5 score at one month was 19. Low-intensity extracorporeal shock wave therapy has the potential to treat radiation-induced erectile dysfunction.

  4. Quantitative sensory and autonomic testing in male diabetic patients with erectile dysfunction.

    Science.gov (United States)

    Wellmer, A; Sharief, M K; Knowles, C H; Misra, V P; Kopelman, P; Ralph, D; Anand, P

    1999-01-01

    To correlate abnormalities of nerve fibres in the lower limbs with erectile dysfunction in male diabetic patients, using a range of quantitative sensory and autonomic function tests. The study included 68 male diabetic patients with symptomatic erectile dysfunction and 11 matched diabetics without erectile dysfunction; none had clinical evidence of peripheral vascular disease or psychological disorder. Patients were evaluated with a symptom questionnaire based on the Michigan Neuropathy Screening Instrument questionnaire and examined clinically. Sural and peroneal nerve-conduction studies, and quantitative sensory and autonomic tests (vibration, thermal, light-touch thresholds, sensory and autonomic cutaneous axon-reflexes) were used to detect nerve abnormalities in the lower limbs, which were correlated with erectile dysfunction. Symptoms of neuropathy were more common in the group with male erectile dysfunction (MED), but statistically significant only for neuropathic pain (53% MED, 18% nonMED, P<0.05, chi-square test) and gastroparesis (44% MED, 0% nonMED, P<0.05). Tests of unmyelinated afferents (warming perception and capsaicin-induced sensory axon-reflex vasodilatation) were most often abnormal, sometimes with no other abnormalities on tests or neurological examination. However, abnormality of warm perception was not significantly different between groups (81% MED, 70% nonMED), suggesting that it is a poorer discriminant than abnormal sensory axon-reflex vasodilatation (89% MED, 22% nonMED, P<0.001). The only other significant test difference was decreased sural nerve action potential (70% MED, 22% non-MED, P<0.01). There appeared to be preferential involvement of unmyelinated sensory fibres that mediate axon-reflex vasodilatation in the limbs of diabetic patients with erectile dysfunction. This test appears to be a helpful indicator of neurological involvement in erectile dysfunction, and may be used to monitor the effect of new treatments.

  5. 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.

  6. 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. 

  7. Environmental agents and erectile dysfunction: a study in a consulting population.

    Science.gov (United States)

    Oliva, Alejandro; Giami, Alain; Multigner, Luc

    2002-01-01

    We evaluated chemical and physical environmental agents as risk factors for erectile dysfunction among a consulting population. We studied 199 men who sought medical help for erectile disorders between 1996 and 1998 in 3 andrology units in the Litoral Sur region of Argentina. Patients were evaluated by monitoring nocturnal penile tumescence and rigidity, and were classified as having normal (n = 26), irregular (dissociation, short episode or low amplitude, n = 146), or flat erectile pattern (n = 26). Exposure to environmental agents was assessed by a detailed interview, and 4 groups were constituted: nonexposed, pesticide-exposed, solvent-exposed, and heat-exposed. A multivariate polytomous logistic regression model was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for association between quality of nocturnal erections and exposure groups adjusted for confounding factors. Exposure to environmental agents was a risk factor for a flat erectile pattern (OR 7.1, 95% CI 1.5-33.0 for pesticides; OR 12.2, 95% CI 1.2-124.8 for solvents; and OR 1.7, 95% CI 0.3-9.4 for heat). Associations were much weaker for an irregular erectile pattern (OR 1.8, 95% CI 0.5-6.7 for pesticides; OR 2.1, 95% CI 0.3-17.9 for solvents; and OR 1.2, 95% CI 0.4-4.0 for heat). Our results suggest that environmental agents constitute a risk factor for erectile dysfunction by interfering with erectile ability.

  8. Erectile dysfunction in patients with liver disease related to chronic hepatitis B

    OpenAIRE

    Kim, Min; Kim, Seul Young; Rou, Woo Sun; Hwang, Se Woong; Lee, Byung Seok

    2015-01-01

    Background/Aims Despite sexual function making an important contribution to the quality of life, data on erectile function are relatively scant in patients with chronic liver disease. We evaluated the prevalence of and risk factors for erectile dysfunction (ED) in patients with liver disease related to hepatitis B, especially among those with chronic hepatitis B (CHB) or early-stage cirrhosis. Methods In total, 69 patients (35 with CHB and 34 with hepatitis-B-related liver cirrhosis [HBV-LC])...

  9. Does educational status affect a patient's behavior toward erectile dysfunction?

    Science.gov (United States)

    Salonia, Andrea; Abdollah, Firas; Gallina, Andrea; Pellucchi, Federico; Castillejos Molina, Ricardo Alonso; Maccagnano, Carmen; Rocchini, Lorenzo; Zanni, Giuseppe; Rigatti, Patrizio; Montorsi, Francesco

    2008-08-01

    Educational status has been investigated rarely as a potential factor affecting the behavior of patients with new onset erectile dysfunction (ED) toward seeking first medical help and subsequent compliance with prescribed phosphodiesterase type 5 inhibitor (PDE5) therapy. To test whether the educational status of patients with new onset ED and naïve to PDE5 therapy may have a significant impact on the delay before seeking first medical help (DSH) and compliance with the suggested PDE5. Assessing DSH and compliance with PDE5 in new onset ED patients according to their educational status by means of detailed logistic regression analyses. Data from 302 consecutive patients with new onset ED and naïve to PDE5s were comprehensively analyzed. Patients were segregated according to their educational status into low (elementary and/or secondary school education) and high (high school and/or university degrees) educational levels. Complete data were available for 231 assessable patients. Univariate (UVA) and multivariate (MVA) logistic regression analyses addressed the association between educational status and DSH after adjusting for age, relationship status, and Sexual Health Inventory for Men score. Likewise, UVA and MVA were performed to test the association between educational status and patient compliance with PDE5 at the 9-month median follow-up. Median DSH was 24 months (range 1-350; mean 38.1 +/- 42.8). The lower the educational status, the shorter the DSH (P = 0.03). In contrast, a significantly (P patients with a higher educational status showed compliance with the suggested PDE5 at the 9-month follow-up. Overall, educational status was not an independent predictor of either DSH or patient compliance with PDE5 therapy. After adjusting for other variables, our findings suggest that in new onset ED patients, educational status does not independently affect the DSH and patient compliance with PDE5 therapy.

  10. Heart Rate Variability in Men with Erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Ji Yong Lee

    2011-06-01

    Full Text Available Purpose The objective of this study is to investigate alteration of autonomic nervous system (ANS activity in patients suffering from erectile dysfunction (ED by comparing parameters of heart rate variability (HRV between men with ED and healthy subjects. Methods A retrospective review was performed on 40 ED patients (mean age, 46.0±8.49 years without any disease and 180 healthy control people (mean age, 44.4±7.83 years without ED in our institution from June 2008 to July 2010. And electrocardiographic signals were obtained to measure HRV parameters for both patients and controls in a resting state. Results For the time domain analysis, square root of the mean differences between successive RR intervals (RMSSD representing parasympathetic activity was lower in patients than controls although P-value was not statistically significant (P=0.060. For the frequency domain analysis, high frequency (HF representing parasympathetic activity was lower in patients than controls (P=0.232 and low frequency (LF representing mainly sympathetic activity was higher in patients than controls (P=0.416. Lastly, LF/HF ratio reflecting sympathetic/parasympathetic activity ratio was statistically higher in patients than controls (P=0.027. Conclusions Patients with ED exhibited different HRV parameters compared with normal controls. This suggests that the patients with ED may have some kind of imbalance in the ANS and it may be possible that general imbalance of the ANS is one of the causes of ED. Thus, HRV analysis may give valuable diagnostic information and serve as a rapid screening tool to evaluate altered ANS activity in patients with ED.

  11. USE OF SILDENAFIL (VIAGRA® FOR ERECTILE DYSFUNCTION IN DIALYSIS PATIENTS – OUR FIRST EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Bojan Vujkovac

    2002-01-01

    Full Text Available Background. Male patients with end stage renal disease often report erectile dysfunction, which is very common especially in younger males. Impotence is reported to exceed 50% in male chronic renal failure patients, and is present in 65% of such patients undergoing hemodialysis. Numerous etiological factors have been reported as possible cause for sexual dysfunction. Sildenafil (Viagra®, a potent specific inhibitor of cGMP phosphodiesterase, was used in this case study to improve erectile dysfunction in dialysis male patients.Methods and results. During 12 weeks we treated 4 dialysis patients. 2 patients were treated with peritoneal dialysis and 2 patients were in the program of chronic hemodialysis. All patients were in the program of dialysis for more than 24 months, and reported erectile dysfunction and impotence after they had started with dialysis treatment. Sildenafil was used in the treatment. The dosage schedule for sildenafil was 50mg/ week orally for 2 weeks followed by 100 mg/week for the next 10 weeks if there was no effect on initial dosage. Efficacy of treatment was evaluated by means of the International Index of Erectile Dysfunction. All 4 patients reported no significant effect on initial dose. With higher dose of sildenafil treatment was overwhelmingly successful, with reported prolonged improvement of erectile dysfunction for 42 to 72 hours. Side effects were present only in 1 patient who had severe headaches after higher dose. No patients experienced priapism.Conclusions. There have been only few reports in the literature on the use of sildenafil in dialysis patients. Our small case study suggests that sildenafil could be successfully and safely used for treatment of erectile dysfunction also in dialysis patients. A large trial would be necessary to confirm the efficacy of the drug for this specific group of patients.

  12. 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

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

    International Nuclear Information System (INIS)

    Ghafoor, A.; Zaidi, S.M.H.; Moazzam, A.

    2015-01-01

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

  14. Efficacy of Ashwagandha (Withania somnifera Dunal. Linn.) in the management of psychogenic erectile dysfunction.

    Science.gov (United States)

    Mamidi, Prasad; Thakar, A B

    2011-07-01

    Erectile dysfunction (ED) has been defined as the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance. By 2025, men with ED will be approximately 322 million, an increase of nearly 170 million men from 1995. The present study was aimed to evaluate the efficacy of Ashwagandha (Withania somnifera) in the management of psychogenic erectile dysfunction. In this study, a total of 95 patients with psychogenic erectile dysfunction satisfying the DSM IV TR diagnostic criteria were selected, out of them 86 patients completed the course of treatment. In Trial Group, Ashwagandha root powder and in Control group, Placebo (Wheat powder) were given for 60 days. Treatment selection and its allocation were done by following computerized randomization plan. Criterion of assessment was based on the scoring of International Index of Erectile Function (IIEF) Scale. Paired and Unpaired t test were used for statistical analysis. In Trial group (n=41), 12.6% and in Control group (n=45), 19.11% of improvement was observed with the significance of (P0.05) found in between the two groups. Both Ashwagandha and Placebo provided no relief (<25% improvement on IIEF) in psychogenic erectile dysfunction.

  15. Prevalence and determinants of erectile dysfunction among diabetic patients attending in hospitals of central and northwestern zone of Tigray, northern Ethiopia: a cross-sectional study

    OpenAIRE

    Seid, Awole; Gerensea, Hadgu; Tarko, Shambel; Zenebe, Yosef; Mezemir, Rahel

    2017-01-01

    Background The prevalence of erectile dysfunction among diabetic men varies between 35?90%. Although erectile dysfunction is widespread among men with diabetes, the condition often remains undiagnosed and demands appropriate assessment and prompt treatment. Erectile dysfunction can affect all aspects of a patient?s life including physical, emotional, social, sexual, and relationships. The main aim of this study is to determine the prevalence and determinants of erectile dysfunction among diab...

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

    Directory of Open Access Journals (Sweden)

    Kenneth J DeLay

    2016-08-01

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

  17. 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/.

  18. The burden of erectile dysfunction in hypertensive men attending a ...

    African Journals Online (AJOL)

    Background: Hypertension is often cited as a cause of erectile dysfuntion (ED) which is currently known to be a risk factor for coronary artery disease (CAD). Both ED and CAD lower the quality of life of affected men. Objectives: To study the characteristics of men with hypertension-associated ED and to determine the ED ...

  19. TADALAFIL IN THE TREATMENT OF ERECTILE DYSFUNCTION FOLLOWING RADICAL PROSTATECTOMY: A REVIEW

    Directory of Open Access Journals (Sweden)

    A. V. Govorov

    2014-08-01

    Full Text Available Erectile dysfunction is a frequent complication of radical prostatectomy despite numerous modifications in surgical technique. The term «penile rehabilitation» refers usually to treatments intended to restore functional penile erection after radical prostatectomy. Selective phosphodiesterase type 5 inhibitors are the mainstay of this rehabilitation at present. Tadalafil seems a logical choice for recovering of erectile functionafter radical prostatectomy given its prolonged duration of action. The once-daily dose of tadalafil has the theoretical benefit in terms of safety and separation of medication from sexual activity. In this paper we review the published clinical and basic science research studies on the role of tadalafil in patients with postprostatectomy erectile dysfunction.

  20. TADALAFIL IN THE TREATMENT OF ERECTILE DYSFUNCTION FOLLOWING RADICAL PROSTATECTOMY: A REVIEW

    Directory of Open Access Journals (Sweden)

    A. V. Govorov

    2011-01-01

    Full Text Available Erectile dysfunction is a frequent complication of radical prostatectomy despite numerous modifications in surgical technique. The term «penile rehabilitation» refers usually to treatments intended to restore functional penile erection after radical prostatectomy. Selective phosphodiesterase type 5 inhibitors are the mainstay of this rehabilitation at present. Tadalafil seems a logical choice for recovering of erectile functionafter radical prostatectomy given its prolonged duration of action. The once-daily dose of tadalafil has the theoretical benefit in terms of safety and separation of medication from sexual activity. In this paper we review the published clinical and basic science research studies on the role of tadalafil in patients with postprostatectomy erectile dysfunction.

  1. 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

  2. A shared care approach to the management of erectile dysfunction in the community.

    NARCIS (Netherlands)

    Wagner, G.; Claes, H.; Costa, P.; Cricelli, C.; Boer, J. de; Debruyne, F.M.J.; Dean, J.; Dinsmore, W.W.; Fitzpatrick, J.M.; Ralph, D.J.; Hackett, G.I.; Heaton, J.P.; Hatzichristou, D.G.; Mendive, J.; Meuleman, E.J.H.; Mirone, V.; Montorsi, F.; Raineri, F.; Schulman, C.C.; Stief, C.G.; Keitz, A.T. Von; Wright, P.J.

    2002-01-01

    Erectile dysfunction (ED) affects men of all ages and results in considerable distress and impact on quality of life for those who suffer from it. As ED is associated with a wide variety of under-lying conditions and cardiovascular co-morbidities, there is a requirement for diversity of treatment

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

    Directory of Open Access Journals (Sweden)

    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. Erectile Dysfunction and Mental Health in a General Population of Older Men

    NARCIS (Netherlands)

    Korfage, Ida J.; Pluijm, Saskia; Roobol, Monique; Dohle, Gert R.; Schröder, Fritz H.; Essink-Bot, Marie-Louise

    2009-01-01

    ABSTRACT Introduction. Erectile dysfunction (ED) is more prevalent with increasing age. Previous studies showed that ED was negatively associated with mental health (MH) in specific patient groups. Aim. To examine the association, and potential mediating factors, between ED and MH in healthy elderly

  5. Evaluation and treatment of erectile dysfunction in the aging male: a mini-review.

    Science.gov (United States)

    Albersen, Maarten; Orabi, Hazem; Lue, Tom F

    2012-01-01

    Before the 20th century, individuals often did not live beyond the reproductive years, and sexuality of the elderly was not an issue. However, in the current era it is known that as life expectancy improves, both men and women are seeking to preserve their sexuality into old age. While the appreciation of sexuality persists with aging, a decline in sexual activity is typically seen with, and can be attributed to both general health problems as well as specific sexual dysfunctions. Erectile dysfunction is the most frequently diagnosed sexual dysfunction in the older male population. This mini-review provides an overview of contemporary literature concerning epidemiology, pathophysiology, assessment and treatment of erectile dysfunction in the aging male. Copyright © 2011 S. Karger AG, Basel.

  6. Tadalafil in the treatment of erectile dysfunction; an overview of the clinical evidence

    OpenAIRE

    Frajese, Giovanni Vanni; Pozzi, Flavio; Frajese, Gaetano

    2006-01-01

    Prevalence and severity of erectile dysfunction (ED) increase with aging and are often associated with illnesses, like diabetes mellitus, heart disease, and hypertension, pathologically characterized by endothelial dysfunction and whose prevalence increases with age. The assumption that ED is mainly a neurovascular disease is supported by the evidence that specific phosphodiesterase type 5 (PDE5) inhibition produces an efficient erection in a wide range of ages and conditions. The availabilit...

  7. Penile prosthesis – a viable solution for erectile dysfunction refractory to conservative therapy

    OpenAIRE

    D. Marcu; Ovidiu Bratu; D. Spînu; A. Rădulescu; C. Farcaș; Dan Mischianu

    2015-01-01

    Introduction: Erectile dysfunction(ED) is a serious condition which can affect men of all ages, with an important impact over the quality of life. When conservative therapy fails, a viable solution is the penile prosthesis implantation (PPI). Objective: The purpose of this paper is to present data from recent literature regarding the satisfaction rates of men who have undergone penile PPI and as well as the partners satisfaction rates, ease of use, informations regarding long term su...

  8. Prevalence of erectile dysfunction and possible risk factors among men of South-Western Nigeria: a population based study

    OpenAIRE

    Oyelade, Bolaji Oyetunde; Jemilohun, Abiodun Christopher; Aderibigbe, Sunday Adedeji

    2016-01-01

    Introduction Erectile dysfunction (ED) is currently one of the most common sexual dysfunctions worldwide but it is usually underestimated because it is not a life threatening condition. The associated stigma makes men who have it to suffer in silence. This study was conducted to determine the prevalence of erectile dysfunction and the possible associated risk factors among Nigerian men. Methods The study was a descriptive cross-sectional population based survey among men aged 30-80 years in O...

  9. Pelvic-floor muscle rehabilitation in erectile dysfunction and premature ejaculation.

    Science.gov (United States)

    Lavoisier, Pierre; Roy, Pascal; Dantony, Emmanuelle; Watrelot, Antoine; Ruggeri, Jean; Dumoulin, Sébastien

    2014-12-01

    In men, involuntary or voluntary ischiocavernosus muscle contractions after erection lead to intracavernous blood pressures far higher than the systolic pressure, which builds and maintains penile rigidity. Thus, erectile dysfunction may be partly due to ischiocavernosus muscle atrophy and may be treated by rehabilitation interventions. The purpose of this study was to determine whether pelvic-floor muscle strengthening interventions could be associated with increases in intracavernous pressure that would increase penile rigidity. An observational study was conducted. One hundred twenty-two men with isolated erectile dysfunction and 108 men with isolated premature ejaculation participated (no neuromuscular diseases or previous perineal rehabilitation). Thirty-minute sessions of voluntary contractions coupled with electrical stimulation were designed to increase ischiocavernosus muscle strength (monitored through intracavernous pressure increase). A linear mixed-effects model per group analyzed separately, then jointly, the maximum change in pressure (ΔP) and the maximum baseline (ie, respectively, the average contraction-generated difference in intracavernous pressure and the intracavernous pressure plateau at full erection, both measured during the highest moving average of the best 2 minutes of each session). Over 20 sessions, the maximum ΔP increased in erectile dysfunction as well as in premature ejaculation (87% and 88%, respectively, in men with positive trends). The maximum baseline also increased (99% and 72%, respectively, in men with positive trends). The joint modeling indicated that the mean expected progressions of the intracavernous pressure after 5 sessions in erectile dysfunction and premature ejaculation were 62.85 and 64.15 cm H2O, respectively. Indirect measurements were obtained of intracavernous pressure and ischiocavernosus muscle force. Pelvic-floor muscle rehabilitation was found to be beneficial in erectile dysfunction. However, its

  10. Evaluation of the Causes of Erectile Dysfunction in Patients Undergoing Penile Doppler Ultrasonography in Pakistan

    Directory of Open Access Journals (Sweden)

    Usman Khanzada

    2017-04-01

    Full Text Available Purpose: In patients with erectile dysfunction, it is important to differentiate psychogenic from organic causes. Penile Doppler ultrasonography is a relatively inexpensive and minimally invasive tool for this purpose. This study was conducted to evaluate the causes of erectile dysfunction in an adult male population, using penile Doppler ultrasonography. Materials and Methods: A retrospective study was conducted in a single center. All patients who presented with complaints of erectile dysfunction and underwent penile Doppler ultrasonography between July 2014 and June 2016 were included in this study. All examinations were performed using GE Voluson S6 and GE Logiq P5 devices. Following baseline scans, an intracavernosal injection of 20 μg of prostaglandin E1 was given. Peak systolic and end diastolic velocities were measured in each cavernosal artery. Patients with a peak systolic velocity of <25 cm/s were considered to have arterial insufficiency, while an end diastolic velocity of >5 cm/s was considered to indicate venous incompetence. Results: Out of 97 patients (mean age, 37.09±11.59 years; range, 19∼69 years, 50 patients (51.5% had normal findings, 24 patients (24.7% had arterial insufficiency, 15 patients (15.5% had a venous leak, and 8 patients (8.2% patients had arterial insufficiency with a venous leak. Psychogenic erectile dysfunction was significantly higher among patients aged ≤40 years, while arterial insufficiency with or without a venous leak was significantly higher among patients aged >40 years (p=0.022. Conclusions: A majority of the studied individuals demonstrated no organic cause of erectile dysfunction, thus confirming a high prevalence of the psychogenic etiology, particularly in relatively young individuals.

  11. [Hypogonadism, erectile dysfunction and endothelial dysfunction among HIV-infected men].

    Science.gov (United States)

    Moreno-Pérez, Oscar; Picó Alfonso, Antonio Miguel; Portilla, Joaquín

    2009-03-07

    HIV-associated hypogonadism is known to be a prevalent endocrine disorder, with a multifactorial etiology. Low testosterone levels are associated with decreased muscle mass, exercise capacity loss, erectile dysfunction, cognitive impairment, depression and decreased quality of life. In the same way, hypogonadism in HIV-infected men is associated with decreased muscle mass quantity and function, changes in corporal fat mass distribution and quantity, secretion of adipocytokines and endothelial dysfunction. This combined effect renders the entire body less sensitive to insulin, promoting development of atherosclerosis and glucose metabolism disorders. The clinical presentation is non-specific and hypogonadism screening scales are not useful in this population. Diagnostic procedures must include determination of free testosterone (FTc) in any HIV-infected men at the time of first HIV diagnosis and periodically, because of the clinical implications and the absence of specific predictive disease factors. Substitutive hormonal treatment must be offered only for HIV-infected men with FTc under reference levels and when reversible causes have been ruled out. Metabolic impact of hypogonadism suggests the incorporation of low testosterone levels to the list of cardiovascular risk factor in HIV-infected men.

  12. Intravenous Infusion of Bone Marrow-Derived Mesenchymal Stem Cells Reduces Erectile Dysfunction Following Cavernous Nerve Injury in Rats.

    Science.gov (United States)

    Matsuda, Yohei; Sasaki, Masanori; Kataoka-Sasaki, Yuko; Takayanagi, Akio; Kobayashi, Ko; Oka, Shinichi; Nakazaki, Masahito; Masumori, Naoya; Kocsis, Jeffery D; Honmou, Osamu

    2018-03-01

    Intravenous preload (delivered before cavernous nerve [CN] injury) of bone marrow-derived mesenchymal stem cells (MSCs) can prevent or decrease postoperative erectile dysfunction (J Sex Med 2015;12:1713-1721). In the present study, the potential therapeutic effects of intravenously administered MSCs on postoperative erectile dysfunction were evaluated in a rat model of CN injury. Male Sprague-Dawley rats were randomized into 2 groups after electric CN injury. Intravenous infusion of bone marrow-derived MSCs (1.0 × 10 6 cells in Dulbecco's modified Eagle's medium 1 mL) or vehicle (Dulbecco's modified Eagle's medium 1 mL) was performed 3 hours after electrocautery-induced CN injury. To assess erectile function, we measured intracavernous pressure at 4 weeks after MSC or vehicle infusion. Histologic examinations were performed to investigate neuronal innervation and inhibition of smooth muscle atrophy. Green fluorescent protein-positive bone marrow-derived MSCs were used for cell tracking. To investigate mRNA expression levels of neurotrophins in the major pelvic ganglia (MPGs), quantitative real-time polymerase chain reaction was performed. The decrease of intracavernous pressure corrected for arterial pressure and area under the curve of intracavernous pressure in the bone marrow-derived MSC group was significantly lower than that in the vehicle group at 4 weeks after infusion (P derived MSCs were detected in the MPGs and injured CNs using confocal microscopy, indicating homing of cells to the MPGs and injured CNs. Brain-derived neurotrophic factor and glial cell-derived neurotrophic factor expression levels in the MPGs were significantly higher in the MSC group than in the vehicle group (P derived MSCs after CN injury might have therapeutic efficacy in experimental erectile dysfunction. Matsuda Y, Sasaki M, Kataoka-Sasaki Y, et al. Intravenous Infusion of Bone Marrow-Derived Mesenchymal Stem Cells Reduces Erectile Dysfunction Following Cavernous Nerve Injury in

  13. Five-year prospective study on cardiovascular events, in patients with erectile dysfunction and hypotestosterone

    Directory of Open Access Journals (Sweden)

    Rosanna Iacona

    2017-12-01

    Full Text Available Objective: Testosterone levels play a role in cardiac and vascular pathology. In the present study we investigated the prognostic significance of this hormone for cardiovascular outcome, in a 5-year follow-up. Materials and methods: Our cohort included 802 adult subjects, from 40 to 80 years. Patients were excluded if they had a past history of peripheral or coronary artery disease, and revascularization. A blood sample was drawn to valuate testosterone level, and we considered normal testosterone levels 300 ng/dl. FMD (flow mediated dilatation of the brachial artery was assessed by measuring the increase of the brachial artery diameter during reactive hyperemia after transient forearm ischemia. B-mode longitudinal images of the brachial artery were obtained at the level of the antecubital fossa. The FMD was defined as the percentage change in the brachial artery diameter 60 s after releasing the ischemic cuff. Erectile dysfunction (ERD was assessed by the International Index of Erectile Function-5 (IIEF-5 score questionnaire. We considered composite end points including the following major adverse cardiovascular events (MACEs Results: Subjects with lower serum testosterone levels (n = 332 had higher prevalence of traditional cardiovascular risk factors, such as hypertension (p = 0.009, diabetes (p = 0.03, dyslipidemia (p < 0.0001, obesity (p = 0.002, and endothelial function score (p < 0.0001. AMI, death after AMI, major stroke and all clinical events were more frequent (p < 0.001 in patients with testosterone levels < 300 ng/dl. Further, by multiple logistic regression analysis we found that only dyslipidemia (p = 0,001, obesity (p = 0,007, testosterone < 300 ng/dl (p < 0,0001 and ED (p < 0,0001 were independent predictors of future events. Conclusions: A therapeutic intervention on testosterone may not only have a positive effect on the cardiovascular system but also an important role in preventing new cardiovascular events.

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-09-15

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

  16. Erectile Dysfunction, Boredom, and Hypersexuality among Coupled Men from Two European Countries.

    Science.gov (United States)

    Klein, Verena; Jurin, Tanja; Briken, Peer; Štulhofer, Aleksandar

    2015-11-01

    Much of the research on the association between erectile dysfunction (ED) and possible clinical relevant hypersexuality up to now has been only descriptive in nature. The present study aimed to explore the relationships among hypersexuality, ED, and sexual boredom in a sample of coupled community men. An Internet-based survey was conducted in two European countries. The sample included 911 Croatian and 210 German coupled men. The survey comprised the Hypersexual Disorder Screening Inventory, the International Index of Erectile Function and the Sexual Boredom Scale. Poisson regression analysis was used to examine how ED, solitary sexual activities and sexual boredom were associated with hypersexuality. Among Croatian and German men, hypersexuality was significantly correlated with proneness to sexual boredom and more problems with erectile function. In some men, hypersexual behavior may serve as a coping mechanism for sexual fantasy poverty-associated boredom. In addition, ED within an intimate relationship can accompany this simultaneously. © 2015 International Society for Sexual Medicine.

  17. Impact of erectile dysfunction on confidence, self-esteem and relationship satisfaction after 9 months of sildenafil citrate treatment.

    Science.gov (United States)

    Althof, Stanley E; O'Leary, Michael P; Cappelleri, Joseph C; Crowley, Arthur R; Tseng, Li-Jung; Collins, Suzanne

    2006-11-01

    The first double-blind, placebo controlled trial in the United States of the Self-Esteem And Relationship questionnaire revealed that treatment with sildenafil citrate improves erectile function and measures of quality of life in men with erectile dysfunction. We investigated long-term improvement, and correlations between improved erectile function and confidence, self-esteem and sexual relationship satisfaction in men with erectile dysfunction. This was a 36-week open label extension of the double-blind, placebo controlled trial. The blind was not broken. Patients were 18 years or older with clinically diagnosed erectile dysfunction. Erectile function was assessed using the International Index of Erectile Function. Self-esteem, confidence and relationship satisfaction were assessed using the Self-Esteem And Relationship questionnaire. Correlations were determined using Pearson's product moment coefficients. A total of 204 participants were enrolled in the open label extension, including 108 on placebo and 96 on sildenafil. In men who received placebo in the double-blind, placebo controlled phase mean erectile function scores and self-esteem, confidence and relationship satisfaction scores were increased significantly at week 36 of the open label extension (p self-esteem, confidence and relationship satisfaction were strong and positive (p self-esteem, confidence and relationship satisfaction. Following an initial 12 weeks of double-blind, placebo controlled sildenafil therapy for erectile dysfunction improvements were sustained an additional 9 months. Positive correlations between erectile function, and self-esteem, confidence and relationship satisfaction suggest that improved erectile quality can improve long-term psychosocial quality of life.

  18. Predictors of Erectile Dysfunction in Men with Type 2 Diabetes Mellitus Referred to a Tertiary Healthcare Centre

    Directory of Open Access Journals (Sweden)

    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.

  19. Oestrogen-mediated hormonal imbalance precipitates erectile dysfunction.

    Science.gov (United States)

    Adaikan, P G; Srilatha, B

    2003-02-01

    Declining testosterone (T) in an aging male offsets the equilibrium between androgen and oestrogen (oestradiol, E(2)) with a resultant increase in E(2)-T ratio. Similar functional hormone imbalance is existent in clinical states of hypogonadism and is likely to arise from exposure of males to environmental oestrogens. The pathophysiological significance of this derangement on erectile function, hitherto unknown, was estimated in sexually mature male rats following acute and chronic treatment with oestrogen. A total of 60 male Sprague-Dawley rats (200-250 g) were divided into control and two treatment groups, administered 0.01 and 0.1 mg of oestradiol through oral gavage daily for 1 week (n=30, acute study) and 12 weeks (n=30, long-term study), respectively. Sexual activity in the presence of hormonally primed female rats and intracavernous pressure (ICP) response to electrical stimulation estimated treatment-induced changes, which were correlated with hormone levels and penile morphology at 12 weeks. Following two to five-fold elevation in serum E(2) levels (and simultaneous reduction in testosterone), there was a significant prolongation of mount, intromission, ejaculation latencies and some decrease in frequencies. The ICP response to nerve stimulation was also impaired in all the treated groups. Histologically, trichrome staining highlighted the cavernosal connective tissue hyperplasia in the long-term study groups. Results of this investigation indicate that oestradiol causes pathophysiological changes in erectile function. These observations provide an indirect evidence for the possible sexual health hazards in man upon inadvertent exposure to environmental oestrogens, ageing and derangement of E(2)-T ratio.

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

    Directory of Open Access Journals (Sweden)

    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

  1. 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.

  2. Evaluation and treatment of erectile dysfunction in the aging male: a mini-review

    OpenAIRE

    Albersen, Maarten; Orabi, Hazem; Lue, Tom F

    2012-01-01

    Before the 20th century, individuals often did not live beyond the reproductive years, and sexuality of the elderly was not an issue. However, in the current era it is known that as life expectancy improves, both men and women are seeking to preserve their sexuality into old age. While the appreciation of sexuality persists with aging, a decline in sexual activity is typically seen with, and can be attributed to both general health problems as well as specific sexual dysfunctions. Erectile dy...

  3. 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.

  4. 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. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Dipyridamole reduces penile apoptosis in a rat model of post-prostatectomy erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Omer Kutlu

    Full Text Available ABSTRACT Purpose: Despite the nerve-sparing technique, many patients suffer from erectile dysfunction after radical prostatectomy (RP due to cavernous nerve injury. The aim of this study was to evaluate dipyridamole as a potential treatment agent of post-radical prostatectomy erectile dysfunction. Material and methods: A total of 18 male Sprague-Dawley rats were randomized into three experimental Groups (SHAM+DMSO, BCNI+DMSO and BCNI+DIP. An animal model of bilateral cavernous nerve crush injury (BCNI was established to mimic the partial nerve damage during nerve-sparing RP. After creating of BCNI, dimethyl sulphoxide (DMSO was administered transperitoneally as a vehicle to SHAM+DMSO and BCNI+DMSO Groups. BCNI+DIP Group received dipyiridamole (10mg/kg/day as a solution in DMSO for 15 days. Afterwards, rats were evaluated for in vivo erectile response to cavernous nerve stimulation. Penile tissues were also analyzed biochemically for transforming growth factor-β1 (TGF-β1 level. Penile corporal apoptosis was determined by TUNEL method. Results: Erectile response was decreased in rats with BCNI and there was no significant improvement with dipyridamole treatment. TGF-β1 levels were increased in rats with BCNI and decreased with dipyridamole treatment. Dipyridamole led to reduced penile apoptosis in rats with BCNI and there was no significant difference when compared to sham operated rats. Conclusions: Although fifteen-day dipyridamole treatment has failed to improve erectile function in rats with BCNI, the decline in both TGF-β1 levels and apoptotic indices with treatment may be helpful in protecting penile morphology after cavernous nerve injury.

  6. [Treatment of erectile dysfunction in patients with plastic induration of the penis].

    Science.gov (United States)

    Sokol'shchik, M M; Gagarina, S V; Petrovich, R Iu; Sadakova, I V

    2008-01-01

    In selection of patients with erectile dysfunction perspective for conservative treatment we conducted a sialis-test (oral test with tadalafil which is a vasoactive drug, inhibitor of phosphodiesterase of type 5). In sialis negative test we studied a hormonal status of the patient (testosteron level in the blood serum) and performed dopplerography of penile vessels in the course of intracavernous injection of a vasoactive drug. In 2002-2005 we treated 115 patients with erectile dysfunction suffering from plastic induration of the penis. We gave conservative treatment to 66 patients and surgical treatment - to 50 (43%) patients. All surgical patients had evident alterations of penile vessels of cavernous tissue and were not perspective for conservative treatment. Treatment policy in erectile dysfunction in Peyronie's disease is the following: in positive sialis test the patients receive conservative treatment - inhibitors of phosphodiesterase of type 5; in negative sialis test blood hormones (testosteron) should be measured and penile vessels should be studied (dopplerography). In detection of low level of testosteron and normal penile vessels the patients receive combined treatment - replacement hormonal therapy plus inhibitors of phosphodiesterase type 5. In vascular pathology verified at dopplerography and negative tadalafil test the patients receive surgical treatment.

  7. Life experiences of Brazilian men with urinary incontinence and erectile dysfunction following radical prostatectomy.

    Science.gov (United States)

    de Moraes Lopes, Maria Helena Baena; Higa, Rosângela; Cordeiro, Sílvia Nogueira; Rodrigues Estapê, Nuri Aparecida; Levi D'ancona, Carlos Arturo; Turato, Egberto Ribeiro

    2012-01-01

    The objective of this study was to explore the psychosocial meaning and repercussions on lifestyle associated with erectile dysfunction and urinary incontinence (UI) in men following radical prostatectomy. Ten men from Southeastern Brazil who underwent radical prostatectomy for prostate cancer were interviewed. All participants underwent treatment at a urology clinic during the period of September 2007 to February 2009. A clinical-qualitative study was conducted, using semi-structured interviews with open-ended questions. All interviews were recorded and transcribed verbatim. Each man was interviewed once. The average length of the interviews was 37 minutes (range: 16 to 81 minutes). Data from the interviews were subjected to content thematic analysis and development of categories based on psychodynamic references. Three themes were identified: (1) sexuality called into question; (2) a body without governance; and (3) experiencing loss. These men reported difficulties in dealing both with the physical and emotional impotence resulting from the treatment. Urinary incontinence and erectile dysfunction affected their body by accentuating conflicts related to masculinity, triggering subjective feelings of powerlessness, and psychological distress. Study respondents assigned multiple psychological meanings to issues related to feelings of powerlessness in general, leading to a narcissistic wound. The men experienced UI as a bodily deficiency, and erectile dysfunction was experienced as a feeling of being devitalized. These results suggest that UI from prostate cancer treatment affects sexuality and self-esteem.

  8. 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.

  9. AB003. Erectile dysfunction (ED) after radical prostatectomy: mile stones in development of rehabilitation strategy

    Science.gov (United States)

    Wang, Run; Crigler, Cecil M.

    2015-01-01

    Radical Prostatectomy is a commonly used treatment modality for localized prostate cancer. The nerve-sparing technique was one of the major break-troughs in the last century with the hope to preserve erectile function. Unfortunately, despite the perfection of nerve-sparing surgery with robot, many men still suffer from erectile dysfunction (ED) as a complication of prostatectomy. In the last two decades, the concept of penile rehabilitation was introduced and many therapeutic approaches have been studied with the aim to promote erectile function recovery. Despite the understanding of the mechanisms and well-established rationale for post-prostatectomy penile rehabilitation, there is still no consensus regarding effective rehabilitation programs. This presentation will provide an overview of the mile stones in basic, translational and clinical research aimed at preserving or promoting erectile function after radical prostatectomy. The contemporary series of trials that assess penile rehabilitation and explore treatment modalities that might play a role in the future will also be analyzed. Although recent trials have shown that most therapies are well-tolerated and aid in some degree on EF recovery, we currently do not have tangible evidence to recommend an irrefutable penile rehabilitation algorithm. However, advancements in research and technology will ultimately create and refine management options for penile rehabilitation.

  10. Clinical characteristics of older male military veterans seeking treatment for erectile dysfunction.

    Science.gov (United States)

    Beaudreau, Sherry A; Rideaux, Tiffany; Zeiss, Robert A

    2011-02-01

    Male sexual dysfunction is a significant international public health issue affecting both middle-aged and older adults. To date, however, no studies have compared age differences in psychiatric issues, frequency of sexual activity and treatment recommendations between older and middle-aged male military Veterans seeking treatment for erectile dysfunction (ED) in the U.S.A. Data were collected between 1982 and 2003 at the Palo Alto Veterans Affairs Andrology Clinic. The 1,250 participants, aged 22 to 87 years (median = 63), completed a semi-structured interview. Using multiple linear regressions, we examined age differences in five domains: medical and endocrine risk factors; psychiatric and psychosocial risk factors; frequency of sexual behaviors; self-reported and objectively measured erectile function; and treatment recommendations. Compared with middle-aged adults, older adults were more likely to present for ED treatment with medical risk factors and were more often recommended a vacuum pump treatment. Middle-aged male Veterans were more likely to experience psychiatric risk factors for ED and were more sexually active than older Veterans. Despite greater objective erectile ability in middle-aged adults, there were no age differences in maximum self-reported erectile functioning. These results provide some evidence of age-related characteristics and treatment needs of male patients seeking treatment for sexual dysfunction. We encourage health care professionals working with adults across the lifespan to consider ways to individualize psychoeducation and brief psychotherapy for the treatment of ED to the specific needs of the patient, which may vary between middle-aged and older cohorts of patients.

  11. 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

    2013-01-01

    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 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. PMID:23435473

  12. Testosterone and Erectile Function: From Basic Research to a New Clinical Paradigm for Managing Men with Androgen Insufficiency and Erectile Dysfunction

    Science.gov (United States)

    Traish, Abdulmaged M.; Goldstein, Irwin; Kim, Noel N.

    2007-01-01

    Objectives Androgens are essential for the development and growth of the penis, and they regulate erectile physiology by multiple mechanisms. Our goal is to provide a concise overview of the basic research and how this knowledge can be translated into a new clinical paradigm for patient management. In addition, this new paradigm may serve as a basis for stimulating constructive debate regarding the use of testosterone in men, and to promote new, innovative basic and clinical research to further understand the underlying mechanisms of androgen action in restoring erectile physiology. Methods A literature review was performed utilizing the US National Library of Medicine's PubMed database. Results On the basis of evidence derived from laboratory animal studies and clinical data, we postulate that androgen insufficiency disrupts cellular-signaling pathways and produces pathologic alterations in penile tissues, leading to erectile dysfunction. In this review, we discuss androgen-dependent cellular, molecular, and physiologic mechanisms modulating erectile function in the animal model, and the implication of this knowledge in testosterone use in the clinical setting to treat erectile dysfunction. The new clinical paradigm incorporates many of the consensed points of view discussed in traditional consensed algorithms exclusively designed for men with androgen insufficiency. There are, however, novel and innovative differences with this new clinical paradigm. This paradigm represents a fresh effort to provide mandatory and optional management strategies for men with both androgen insufficiency and erectile dysfunction. Conclusions The new clinical paradigm is evidence-based and represents one of the first attempts to address a logical management plan for men with concomitant hormonal and sexual health concerns. PMID:17329016

  13. Testosterone and erectile function: from basic research to a new clinical paradigm for managing men with androgen insufficiency and erectile dysfunction.

    Science.gov (United States)

    Traish, Abdulmaged M; Goldstein, Irwin; Kim, Noel N

    2007-07-01

    Androgens are essential for the development and growth of the penis, and they regulate erectile physiology by multiple mechanisms. Our goal is to provide a concise overview of the basic research and how this knowledge can be translated into a new clinical paradigm for patient management. In addition, this new paradigm may serve as a basis for stimulating constructive debate regarding the use of testosterone in men, and to promote new, innovative basic and clinical research to further understand the underlying mechanisms of androgen action in restoring erectile physiology. A literature review was performed utilizing the US National Library of Medicine's PubMed database. On the basis of evidence derived from laboratory animal studies and clinical data, we postulate that androgen insufficiency disrupts cellular-signaling pathways and produces pathologic alterations in penile tissues, leading to erectile dysfunction. In this review, we discuss androgen-dependent cellular, molecular, and physiologic mechanisms modulating erectile function in the animal model, and the implication of this knowledge in testosterone use in the clinical setting to treat erectile dysfunction. The new clinical paradigm incorporates many of the consensed points of view discussed in traditional consensed algorithms exclusively designed for men with androgen insufficiency. There are, however, novel and innovative differences with this new clinical paradigm. This paradigm represents a fresh effort to provide mandatory and optional management strategies for men with both androgen insufficiency and erectile dysfunction. The new clinical paradigm is evidence-based and represents one of the first attempts to address a logical management plan for men with concomitant hormonal and sexual health concerns.

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

    OpenAIRE

    Gagik Radikovich Galstyan; yana Grigor'evna Shwarts; Sergey Anatol'evich Dubsky; Aleksandr Evgen'evich Lepetukhin; Roman Viktorovich Rozhivanov; Dmitry Gennadievich Kurbatov

    2014-01-01

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

  15. Erectile dysfunction and comorbidities in aging men: an urban cross-sectional study in Malaysia.

    Science.gov (United States)

    Khoo, Ee Ming; Tan, Hui Meng; Low, Wah Yun

    2008-12-01

    Erectile dysfunction (ED), lower urinary tract symptoms (LUTS), cardiovascular disease (CVD), depression, and androgen deficiency are common conditions affecting aging men over 50 years. However, data were limited in developing countries. To investigate the prevalence of ED, LUTS, chronic diseases, depression, androgen deficiency symptoms, and lifestyle of aging men in Malaysia, and to examine their associations with sociodemographic factors. ED, LUTS, chronic diseases, depression, positive Androgen Deficiency in the Aging Male (ADAM) questionnaire A randomized survey of 351 men using structured questionnaires consisting of self-reported medical conditions, International Index for Erectile Function-5, International Prostate Symptom Score, Geriatric Depression Scale-15, and St Louis University questionnaire for ADAM. Blood samples were taken for glucose, lipid, prostate specific antigen (PSA), and hormones. Mean age was 58+/-7 years. Prevalence of ED was 70.1% (mild ED 32.8%, mild to moderate ED 17.7%, moderate ED 5.1%, and severe ED 14.5%). There were 29% of men with moderate and severe LUTS; 11.1% had severe depression; 25.4% scored positive on ADAM questionnaire; 30.2% self-reported hypertension, 21.4% self-reported diabetes mellitus; 10.8% self-reported coronary artery disease; 19.1% were smokers; and 34% consumed alcohol. There were 78.6% of men that are overweight and obese; 28.8% had a fasting blood sugar (FBS) >or=6.1 mmol/L, 70.1% had total cholesterol >5.2 mmol/L, 19.1% had total testosterone >or=11.0 nmoL/L, 14.0% had calculated free testosterone 4 microg/L; 9.4% had insulin-like growth factor-1 (IGF-1) level below age specific range, 5.1% had abnormal sex hormone binding globulin (70 nmol/L). ED was found to be significantly associated with LUTS, depression (Paging men. As these conditions are possibly interrelated, strategies for early disease prevention and detection are warranted when one disease presents.

  16. 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

  17. Sexual activity, erectile dysfunction and their correlates among 1,566 older Chinese men in Southern China.

    Science.gov (United States)

    Wong, Samuel Yeung Shan; Leung, Jason Chi Shun; Woo, Jean

    2009-01-01

    Few studies on sexuality and its correlates in adults have been conducted in Asia; most studies in Asia have focused instead on erectile dysfunction in men rather than sexuality or sexual activities. This study was conducted to evaluate the prevalence and factors associated with sexual activity and erectile dysfunction in elderly Chinese men aged 65 years and above. Sexual activity and sexual functions were assessed using the International Index of Erectile Function-5. Depressive symptoms were measured by the Chinese version of the Geriatric Depression Scale. Lower urinary tract symptoms (LUTS) were measured by the International Prostatic Symptom Score. Cross-sectional data from a large prospective cohort study of Chinese elderly men were used in this study. A questionnaire that included demographic, lifestyle, and medical risk factors and physical examination were administered to 1566 Chinese men aged between 65 to 92 years in Hong Kong. Only 30.7% of men were sexually active in the previous 6 months in this sample and among those who were sexually active, 88% had some form of erectile dysfunction. Being sexually inactive in the previous 6 months was associated with being older (odds ratio [OR] = 1.80; confidence interval [CI]: 1.56-2.09), single (OR = 1.87; CI = 1.19-2.94) and the presence of peripheral arterial disease (OR = 2.43; CI: 1.25-4.71). In multiple multinomial logistic regression, having clinically relevant depressive symptoms (OR = 3.37; CI: 1.31-8.70) and having moderate to severe LUTS (OR = 1.63; CI: 1.01-2.64) were independently associated with increased risk of having erectile dysfunction. We showed that a large proportion of elderly men were not sexually active in Hong Kong. For those who were sexually active, most suffered from some degree of erectile dysfunction. Having clinically relevant depressive symptoms and LUTS were independently associated with increased risk of erectile dysfunction.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Transient erectile dysfunction associated with intramuscular injection of botulinum toxin type A.

    Science.gov (United States)

    Papadonikolakis, Anastasios S; Vekris, Marios D; Kostas, John P; Korompilias, Anastasios V; Soucacos, Panayotis N

    2002-01-01

    Autonomic nervous system dysfunction occurs rarely after botulinum toxin type A (BTX-A) intramuscular injections. We report a case of a 23-year-old man with spastic diplegia who had transient erectile dysfunction after intramuscular injection of BTX-A (total dosage, 300 IU, body weight 95 kg) in both hamstring muscles. Some investigators believe that the local spread of the toxin is responsible for autonomic dysfunction, while others believe that the transportation of the toxin to the spinal cord via retrograde flow or via the blood flow after entering the circulation are possible mechanisms of neurologic side effects. On the basis of our case, a retrograde axoplasmic flow to the spinal cord could probably occur because the spinal cord level of hamstring muscles is close to spinal cord levels responsible for erection control.

  20. 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.

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

    Science.gov (United States)

    Davis, Niall F; Smyth, Lisa G; Flood, Hugh D

    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. • To assess Internet search trends for erectile dysfunction (ED) subsequent to public awareness campaigns being launched within the Republic of Ireland • To assess whether the advent of such campaigns correlates with increased Internet search activity for ED. • Google insights for search was utilized to examine Internet search trends for the term 'erectile dysfunction' across all categories between January 2005 and December 2011. • Search activity was limited to users from the Republic of Ireland within this timeframe. • Additionally, the number of Irish Internet media campaigns and Irish web pages providing information on ED was assessed between January 2005 and December 2011. • Statistical analysis of the data was performed using analysis of variance and Student's t-tests for pairwise comparisons. • There has been a significant increase in mean search activity for ED on an annual basis since 2007 (P search activity for ED from 2005 to 2007 • The advent of recent Internet media campaigns and increasing number of Irish web pages is associated with a significant increase in online activity for ED in the Republic of Ireland. • Novel online technologies appear to provide a useful tool for educating the general public on the symptoms and treatment options available for ED. © 2012 BJU INTERNATIONAL.

  2. 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.

  3. A survey on relative frequency of metabolic syndrome and testosterone deficiency in men with erectile dysfunction.

    Science.gov (United States)

    Hamidi Madani, Ali; Heidarzadeh, Abtin; Akbari Parsa, Niloofar; Khosravi Darestani, Fatemeh; Hamidi Madani, Zahra

    2012-06-01

    Erectile dysfunction (ED) is a common male sexual dysfunction and affects the individual's physical and psychological well-being. It has been classified as organic and psychogenic. Men with low testosterone levels have an increased risk of ED. On the other hand, direct detrimental effect of metabolic syndrome on the endothelium, smooth muscle and nerves of the vascular system of the penis is what causes ED to develop in men with metabolic syndrome. Therefore, it is supposed that a large number of men with erectile dysfunction are patients who have ED, metabolic syndrome and testosterone deficiency as a triad. The aim of this study is determining relative frequencies of metabolic syndrome and testosterone deficiency in a group of men with ED. Men suffering from ED who were referred to a certain private urology clinic between 22.11.2009 and 22.9.2010 were evaluated for metabolic syndrome criteria; their morning free testosterone levels were measured, and then the related questionnaires were filled out. Of 241 men with ED, the relative frequency of metabolic syndrome was 41.5%, of testosterone deficiency was 36.5% and of metabolic syndrome in combination with testosterone deficiency was 19.5%. The relative frequencies of metabolic syndrome and testosterone deficiency in men with ED seem to be significant, and it is the time that we should evaluate ED not as a disease but as a presentation of multiple underlying pathologies which needs medical attention to general health.

  4. 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.

  5. Endocrine milieu and erectile dysfunction: is oestradiol–testosterone imbalance, a risk factor in the elderly?

    OpenAIRE

    Srilatha, Balasubramanian; Adaikan, P Ganesan

    2011-01-01

    Oestrogens are not exclusive to the female gender but occur in moderate circulating levels of 25–70 pg ml−1 in men, compared to 44–153 pg ml−1 in women. Arising from aromatisation of testosterone (T), oestrogen is considered to have many opposing physiological functions and the progressive T decline in the aging male is associated with relative and/or absolute increase in serum oestradiol (E2). Sexual disinterest and erectile dysfunction (ED) in the elderly may well be due to pathophysiologic...

  6. Endocrine milieu and erectile dysfunction: is oestradiol-testosterone imbalance, a risk factor in the elderly?

    Science.gov (United States)

    Srilatha, Balasubramanian; Adaikan, P Ganesan

    2011-07-01

    Oestrogens are not exclusive to the female gender but occur in moderate circulating levels of 25-70 pg ml⁻¹ in men, compared to 44-153 pg ml⁻¹ in women. Arising from aromatisation of testosterone (T), oestrogen is considered to have many opposing physiological functions and the progressive T decline in the aging male is associated with relative and/or absolute increase in serum oestradiol (E₂). Sexual disinterest and erectile dysfunction (ED) in the elderly may well be due to pathophysiological E₂-T imbalance; the altered hormonal ratio may also explain the higher incidence of ED in hyperestrogenism or following exposure to environmental/plant oestrogens.

  7. 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...

  8. 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. 2011 Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Torres, Luiz Otavio

    2015-01-01

    In 1973 V. Michal, a vascular surgeon said “Erectile dysfunction (ED) is related to diseases of the vascular bed”. And this makes sense since ED and cardiovascular diseases (CVD) share many risk factors like aging, obesity, inactivity, smoking, depression, dyslipidemia, hypertension, diabetes/insuline resistance. These conditions may lead to an oxidative stress which ultimately can promote vasoconstriction, thrombosis, atherosclerosis and finally ED and CVD. One of the most accepted Idea is that small vessels plug earlier, it means, small arteries when have for example 50% of obstruction will probably have a clinical manifestation before bigger arteries!

  10. Penile prosthesis in the management of erectile dysfunction following cancer therapy

    Science.gov (United States)

    Dadhich, Pranav; Hockenberry, Mark; Kirby, E. Will

    2017-01-01

    Erectile dysfunction (ED) is a common problem in older men and occurs with even greater frequency following the treatment of pelvic malignancies. Inflatable penile prosthesis (IPP) implantation is a safe and effective form of definitive ED treatment for those men who fail more conservative measures, and it can be used with similar outcomes in men following cancer therapy. Although many of these men remain dissatisfied with other therapeutic options for ED, IPPs are underutilized in this population. This review will discuss the current practice patterns, outcomes and nuances to surgical technique regarding the use of IPPs in patients with ED following cancer therapy. PMID:29238667

  11. 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.

  12. 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-assisted...... 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...

  13. Paraganglioma of the Cauda Equina Presenting with Erectile and Sphincter Dysfunction

    Directory of Open Access Journals (Sweden)

    Wiesław Marcol

    2009-06-01

    Full Text Available Paragangliomas of the cauda equina are rare neuroepithelial tumors, usually manifesting clinically as sciatica. Here, we report a case of cauda equina paraganglioma with an unusual course in a 43-year-old man. His main complaints were erectile and sphincter dysfunction. The low back pain was initially ascribed to accidental injury. Magnetic resonance imaging revealed intradural tumor at the L2/L3 level. The patient underwent gross tumor resection, and the diagnosis of paraganglioma was based on neuropathologic examination. The symptoms completely resolved after tumor resection.

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

    Directory of Open Access Journals (Sweden)

    Murat Savas

    2010-01-01

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

  15. 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.

  16. [Erectile dysfunction: results of the Brazilian Sexual Life Study].

    Science.gov (United States)

    Abdo, Carmita Helena Najjar; Oliveira, Waldemar Mendes de; Scanavino, Marco de Tubino; Martins, Fernando Gonini

    2006-01-01

    To estimate the prevalence of ED and related risk factors in a sample of the Brazilian male population. Cross-sectional study was carried out with a convenience sample of 2,862 men, 18 years of age or older, using an anonymous self-administered questionnaire. ED prevalence in the sample was obtained by a general question which was directly derived from the ED definition. Data were submitted to chi-square or Student's t tests. Logistic regression analyses were used for risk factor calculations. The prevalence of ED was 45.1% (31.2% mild, 12.2% moderate and 1.7% complete). Subjects with ED presented lower self-esteem, hindered interpersonal relationships, fewer sexual intercourses per week, more extra-marital relationships, complaints of lack of libido and premature ejaculation. When compared with men aged 18-39 years, men aged 60-69 presented 2.2 higher risk of ED (95% CI; 1.4-3.4; p < 0.01), whereas men aged 70 or older presented 3.0 higher risk of ED (95% CI; 1.4-6.3; p < 0.01). Level of education was inversely proportional to risk of ED. Yellow race, unemployment, religious affiliation, prostate tumor, hypertension and depression were variables that increased ED risk. The prevalence of ED was high and comparable to that found in other studies. Subjects with ED suffer from less sexual activity and poorer quality of life. Age and lower socioeconomic level are directly proportional to ED risk. Therapeutic and preventive measures should be implemented to minimize the negative impact of this condition, especially in developing countries.

  17. A novel experimental model of erectile dysfunction in rats with heart failure using volume overload.

    Directory of Open Access Journals (Sweden)

    Fábio Henrique Silva

    Full Text Available Patients with heart failure (HF display erectile dysfunction (ED. However, the pathophysiology of ED during HF remains poorly investigated.This study aimed to characterize the aortocaval fistula (ACF rat model associated with HF as a novel experimental model of ED. We have undertaken molecular and functional studies to evaluate the alterations of the nitric oxide (NO pathway, autonomic nervous system and oxidative stress in the penis.Male rats were submitted to ACF for HF induction. Intracavernosal pressure in anesthetized rats was evaluated. Concentration-response curves to contractile (phenylephrine and relaxant agents (sodium nitroprusside; SNP, as well as to electrical field stimulation (EFS, were obtained in the cavernosal smooth muscle (CSM strips from sham and HF rats. Protein expression of endothelial NO synthase (eNOS and neuronal NO synthase (nNOS and phosphodiestarese-5 in CSM were evaluated, as well as NOX2 (gp91phox and superoxide dismutase (SOD mRNA expression. SOD activity and thiobarbituric acid reactive substances (TBARs were also performed in plasma.HF rats display erectile dysfunction represented by decreased ICP responses compared to sham rats. The neurogenic contractile responses elicited by EFS were greater in CSM from the HF group. Likewise, phenylephrine-induced contractions were greater in CSM from HF rats. Nitrergic response induced by EFS were decreased in the cavernosal tissue, along with lower eNOS, nNOS and phosphodiestarese-5 protein expressions. An increase of NOX2 and SOD mRNA expression in CSM and plasma TBARs of HF group were detected. Plasma SOD activity was decreased in HF rats.ED in HF rats is associated with decreased NO bioavailability in erectile tissue due to eNOS/nNOS dowregulation and NOX2 upregulation, as well as hypercontractility of the penis. This rat model of ACF could be a useful tool to evaluate the molecular alterations of ED associated with HF.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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

  20. 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.

  1. Functional and structural changes in internal pudendal arteries underlie erectile dysfunction induced by androgen deprivation

    Directory of Open Access Journals (Sweden)

    Rhéure Alves-Lopes

    2017-01-01

    Full Text Available Androgen deficiency is strongly associated with erectile dysfunction (ED. Inadequate penile arterial blood flow is one of the major causes of ED. The blood flow to the corpus cavernosum is mainly derived from the internal pudendal arteries (IPAs; however, no study has evaluated the effects of androgen deprivation on IPA′s function. We hypothesized that castration impairs IPAs reactivity and structure, contributing to ED. In our study, Wistar male rats, 8-week-old, were castrated and studied 30 days after orchiectomy. Functional and structural properties of rat IPAs were determined using wire and pressure myograph systems, respectively. Protein expression was determined by Western blot and immunohistochemistry. Plasma testosterone levels were determined using the IMMULITE 1000 Immunoassay System. Castrated rats exhibited impaired erectile function, represented by decreased intracavernosal pressure/mean arterial pressure ratio. IPAs from castrated rats exhibited decreased phenylephrine- and electrical field stimulation (EFS-induced contraction and decreased acetylcholine- and EFS-induced vasodilatation. IPAs from castrated rats exhibited decreased internal diameter, external diameter, thickness of the arterial wall, and cross-sectional area. Castration decreased nNOS and α-actin expression and increased collagen expression, p38 (Thr180/Tyr182 phosphorylation, as well as caspase 3 cleavage. In conclusion, androgen deficiency is associated with impairment of IPA reactivity and structure and increased apoptosis signaling markers. Our findings suggest that androgen deficiency-induced vascular dysfunction is an event involving hypotrophic vascular remodeling of IPAs.

  2. 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

  3. Hypogonadism as a possible link between metabolic diseases and erectile dysfunction in aging men.

    Science.gov (United States)

    Corona, Giovanni; Bianchini, Silvia; Sforza, Alessandra; Vignozzi, Linda; Maggi, Mario

    2015-01-01

    There is evidence demonstrating that sexual complaints represent the most specific symptoms associated with late onset hypogonadism, while central obesity is the most specific sign. In obese men, hypogonadism can further worsen the metabolic profile and increase abdominal fat. In addition, although hypogonadism can exacerbate obesity-associated erectile dysfunction (ED), recent data suggest that a direct contribution of fat-derived factors could be hypothesized. In particular, an animal model recently documented that fat accumulation induces several hepatic pro-inflammatory genes closely linked to corpora cavernosa endothelial dysfunction. Lifestyle modifications and weight loss are the first steps in the treatment of ED patients with obesity or metabolic diseases. In symptomatic hypogonadal men with metabolic impairment and obesity, combining the effect of testosterone substitution with lifestyle modifications could result in better outcomes.

  4. Early onset erectile dysfunction is usually not associated with abnormal cavernosal arterial Inflow.

    Science.gov (United States)

    Rajfer, J; Valeriano, J; Sinow, R

    2013-01-01

    Endothelial dysfunction, a marker for atherosclerosis and hence arterial disease, has recently been proffered as the main offender within the vascular system to predict not only the future onset of erectile dysfunction (ED) but also as the main cause of the ED. To glean more insight into whether arterial disease is indeed operative during the early onset of ED, we reviewed the duplex ultrasound scans of 23 men with ED who were younger than 50 years of age. Depending on the criteria used for abnormal arterial responses, it was determined in this cohort of young men that there was only a 4-13% incidence of abnormal arterial responses. These observations suggest that the penile arterial system does not appear to be primarily involved in the etiology of the majority cases of ED that occur in young men.

  5. Erectile dysfunction in patients with hyper- and hypothyroidism: how common and should we treat?

    Science.gov (United States)

    Krassas, Gerasimos E; Tziomalos, Kostas; Papadopoulou, Fotini; Pontikides, Nikolaos; Perros, Petros

    2008-05-01

    Erectile dysfunction (ED) is associated with numerous diseases and aging. The objective of the study was to investigate the impact of hyper- and hypothyroidism on male sexual health by using the Sexual Health Inventory for Males (SHIM). Seventy-one men, 27 hyper- and 44 hypothyroid and a similar number of controls were included in the study. A validated SHIM 5-item questionnaire was administered to all participants. Patients were asked to respond before and a year after initiation of treatment for thyroid dysfunction. A score between 25 and 22 is considered normal, between 21 and 11 diagnostic of mild to moderately severe ED, and 10 or less diagnostic of severe ED. Fifty-six men with thyroid dysfunction (78.9%; 19 hyperthyroid and 37 hypothyroid) had a SHIM score of 21 or less, compared with 24 controls (33.8%) (P < 0.0001). Twenty-one patients with ED (37.5%) had SHIM scores 10 or less, indicative of severe ED, compared with six controls (25%) (P < 0.01). ED was more prevalent in patients with hyperthyroidism and hypothyroidism, compared with controls (P < 0.001 and P < 0.0001, respectively). Positive correlation was found between SHIM scores and serum free T(4) (r = 0.413, P = 0.005) and negative for TSH (r = -0.669, P < 0.001). After treatment a significant increase of SHIM scores was noted in both hyperthyroid (P < 0.0001) and hypothyroid (P < 0.0001) patients. ED is extremely common in males with dysthyroidism. Treatment of the latter restores erectile function. Screening for thyroid dysfunction in men presenting with ED is recommended, whereas specific treatment for ED should be postponed in such patients for at least 6 months after achieving euthyroidism because the latter might be responsible for ED.

  6. Erectile Dysfunction

    OpenAIRE

    2015-01-01

    A partir de 1993, após o consenso do Instituto Nacional de Saúde dos Estados Unidos, o termo disfunção erétil (DE) passou a substituir a expressão impotência sexual, já que reflete com maior precisão a natureza desta disfunção. A disfunção erétil (DE) é então definida como a incapacidade persistente em obter ou manter uma ereção suficiente para uma relação sexual satisfatória.

  7. Erectile dysfunction

    African Journals Online (AJOL)

    an erection from time to time, and such occurrences are considered normal. However, ED may be a regular and more severe problem in some men. It can cause low self-esteem, performance anxiety, depression and stress, and may also affect the quality of a marriage or intimate relationships. Lifestyle changes, such as ...

  8. Erectile Dysfunction

    Science.gov (United States)

    ... Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información ... Kidney Disease Weight Management Liver Disease Urologic Diseases Endocrine Diseases Diet & Nutrition Blood Diseases Diagnostic Tests La información ...

  9. Penile prosthesis – a viable solution for erectile dysfunction refractory to conservative therapy

    Directory of Open Access Journals (Sweden)

    D. Marcu

    2015-12-01

    Full Text Available Introduction: Erectile dysfunction(ED is a serious condition which can affect men of all ages, with an important impact over the quality of life. When conservative therapy fails, a viable solution is the penile prosthesis implantation (PPI. Objective: The purpose of this paper is to present data from recent literature regarding the satisfaction rates of men who have undergone penile PPI and as well as the partners satisfaction rates, ease of use, informations regarding long term survival of these prosthesis, postoperative complications and long distance complications, the effectiveness and the way that penile prosthesis have influenced the quality of life of the men who have opted for this solution. Material and methods: We have analyzed recent long term studies concerning the outcomes of the PPI, studies which were made retrospectively, over a period of time of 10 to 15 years. Results: Compared with the conservative treatment for ED, the satisfaction rates achieved after penile prosthesis implantation are higher. According to these studies, the overall patient’s satisfaction is 70-90%. The difference between patient and their partners’ satisfaction rate is negligible, this difference ranging between 2 to 8%. The satisfaction rate regarding the adequate erection for sexual intercourse is 80-90%. The overall satisfaction rates for the malleable prostheses are lower compared with inflatable devices, 30-75%, respectively 75-90% for the inflatable prosthesis. The mechanical and overall survival rates for the malleable prosthesis range between 65-80% at 10 years, and 58-75% for the inflatable devices. Overall ease of use is rated as 78%. Complications after implantation can be encountered in less than 5% of cases and infections in less than 2%. The likelihood of continued use is higher in the group of the patients with the inflatable prosthesis compared with the malleable ones 70-80%, respectively 50-60%. Up to 85-90% of patients with inflatable

  10. An analysis of treatment preferences and sexual quality of life outcomes in female partners of Chinese men with erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Hong-Jun Li

    2016-01-01

    Full Text Available The impact of erectile dysfunction is distressing to both males and their female partners, but less attention has been paid to identify female partners′ preferred treatment and sexual quality of life outcomes. The present analysis explores female partners′ treatment preference for erectile dysfunction in Chinese Men. This was a phase 4, randomized, open-label, multicenter, crossover study in Chinese men with erectile dysfunction who were naïve to phosphodiesterase type 5 inhibitor treatments. Eligible patients were randomized to sequential 20-mg tadalafil/100-mg sildenafil or 100-mg sildenafil/20-mg tadalafil for 8 weeks each. Of 418 patients, female partners of 64 patients agreed to enter the study; of 64 patients who entered the study with female partners, 63 were randomized, and 62 completed the study. Baseline demographics and disease characteristics were comparable between treatment groups. Significantly more couples preferred tadalafil compared with sildenafil overall (75.4% vs 24.6%; P < 0.001, and irrespective of erectile dysfunction severity at baseline (P ≤ 0.005. Significant improvements in sexual quality of life scores were reported at endpoint (Visit 8 in male patients and female partners in both tadalafil and sildenafil treatment groups (P < 0.001. Significantly higher mean changes from baseline were observed for male patients in the tadalafil group compared with the sildenafil group for the erectile function (P = 0.013 and overall satisfaction (P = 0.019 International Index for Erectile Function domains and the spontaneity domain (P < 0.001 of the Psychological and Interpersonal Relationship Scale. No major safety concerns were reported during the study. Though both treatments were effective, safe, and tolerable, more couples preferred tadalafil compared with sildenafil.

  11. Uric acid level and erectile dysfunction in patients with coronary artery disease.

    Science.gov (United States)

    Solak, Yalcin; Akilli, Hakan; Kayrak, Mehmet; Aribas, Alpay; Gaipov, Abduzhappar; Turk, Suleyman; Perez-Pozo, Santos E; Covic, Adrian; McFann, Kim; Johnson, Richard J; Kanbay, Mehmet

    2014-01-01

    Erectile dysfunction (ED) is a frequent complaint of elderly subjects and is closely associated with endothelial dysfunction and cardiovascular disease (CVD). Uric acid is also associated with endothelial dysfunction, oxidative stress, and CVD, raising the hypothesis that an increased serum uric acid might predict ED in patients who are at risk for coronary artery disease (CAD). This study aims to evaluate the association of serum uric acid levels with presence and severity of ED in patients presenting with chest pain of presumed cardiac origin. This is a cross-sectional study of 312 adult male patients with suspected CAD who underwent exercise stress test (EST) for workup of chest pain and completed a sexual health inventory for men survey form to determine the presence and severity of ED. Routine serum biochemistry (and uric acid levels) were measured. Logistic regression analysis was used to assess risk factors for ED. The short version of the International Index of Erectile Function questionnaire diagnosed ED (cutoff score ≤ 21). Serum uric acid levels were determined. Patients with chest pain of suspected cardiac origin underwent an EST. One hundred forty-nine of 312 (47.7%) male subjects had ED by survey criteria. Patients with ED were older and had more frequent CAD, hypertension, diabetes and impaired renal function, and also had significantly higher levels of uric acid, fibrinogen, glucose, C-reactive protein, triglycerides compared with patients without ED. Uric acid levels were associated with ED by univariate analysis (odds ratio = 1.36, P = 0.002); however, this association was not observed in multivariate analysis adjusted for estimated glomerular filtration rate. Subjects presenting with chest pain of presumed cardiac origin are more likely to have ED if they have elevated uric acid levels. © 2013 International Society for Sexual Medicine.

  12. 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.

  13. Efficacy of Low Density Linear Shockwave Treatment in Severe Arteriogenic Erectile Dysfunction Patients

    Directory of Open Access Journals (Sweden)

    Mehmet Giray Sönmez

    2017-12-01

    Full Text Available Objective: The aim of this study was to evaluate the efficacy of low-intensity linear shockwave treatment (LI-ESWT in patients with severe arteriogenic erectile dysfunction (ED by comparing LI-ESWT combined with daily use of phosphodiesterase type 5 inhibitors (PDE5i with the daily use of PDE5i alone. Materials and Methods: A total of 23 patients were included in the study. The patients were separated into two groups: LI-ESWT + tadalafil 5 mg (n=10 group and tadalafil 5 mg only group (n=13. LI-ESWT was applied once a week for four weeks. Oral tadalafil 5 mg once a day was started and continued for three months in both groups. The patients were evaluated with the International Erectile Function Index Questionnaire Erectile Function Domain (IIEF-EF, Erection Hardness Score (EHS and Sexual Encounter Profile (SEP 2 and 3 before treatment and the 1 and 3 months after treatment. Results: No statistically significant difference was detected among IIEF-EF scores measured before and 1 and 3 months after treatment (p=0.091, p=0.198. At the end of the third month, IIEF score increased 4 points in LI-ESWT + tadalafil 5 mg group and 3.2 points in tadalafil 5 mg only group. No statistically significant difference was detected in EHS, and the rate of positive responses to SEP2 and SEP3 questions at the 1st and 3rd months between the groups. Conclusion: LI-ESWT is easily applicable without any significant side effects and it has positive effects on the outcomes, however, it is not an effective treatment method in patients with severe arteriogenic ED.

  14. Erectile dysfunction in patients with liver disease related to chronic hepatitis B

    Directory of Open Access Journals (Sweden)

    Min Kim

    2015-12-01

    Full Text Available Background/AimsDespite sexual function making an important contribution to the quality of life, data on erectile function are relatively scant in patients with chronic liver disease. We evaluated the prevalence of and risk factors for erectile dysfunction (ED in patients with liver disease related to hepatitis B, especially among those with chronic hepatitis B (CHB or early-stage cirrhosis.MethodsIn total, 69 patients (35 with CHB and 34 with hepatitis-B-related liver cirrhosis [HBV-LC] aged 40-59 years were analyzed. Child-Pugh classes of A and B were present in 30 (88.2% and 4 (11.8% of the patients with HBV-LC, respectively. The erectile function of the patients was evaluated using the Korean version of IIEF-5.ResultsThe prevalence of any ED was 24.6% for all patients, and 8.6% and 41.2% for those with CHB and HBV-LC, respectively (P=0.002. While there was only one (2.9% CHB patient for each stage of ED, mild, moderate, and severe ED stages were seen in three (8.8%, one (2.9%, and ten (29.4% of the HBV-LC patients, respectively. Multiple regression analysis identified the type of liver disease (P=0.010, hypertension (P=0.022, score on the Beck Depression Inventory (P =0.044, and the serum albumin level (P=0.014 as significant independent factors for the presence of ED.ConclusionsThe prevalence of ED was significantly higher in patients with early-stage HBV-LC than in those with CHB. Therefore, screening male patients with early viral cirrhosis for ED and providing appropriate support are needed, especially when the cirrhosis is accompanied by hypertension, depression, or a depressed level of serum albumin.

  15. Correlation between Fasting Glucose, Erectile Dysfunction, and Lower Urinary Tract Symptoms in Benign Prostate Hyperplasia Patients

    Directory of Open Access Journals (Sweden)

    Tommie Prasetyo

    2017-01-01

    Full Text Available This study is aimed to determine the correlation between fasting glucose level, erectile dysfunction,and lower urinary tract symptoms (LUTS in patients diagnosed with benign prostatic hyperplasia (BPH. Weenrolled patients with BPH-related LUTS aged over 50 years old. LUTS and erectile dysfunction (ED wereevaluated using International Prostate Symptom Score (IPSS and International Index of Erectile Function-5(IIEF-5. Diabetes mellitus was established if fasting glucose level was above 126mg/dL. Forty-two patientswere enrolled in this study from outpatient clinic in Kardinah Hospital, Tegal during January–March 2015.Patients’ mean age was 68.8±8.6 years old with most of them suffered from ED (83.3% and also suffered fromsevere LUTS (80.96%. Mean fasting glucose level was 108.3 + 21.1 mg/dl. However, diabetes mellitus wasobserved in 26.2% subjects with mean fasting glucose level was 136.8+7.8mg/dl. IPSS score was correlatedwith fasting glucose level (r=0.879, p<0.001 and IIEF-5 score (r= -0.346, p=0.025. IIEF-5 score showednegative correlation with age (r=-0.31, p=0.046 and fasting glucose level (r=-0.305, p=0.049. Higher fastingglucose level in a man older than 50 years with BPH would increase severity of LUTS and ED. Keywords: Diabetes mellitus, lower urinary tract symptoms, erectile dysfunction   Korelasi antara Glukosa Darah Puasa, Disfungsi Ereksi, dan GejalaSaluran Kemih Bagian Bawah pada PasienBenign Prostatic Hyperplasia AbstrakPenelitian ini bertujuan untuk mengetahui hubungan antara nilai glukosa darah puasa, disfungsi ereksi(DE, dan gejala saluran kemih bagian bawah (LUTS pada pasien dengan pembesaran prostate jinak/benignprostatic hyperplasia (BPH. Subjek adalah pasien berusia lebih dari 50 tahun dengan pembesaran prostatjinak di RS Kardinah, Tegal pada bulan Januari-Maret 2015. LUTS dan DE dievaluasi dengan menggunakanInternational Prostate Symptom Score (IPSS and International Index of Erectile Function-5 (IIEF-5

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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

  18. Erectile dysfunction in patients with psoriasis: potential impact of the metabolic syndrome.

    Science.gov (United States)

    Tasliyurt, T; Bilir, Y; Sahin, S; Seckin, H Y; Kaya, S U; Sivgin, H; Demir, A K; Erdemir, F

    2014-01-01

    Psoriasis is a chronic inflammatory skin disease that affects up to 5.5% of world population and is associated with erectile dysfunction (ED). Aim of the present study was to investigate impact of metabolic syndrome (MetS) on association between psoriasis and ED as well as to improve our understanding of this association via studying other possible causes of ED such as psychological factors and disease effects. The patient group included 37 male psoriasis patients and control group 28 healthy men. Severity of psoriasis was determined using Psoriasis Area and Severity Index (PASI), and ED was evaluated using International Index of Erectile Function (IIEF) Scale. Psychiatric state of the patients were determined using Beck Depression Inventory (BDI). MetS was diagnosed using the National Cholesterol Education Program Adult Treatment Panel III criteria. MetS, ED prevalence and BDI score were significantly higher in psoriasis patient group (p = 0.032, p = 0.018 and p old age and smoking (but not MetS) were found to be independent predictors of ED. ED, MetS and depression frequencies were significantly higher in psoriasis patient group. In addition, psoriasis severity and ED parameters were closely associated. Depression, old age and smoking were found to be independent risk factors for ED.

  19. 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.

  20. Metabolic Syndrome, Hormone Levels, and Inflammation in Patients with Erectile Dysfunction

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Arrabal-Polo

    2012-01-01

    Full Text Available Background. The end point of this study was to investigate the prevalence of MS in patients with ED in comparison with control subjects and to analyse the association with acute phase reactants (CRP, ESR and hormone levels. Methods. This case-control study included 65 patients, 37 with erectile dysfunction, according to the International Index of Erectile Function (IIEF from the Urology Department of San Cecilio University Hospital, Granada (Spain and 28 healthy controls. The prevalence of metabolic syndrome was calculated according to ATP-III criteria. Hormone levels and acute phase parameters were studied in samples drawn. Results. The ATP-III criteria for MS were met by 64.9% of the patients with ED and only 9.5% of the controls (P<0.0001, OR = 17.53, 95% CI: 3.52–87.37. Binary logistic regression analysis showed a strong association between patients with ED and MS, even after additional adjustment for confounding factors (OR = 20.05, 95% CI: 1.24–32.82, P<0.034. Patients with hypogonadism presented a significantly higher prevalence of metabolic syndrome. Multiple linear regression analysis showed that systolic BP and CRP predicted 0.46 (model R2 of IIEF changes. Conclusion. Chronic inflammation found in patients with ED might explain the association between ED and metabolic syndrome.

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

    Directory of Open Access Journals (Sweden)

    Gagik Radikovich Galstyan

    2014-05-01

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

  2. Effect of tadalafil 5mg daily treatment on the ejaculatory times, lower urinary tract symptoms and erectile function in patients with erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Mehmet Karabakan

    Full Text Available ABSTRACT Objective To investigate the effect of a 5mg daily tadalafil treatment on the ejaculation time, erectile function and lower urinary tract symptoms (LUTS in patients with erectile dysfunction. Materials and Methods A total of 60 patients diagnosed with erectile dysfunction were retrospectively evaluated using the international index of erectile function questionnaire-5 (IIEF-5, intravaginal ejaculatory latency time (IELT and international prostate symptoms scores (IPSS. After the patients were treated with 5mg tadalafil once a day for three months, their erection, ejaculation and LUTS were assessed again. The fasting levels of blood glucose, total testosterone, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and total cholesterol were measured. The independent-samples t-test was used to compare the pre- and post-treatment scores of the patients. Results The mean age of the 60 participants was 50.4±7.9 and the mean baseline serum total testosterone, total cholesterol, and fasting blood sugar were 444.6±178.6ng dL-1, 188.7±29.6mg/dL-1,104 (80-360 mg dL-1, respectively. The mean baseline scores were 2.2±1.4 min for IELT, 9.5±3.7 for IIEF-5 and 14.1±4.5 for IPSS. Following the three-month daily 5mg tadalafil treatment, the scores were found to be 3.4±1.9 min, 16.1±4.7, and 10.4±3.8 for IELT, IIEF and IPSS, respectively. When the baseline and post-treatment scores were compared, a statistically significant increase was observed in the IELTs and IIEF-5 values whereas there was a significant decrease in IPSS (p<0.01. Conclusion A daily dose of 5mg tadalafil can be safely used in the treatment of erectile dysfunction and LUTS, that prolongs the ejaculatory latency time.

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

    Directory of Open Access Journals (Sweden)

    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.

  4. Endocrine milieu and erectile dysfunction: is oestradiol–testosterone imbalance, a risk factor in the elderly?

    Science.gov (United States)

    Srilatha, Balasubramanian; Adaikan, P Ganesan

    2011-01-01

    Oestrogens are not exclusive to the female gender but occur in moderate circulating levels of 25–70 pg ml−1 in men, compared to 44–153 pg ml−1 in women. Arising from aromatisation of testosterone (T), oestrogen is considered to have many opposing physiological functions and the progressive T decline in the aging male is associated with relative and/or absolute increase in serum oestradiol (E2). Sexual disinterest and erectile dysfunction (ED) in the elderly may well be due to pathophysiological E2–T imbalance; the altered hormonal ratio may also explain the higher incidence of ED in hyperestrogenism or following exposure to environmental/plant oestrogens. PMID:21423199

  5. Amelioration of erectile dysfunction following a switch from carbamazepine to oxcarbazepine: recent clinical experience.

    Science.gov (United States)

    Sachdeo, Rajesh; Sathyan, Revathi R

    2005-07-01

    Oxcarbazepine is an antiepileptic drug (AED) indicated for use as monotherapy and add-on therapy in adults and children 4 years of age and older. Despite being structurally related to carbamazepine, oxcarbazepine differs substantially in its pharmacokinetic and safety profile; oxcarbazepine has a much lower risk of pharmacokinetic drug-drug interactions than carbamazepine. Carbamazepine has also been shown to induce the hepatic synthesis of sex hormone-binding globulin, thus reducing free serum testosterone levels and possibly causing erectile dysfunction (ED) in some men; these effects have not been observed with oxcarbazepine. This paper provides a discussion of recent clinical experience with men who presented in private clinical practice with complaints of ED while being treated with carbamazepine for seizure disorders. The four illustrative case studies presented in this report suggest that switching AED treatment from carbamazepine to oxcarbazepine in men with epilepsy can reduce the ED side effects observed with carbamazepine.

  6. 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.

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. 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 study...... with LUTS, the results indicated DAN-PSS-1, total score median 13 (4-17) versus 3 (2-6), p = .05; IIEF-5 25 (14-25) versus 24 (23-25), p = .06; SF-12, total score 499 (360-679) versus 695 (644-734), p = .02; and N-QoL 98 (70-100) versus 96 (90-100), p = .65. In the age group >55 years, comparing poststroke...... men with healthy controls both with LUTS, the results indicated DAN-PSS-1, total score 13 (8-24) versus 5 (2-7), p

  10. 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

  11. The Relationship Between Incontinence and Erectile Dysfunction After Robotic Prostatectomy: Are They Mutually Exclusive?

    Science.gov (United States)

    Tsikis, Savas T; Nottingham, Charles U; Faris, Sarah F

    2017-10-01

    Urinary incontinence (UI) and erectile dysfunction (ED) remain the most common long-term complications of prostatectomy, with a significant impact on sexual health and quality of life. To determine the relation between UI and moderate to severe ED and the risk factors for UI in patients undergoing robotic-assisted laparoscopic prostatectomy. Patients in our institutional database who underwent robotic-assisted laparoscopic prostatectomy for prostate cancer (2006-2013) and who completed the University of California-Los Angeles Prostate Cancer Index and the Sexual Health Inventory for Men (SHIM) surveys at 12 months after prostatectomy were eligible for inclusion. Men who reported use of no urinary pads per day were considered continent, whereas men who used at least one pad per day were considered incontinent. Men with moderate to severe ED based on a SHIM score no higher than 11 were considered to have ED. Patients who had preoperative moderate to severe ED and/or UI based on these definitions were excluded from further analysis. A better understanding of what increases the risk for UI after a prostatectomy and how it can co-occur with ED. We analyzed 464 patients who met the inclusion criteria. After prostatectomy, 36% of patients had UI and 47% of patients had moderate to severe ED. Of all patients with ED, 45% (98 of 216) were incontinent compared with 27% (67 of 248) of patients without ED (P Faris SF. The Relationship Between Incontinence and Erectile Dysfunction After Robotic Prostatectomy: Are They Mutually Exclusive? J Sex Med 2017;14:1241-1247. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  12. 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.

  13. Complex beam diagnostics erectile dysfunction of the venoocclusive apparatus of a penis

    Directory of Open Access Journals (Sweden)

    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.

  14. Factors influencing distress toward erectile dysfunction and attitude toward erectile dysfunction drugs among middle-aged and elderly Chinese women and men in Hong Kong.

    Science.gov (United States)

    Liong, Chan Ching Mario

    2013-03-01

    This study aims to explain distress toward erectile dysfunction (ED), attitude toward ED drugs, and experiences with ED drug use in terms of sexual attitudes, relationship satisfaction, and sociodemographic factors among the middle-aged and elderly Chinese population. Studies show that a significant number of middle-aged and elderly men in Asia suffer from ED. However, people's attitudes toward ED drugs are not positive. Few studies have sought to reveal the influencing factors of this negative attitude. Nine hundred forty-six Hong Kong women and men aged 36-80 with stable partners were administered a structured questionnaire through face-to-face street-intercept survey. Self-reporting on single-item questions using a five-point Likert scale was adopted for most of the variables, including attitude toward sex, relationship satisfaction, distress toward ED, and attitude toward ED drugs. Perceived importance of sex in an intimate relationship and attitude toward sex were assessed through three items. Respondents were asked to report whether they had taken ED drugs or bought ED drugs for their partners. While perceived importance of sex in an intimate relationship and distress toward ED both contributed to the estimation of attitudes toward ED drugs for both genders, relationship satisfaction was only associated with men's attitude, while women's attitude was related to two other factors: relationship status and income level. Both age and attitude toward ED drugs influenced experiences with ED drug use for women and men. Men's experience with ED drug use was further related to the perceived importance of sex and to men's self-esteem and relationship status. Results of this study could help identify people who are disturbed by ED but reluctant to seek treatment. Clinicians and public health policy makers could make use of the findings to encourage proper understanding of ED. © 2012 International Society for Sexual Medicine.

  15. The relationship between anxiety, depression and religious coping strategies and erectile dysfunction in Iranian patients with spinal cord injury.

    Science.gov (United States)

    Pakpour, A H; Rahnama, P; Saberi, H; Saffari, M; Rahimi-Movaghar, V; Burri, A; Hajiaghababaei, M

    2016-11-01

    To assess the role of anxiety, depressive mood and religious coping in erectile function among Iranian patients with spinal cord injury (SCI). Brain and Spinal Cord Injury Repair Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. A sample of N=93 men with SCI participated in this cross-sectional study. Levels of anxiety and depressive mood were assessed using the Hospital Anxiety and Depression Scale. Religious coping strategies were measured using the 14-items Brief Coping Questionnaire. Erectile function was assessed using the International Index of Erectile Function. The joint effect of anxiety, depressive mood and religious coping strategies on erectile function was assessed by performing stepwise multiple linear regression analyses. The mean age of the SCI patients was 37.8 years with a mean post-injury time of 4.6 years. Multivariate regression analyses indicated that age (B=-0.27, 95% CI=-0.47 to -0.07), education (B for higher education=0.63, 95% CI=0.24 to 1.02), the American Spinal Injury Association impairment scale (B for complete impairment=-3.36, 95% CI=-3.82 to -2.89), anxiety (B=-3.56, 95% CI=-5.76 to -1.42), positive religious coping (B=0.30, 95% CI=0.03 to 0.57), negative religious coping (B=-0.56, 95% CI=-0.82 to -0.29) and the duration of injury (B=-0.25, 95% CI=-0.22 to -0.29) were all independent factors influencing erectile function in SCI patients. Overall, the results indicated that SCI patients who use positive religious coping strategies had better erectile function compared with individuals who applied negative religious coping strategies. Furthermore, higher levels of anxiety, greater impairment and longer duration of injury turned out to be risk factors for erectile dysfunction.

  16. Erectile dysfunction is a prognostic indicator of comorbidities in men with late onset hypogonadism.

    Science.gov (United States)

    Almehmadi, Yousef; Yassin, Dany-Jan; Yassin, Aksam A

    2015-01-01

    The role of testosterone deficiency in erectile dysfunction (ED) is increasingly recognized; however, there is a need to clarify the nature of the relationship between ED and late onset hypogonadism (LOH). In this study, we sought to determine the correlators of ED severity amongst men with LOH. 130 patients diagnosed with LOH fulfilling the criteria of total testosterone ≤3.5 ng/ml (<12 nmol/l) and with an erectile function domain score <21 on the International Index of Erectile Function questionnaire (IIEF questions 1-5) were enrolled for a subsequent trial of Testosterone Undecanoate. Demographic data were recorded at baseline. Subjects completed three standardised questionnaires to assess sexual health including International Prostate Symptom Score (IPSS), Aging Males Symptoms (AMS) and IIEF Sexual Health Inventory for Men (SHIM). Patients were stratified by ED severity with SHIM scores of 1-7 considered severe ED, 8-11 moderate ED and 12-16 mild to moderate. Serum testosterone, sex hormone binding globulin (SHBG) and lipids (total cholesterol, triglycerides, high-density lipoprotein and low-density lipoprotein) were assessed along with plasma fasting glucose and HbA1c. Weight, BMI and waist circumference were also recorded. A significant association was observed between severity of ED and mean weight (p = 0.000), waist circumference (p = 0.000), triglycerides (p = 0.009), total cholesterol (p = 0.027), HbA1c (p = 0.000), fasting glucose (p = 0.003) and AMS scores (p = 0.043). No significant differences were seen in testosterone fractions and SHBG levels between ED subgroups. A positive correlation existed between the prevalence of diabetes mellitus (type 1 and type 2) and ED severity in this cohort (p = 0.018). The descriptive data of our cohort show that increased severity of ED within LOH patients correlated with an increased waist circumference, hyperglycemia, hypertriglyceridemia, hyperlipidemia and a history of

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

    Directory of Open Access Journals (Sweden)

    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

  18. Erectile dysfunction among men with diabetes is strongly associated with premature ejaculation and reduced libido.

    Science.gov (United States)

    Malavige, Lasantha S; Jayaratne, Shanthilal D; Kathriarachchi, Samudra T; Sivayogan, Sivagurunathan; Fernando, Devaka J; Levy, Jonathan C

    2008-09-01

    Among men with diabetes, little attention has been given to premature ejaculation (PE), reduced libido, and their associations with erectile dysfunction (ED), despite the presence of physical and psychologic factors that could predispose to all three. To estimate the prevalence and inter-associations of ED, PE, and reduced libido among diabetic men and to describe the associated clinical, socioeconomic, and lifestyle parameters. Cross-sectional observational study of 253 men with type 2 diabetes randomly selected from a clinic in Colombo, Sri Lanka. Erectile function was assessed using the five-item version of the International Index of Erectile Function scale. The presence of PE, reduced libido, sociodemographic, and lifestyle data was obtained using an interviewer-administered questionnaire. Clinical data were obtained from relevant physical examination, patient records, and laboratory tests, which included glycosylated hemoglobin, serum cholesterol, serum creatinine, and electrocardiogram. One hundred and eighty-five (73.1%) of the individuals had some degree of ED, while 84 (33.2%) had severe to complete ED. After excluding men with complete ED, the prevalence of PE was 68 (40.2%). The overall prevalence of reduced libido was 64 (25%). In the multivariate analysis, the strongest associations with ED were PE (odds ratio [OR] = 4.41, 95% confidence interval [CI] = 2.08-9.39) and reduced libido (OR = 4.38, CI = 1.39-13.82) followed by lower income (OR = 2.16, CI = 1.32-3.52), advancing age (OR = 2.06, CI = 1.44-2.95), and duration of diabetes (OR = 1.48, CI = 1.09-2.01). In addition, ED was univariately associated with lower educational level (P = 0.05), the presence of hypertension (P = 0.005), and no alcohol intake (P = 0.001). The only significant association of PE was the severity grade of ED. Associations of reduced libido in the multivariate analysis were ED (OR=1.61, CI = 1.23-2.70), advancing age (OR = 1.7, CI = 1.4-2.2), and absence of masturbation (OR

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

    Directory of Open Access Journals (Sweden)

    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

  20. Decreased Endogenous Hydrogen Sulfide Generation in Penile Tissues of Diabetic Rats with Erectile Dysfunction.

    Science.gov (United States)

    Zhang, Yan; Yang, Jun; Wang, Tao; Wang, Shao-Gang; Liu, Ji-Hong; Yin, Chun-Ping; Ye, Zhang-Qun

    2016-03-01

    Hydrogen sulfide (H2S) is an endogenous gasotransmitter. The levels of H2S-generating enzyme expression and endogenous H2S production in diabetic rats with erectile dysfunction (ED) remain unknown. The aim of this study was to investigate the expression of the H2S-generating enzymes and endogenous production of H2S in penile tissues of diabetic ED rats. Experimental rats were randomly divided into normal control group, apomorphine (APO)-positive group and APO-negative group. Primary rat corpus cavernosum smooth muscle cells (CCSMCs) and aortic endothelial cells (AECs) were isolated and cultured in vitro under 3 different conditions: normal glucose (NG) condition, high glucose (HG) condition, and osmotic control (OC) condition. Erectile function; H2S concentrations in plasma or penile tissues; expression of H2S-generating enzymes and endogenous H2S production in penile tissues, CCSMCs, and AECs. Erectile function was significantly decreasedin the APO-negative group. In addition to significantly decreased expression of cysteine aminotransferase (CAT), d-amino acid oxidase (DAO), and 3-mercaptopyruvate sulfurtransferase (3-MST), the H2S concentrations in plasma and penile tissues and endogenous H2S production were significantly decreased in the APO-negative group. Endogenous H2S production by cystathionine β-synthase (CBS) and cystathionine γ-lyase (CSE) decreased to the same levels in the APO-negative and APO-positive groups as that in the normal control group. However, CBS and CSE expression remained unchanged in the 3 groups. Under HG conditions, H2S-generating enzyme expression in AECs did not change, while CAT, DAO, and 3-MST expression in CCSMCs was significantly decreased. In both cell types, H2S production by these enzymes was decreased in the HG group. Endogenous H2S production was significantly decreased in the diabetic ED rats' penile tissues due to downregulated expression of the CAT/3-MST and DAO/3-MST pathways and low activities of CBS and CSE

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

    Directory of Open Access Journals (Sweden)

    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. .

  2. Lichen Simplex Chronicus Associated With Erectile Dysfunction: A Population-Based Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    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.

  3. Tadalafil in the treatment of erectile dysfunction; an overview of the clinical evidence.

    Science.gov (United States)

    Frajese, Giovanni Vanni; Pozzi, Flavio; Frajese, Gaetano

    2006-01-01

    Prevalence and severity of erectile dysfunction (ED) increase with aging and are often associated with illnesses, like diabetes mellitus, heart disease, and hypertension, pathologically characterized by endothelial dysfunction and whose prevalence increases with age. The assumption that ED is mainly a neurovascular disease is supported by the evidence that specific phosphodiesterase type 5 (PDE5) inhibition produces an efficient erection in a wide range of ages and conditions. The availability of specific PDE5 inhibitors has enabled the development of effective treatment strategies, in this contest, tadalafil may be considered as the least "typical" PDE5 inhibitor. In clinical trials, tadalafil significantly enhanced, in patients of different ages, all efficacy outcomes across disease etiologies and severities. With an effectiveness lasting up to 36h, tadalafil allows patients to choose when to have sexual activities without the need to time it, showing positive feedback in terms of quality of life related to the treatment. Headache and dyspepsia were the most frequent side-effects of tadalafil, followed by back pain, nasal congestion, myalgia, and flushing, but the impact that long time action could have on effectiveness and safety is not yet entirely defined. The aim of this article is to critically review the available evidence from the tadalafil clinical research program and give the physician a rational approach for intervention in the treatment of ED and related diseases.

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

    Science.gov (United States)

    Hamilton, Zachary; Mirza, Moben

    2014-01-01

    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 treatment selection, patient satisfaction and improved erectile function can be achieved. We advise that patients use a vacuum erection device daily in the early postoperative period

  5. Skin autofluorescence (a marker for advanced glycation end products) and erectile dysfunction in diabetes.

    Science.gov (United States)

    Kouidrat, Youssef; Zaitouni, Ahmad; Amad, Ali; Diouf, Momar; Desailloud, Rachel; Loas, Gwenole; Lalau, Jean-Daniel

    2017-01-01

    Although diabetes-related erectile dysfunction (ED) has many etiological factors, little is known about the putative pathophysiological role of advanced glycation end products (AGEs). Skin autofluorescence is a noninvasive marker of AGEs. Recent studies have evidenced a relationship between skin autofluorescence and several complications of diabetes. We hypothesized that AGEs (assessed by skin autofluorescence) are associated with ED in diabetes patients. Between March 2014 and April 2015, 42 patients with type 1 diabetes (T1D) and 44 patients with type 2 diabetes (T2D) were consecutively enrolled in a descriptive, cross-sectional study and compared to 54 healthy controls. ED was evaluated via the 5-item version of the International Index of Erectile Function (IIEF-5). Skin autofluorescence was measured on the volar aspect of the arm with an AGE-Reader. Patients with diabetes had a mean±standard deviation age of 50±15 and a mean duration of diabetes of 16±12years. Skin autofluorescence was strongly and significantly correlated with the IIEF-5 score in the T1D subgroup (r=-0.52; P=0.004), the T2D subgroup (r=-0.32; Pmultivariate analyses that controlled for potentially confounding clinical and biochemical factors, only skin autofluorescence was still significantly correlated with the IIEF-5 score (Panalysis revealed that a skin autofluorescence value ≥3.2AU determined severe ED with a sensitivity of 60% and a specificity of 87% in diabetic patients. Skin autofluorescence is significantly associated with ED in diabetes, independently of classical confounding factors. Copyright © 2017 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. 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.

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

    International Nuclear Information System (INIS)

    Wein, B.; Sohn, M.; Ulose, K.; Bohndorf, K.

    1991-01-01

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

  9. The study of venous leakage in erectile dysfunction by cavernosometry and cavernosography: A case series in Sina Hospital

    Directory of Open Access Journals (Sweden)

    Beidaghian A

    2001-08-01

    Full Text Available Erectile dysfunction is an important problem for men and their families which has an organic cause in about 50 percent of cases. When there is a vasculogenic etiology for this defect, radiologic assessment is unavoidable. Cavernosometry and Cavernosography are ultimate procedures for diagnosis of venous leakage. There is no reliable data about this defects in Iran. The objective of this study was to determine the rate of venous leakage in patients with erectile dysfunction by Pharmarco-Cavernosometry and Cavernosography. In this case series study, 100 patient with erectile dysfunction who referred to radiologic ward in Sina hospital was selected and Pharmarco-Cavernosometry and Cavernosography were conducted for them. In Cavernosometry, after injection of Prostaglandin E1 and salin normal infusion into corpus covernosum, the pressure was determined. In cavernosography, diluted omnipaque was injected and venous leakage and other defects were recognized. Myoclinic's criteria was use for analysis of the results. Mean age of patients was 35.6±11.6. Most of the cases were in 20 to 40 age group. The frequency of venous leakage based on 50 mmHg reduction in pressure (from 150 mmHg, after 30 seconds discountinuance of normal salin infusion was 90 percent. This figure based on the ratio of Maintenance Flow Rate to Induced Flow Rate, was more than 92 percent. The frequency of venous leakage according to Cavernosography was 89 percent. There was no significant side effects in any of cases induced by procedures. The results of study, shows the high prevalence of venous leakage in patients referring for erectile dysfunction.

  10. Erectile Dysfunction in Young Men-A Review of the Prevalence and Risk Factors.

    Science.gov (United States)

    Nguyen, Hoang Minh Tue; Gabrielson, Andrew T; Hellstrom, Wayne J G

    2017-10-01

    Erectile dysfunction (ED) is an important health concern that can significantly affect a man's psychosocial well-being. ED has traditionally been considered a disease of old age; however, contemporary evidence suggests a growing incidence of ED in men younger than 40 years. The process of achieving an erection is multifaceted; there are many potential mechanisms that can be disrupted. It is critical to identify the specific causes of ED before proceeding with potentially costly and invasive therapeutic options. Advances in diagnostic and treatment modalities offer opportunities to identify and manage young men with ED. To provide an update on the prevalence and risk factors of ED in young men and to provide a framework to guide clinicians in identifying and managing the affected young man. Comprehensive review of the literature pertaining to ED in young men. ED in young men was assessed by outlining the prevalence according to recent epidemiologic studies. The pathophysiology, diagnostic considerations, risk factors, and etiologies were reviewed. Large multinational studies have estimated the prevalence of ED in young men to be as high as 30%. Several studies have stratified the etiologies of ED into psychogenic and organic causes. Psychogenic etiologies of ED include depression, anxiety, and partner-related difficulties. These patients tend to experience sudden onset of symptoms, with decreased libido and good quality of spontaneous or self-stimulated erections. Organic etiologies include vasculogenic, endocrinologic, neurogenic, iatrogenic, and structural components. These patients usually experience gradual onset of symptoms and a low to normal libido. Conservative treatments such as phosphodiesterase type 5 inhibitors continue to be the mainstay treatment. ED in young men is an increasingly common condition. A careful diagnostic evaluation should focus on the identification of any underlying etiology to ensure appropriate management of patients. Nguyen HMT

  11. Newly diagnosed panic disorder and the risk of erectile dysfunction: A population-based cohort study in Taiwan.

    Science.gov (United States)

    Wang, Yao-Ting; Chen, Hsi-Han; Lin, Ching-Heng; Lee, Shih-Hsiung; Chan, Chin-Hong; Huang, Shiau-Shian

    2016-10-30

    Previous studies indicated that panic disorder is correlated with erectile dysfunction (ED). The primary aim of this study was to explore the incidence rate of ED among panic disorder patients in an Asian country. The secondary aim was to compare the risk of ED in panic disorder patients that were treated with different kinds of antidepressants, and to explore the possible mechanism between these two disorders. We identified 1393 male patients with newly diagnosed panic disorder from the Taiwan's National Health Insurance Database. Four matched controls per case were selected for the study group by propensity score. After adjusting for age, obesity and comorbidities, the panic disorder patients had a higher hazard ratio of ED diagnosis than the controls, especially among the untreated panic disorder patients. This retrospective dynamic cohort study supports the link between ED and prior panic disorder in a large sample of panic disorder patients. This study points out the need of early antidepressant treatment for panic disorder to prevent further ED. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Treatment of erectile dysfunction in the obese type 2 diabetic ZDF rat with adipose tissue-derived stem cells

    Science.gov (United States)

    Garcia, MM; Fandel, TM; Lin, G; Shindel, AW; Banie, L; Lin, CS; Lue, TF

    2010-01-01

    Introduction Impotence, or erectile dysfunction (ED), is a major complication of type-II diabetes, and many diabetic men with ED are refractory to common ED therapies. Aim To determine whether autologous adipose tissue derived stem cells (ADSC) injected into the penis of impotent obese type-II diabetic rats survive and improve erectile function. Main outcome measures Intracorporal pressure (ICP) increase with cavernous nerve (CN) electrostimulation, immunohistochemistry, real-time PCR, and serum glucose and testosterone assays. Methods Twenty-two 10-week old male fatty type-II diabetic ZDF rats underwent weight and blood glucose measurement every 2 weeks. At age 22 weeks, all animals underwent unilateral CN electrostimulation and ICP measurement to confirm impotence, and paragonadal adipose tissue (5 grams) was harvested and digested to yield 1.5 million ADSC. Impotent animals were randomized to ADSC treatment and sham control groups. At age 23 weeks, treatment group animals underwent penile injection of 1.5 million ADSC; control group animals received only PBS. Erectile function studies were repeated at age 26 weeks, followed by harvest of tissue and serum. Results Pre- and post-treatment stimulation ICP increase was significantly different between groups (ppenis appear to survive and improve erectile function. Autologous ADSC therapy is a promising approach to treat diabetic impotence. PMID:20104670

  13. [Psychological impact of erectile dysfunction on self-esteem and self-confidence].

    Science.gov (United States)

    Martin-Morales, A; Meijide Rico, F; García González, J I; Regadera Anechina, L; Manero Font, M

    2005-05-01

    Erectile dysfunction (ED) is caused by a large range of organic, psychological, psychiatric, interpersonal and pharmacological factors. Numerous scientific publications mention the loss of self-esteem as a collateral effect of ED, with a very probable affectation of the subject's self-confidence. The objective of this study was to evaluate the self-esteem and self-confidence of subjects with ED and to compare them with a group of non-ED subjects. An epidemiological, cross-sectional, observational, comparative and multicentric study was conducted. General Practitioners selected 405 men older than 18 years in which they suspected ED. All the participants had to complete the self administered form of the Spanish version of the Rosenberg self-esteem scale and the Spanish culturally adapted version of the Johnson and McCoy self-confidence scale. After that, patients were referred to the urologist in order to confirm the ED diagnosis. The statistical analysis of the data showed that the subjects with ED obtained significantly lower scores in the self-confidence and self-esteem scales than the non-ED subjects (p self-confidence and self-esteem that suffer patients with ED.

  14. Prevalence of Erectile Dysfunction and Associated Factors in Korean Older Adults With Coronary Artery Disease.

    Science.gov (United States)

    Son, Youn-Jung; Jang, Miyoun; Jun, Eun-Young

    2016-10-01

    The current study aimed to identify the prevalence and associated factors of erectile dysfunction (ED) among 161 Korean adults 60 and older with coronary artery disease (CAD). ED was diagnosed in 72.2% of patients-the prevalence of which was significantly associated with age, education, employment, monthly income, frequency of sexual intercourse, body mass index, and low-density lipoprotein. Health-related quality of life (HRQoL) was lower in patients with ED than in those without ED (p < 0.001). Hierarchical multiple regression analysis revealed that ED significantly influenced HRQoL in patients with CAD after adjusting for sociodemographic and disease-related characteristic variables (p < 0.001). Interventions and training courses for health care providers should focus on improving caregivers' knowledge and communication skills with patients and spouses regarding sexual health. Furthermore, guidelines to improve HRQoL in patients with CAD should consider incorporating sexual counseling. [Journal of Gerontological Nursing, 42(10), 32-41.]. Copyright 2016, SLACK Incorporated.

  15. Study on alcohol dependence and factors related to erectile dysfunction among aborigines in Taiwan.

    Science.gov (United States)

    Chao, Jian-Kang; Ma, Mi-Chia; Lin, Yen-Chin; Chiang, Han-Sun; Hwang, Thomas I-Sheng

    2015-05-01

    Relatively few studies have addressed the risk factors of erectile dysfunction (ED) in Taiwanese- most have described ED and medical problems in the general population. In this study, the cardiovascular risk factors of ED among aborigines in Taiwan were investigated. However, alcohol dependence (AD) was prevalent in Taiwan's aborigine population. So this study also focused on the relationship among AD, the cardiovascular risk factors and ED. A cross-sectional study was conducted, and data was obtained from a baseline survey of 192 aboriginal adults (35-75 years of age). The participants' demographic data, AD, markers of endothelial function, serum testosterone, and ED status were assessed. Ninety-four (49%) of the 192 participants had a history of alcoholism and 79 (84%) of those with alcoholism had ED. The study reported that AD and hyperlipidemia, metabolic syndrome (MetS), ED, abnormality of testosterone, and high-sensitivity C-reactive protein are highly prevalent among the aborigines. Factors that may affect ED included age, AD, central obesity, diabetes mellitus, hyperlipidemia, hypertension, MetS, and testosterone. ED is highly prevalent among aborigines with the risk factors of AD, MetS, old age, and abnormal testosterone serum level. MetS, atherosclerosis, and ED are risk factors for cardiovascular diseases. Hence, an increased focus on Taiwanese aborigines with ED is necessary. © The Author(s) 2014.

  16. Erectile dysfunction and diabetes: Association with the impairment of lipid metabolism and oxidative stress.

    Science.gov (United States)

    Belba, Arben; Cortelazzo, Alessio; Andrea, Giansanti; Durante, Jacopo; Nigi, Laura; Dotta, Francesco; Timperio, Anna Maria; Zolla, Lello; Leoncini, Roberto; Guerranti, Roberto; Ponchietti, Roberto

    2016-01-01

    To test the hypothesis that exists an association of non-diabetic and diabetic patients suffering from erectile dysfunction (ED) with lipid metabolism and oxidative stress. Clinical and laboratory characteristics in non-diabetic (n = 30, middle age range: 41–55.5 years; n = 25, old age range: 55.5–73), diabetic ED patients (n = 30, age range: 55.5–75 years) and diabetic patients (n = 25, age range: 56–73.25), were investigated. Proteomic analysis was performed to identify differentially expressed plasma proteins and to evaluate their oxidative posttranslational modifications. A decreased level of high-density lipoproteins in all ED patients (P < 0.001, C.I. 0.046–0.10), was detected by routine laboratory tests. Proteomic analysis showed a significant decreased expression (P < 0.05) of 5 apolipoproteins (i.e. apolipoprotein H, apolipoprotein A4, apolipoprotein J, apolipoprotein E and apolipoprotein A1) and zinc-alpha-2-glycoprotein, 50% of which are more oxidized proteins. Exclusively for diabetic ED patients, oxidative posttranslational modifications for prealbumin, serum albumin, serum transferrin and haptoglobin markedly increased. Showing evidence for decreased expression of apolipoproteins in ED and the remarkable enhancement of oxidative posttranslational modifications in diabetes-associated ED, considering type 2 diabetes mellitus and age as independent risk factors involved in the ED pathogenesis, lipid metabolism and oxidative stress appear to exert a complex interplay in the disease.

  17. Asymmetric development of peripheral atherosclerosis in patients with erectile dysfunction: an ultrasonographic study.

    Science.gov (United States)

    Foresta, Carlo; Palego, Pierfrancesco; Schipilliti, Mirko; Selice, Riccardo; Ferlin, Alberto; Caretta, Nicola

    2008-04-01

    Recent literature focused on erectile dysfunction (ED) as a reliable predictive parameter of cardiovascular diseases. ED patients have a higher prevalence of atherosclerotic lesions (increased intima-media thickness and plaques) at carotid site, but data on femoral site are still lacking. Nevertheless, there is accumulating evidence concerning a significant involvement of femoral atherosclerosis in other clinical conditions associated to ED, such as diabetes mellitus and coronary disease. Therefore, we investigated the prevalence of carotid and femoral atherosclerotic lesions and penile peak systolic velocity (PSV) in 238 ED patients by Eco-Colour Doppler ultrasonography (US). We found - irrespective of the presence of cardiovascular risk factors - a significant increase of atherosclerotic lesions in ED group with respect to 52 controls (66.4% versus 36.5%) and a higher prevalence of atherosclerosis at the femoral site (23.1% versus 5.7%), also with respect to the carotid site (8%). Moreover, PSV was significantly lower in ED patients with atherosclerosis compared to those without atherosclerotic lesions (41.9+/-15.3 cm/s versus 55.2+/-17.7 cm/s), and it was particularly low in those with combined carotid and femoral atherosclerosis (34.8+/-13.3 cm/s) and those with isolated carotid atherosclerosis (37.9+/-13.0 cm/s). These data confirm the strong relation between atherosclerosis and ED, an asymmetric development of atherosclerotic lesions in ED patients and suggest to perform an US study of both femoral and carotid district in these subjects.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-10-01

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

  19. The Association of Erectile Dysfunction and Cardiovascular Disease: A Systematic Critical Review.

    Science.gov (United States)

    Raheem, Omer A; Su, Jeannie J; Wilson, Joel R; Hsieh, Tung-Chin

    2017-05-01

    Despite strong association between erectile dysfunction (ED) and cardiovascular disease (CVD), there is a paucity of clear clinical guidelines detailing when and how to evaluate for ED in patients with known CVD, or vice versa. This systematic review discuss the role of cardiologists and urologists in the characterization of risk and management of CVD in the setting of ED, as well as contrasting the current evaluation of CVD and ED from the standpoint of published consensus statements. A comprehensive literature review utilizing MEDLINE®, the Cochrane Library® Central Search, and the Web of Science was performed to identify all published peer-reviewed articles in the English language describing ED and CVD across various disciplines. There is strong consensus that men with ED should be considered at high risk of CVD. Available risk assessment tools should be used to stratify the coronary risk score in each patient. The 2012 Princeton III Consensus Conference expanded on existing cardiovascular recommendations, proposing an approach to the evaluation and management of cardiovascular risk in men with ED and no known CVD. This systematic review highlights the similarities and differences of the existing clinical guidelines and recommendations regarding assessment and management of ED and CVD, as well as the pathophysiological linkage between ED and CVD, which may permit physicians, including urologists, to perform opportunistic screening and initiate secondary prophylaxis with regard to cardiovascular risk factors, particularly in young, nondiabetic men with ED.

  20. The Role of Oxygen Tension in Penile Erection and Its Relationship to Erectile Dysfunction

    Directory of Open Access Journals (Sweden)

    Jong-Kwan Park

    2004-01-01

    Full Text Available The corpus cavernosum of the penis is one of the few vascular beds in which there is a change in oxygen tension with function (blood PO2 25-40mm Hg in the flaccid state, and 90-100mm Hg in the erect state. This change in oxygen tension exposes the components of the corpus cavernosum to a variety of cytokines, humoral, vasoactive, and growth factors which may affect the structure and function of the endothelial cells, smooth muscle cells, neurons and extracellular matrix. Among these cell types, endothelial cells are the first line of defense to blood-borne stress and can affect the underlying smooth muscle via paracrine mechanisms. Impotence is defined as the inability to obtain or sustain an erection sufficient for vaginal penetration and can result from a variety of pathological conditions, vascular disease, endocrine disease, neurological disease, and psychogenic disorders. The penis is a vascular organ and as such is susceptible to the effects of vascular diseases. This review will discuss the basic etiology of erection and vasculogenic erectile dysfunction and explore the role oxygen tension in regulating various cellular and humoral factors as well as trabecular structure and function.

  1. Australian gay and bisexual men's use of erectile dysfunction medications during recent sexual encounters.

    Science.gov (United States)

    Prestage, Garrett; Jin, Fengyi; Bavinton, Benjamin; Grulich, Andrew; Brown, Graham; Pitts, Marian; Hurley, Michael

    2014-03-01

    Use of erectile dysfunction medications (EDMs) is relatively common among gay and bisexual men and has been associated with human immunodeficiency virus sexual risk behavior. We aimed to determine what factors were related to EDM use on occasions when participants engaged in protected anal intercourse (PAIC) and when they engaged in unprotected anal intercourse (UAIC) with casual partners. An online cross-sectional survey was conducted, resulting in a sample of 1,376 Australian gay and bisexual men who reported an occasion of anal intercourse with casual male partners in the previous year. The main outcome measure was the use of EDM during most recent occasions of PAIC and UAIC. Men were as likely to use EDM on occasions when they were using condoms (11.6%) as they were on occasions when they did not use condoms (13.0%). There was no association between use of EDM and self-esteem, nor was there an association between sexual risk behavior and self-esteem. Men who used EDM were more sexually active overall and appeared to often use EDM to enhance and extend their sexual experiences. Men did not appear to use EDM specifically for the purposes of risk-taking and mainly used EDM to enhance sexual pleasure. Mental health issues were not indicated by use of EDM. © 2013 International Society for Sexual Medicine.

  2. Erectile dysfunction in male heroin users, receiving methadone and buprenorphine maintenance treatment.

    Science.gov (United States)

    Quaglio, Gianluca; Lugoboni, Fabio; Pattaro, Cristian; Melara, Barbara; Mezzelani, Paolo; Des Jarlais, Don C

    2008-04-01

    Erectile dysfunction (ED) is common among people in treatment for heroin addiction. The purpose of the study was to examine the frequency of ED among methadone and buprenorphine maintenance therapy patients, and to identify factors associated with ED. Patients - recruited from 7 centres in Italy - underwent: (i) a structured interview on socio-demographic characteristics, drug use and sexual behaviour; (ii) IIEF-15 test, a test of sexual function; (iii) Zung test for depression. The study included 201 males: 42% were on methadone maintenance, 58% were on buprenorphine. Overall, 58% reported no ED, 24% reported mild to moderate ED, and 18% severe ED. In univariate analysis buprenorphine patients had less ED than methadone patients (p=0.0135). Subjects living with a partner had less ED than others (p=0.0018). More depressed subjects had more ED (phistory of drug use and not having a steady partner were associated with a greater likelihood of ED. The significant association between treatment and ED which appeared in univariate analysis (with buprenorphine patients reporting less ED than methadone patients) was not confirmed by the multivariate analysis. Both psychological and social factors were associated with ED which is an important problem for many males in methadone and buprenorphine treatment.

  3. Association between periodontal flap surgery for periodontitis and vasculogenic erectile dysfunction in Koreans

    Science.gov (United States)

    2017-01-01

    Purpose The National Health Insurance Service-National Sample Cohort and medical checkup data from 2002 to 2013 were used to evaluate the association between periodontal surgery for the treatment of periodontitis (PSTP) and vasculogenic erectile dysfunction (VED). Methods Bivariate and multivariate logistic regression analyses were applied to a longitudinal retrospective database to assess the association between PSTP and VED while adjusting for the potential confounding effects of sociodemographic factors (age, household income, insurance status, health status, residence area, and smoking status) and comorbidities (diabetes mellitus, angina pectoris, cerebral infarction, and myocardial infarction). Results Among the 7,148 PSTP within the 268,296 recruited subjects, the overall prevalence of VED in PSTP was 1.43% (n=102). The bivariate analysis showed that VED was significantly related to PSTP (odds ratio [OR], 1.99; 95% confidence interval [CI], 1.38–2.06; Pperiodontal flap surgery had a significantly higher risk of VED, after adjusting for potential confounding factors. Further studies are required to identify the key mechanisms underlying the association between severe periodontal disease and VED. PMID:28462008

  4. A community-based study on prevalence and correlates of erectile dysfunction among Kinondoni District Residents, Dar Es Salaam, Tanzania.

    Science.gov (United States)

    Pallangyo, Pedro; Nicholaus, Paulina; Kisenge, Peter; Mayala, Henry; Swai, Noel; Janabi, Mohamed

    2016-11-29

    Globally, erectile dysfunction burden (ED) is rising appreciably and it is projected to affect about 332 million men by the year 2025. This rise is attributable to the rising incidence of conditions associated with ED including obesity, diabetes, hypertension, coronary artery disease and depression. We conducted this community-based screening to elucidate on the prevalence of ED and its associated factors among men residing in an urban community in Tanzania. We conducted a cross-sectional community-based study and interviewed 441 men aged at least 18 years. Diabetes and hypertension were defined as per the International Diabetes Federation (IDF) and the 7th Report of the Joint National Committee (JNC 7) respectively. The 5-item version of the International Index of Erectile Function (IIEF-5) Scale was used to assess for erectile dysfunction. Multivariate logistic regression analyses were performed to explore the factors associated with ED. The mean age was 47.1 years, 57.6 % had excess body weight, 8.2 % had diabetes and 61.5 % had high blood pressure. Overall, 24 % (106/441) of men in this study had some form of ED. Participants with age ≥55, positive smoking history, obesity, diabetes and hypertension displayed highest rates of ED in their respective subgroups. However, age ≥40 and diabetes were ultimately the strongest factors for ED after multivariate logistic regression analyses, (OR 5.0, 95 % CI 2.2-11.2, p Erectile dysfunction affects about a quarter of adult men living in Kinondoni district. Old age, obesity, smoking, hypertension and diabetes have the potential to increase the odds of ED up-to 5 times. In view of this, men with diabetes and hypertension should be offered screening services and treatment of ED as an integral component in their management.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Testosterone deficiency in patients with erectile dysfunction: when should a higher cardiovascular risk be considered?

    Science.gov (United States)

    Martínez-Jabaloyas, José M

    2014-08-01

    Low testosterone levels (low T) increase the cardiovascular (CV) risk of men with erectile dysfunction (ED). T levels associated with a higher CV risk are unknown. To determine the prevalence of CV risk factors associated with low T as defined by European Guidelines and their contribution to low T, overall and at different ages. Multicenter, cross-sectional, observational study conducted in Spain among men with ED aged ≥ 18 years visiting Urology/Andrology offices for sexual dysfunction. Anthropometric, clinical, and laboratory data, including total T (TT) values, were collected for 1,278 men. Risk factors were assessed in men with TT ≤ 8, 8-12, and ≥ 12 nmol/L, and two-group comparisons were made. Bivariate and multivariate logistic regression analyses were performed to calculate odds ratios for low T after adjusting for possible confounding factors. Mean age (standard deviation) was 58.0 (9.2) years. Age and prevalence of CV risk factors was similar in men with TT ≤ 8 nmol/L or 8-12 nmol/L and significantly higher than in men with TT >12 nmol/L. Low T was therefore considered as TT ≤ 12 nmol/L, with a prevalence of 33.3%. Obesity, hypertension, hyperlipidemia, and severe ED were the variables most strongly associated with low T: obesity in middle-aged men; hyperlipidemia, and hypertension in older men. Severe ED was a risk factor in both groups. Hypolipidemic therapy had the greater effect in young men. Multivariate analysis showed that severe ED and obesity were the strongest predictors of low T. T levels associated with increased CV risk could go as high as 12 nmol/L in men with ED, with distribution of risk factors showing differences according to age. Obesity and severe ED are the best predictors of low T-related CV risk. © 2014 International Society for Sexual Medicine.

  7. 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

  8. Factors associated with sex hormones and erectile dysfunction in male Taiwanese participants with obesity.

    Science.gov (United States)

    Shi, Ming-Der; Chao, Jian-Kang; Ma, Mi-Chia; Hao, Lyh-Jyh; Chao, I-Chen

    2014-01-01

    Obesity has been receiving an increasing amount of attention recently, but investigations regarding the potential impact of obesity, sexual behaviors, and sex hormones on erectile dysfunction (ED) in men have not completely clarified the association. To identify the relationship between ED, sexual behavior, sexual satisfaction, sex hormones, and obesity in older adult males in Taiwan. Data were obtained from a baseline survey of 476 older adult males (≧40 years old). Their demographic data, body mass index (BMI), sex hormones, sexual desire, sexual satisfaction, and ED status were assessed. The International Index of Erectile Function-5 (IIEF-5), Sexual Desire Inventory (SDI), and Sexual Satisfaction Scale (SSS) were used to assess ED, sexual desire, and sexual satisfaction. In all, 476 men were available for analysis. The mean age of the sample was 51.34 ± 7.84 years (range 40 to 70 years). The IIEF total score had a mean of 19.44 ± 4.98; 264 (55.5%) subjects had ED, 250 (52.9%) were currently obese (BMI ≧27), and 297 (62.4%) had metabolic syndrome. The results showed an increased risk of ED among obese men and subjects with lower levels of sex hormones and lower sexual desire. Testosterone levels were lower in subjects with obesity (P < 0.001). Among the predictors of ED, obesity (odds ratio [OR] = 1.62, 95% CI = 1.07-2.44, P = 0.021), abnormal high sensitivity C-reactive protein (hs-CRP) (OR = 10.59, 95% CI = 4.70-23.87, P < 0.001), and lower serum full testosterone (OR = 3.27, 95% CI = 2.16-4.93, P < 0.001) were significantly independent factors. This study supports the idea of a close relationship between low levels of sex hormones, sexual desire, sexual satisfaction, obesity, and ED, and also shows that low free testosterone and hs-CRP may predict ED, even in obese populations. © 2013 International Society for Sexual Medicine.

  9. An unresolved discussion: presence of premature ejaculation and erectile dysfunction in lumbar disc hernia.

    Science.gov (United States)

    Yazici, Cenk Murat; Sarifakioglu, Banu; Guzelant, Aliye; Turker, Polat; Ates, Ozkan

    2013-06-01

    Premature ejaculation (PE) and erectile dysfunction (ED) are both frequent diseases with several questions about the aetiological factors for these disorders. Lumbar disc herniation (LDH), which can cause both neurological and physiological impairments, may be a causative reason. We prospectively tried to evaluate the presence of PE and ED in patients with LDH and identify the effect of both surgical and physical therapy treatments for LDH on PE and ED. A total of 50 patients with LDH and a corresponding control group without LDH at an age of 18-50 years were included in the study. Both PE and ED were evaluated with premature ejaculation diagnostic tool (PEDT) and International Index of Erectile Function. Mean intravaginal ejaculatory latency time (IELT) was calculated at their 5 consecutive intercourse. Physical therapy or microdiscectomy was performed according to indication. After 6 months of follow-up, patients in treatment group were re-evaluated for PE and ED. Mean age of study and control group was 34.1 ± 3.3 and 34.2 ± 4.0 years, respectively (p = 0.979). In LDH group, IELT was <1 min in 12 (24 %), 1-2 (16 %) min in 8, 2-3 min in 7 (14 %), 3-4 min in 7 (14 %) and 4 or more minutes in 16 (32 %) patients. These numbers were 11 (22 %), 8 (16 %), 5 (10 %), 9 (18 %) and 17 (34 %) in control group, respectively. Mean PEDT score of patients who had IELT < 1 min was 11.9 ± 2.1 and 10.7 ± 2.1 in study and control group, whereas it decreased to 1.0 ± 2.8 and 0.5 ± 1.8 as IELT increased over 4 min, respectively. There were 11 (22 %) patients with ED in LDH group, whereas there were only 2 (4 %) in control group (p = 0.017). Twenty patients with LDH underwent surgery while 30 had been taken into physical therapy. After 6 months, patients with PE significantly decreased in both surgery and physical therapy group (p = 0.025 and p = 0.046). Patients with ED also decreased after treatment, but the numbers were so limited for statistical evaluation. Although ED was

  10. Prevalence and determinants of erectile dysfunction among diabetic patients attending in hospitals of central and northwestern zone of Tigray, northern Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Seid, Awole; Gerensea, Hadgu; Tarko, Shambel; Zenebe, Yosef; Mezemir, Rahel

    2017-03-15

    The prevalence of erectile dysfunction among diabetic men varies between 35-90%. Although erectile dysfunction is widespread among men with diabetes, the condition often remains undiagnosed and demands appropriate assessment and prompt treatment. Erectile dysfunction can affect all aspects of a patient's life including physical, emotional, social, sexual, and relationships. The main aim of this study is to determine the prevalence and determinants of erectile dysfunction among diabetic patients attending hospitals in the Central and Northwest zone of Tigray, Ethiopia. A hospital based cross-sectional study was conducted on 249 male diabetic patients attending five hospitals in the Central and Northwestern Zone of Tigray, Ethiopia using systematic random sampling. The data was collected from January 1 - February 30, 2016 and was entered and analyzed using SPSS version 20. Correlation and multivariate logistic regression was employed to test associations between independent and outcome variables. The mean age of study participants was 43.39 years and the mean duration of diabetes diagnosis was 6.22 years. The overall prevalence of erectile dysfunction was 69.9%, with 32.9% suffering from mild, 31.7% moderate, and 5.2% severe erectile dysfunction. Multivariate logistic regression revealed that erective dysfunction was significantly predicted by old age (Adjusted Odds Ratio [AOR] =15.013, CI:3.212-70.166), longer duration of diabetes (AOR = 3.77, CI:1.291-11.051), and lower monthly income (AOR = 0.285, CI:0.132-0.615). No association was found with body mass index, co-morbidity, glycemic control, and alcohol consumption. The prevalence of erective dysfunction in this study population was very high. Age, income, and duration of diabetes were the independent predictors of erectile dysfunction. Nearly all of the patients in the sample (97%) had not been screened or treated for erectile dysfunction. Assessment and management of erectile dysfunction in the

  11. Persistent erectile dysfunction in men exposed to the 5α-reductase inhibitors, finasteride, or dutasteride

    Directory of Open Access Journals (Sweden)

    Tina Kiguradze

    2017-03-01

    Full Text Available Importance Case reports describe persistent erectile dysfunction (PED associated with exposure to 5α-reductase inhibitors (5α-RIs. Clinical trial reports and the manufacturers’ full prescribing information (FPI for finasteride and dutasteride state that risk of sexual adverse effects is not increased by longer duration of 5α-RI exposure and that sexual adverse effects of 5α-RIs resolve in men who discontinue exposure. Objective Our chief objective was to assess whether longer duration of 5α-RI exposure increases risk of PED, independent of age and other known risk factors. Men with shorter 5α-RI exposure served as a comparison control group for those with longer exposure. Design We used a single-group study design and classification tree analysis (CTA to model PED (lasting ≥90 days after stopping 5α-RI. Covariates included subject attributes, diseases, and drug exposures associated with sexual dysfunction. Setting Our data source was the electronic medical record data repository for Northwestern Medicine. Subjects The analysis cohorts comprised all men exposed to finasteride or dutasteride or combination products containing one of these drugs, and the subgroup of men 16–42 years old and exposed to finasteride ≤1.25 mg/day. Main outcome and measures Our main outcome measure was diagnosis of PED beginning after first 5α-RI exposure, continuing for at least 90 days after stopping 5α-RI, and with contemporaneous treatment with a phosphodiesterase-5 inhibitor (PDE5I. Other outcome measures were erectile dysfunction (ED and low libido. PED was determined by manual review of medical narratives for all subjects with ED. Risk of an adverse effect was expressed as number needed to harm (NNH. Results Among men with 5α-RI exposure, 167 of 11,909 (1.4% developed PED (persistence median 1,348 days after stopping 5α-RI, interquartile range (IQR 631.5–2320.5 days; the multivariable model predicting PED had four variables: prostate disease

  12. Efficacy of low-intensity shock wave therapy for erectile dysfunction: A systematic review and meta-analysis.

    Science.gov (United States)

    Angulo, J C; Arance, I; de Las Heras, M M; Meilán, E; Esquinas, C; Andrés, E M

    2017-10-01

    The low-intensity shockwave (LISW) therapy is a recently developed modality for treating erectile dysfunction. To assess the efficacy of LISW therapy for treating erectile dysfunction as described in the literature. Two independent reviewers identified studies eligible for a systematic review and meta-analysis of various sources written in English and Spanish, using the databases of PubMed, EMBASE and Web of Science. We excluded studies on Peyronie's disease. We employed the DerSimonian-Laird method for defining heterogeneity, calculating the grouped standard deviation of the mean (SDM). The primary objective of this review is to assess efficacy based on the change in the International Index of Erectile Function (IIEF-EF) over baseline at 1 month from the start of treatment, both for the treatment arm and the placebo arm. The secondary objective is focused on analysing IIEF-EF at 3-6 months from the start of the therapy. The pooled data of 636 patients from 12 studies showed that treatment with LISW resulted in a significant increase in IIEF-EF at 1 month with respect to baseline (SDM, -2.92; P=.000), to a greater degree than placebo (SDM, -.99; P=.000). The IIEF-EF at 3-6 months for the treated patients was significantly greater than baseline (SDM, -2.78; P=.000). Only one study compared the efficacy of placebo at 3-6 months versus baseline (SDM, -9.14). The comparison between LISW and placebo favours active treatment (SDM, 2.53; P=.000) at 1 month. There are insufficient data in the literature to assess the response over placebo at 3-6 months. According to the literature, treatment with LISW for erectile dysfunction is effective, both in the short and medium term. LISW has been described as more effective than placebo in the short term. The long-term efficacy data are insufficient. More studies are needed to explain the role of this therapy according to specific causes of erectile dysfunction. Copyright © 2016 AEU. Publicado por Elsevier España, S.L.U. All

  13. 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. © 2011 The Authors. International Journal of Andrology © 2011 European Academy of Andrology.

  14. Erectile dysfunction in obstructive sleep apnea syndrome—Prevalence and determinants

    Directory of Open Access Journals (Sweden)

    T. Santos

    2012-03-01

    Full Text Available Introduction: OSAS (obstructive sleep apnea syndrome is defined by recurrent episodes of upper airway obstruction during sleep, causing multiple clinical consequences. Literature review suggests that OSAS induces a spectrum of abnormalities in neural, hormonal and vascular regulation that contribute to the development of ED (erectile dysfunction.The aims of this study were to estimate the prevalence of ED in OSAS patients and evaluate its determinants. Methods: 62 patients from Hospital S. João Sleep Laboratory with newly diagnosed OSAS were included in the study and answered the IIEF-5 (international index erectile function 5 item version questionnaire. Results: The prevalence of ED in OSAS patients was 64.4%. Age and diabetes constituted themselves as independent risk factors for more severe degrees of ED: OR = 1.226 (95% CI: 1.062–1.415 and OR = 31.205 (95% CI: 1.222–796.557, respectively. Compared with nonsmokers, ex-smokers group revealed a positive association with ED: OR = 4.32 (95% CI: 1.09–17.11. Hypertension and ACEI (angiotensin converting enzyme inhibitors or ARB (angiotensin II receptor blockers therapy were also correlated to ED symptoms: OR = 3.25 (95% CI: 1.09–9.65 and 7.39 (95% CI: 1.52–35.99, respectively.No association was found relating BMI (p = 0.254, alcoholic habits (p = 0.357, acute myocardial infarction (p = 0.315, dyslipidemia (p = 0.239, metabolic syndrome (p = 0.215 and ED.OSAS severity was not associated with ED in our sample. Conclusions: The prevalence of ED in OSAS patients is high. ED determinants in our sample were age and diabetes. Past smoking habits, hypertension and ACEI/ARB therapy also revealed a statistically significant association with ED. Resumo: Introdução: A SAOS (síndroma de apneia obstrutiva do sono define-se pela ocorrência frequente de obstrução da via aérea superior durante o sono, com m

  15. Erectile dysfunction, obesity, insulin resistance, and their relationship with testosterone levels in eugonadal patients in an andrology clinic setting.

    Science.gov (United States)

    Knoblovits, Pablo; Costanzo, Pablo R; Valzacchi, Gastón J Rey; Gueglio, Guillermo; Layus, Alberto O; Kozak, Andrea E; Balzaretti, Marta I; Litwak, León E

    2010-01-01

    Erectile dysfunction (ED) is associated with metabolic and endocrine diseases including obesity, metabolic syndrome (MS), and type 2 diabetes mellitus (DM2). Insulin resistance (IR), present in patients with obesity, MS, and DM2, causes disturbances in the signaling pathways required for nitric oxide production, with subsequent endothelial dysfunction. In addition, IR appears to alter testosterone production. We evaluated in eugonadal patients with ED: 1) the presence of obesity and IR, 2) testosterone levels and their association with obesity and IR, and 3) the degree of ED according to the presence of IR. In a prospective study, 78 eugonadal patients with ED (group P) were recruited and compared with 17 men without ED as a control group (group C). Erectile function was evaluated according to the International Index of Erectile Function 5 (IIEF-5). IR was measured by homeostasis model assessment (HOMA). IR was defined as HOMA of 3 or greater. Patients with ED had significantly higher body mass index (BMI), waist circumference (WC), HOMA values, and prevalence of IR when compared with group C. Total (TT) and bioavailable testosterone (BT) levels were lower in group P compared with group C. There was a significant negative correlation between HOMA and IIEF-5, HOMA and TT, WC and IIEF-5, WC and TT, and WC and BT. Group P patients with IR had higher WCs and lower IIEF-5 scores when compared with patients in group P without IR. In conclusion, patients with ED showed a higher BMI, WC, and HOMA and lower levels of TT and BT. There is a negative correlation between erectile function and IR and abdominal obesity. The TT levels are lower in patients with increased BMI, WC, and IR. However, a negative correlation was shown only between BT (biologically active fraction) and abdominal obesity.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  17. Constitutive NOS uncoupling and NADPH oxidase upregulation in the penis of type 2 diabetic men with erectile dysfunction.

    Science.gov (United States)

    Musicki, B; Burnett, A L

    2017-03-01

    Erectile dysfunction (ED) associated with type 2 diabetes mellitus (T2DM) involves dysfunctional nitric oxide (NO) signaling and increased oxidative stress in the penis. However, the mechanisms of endothelial NO synthase (eNOS) and neuronal NO synthase (nNOS) dysregulation, and the sources of oxidative stress, are not well defined, particularly at the human level. The objective of this study was to define whether uncoupled eNOS and nNOS, and NADPH oxidase upregulation, contribute to the pathogenesis of ED in T2DM men. Penile erectile tissue was obtained from 9 T2DM patients with ED who underwent penile prosthesis surgery for ED, and from six control patients without T2DM or ED who underwent penectomy for penile cancer. The dimer-to-monomer protein expression ratio, an indicator of uncoupling for both eNOS and nNOS, total protein expressions of eNOS and nNOS, as well as protein expressions of NADPH oxidase catalytic subunit gp91phox (an enzymatic source of oxidative stress) and 4-hydroxy-2-nonenal [4-HNE] and nitrotyrosine (markers of oxidative stress) were measured by western blot in this tissue. In the erectile tissue of T2DM men, eNOS and nNOS uncoupling and protein expressions of NADPH oxidase subunit gp91phox, 4-HNE- and nitrotyrosine-modified proteins were significantly (p penis may involve uncoupled eNOS and nNOS and NADPH oxidase upregulation. Our description of molecular factors contributing to the pathogenesis of T2DM-associated ED at the human level is relevant to advancing clinically therapeutic approaches to restore erectile function in T2DM patients. © 2017 American Society of Andrology and European Academy of Andrology.

  18. Erectile dysfunction and constructs of masculinity and quality of life in the multinational Men's Attitudes to Life Events and Sexuality (MALES) study.

    Science.gov (United States)

    Sand, Michael S; Fisher, William; Rosen, Raymond; Heiman, Julia; Eardley, Ian

    2008-03-01

    The Men's Attitudes to Life Events and Sexuality (MALES) study assessed the prevalence and correlates of erectile dysfunction, and examined men's attitudes and behavior in relation to this dysfunction. To report on the attitudes of men, with and without self-reported erectile dysfunction, concerning masculine identity and quality of life. The MALES Phase I study included 27,839 randomly selected men (aged 20-75 years) from eight countries (United States, United Kingdom, Germany, France, Italy, Spain, Mexico, and Brazil) who responded to a standardized computer-assisted telephone interview. Perceptions of masculinity and quality of life in men with and without erectile dysfunction. Men's perceptions of masculinity differed substantially from stereotypes in the literature. Men reported that being seen as honorable, self-reliant, and respected by friends were important determinants of self-perceived masculinity. In contrast, factors stereotypically associated with masculinity, such as being physically attractive, sexually active, and successful with women, were deemed to be less important to men's sense of masculinity. These findings appeared consistently across all nationalities and all age groups studied. For quality of life, factors that men deemed of significant importance included good health, harmonious family life, and a good relationship with their wife/partner. Such factors had significantly greater importance to quality of life than concerns such as having a good job, having a nice home, living life to the full, or having a satisfying sex life. Of note, rankings of constructs of masculinity and quality of life did not meaningfully differ in men with or without erectile dysfunction, and men with erectile dysfunction who did or did not seek treatment for their sexual dysfunction. The present findings highlight the significance of partnered relationships and interpersonal factors in the management of erectile dysfunction, and empirically challenge a number of

  19. Oral sildenafil citrate (viagra) for erectile dysfunction: a systematic review and meta-analysis of harms.

    Science.gov (United States)

    Tsertsvadze, Alexander; Yazdi, Fatemeh; Fink, Howard A; MacDonald, Roderick; Wilt, Timothy J; Bella, Anthony J; Ansari, Mohammed T; Garritty, Chantelle; Soares-Weiser, Karla; Daniel, Raymond; Sampson, Margaret; Moher, David

    2009-10-01

    To summarize and compare evidence on harms in sildenafil- and placebo-treated men with erectile dysfunction (ED) in a systematic review and meta-analysis. Randomized placebo-controlled trials (RCTs) were identified using an electronic search in MEDLINE, EMBASE, PsycINFO, SCOPUS, and Cochrane CENTRAL. The rates of any adverse events (AEs), most commonly reported AEs, withdrawals because of adverse events, and serious adverse events were ascertained and compared between sildenafil and placebo groups. The results of men with ED were stratified by clinical condition(s). Statistical heterogeneity was explored. Meta-analyses based on random-effects model were also performed. A total of 49 RCTs were included. Sildenafil-treated men had a higher risk for all-cause AEs (RR = 1.56, 95% CI: 1.38, 1.76), headache, flushing, dyspepsia, and visual disturbances compared with placebo-treated men. The magnitude of excess risk was greater in fixed- than in flexible-dose trials. The rates of serious adverse events and withdrawals because of adverse events did not differ in sildenafil vs placebo groups. A higher dose of sildenafil corresponded to a greater risk of AEs. The increased risk of harms was observed within and across clinically defined specific groups of patients. There was a lack of RCTs reporting long-term (>6 months) harms data. In short-term trials, men with ED randomized to sildenafil had an increased risk of all-cause any AEs, headache, flushing, dyspepsia, and visual disturbances. The exploration of different modes of dose optimization of sildenafil may be warranted.

  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. Erectile dysfunction in patients taking psychotropic drugs and treated with phosphodiesterase-5 inhibitors

    Directory of Open Access Journals (Sweden)

    Rossella Mazzilli

    2018-03-01

    Full Text Available Objectives: The aim of this study was to assess the prevalence of patients with Erectile Dysfunction (ED receiving psychotropic drugs, the impact of these drugs on hormonal profile, and the efficacy of PDE5-i in these patients. Materials and methods: We recruited 1872 patients referring for ED to our Andrology Unit. Assessment included serum testosterone, gonadotropins, TSH, prolactin, and PSA, and the IIEF-5 questionnaire for ED diagnosis. Inclusion criteria were age 21-75 years and IIEF-5 total score ≤ 21; exclusion criteria included hypogonadism, diabetes mellitus, previous prostatectomy, other medication intake, and ED diagnosis prior to psychotropic drug treatment. Efficacy was rated with the IIEF-5 (remission: total score ≥ 22. Results: The prevalence of ED patients treated with psychotropic drugs since ≥ 3 months was 9.5% (178/1872, subdivided according to the drugs used into: Group A, 16 patients treated with atypical antipsychotics (9.0%; Group B, 55 patients with benzodiazepines (30.9%; Group C, 33 patients with antidepressant drugs (18.5%; and Group D, 74 patients with multiple psychotropic drugs (41.6%. Patients in Group A were significantly younger than other groups (p < 0.05. The hormonal profile presented only higher prolactin level in patients treated with antipsychotics, alone or in combination (p < 0.05. Overall, 146 patients received PDE5-i. Remission rate, after three months of treatment, was significantly higher in Group B compared to C and D groups (p < 0.05. Conclusions: A substantial portion of patients receiving psychotropic drugs show ED. Sexual performance in these patients benefits from PDE5-i. Age, effects of psychiatric disorders, psychotropic drugs, and PDE5-i treatment modality accounted for variability of response in this sample.

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

    Directory of Open Access Journals (Sweden)

    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.

  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, Pprosthesis group was higher than in the malleable prosthesis group (P<0.05). Satisfaction, however, between the types of prostheses, did not differ in the partner survey. PPI is a safe and effective treatment option for Chinese patients 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. Role of Caffeine Intake on Erectile Dysfunction in US Men: Results from NHANES 2001-2004.

    Science.gov (United States)

    Lopez, David S; Wang, Run; Tsilidis, Konstantinos K; Zhu, Huirong; Daniel, Carrie R; Sinha, Arup; Canfield, Steven

    2014-01-01

    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.

  5. Importance of Different Grades of Abdominal Obesity on Testosterone Level, Erectile Dysfunction, and Clinical Coincidence.

    Science.gov (United States)

    Fillo, Juraj; Levcikova, Michaela; Ondrusova, Martina; Breza, Jan; Labas, Peter

    2017-03-01

    The aim of the current study was to investigate the influence of different grades of abdominal obesity (AO) on the prevalence of testosterone deficiency syndrome (TDS), erectile dysfunction (ED), and metabolic syndrome (MetS). In a cross-sectional descriptive study, a total of 216 males underwent a complete urological, internal, and hormonal evaluation. Males were divided according to waist circumference into five groups: less than 94 cm (Grade [G] 0), 94 to 101 cm (G1), 102 to 109 cm (G2), 110 to 119 cm (G3), and more than 120 cm (G4). Incidence of ED, TDS, and MetS was compared in these groups and in participants without AO. Some degree of ED was identified in 74.7% of males with AO. In G1, there were 61% of males with ED, in G2 68%, in G3 83%, and in G4 87%. A strong correlation between testosterone (TST) level and AO was identified. Ninety-eight out of 198 (49.5%) males with AO and 1/18 (5.5%) males without AO had TDS. There were significant differences between individual groups. In the group of males with AO G4 (more than 120 cm), 87.1% had TDS. MetS was diagnosed in 105/198 (53.0%) males with AO, but in G4, 83.9% of males with AO had MetS. Males older than 40 years of age with AO have a higher incidence of ED, TDS, and MetS. Dividing males into five groups according to waist circumference seems to be reasonable. With growing AO, there were significantly more males with ED, TDS, and MetS.

  6. 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

    2013-01-01

    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, Preported by 178 men (88.6%), and overall satisfaction with the PPI surgery was reported by 89.0% of men and 82.5% of partners. Patient satisfaction in the three-piece inflatable prosthesis group was higher than in the malleable prosthesis group (P<0.05). Satisfaction, however, between the types of prostheses, did not differ in the partner survey. PPI is a safe and effective treatment option for Chinese patients 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. PMID:23872664

  7. Lack of information underlies women's perceptions of erectile dysfunction (ED) drugs in Japan.

    Science.gov (United States)

    Mita, Koji; Kakehashi, Masayuki; Hasegawa, Yasuhisa; Inoue, Yoji; Shigeta, Masanobu; Matsubara, Akio; Usui, Tsuguru

    2008-12-01

    Some Japanese women are known to have negative attitudes toward erectile dysfunction (ED) drugs, but the environment underlying these perceptions is unclear. To reveal the underlying environment that shapes women's perceptions of ED drugs in Japan. A web-based questionnaire was conducted through an Internet-based market research company. A total of 2,593 women in five age groups (20s, 30s, 40s, 50s, and 60s or older) were randomly invited to participate in this study, with an almost equal number in each age group. The questionnaire contained 30 items related to individual background and sexual information, concerns about the image of ED drugs, ED drug-related perceptions, and attitude toward sexual information media. The women's attitude and the independent predictors that affect their partner's use of ED drugs were clarified. Answers were obtained from 1,077 women, of whom 35.4% (n=381) had a negative image of ED drugs. Although 69.5% (n=749) agreed that a sexual relationship with a male partner was important, only 26.7% (n=288) agreed that this remained important if ED drugs were used. However, 56.7% (n=611) and 57.7% (n=621) of respondents, respectively, answered that they would allow their partner's use of ED drugs if they imagined that they understood the safety and effectiveness of ED drugs and that their quality of life was improved by their partner's use of the drugs. Lack of information about ED drugs was a significant predictor for acceptance of a partner's use of ED drugs among women with a negative image of ED drugs, since they were more likely to accept the use of these drugs if they were convinced about their safety and effectiveness or positive effect on quality of life. Lack of information about ED drugs may influence the perception of women in Japan regarding these drugs.

  8. 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

  9. [Effectiveness and treatment satisfaction in patients with erectile dysfunction in Spain: EDOS study].

    Science.gov (United States)

    Martín-Morales, A; Gutiérrez Hernández, P R; Meijide Rico, F; Arrondo Arrondo, J L; Turbí Disla, C

    2010-04-01

    Erectile dysfunction (ED) is a worldwide health problem with an ever increasing prevalence, affecting the quality of life of many patients. The aim of this study was to describe treatment effectiveness and patient satisfaction with ED treatment in the Spanish cohort of the EDOS study. This observational, pan-European study, assessed treatment effectiveness and patient satisfaction with ED treatment under routine clinical settings, using standard questionnaires. Men > or =18 years about to initiate or change ED treatment were enrolled. Patients were assessed at baseline, 3 and 6 months. A total of 1,029 patients were analyzed (12.8% of the total European sample). In general, the Spanish population characteristics are consistent with the overall population. At baseline 56.6% of patients received tadalafilo, 16.6% sildenafilo, 19.6% vardenafilo, and 7.2% received other treatments. At 3 months, a higher proportion of patients on tadalafil reported improved erections (GAQ 1: 96.5% tadalafil, 85.7% sildenafil and 87.2% vardenafil), satisfaction with treatment (EDITS: 84.2% tadalafil, 75.0% sildenafil and 76.0% vardenafil), and sexual self confidence (SF-PAIRS: 2.73 tadalafil, 2.39 sildenafil and 2.55 vardenafil), in comparison with sildenafil and vardenafil. At 6 months, differences between treatments were not significant. The mean+/-SD time elapsed from drug intake to sexual intercourse was higher for patients on tadalafil (18.6+/-26.4 h) compared to sildenafil (3.6+/-7.5) and vardenafil (8.6+/-19.4). The longer duration of action for tadalafil, and thus, the longer period of time between dosing and sexual intercourse may contribute to enhance sexual spontaneity, patient satisfaction with the treatment and greater self-confidence.

  10. Determination of human angiotensin converting enzyme (ACE) gene polymorphisms in erectile dysfunction: frequency differences of ACE gene polymorphisms according to the method of analysis.

    Science.gov (United States)

    Kim, D S; Choi, S I; Lee, H S; Park, J K; Yi, H K

    2001-01-01

    The D polymorphism of angiotensin converting enzyme (ACE) gene has been found to be associated with various diseases, and ACE may also be involved in the pathogenesis of erectile dysfunction. On the other hand, interpretation of the data on the association of DD genotype with various diseases is controversial, due to methodological and technical variations in detection of the polymorphisms. We investigated a possible association between the DD genotype and erectile dysfunction in a Korean population, and compared the frequency of ACEgenotypes using our multiplexed PCR method with those based on the conventional PCR method in a sample of erectile dysfunctional and control subjects. There was significant difference in the distribution of ACE genotypes between the erectile dysfunctional (conventional PCR) and the control subjects (multiplexed PCR) (chi2=7.395, p0.05) when our multiplexed PCR method was used. Therefore our results suggest that especially the conventional PCR method for ACE gene polymorphism may require careful control and may need repeated testing to verify the insertion deletion (ID) heterozygotes, and that a multiplexed PCR method can markedly increase the detection rate of the I allele in ID heterozygotes. No association was found between I/D polymorphism and erectile dysfunctional subjects in the Korean population studied.

  11. A phase 3, placebo controlled study of the safety and efficacy of avanafil for the treatment of erectile dysfunction after nerve sparing radical prostatectomy.

    Science.gov (United States)

    Mulhall, John P; Burnett, Arthur L; Wang, Run; McVary, Kevin T; Moul, Judd W; Bowden, Charles H; DiDonato, Karen; Shih, Winnie; Day, Wesley W

    2013-06-01

    We evaluated the safety and efficacy of 100 and 200 mg avanafil for the treatment of adult males with erectile dysfunction after bilateral nerve sparing radical prostatectomy. This was a double-blind, placebo controlled, parallel group, phase 3 study in males age 18 to 70 years with a history of erectile dysfunction of 6 months or more after bilateral nerve sparing radical prostatectomy. Patients were randomized to 100 or 200 mg avanafil or placebo (taken 30 minutes before sexual activity) for 12 weeks. Primary end points included successful vaginal insertion (Sexual Encounter Profile [SEP] question 2), successful intercourse (SEP3) and change in score on the erectile function domain of the International Index of Erectile Function (IIEF-EF) questionnaire. A total of 298 patients were randomized and 84.6% completed the study. At baseline 16.1% were age 65 years or older and 71.5% had severe erectile dysfunction (mean overall IIEF-EF domain score 9.2). After 12 weeks there were significantly greater increases in SEP2 and SEP3 and change in mean IIEF-EF domain score with 100 and 200 mg avanafil vs placebo (p erectile function after prostatectomy. Results suggest a rapid onset of action and sustained duration of effect, with all 3 primary end points being achieved at both dose levels. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  12. Erectile dysfunction drug receipt, risky sexual behavior and sexually transmitted diseases in HIV-infected and HIV-uninfected men.

    Science.gov (United States)

    Cook, Robert L; McGinnis, Kathleen A; Samet, Jeffrey H; Fiellin, David A; Rodriguez-Barradas, Maria C; Rodriquez-Barradas, Maria C; Kraemer, Kevin L; Gibert, Cynthia L; Braithwaite, R Scott; Goulet, Joseph L; Mattocks, Kristin; Crystal, Stephen; Gordon, Adam J; Oursler, Krisann K; Justice, Amy C

    2010-02-01

    Health care providers may be concerned that prescribing erectile dysfunction drugs (EDD) will contribute to risky sexual behavior. To identify characteristics of men who received EDD prescriptions, determine whether EDD receipt is associated with risky sexual behavior and sexually transmitted diseases (STDs), and determine whether these relationships vary for certain sub-groups. Cross-sectional study. Two thousand seven hundred and eighty-seven sexually-active, HIV-infected and HIV-uninfected men recruited from eight Veterans Health Affairs outpatient clinics. Data were obtained from participant surveys, electronic medical records, and administrative pharmacy data. EDD receipt was defined as two or more prescriptions for an EDD, risky sex as having unprotected sex with a partner of serodiscordant or unknown HIV status, and STDs, according to self-report. Overall, 28% of men received EDD in the previous year. Eleven percent of men reported unprotected sex with a serodiscordant/unknown partner in the past year (HIV-infected 15%, HIV-uninfected 6%, P sexual behavior (11% vs. 10%, p = 0.9) and STDs (7% vs 7%, p = 0.7). In multivariate analyses, EDD receipt was not significantly associated with risky sexual behavior or STDs in the entire sample or in subgroups of substance users or men who had sex with men. EDD receipt was common but not associated with risky sexual behavior or STDs in this sample of HIV-infected and uninfected men. However, risky sexual behaviors persist in a minority of HIV-infected men, indicating ongoing need for prevention interventions.

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

    Directory of Open Access Journals (Sweden)

    Ghafoori M

    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.

  14. Erectile dysfunction in type 2 diabetic men: relationship to exercise fitness and cardiovascular risk factors in the Look AHEAD trial.

    Science.gov (United States)

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

    2009-05-01

    Determinants of erectile dysfunction in diabetic men have not been adequately investigated as potential mediators of change. To determine the prevalence and correlates of erectile dysfunction (ED) in overweight men with type 2 diabetes in the multicenter, Look AHEAD trial (Action for Health in Diabetes). International Index of Erectile Function (IIEF), self-reported use of phosphodiesterase type 5 inhibitors, laboratory measures of adiposity, cardiometabolic parameters, and exercise fitness. Male participants aged 45-75 in the Look AHEAD trial in a committed relationship were recruited for an ongoing study of sexual function and diabetes. Eligible participants completed the IIEF questionnaire and provided updated information on use of medical treatments for sexual dysfunction. Baseline sexual function results for participants in the male ancillary study are reported here; intervention data and results for female participants are presented elsewhere. A total of 373 eligible male participants completed all sexual function questionnaires, of whom 263 (68.7%) were sexually active at the time of the study. Almost half (49.8%) of the men reported mild or moderate degrees of ED, and 24.8% had complete ED. Among sexually active participants, 42.6% had sought medical help for their problem, and 39.7% reported use of ED medications. ED was significantly associated with age (odds ratio [OR] = 1.05; confidence interval [CI]: 1.01-1.10) baseline HbA(1c) (OR = 1.31; CI: 1.05-1.63), hypertension history (OR = 2.41; CI: 1.34-4.36), and metabolic syndrome (OR = 3.05, CI: 1.31-7.11). Of note, cardiorespiratory fitness was found to be protective of ED in a multivariable analysis (OR = 0.61; P type 2 diabetic men in the Look AHEAD study. Cardiovascular risk factors were highly associated with ED in this population, and cardiorespiratory fitness was protective in this analysis.

  15. 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.

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

    Science.gov (United States)

    Cameron, Ann; Tomlin, Molly

    2007-01-01

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

  17. 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.

  18. A Holistic Treatment Approach to Male Erectile Disorder.

    Science.gov (United States)

    Millner, Vaughn S.; Ullery, Elizabeth K.

    2002-01-01

    This article offers information about erectile functioning, provides a DSM-IV-TR interpretation of erectile dysfunction, and discusses a biophysical approach to erectile dysfunction treatment. (Contains 36 references.) (GCP)

  19. Barry shunt for treatment of a 76-hour stuttering priapism without subsequent erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Osmonov DK

    2014-07-01

    Full Text Available Daniar Kurmanbekovich Osmonov, Aleksey Aksenov, Andrea Nathaly Guerra Sandoval, Almut Kalz, Klaus Peter Juenemann Department of Urology and Pediatric Urology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany Introduction: This paper reports treatment of a 76-hour low-flow priapism with a shunting procedure that was first described by Barry in 1976. We were able to observe the preservation of erectile function despite the long period of ischemia. A review of the literature shows that there are few reports of erectile function recovery after a priapism of similar duration. Materials and methods: A 42-year-old patient presented with a 76-hour priapism, probably caused by consumption of alcohol and illegal drugs. A Barry Shunt procedure was performed. The erectile function of the patient was assessed by means of International Index of Erectile Function score over a follow-up period of 30 months. Moreover, we reviewed different surgical options for treatment of priapism in the literature. Results: Partial return of erection without sexual arousal occurred on two occasions during the 10-day hospitalization, but was treated by manipulation of the penis, ie, by milking the tumescence into the shunt. After 3 months, the shunt was still palpable as a subcutaneous swelling. Six months postoperatively, the residual swelling had disappeared. The International Index of Erectile Function score was of 21 without phosphodiesterase type 5 inhibitors after a follow-up of 2.5 years. Conclusion: Barry shunt is an effective alternative surgical option for the treatment of low-flow priapism. In the case of our patient, it was also effective after a 76-hour-lasting priapism. Keywords: low flow priapism, erectile function, cavernovenous shunt, surgical treatment of stuttering priapism

  20. 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

  1. Hormone abnormalities are not related to the erectile dysfunction and decreased libido found in many men with infertility.

    Science.gov (United States)

    Satkunasivam, Raj; Ordon, Michael; Hu, Brian; Mullen, Brendan; Lo, Kirk; Grober, Ethan; Jarvi, Keith

    2014-06-01

    To evaluate whether hormonal markers predict erectile dysfunction (ED) and symptoms of T deficiency syndrome (TDS), which are commonly found in the population of infertile men. Retrospective study utilizing a prospectively maintained infertility database. A tertiary referral center. A total of 1,750 of 2,783 men presenting for evaluation of infertility between 1995 and 2010 completed validated questionnaires. Androgen Deficiency in the Aging Male (ADAM) and Sexual Health Inventory for Men questionnaires were administered. Baseline risk factors for ED and TDS were also measured. Subjects underwent serum hormone evaluation for total T, calculated bioavailable T, sex hormone-binding globulin, E2, LH, FSH, and PRL. Multivariable logistic regression modeling was used to determine the significance of hormonal markers in predicting ED (Sexual Health Inventory for Men score <22) and/or a positive ADAM score. The prevalence of ED and a positive response to the ADAM questionnaire were 30.5% and 45.2%, respectively, in this population (mean age, 36 years). Low serum T (total T < 10 nmol/L) was found in 29.4%. Neither T nor bioavailable T was significantly associated with the symptoms of ED or TDS on multivariable regression analysis. Erectile dysfunction and TDS in young, infertile men seem to be unrelated to hormone changes. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  2. Adipose-Derived Stem Cell-Derived Exosomes Ameliorate Erectile Dysfunction in a Rat Model of Type 2 Diabetes.

    Science.gov (United States)

    Chen, Fengzhi; Zhang, Haibo; Wang, Zhiqiang; Ding, Wei; Zeng, Qinyu; Liu, Wenbing; Huang, Can; He, Shuhua; Wei, Anyang

    2017-09-01

    The efficacy of adipose-derived stem cells (ADSCs) in alleviating erectile dysfunction (ED) of diabetic rats has been demonstrated mainly through a paracrine effect. However, exosomes (EXOs), which are important bioactive substance vectors secreted by ADSCs, have never been associated with ED. To investigate the effect of ADSC-derived EXOs on erectile function in a type 2 diabetic ED rat model. EXOs were isolated from the supernatants of cultured ADSCs by ultracentrifugation. We constructed a type 2 diabetic rat model using a high-fat diet and low-dose streptozotocin administered by intraperitoneal injection. In total, 24 diabetic rats were randomly assigned to three groups and were treated with an intracavernous injection of ADSC-derived EXOs, ADSCs, or phosphate buffered saline. Another eight age-matched rats underwent sham operation and composed the normal control group. Intracavernous pressure and mean arterial pressure testing and histologic and western blot analyses were performed 4 weeks after the intracavernous injection. ADSC-derived EXOs and ADSCs administered by intracavernous injection led to an increase in the ratio of intracavernous pressure to mean arterial pressure compared with that for phosphate buffered saline treatment. Histologic and western blot analyses demonstrated an increased ratio of smooth muscle to collagen, increased expression of an endothelial marker (CD31), a smooth muscle marker (α-smooth muscle actin), and antiapoptotic protein Bcl-2 and decreased the expression of the apoptotic protein cleaved caspase-3 and apoptosis of endothelial and smooth muscle cells in the corpus cavernosum tissue after EXO or ADSC injection compared with values for the phosphate buffered saline treatment. The present results are expected to provide a scientific foundation for clinical application in the near future. Although the results demonstrated that intracavernous injection of ADSC-derived EXOs could ameliorate ED of diabetic rats, the optimum dose

  3. Metabolic syndrome in men with low testosterone levels: relationship with cardiovascular risk factors and comorbidities and with erectile dysfunction.

    Science.gov (United States)

    García-Cruz, Eduardo; Leibar-Tamayo, Asier; Romero, Javier; Piqueras, Marta; Luque, Pilar; Cardeñosa, Oscar; Alcaraz, Antonio

    2013-10-01

    Testosterone deficiency and metabolic syndrome (MetS) are strongly associated. Patients consulting for sexual dysfunction may have testosterone deficiency, providing a valuable opportunity to assess MetS. The identification of variables predicting MetS is of great importance. To identify cardiovascular comorbidities and risk factors, including erectile dysfunction (ED), associated with MetS in men aged≥45 with total testosterone (TT)testosterone was testosterone deficiency. Subjects with data for MetS assessment were included in this analysis. Other data available were anthropometrics, toxic habits, cardiovascular comorbidities, ED diagnosis, and TT values. The MetS harmonized definition was used. Waist circumference threshold was 94 cm. ED was diagnosed and classified using the International Index of Erectile Function-5 (IIEF-5) questionnaire. Bivariate and multivariate logistic regression analyses were performed to calculate odds ratios (ORs) for MetS. Mean age was 61.2±8.1 years. Prevalences of ED and MetS were 97.6% and 69%, respectively, both increasing with age. Bivariate analysis showed that moderate or severe ED, obesity, and peripheral vascular disease (PVD) were the variables associated with the greatest odds of MetS (OR=2.672 and 2.514, respectively), followed by alcohol intake (OR=1.911). Tobacco use, ag,e and testosterone deficiency severity had a minimal effect that disappeared on multivariate analysis. Elevated triglycerides and HDL-cholesterol were MetS risk factors associated with a lower TT level. The high prevalence of MetS among men with testosterone deficiency highlights the opportunity to assess cardiovascular health in patients consulting for sexual dysfunction. Moderate to severe ED, obesity, PVD, and alcohol intake significantly increase the likelihood of MetS. © 2013 International Society for Sexual Medicine.

  4. Efficacy of vardenafil and influence on self-esteem and self-confidence in patients with severe erectile dysfunction.

    Science.gov (United States)

    Martin-Morales, Antonio; Meijide, Fernando; García, Nicolás; Artes, Maite; Muñoz, Ana

    2007-03-01

    To assess the efficacy of vardenafil in a population of Spanish men with erectile dysfunction (ED), its influence on patients' self-esteem and self-confidence, and its effect on their quality of life. Efficacy was assessed by the International Index of Erectile Function-Erectile Function (IIEF-EF) domain, the Rosenberg Self-Esteem scale, the Johnson and McCoy Self-Confidence scale, the Medical Outcome Short Form (SF-36) scale, items 2 and 3 of the Sexual Encounter Profile questionnaire, and the Global Assessment Question (GAQ). Safety assessments included laboratory tests, physical exam, electrocardiogram, vital signs, and adverse events. This was a randomized, double-blind, multicenter, placebo-controlled study. After a 4-week treatment-free period, patients received flexible-dose vardenafil or placebo for 12 weeks. The initial dose was 10 mg, which could be titrated up to 20 mg or down to 5 mg at weeks 4 and 8. A total of 121 patients were included in the intention-to-treat analysis (61 on vardenafil and 60 on placebo). Of these, 16 in the vardenafil group and 14 in the placebo group had severe ED. There was a greater improvement in IIEF-EF domain score with vardenafil vs. placebo for all patients (score change of 10.9 vs. 1.6, respectively, P self-esteem compared with patients receiving placebo (change from baseline -1.51 vs. 3.54, respectively, P = 0.036). Vardenafil treatment was well tolerated. Vardenafil was highly effective for improving EF in all patients with ED, and resulted in significant improvements in self-esteem in patients with severe ED.

  5. Effects of Next-Generation Low-Energy Extracorporeal Shockwave Therapy on Erectile Dysfunction in an Animal Model of Diabetes

    Directory of Open Access Journals (Sweden)

    Hyun Cheol Jeong

    2017-12-01

    Full Text Available Purpose: Gene therapy, stem cell therapy, and low-energy extracorporeal shockwave therapy (ESWT have been investigated as treatments for refractory erectile dysfunction (ED, but inconclusive evidence has been obtained. We investigated the effect of a next-generation electromagnetic cylinder ESWT device on an animal model of ED. Materials and Methods: Diabetes mellitus (DM-induced rats were divided into 3 groups: group 1, control; group 2, DM; and group 3, DM+ESWT. Rats were treated with ESWT 3 times a week for 2 weeks. After the treatment course, intracavernous pressure was measured and the corpus cavernosum and cavernous nerve were evaluated. Results: In the DM group, all parameters predicted to be significantly lower in the ED model had statistically significantly decreased (p<0.01. As a measurement of erectile function, intracavernous pressure was evaluated. The DM+ESWT group exhibited significantly restored erectile function compared to the DM group (p<0.05. Moreover, ESWT treatment restored smooth muscle content, as assessed by Masson’s trichrome staining (p<0.05. Finally, corporal tissue and the dorsal nerve were evaluated by immunohistochemistry, Western blotting, and ELISA. After ESWT treatment, vascular endothelial growth factor (VEGF, endothelial nitric oxide synthase (eNOS, platelet endothelial cell adhesion molecule-1, cyclic guanosine monophosphate, and neuronal nitric oxide synthase (nNOS expression levels were restored to levels in the DM group (p<0.05. Conclusions: Electromagnetic cylinder ESWT device resulted in increased VEGF, nNOS, and eNOS expression; reduced smooth muscle atrophy; and increased endothelial cell regeneration in a DM-associated ED model. Our data suggest that safe and effective application could be possible in future clinical studies.

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

    International Nuclear Information System (INIS)

    Incrocci, Luca; Koper, Peter C.M.; Hop, Wim C.J.; Slob, A. Koos

    2001-01-01

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

  7. Effect of Linear Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction-12-Month Follow-Up of a Randomized, Double-Blinded, Sham-Controlled Study

    DEFF Research Database (Denmark)

    Fojecki, Grzegorz Lukasz; Tiessen, Stefan; Sloth Osther, Palle Jørn

    2018-01-01

    INTRODUCTION: Short-term data on the effect of low-intensity extracorporeal shockwave therapy (Li-ESWT) on erectile dysfunction (ED) have been inconsistent. The suggested mechanisms of action of Li-ESWT on ED include stimulation of cell proliferation, tissue regeneration, and angiogenesis, which...... can be processes with a long generation time. Therefore, long-term data on the effect of Li-ESWT on ED are strongly warranted. AIM: To assess the outcome at 6 and 12 months of linear Li-ESWT on ED from a previously published randomized, double-blinded, sham-controlled trial. METHODS: Subjects with ED...... (N = 126) who scored lower than 25 points in the erectile function domain of the International Index of Erectile Function (IIEF-EF) were eligible for the study. They were allocated to 1 of 2 groups: 5 weekly sessions of sham treatment (group A) or linear Li-ESWT (group B). After a 4-week break, the 2...

  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 relationship between erectile dysfunction severity, mean platelet volume and vitamin D levels.

    Science.gov (United States)

    Culha, Mehmet Gokhan; Atalay, Hasan Anil; Canat, Halil Lutfi; Alkan, Ilter; Ozbir, Sait; Can, Osman; Otunctemur, Alper

    2018-04-04

    The aim of this study was to evaluate the relationship between mean platelet volume (MPV) and vitamin D levels according to ED severity. Between October 2015 and September 2017, patients who applied to the andrology outpatient clinic with an ED complaint were retrospectively reviewed. Patients with diabetes, hypertension, hyperlipidemia, malignancy, late-onset hypogonadism and smokers were not included in the study. The International Erectile Function Index-Erectile Function (IIEF-EF) questionnaire was used to assess the levels of erectile function. According to this scoring system, patients were divided into two groups. IIEF score: between 17 and 25 = mild ED (Group 1) and IIEF score between 16 and 0 = moderate-severe ED (Group 2). Blood samples of the patients were taken from antecubital vein and MPV and 25-hydroxyvitamin D [25(OH)D] levels were evaluated. Ninety patients were included in the study (Group 1: n = 41, Group 2: n = 49). The mean age of the patients was 41.07 ± 8.56 and the mean body mass index (BMI) was 27.59 ± 3.91. 25(OH)D levels were found to be statistically lower in Group 2 (18.85 ± 6.09; 13.98 ± 7.10; p = .001). MPV levels were found to be statistically higher in Group 2 (10.05 ± 0.81; 10.78 ± 1.16; p = .001). Correlation between IIEF-EF scores and 25(OH)D levels was positive (p = .03, r = 0.22). There was negative correlation between IIEF-EF scores and MPV and between 25(OH)D levels and MPV levels [p = .003 for IIEF-EF/MPV, p = .04, r = -0.23 for 25(OH)D/MPV]. There is a significant positive correlation between ED severity and 25(OH)D levels and there is a significant negative correlation between ED severity and MPV levels.

  10. Erectile Dysfunction in Male Survivors of Childhood Cancer-A Report From the Childhood Cancer Survivor Study.

    Science.gov (United States)

    Ritenour, Chad W M; Seidel, Kristy D; Leisenring, Wendy; Mertens, Ann C; Wasilewski-Masker, Karen; Shnorhavorian, Margarett; Sklar, Charles A; Whitton, John A; Stovall, Marilyn; Constine, Louis S; Armstrong, Gregory T; Robison, Leslie L; Meacham, Lillian R

    2016-06-01

    With survival rates higher than 80%, the number of survivors from pediatric cancer continues to increase. Late effects resulting from cancer and cancer therapy are being characterized, but little information exists on sexual health for men who have survived childhood cancer. To assess erectile dysfunction (ED) in men who survived childhood and adolescent cancers and to identify potential risk factors for ED. In total, 1,622 men and 271 eligible brothers in the Childhood Cancer Survivor Study cohort completed the Male Health Questionnaire, which provided information on sexual practices and sexual function. Combined with demographic, cancer, and treatment information from medical record abstraction, results of the Male Health Questionnaire were analyzed using multivariable modeling. The International Index of Erectile Function was used to identify ED in subjects. International Index of Erectile Function. Survivors (mean age = 37.4 years, SD = 7.3 years) reported significantly lower sexual activity in the year before the survey than the brothers (mean age = 38.8 years, SD = 8.5 years) without cancer. ED was reported by 12.3% (95% CI = 10.4-14.3) of survivors and 4.2% (95% CI = 2.0-7.9) of brothers. Survivors showed significantly higher relative risk (RR) for ED (RR = 2.63, 95% CI = 1.40-4.97). In addition to older age, survivors who were exposed to higher-dose (≥10 Gy) testicular radiation (RR = 3.55, 95% CI = 1.53-8.24), had surgery on the spinal cord or nerves (RR = 2.87, 95% CI = 1.36-6.05), prostate surgery (RR = 6.56, 95% CI = 3.84-11.20), or pelvic surgery (RR = 2.28, 95% CI = 1.04-4.98) were at higher risk for ED. Men who have survived childhood cancer have a greater than 2.6-fold increased risk for ED and certain cancer-specific treatments are associated with increased risk. Attention to sexual health, with its physical and emotional implications, and opportunities for early detection and intervention in these individuals could be important

  11. Variations of the internal pudendal artery as a congenital contributing factor to age at onset of erectile dysfunction in Japanese.

    Science.gov (United States)

    Kawanishi, Yasuo; Muguruma, Hiroshi; Sugiyama, Hiroaki; Kagawa, Junichirou; Tanimoto, Syuji; Yamanaka, Masahito; Kojima, Keiji; Numata, Akira; Kishimoto, Tomoteru; Nakanishi, Ryoichi; Kanayama, Hiro-omi

    2008-03-01

    To investigate the relationship between variations of the pelvic artery arrangement and the age at erectile dysfunction (ED) onset, as some men develop ED while relatively young, while others maintain erectile function into old age despite having cardiovascular diseases, thus congenital factors might be involved. We examined 290 units of internal iliac arteries (IIA) in 145 patients showing repeated incomplete erectile response to intracavernosal injections with prostaglandin E(1). Patients with cardiovascular risk factors, neurological disease or pelvic injury were excluded. The pelvic artery arrangement, evaluated by three-dimensional computed tomographic angiography, was classified anatomically into five types: Type 1 (normal or basic type), in which the internal pudendal artery (IPA) originates from the anterior trunk at the level between the linea terminalis and the major ischial notch; Type 2, the IPA originates from the anterior trunk of the IIA at the level of the major ischial notch or more distally; Type 3, the IPA originates directly from the IIA at a level proximal to the linea terminalis; Type 4, the IPA originates together with the superior and inferior gluteal artery within 1 cm of each other; and Type 5, the penile blood supply is dependent on arteries other than the IPA, such as the obturator artery. Among the 290 units, eight could not be classified due to poor image quality. There were no statistically significant differences in blood flow parameters among the types of IIAs, but there was a statistically significant difference in the IPA type at the age of onset of ED. Type 1 (153 units or 53%) anatomy, was more common in patients who developed ED at an advanced age. Types 2, 3 and 4 were more common in patients with onset of ED at an early age (log-rank test P < 0.001, P = 0.044, P < 0.001, respectively). Compared with patients with the common type of IIAs bilaterally, patients with any of the variations bilaterally are at risk of early onset of

  12. Effects of a water-soluble curcumin protein conjugate vs. pure curcumin in a diabetic model of erectile dysfunction.

    Science.gov (United States)

    Abdel Aziz, Mohamed Talaat; Motawi, Tarek; Rezq, Ameen; Mostafa, Taymour; Fouad, Hanan H; Ahmed, Hanan H; Rashed, Laila; Sabry, Dina; Senbel, Amira; Al-Malki, A; El-Shafiey, Raghda

    2012-07-01

    Curcumin is involved in erectile signaling via elevation of cyclic guanosine monophosphate (cGMP). Assessment of the effects of water-soluble curcumin in erectile dysfunction (ED). One hundred twenty male white albino rats were divided into: 1st and 2nd control groups with or without administration of Zinc protoporphyrin (ZnPP), 3rd and 4th diabetic groups with or without ZnPP, 5th diabetic group on single oral dose of pure curcumin, 6th diabetic group on pure curcumin administered daily for 12 weeks, 7th and 8th diabetic groups on single dose of water-soluble curcumin administered with or without ZnPP, 9th and 10th diabetic groups on water-soluble curcumin administered daily for 12 weeks with or without ZnPP. All curcumin dosage schedules were administered after induction of diabetes. Quantitative gene expression of endothelial nitric oxide synthase (eNOS), neuronal NOS (nNOS), inducible NOS (iNOS), heme oxygenase-1 (HO-1), nuclear transcription factor-erythroid2 (Nrf2), NF-Кβ, and p38. Cavernous tissue levels of HO and NOS enzyme activities, cGMP and intracavernosal pressure (ICP). Twelve weeks after induction of diabetes, ED was confirmed by the significant decrease in ICP. There was a significant decrease in cGMP, NOS, HO enzymes, a significant decrease in eNOS, nNOS, HO-1 genes and a significant elevation of NF-Кβ, p38, iNOS genes. Administration of pure curcumin or its water-soluble conjugate led to a significant elevation in ICP, cGMP levels, a significant increase in HO-1 and NOS enzymes, a significant increase in eNOS, nNOS, HO-1, and Nrf2 genes, and a significant decrease in NF-Кβ, p38, and iNOS genes. Water-soluble curcumin showed significant superiority and more prolonged duration of action. Repeated doses regimens were superior to single dose regimen. Administration of ZnPP significantly reduced HO enzyme, cGMP, ICP/ mean arterial pressure (MAP), HO-1 genes in diabetic groups. Water-soluble curcumin could enhance erectile function with more

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

    Science.gov (United States)

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

    2015-09-01

    To determine whether the severity of erectile dysfunction (ED) in a man diagnosed with late-onset hypogonadism (LOH) gives information about his metabolic syndrome state, as patients with LOH often have sexual symptoms and associated cardiovascular and metabolic comorbidities, but the role of ED in predicting the prevalence of comorbid disease in men with low levels of testosterone is currently unknown. Men (130) diagnosed with LOH and fulfilling the criteria of a total testosterone level of <3.5 ng/mL (<12 nmol/L), and with an erectile function domain score of <21 on the International Index of Erectile Function questionnaire (IIEF, questions 1-5), were enrolled for a subsequent trial of supplementation with testosterone undecanoate. Demographic data were recorded at baseline. The men completed three standardised questionnaires to assess sexual health, including the International Prostate Symptom Score, Ageing Males Symptoms (AMS) and IIEF Sexual Health Inventory for Men (SHIM). Patients were stratified by the severity of ED, with SHIM scores of 1-7 considered severe, 8-11 moderate, and 12-16 mild to moderate. Levels of serum testosterone, sex hormone binding globulin (SHBG) and lipids (total cholesterol, triglycerides, high-density and low-density lipoprotein) were assessed, along with plasma fasting glucose and glycated haemoglobin (HbA1c) levels. Body weight, body mass index and waist circumference were also recorded. There was a significant association between the severity of ED and mean weight (P < 0.001), waist circumference (P < 0.001), triglycerides (P = 0.009), total cholesterol (P = 0.027), HbA1c (P < 0.001), fasting glucose (P = 0.003) and AMS scores (P = 0.043). There were no significant differences in testosterone fractions and SHBG levels between the ED subgroups. There was a positive correlation between the prevalence of diabetes mellitus (type 1 and type 2) and the severity of ED in these men (P = 0.018). The descriptive data

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

    Directory of Open Access Journals (Sweden)

    Xiyou Wang

    Full Text Available 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

  15. Phosphodiesterase-5 inhibitors for erectile dysfunction in patients with diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Yatan Pal Singh Balhara

    2015-01-01

    Full Text Available Background and Aims: Patients with diabetes mellitus frequently experience erectile dysfunction. This systematic review and meta-analysis were conducted to find efficacy and tolerability of phosphodiesterase 5 (PDE5 inhibitors in patients with diabetes mellitus experiencing erectile dysfunction. Methodology: Electronic searches were carried out to identify English language peer-reviewed randomized controlled trials (RCTs, which reported clinical efficacy of any PDE5 inhibitor in patients with diabetes mellitus having erectile dysfunction. Effect sizes were computed using Cohen′s d, and I 2-test was used to assess heterogeneity. Pooled mean effect sizes were computed using random-effects model. Number needed to treat (NNT, and the adverse event rates were computed. Results: The systematic review included a total of 17 studies yielding 25 comparisons. Three studies were open RCTs while others were double-blind RCTs. The pooled mean effect size of any PDE5 inhibitor over placebo was 0.926 (95% confidence intervals [CI]: 0.864-0.987; I 2 =26.3. The pooled mean effect size for sildenafil was 1.198 (CI: 1.039-1.357; I 2 =, for tadalafil was 0.910 (CI: 0.838-0.981; I 2 =33.6, and for vardenafil was 0.678 (CI: 0.627-0.729; I 2 =. In pooled analysis, the NNT for sildenafil, tadalafil, vardenafil and any PDE5 inhibitor was 2.4, 2.6, 4.1 and 3.0 respectively. The most common side effects were headache, flushing, and nasal congestion. Conclusions: PDE5 inhibitors are effective and safe medications for the treatment of sexual dysfunction in patients with diabetes mellitus experiencing erectile dysfunction.

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

    International Nuclear Information System (INIS)

    Akilli, H.; Gok, H.; Soylu, A.; Kayrak, M.

    2007-01-01

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

  17. Erectile dysfunction in a sub-saharan African population: Profile and correlates in a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    D G Yovwin

    2015-01-01

    Full Text Available Background: Erectile dysfunction (ED is a common complaint in general medical practice. This study describes the clinicodemographic features of ED. Materials and Methods: Two hundred and twelve subjects in the outpatient clinic of a tertiary care hospital were interviewed for demographic data, tobacco smoking, alcohol consumption, history of medications, previous abdominal surgery, history of diabetes mellitus, hypertension and ED, duration of ED if present, self-assessment of the level of sexual satisfaction, partner's assessment of the level of sexual satisfaction, type of remedies sought and used for ED in the past, whether or not subject has discussed the problem and patients' perception of the cause of the ED, all were interviewed with the international index of erectile function questionnaire for ED. Data was analyzed as appropriate. Results: Forty-two (19.8% had ED and ED score was associated with age (P = 0.013, educational level (P < 0.001, monthly income (P < 0.001, alcohol consumption (P = 0.026, type of abdominal surgery done in the past (P = 0.002, self-rating of ED (P < 0.0001, partner rating (P < 0.0001, partner complaint (P < 0.0001, and frequency of complaint (P < 0.0001, it was however not significantly associated with marital status (P = 0.133, tobacco smoking (P = 0.259, quantity of tobacco smoked in pack years (P = 0.370, duration of ED (P = 0.141, drugs taken (P = 0.680. 77 (36.3% never discussed ED before, 40 (19% claimed that someone else was responsible, and only 15 (7.1% had taken a phosphodiesterase inhibitor. ED score correlated negatively with fasting blood sugar with a trend toward significance (r = −0.134, P = 0.064. Conclusion: ED may be more frequent in the population studied considering the level of knowledge and attitude.

  18. Hypoxia precondition promotes adipose-derived mesenchymal stem cells based repair of diabetic erectile dysfunction via augmenting angiogenesis and neuroprotection.

    Directory of Open Access Journals (Sweden)

    XiYou Wang

    Full Text Available The aim of the present study was to examine whether hypoxia preconditioning could improve therapeutic effects of adipose derived mesenchymal stem cells (AMSCs for diabetes induced erectile dysfunction (DED. AMSCs were pretreated with normoxia (20% O2, N-AMSCs or sub-lethal hypoxia (1% O2, H-AMSCs. The hypoxia exposure up-regulated the expression of several angiogenesis and neuroprotection related cytokines in AMSCs, including vascular endothelial growth factor (VEGF and its receptor FIK-1, angiotensin (Ang-1, basic fibroblast growth factor (bFGF, brain-derived neurotrophic factor (BDNF, glial cell-derived neurotrophic factor (GDNF, stromal derived factor-1 (SDF-1 and its CXC chemokine receptor 4 (CXCR4. DED rats were induced via intraperitoneal injection of streptozotocin (60 mg/kg and were randomly divided into three groups-Saline group: intracavernous injection with phosphate buffer saline; N-AMSCs group: N-AMSCs injection; H-AMSCs group: H-AMSCs injection. Ten rats without any treatment were used as normal control. Four weeks after injection, the mean arterial pressure (MAP and intracavernosal pressure (ICP were measured. The contents of endothelial, smooth muscle, dorsal nerve in cavernoursal tissue were assessed. Compared with N-AMSCs and saline, intracavernosum injection of H-AMSCs significantly raised ICP and ICP/MAP (p<0.05. Immunofluorescent staining analysis demonstrated that improved erectile function by MSCs was significantly associated with increased expression of endothelial markers (CD31 and vWF (p<0.01 and smooth muscle markers (α-SMA (p<0.01. Meanwhile, the expression of nNOS was also significantly higher in rats receiving H-AMSCs injection than those receiving N-AMSCs or saline injection. The results suggested that hypoxic preconditioning of MSCs was an effective approach to enhance their therapeutic effect for DED, which may be due to their augmented angiogenesis and neuroprotection.

  19. Erectile dysfunction, loss of libido and low sexual frequency increase the risk of cardiovascular disease in men with low testosterone.

    Science.gov (United States)

    Ho, Chen-Hsun; Wu, Chia-Chang; Chen, Kuan-Chou; Jaw, Fu-Shan; Yu, Hong-Jeng; Liu, Shih-Ping

    2016-06-01

    Testosterone deficiency increases the cardiovascular disease (CVD) risk. To evaluate the effect of erectile dysfunction (ED), sexual frequency and hypogonadal symptoms on CVD risk. A total of 395 hypogonadal men aged 45-74 years were surveyed using the Androgen Deficiency in the Aging Male and the International Index of Erectile Function. The 10-year CVD risk was measured with the Framingham Risk Score. Logistic regression was performed to obtain the odds ratios of sexual function and hypogonadal symptoms for a 10-year CVD risk ≥20% (high risk). The mean age was 56.1 ± 6.7 years. The mean 10-year CVD risk of the whole cohort was 18.1% ± 11.4%, while 131 subjects (33.2%) were classified as high risk. Logistic regression revealed that ED severity was associated with CVD risk [OR = 2.37 (CI 1.24-4.51) for mild-to-moderate ED, OR = 4.39 (1.78-8.43) for moderate ED and OR = 12.81 (4.65-26.11) for severe ED]. Compared to sexual frequency libido [OR = 2.95 (1.91-4.12)] and less strong erection [OR = 3.87 (CI 2.11-4.95)] increased the risk of high CVD risk. All remained significant after adjustment for age and testosterone. ED, decreased sexual frequency and loss of libido predict a high 10-year CVD risk in hypogonadal men.

  20. MicroRNA-200a is up-regulated in aged rats with erectile dysfunction and could attenuate endothelial function via SIRT1 inhibition

    Directory of Open Access Journals (Sweden)

    Feng Pan

    2016-01-01

    Full Text Available MiR-200a was shown to be upregulated in the corpus cavernosum (CC of rats with aging-related erectile dysfunction (A-ED in our previous study. Among its target genes, SIRT1 was also reported as a protective factor in erectile function by our groups previously. Thus, miR-200a might attenuate the erectile function in A-ED via SIRT1 inhibition. In the present study, three animal groups were included: aged rats with ED (group AE, n = 8, aged rats with normal erectile function (group AN, n = 8, and young rats as normal controls (group YN, n = 8. CCs from each group were collected for histological and molecular measurements to validate the dysregulation of miR-200a and SIRT1. After that, the cavernous endothelial cells (CECs from CC of aged rats with normal erectile function were transfected with miR-200a in vitro. Then the expression of SIRT1 and molecules within the eNOS/NO/PKG pathway were measured to investigate whether the transfection could imitate the attenuated process of erectile function in the aged. As a result, miR-200a was upregulated while the SIRT1, the levels of eNOS and cGMP were all downregulated in the CCs from AE group. After transfection in vitro, the miR-200a was upregulated while the SIRT1 and levels of eNOS and cGMP were obviously downregulated. Finally, based on the results of our previous study, we further verify that up-regulation of miR-200a could participate in the mechanisms of A-ED via SIRT1 inhibition, and mainly attenuate endothelial function via influencing the eNOS/NO/PKGpathway.

  1. Erectile Dysfunction and Sexual Hormone Levels in Men With Obstructive Sleep Apnea: Efficacy of Continuous Positive Airway Pressure.

    Science.gov (United States)

    Zhang, Xiao-Bin; Lin, Qi-Chang; Zeng, Hui-Qing; Jiang, Xing-Tang; Chen, Bo; Chen, Xiao

    2016-01-01

    In this study, the prevalence of erectile dysfunction (ED) and serum sexual hormone levels were evaluated in men with obstructive sleep apnea (OSA). In these patients, the efficacy of continuous positive airway pressure (CPAP) was determined. The 207 men (mean age 44.0 ± 11.1 years) enrolled in the study were stratified within four groups based on their apnea-hypopnea index score: simple snoring (n = 32), mild OSA (n = 29), moderate OSA (n = 38), and severe OSA (n = 108). The International Index of Erectile Dysfunction-5 (IIEF-5) score was obtained from each patient, and blood samples for the analysis of sexual hormones (prolactin, luteotropin, follicle-stimulating hormone, estradiol, progestin, and testosterone) were drawn in the morning after polysomnography. The IIEF-5 test and serum sexual hormone measurements were repeated after 3 months of CPAP treatment in 53 men with severe OSA. The prevalence of ED was 60.6 % in OSA patients overall and 72.2 % in those with severe OSA. Compared with the simple snoring group, patients with severe OSA had significantly lower testosterone levels (14.06 ± 5.62 vs. 17.02 ± 4.68, p = .018) and lower IIEF-5 scores (16.33 ± 6.50 vs. 24.09 ± 1.94, p = .001). The differences in the other sexual hormones between groups were not significant. After 3 months of CPAP treatment, there were no significant changes in sexual hormone levels, but the IIEF-5 score had improved significantly (18.21 ± 4.05 vs. 19.21 ± 3.86, p = .001). Severe OSA patients have low testosterone concentration and high ED prevalence. IIEF-5 scores increased significantly after CPAP treatment, but there was no effect on serum testosterone levels.

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

    International Nuclear Information System (INIS)

    Merrick, Gregory S.; Butler, Wayne M.; Wallner, Kent E.; Lief, Jonathan H.; Anderson, Richard L.; Smeiles, Benjamin J.; Galbreath, Robert W.; Benson, Mark L.

    2002-01-01

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

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

    Science.gov (United States)

    Moyad, Mark A; Park, Kwangsung

    2012-01-01

    Sexual health or erectile dysfunction (ED) state of the art guidelines provide a thorough overview of conventional prescription or other notable extrinsic treatment options. Yet, over the past 10–15 years, a plethora of international researchers have established that individual and comprehensive lifestyle changes can prevent and potentially improve ED. We review the lifestyle evidence that should equate to grade A or level 1 evidence recommendations for ED. We also review the evidence for Panax ginseng, an over-the-counter (OTC) dietary supplement with a 35-year history of laboratory investigations, multiple positive randomized trials over approximately 15 years and several independent meta-analyses and systematic reviews. Perhaps it is time to at least discuss and even emphasize lifestyle and other non-conventional interventions in ED guidelines so that patients can explore a diversity of potentially synergistic choices with their physicians and can improve their quality and quantity of life. Ignoring the consistent, positive data on lifestyle modifications in ED guidelines, for example, is tantamount to ignoring diet and lifestyle changes to reduce the risk of or ameliorate cardiovascular diseases. PMID:23001440

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

    Directory of Open Access Journals (Sweden)

    A. I. Neimark

    2012-01-01

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

  5. Self-esteem, confidence, and relationships in men treated with sildenafil citrate for erectile dysfunction: results of two double-blind, placebo-controlled trials.

    Science.gov (United States)

    Althof, Stanley E; O' Leary, Michael P; Cappelleri, Joseph C; Glina, Sidney; King, Rosie; Tseng, Li-Jung; Bowler, Jessica L

    2006-10-01

    Men with erectile dysfunction (ED) often have low self-esteem, confidence, and sexual relationship satisfaction. We evaluated the impact of sildenafil citrate and its generalizability across cultures on self-esteem, confidence, and sexual relationship satisfaction in men with ED using the Self-Esteem And Relationship (SEAR) questionnaire. Pooled analysis of 2 double-blind, placebo-controlled, flexible-dose trials of sildenafil with identical protocols: 1 was conducted in the United States and the other in Mexico, Brazil, Australia, and Japan. Men > or = 18 years old with ED. The impact of treatment on psychosocial factors associated with ED was determined by patient responses to the SEAR questionnaire. Erectile function was determined using the International Index of Erectile Function (IIEF) and a global efficacy question. Successful sexual intercourse attempts were derived from event logs of sexual activity. Treatment effect sizes were calculated for all study outcomes. Compared with patients who received placebo (n = 274), patients who received sildenafil (n = 279) reported significantly greater improvements (P self-esteem, confidence, sexual relationship satisfaction, and in all sexual function domains of the IIEF. Treatment effect sizes were large (range, 0.7 to 1.2) for all SEAR components, and improvement in psychosocial measures showed moderate to high correlations (range, 0.50 to 0.83, P self-esteem, confidence, and sexual relationship satisfaction. Improvements in these psychosocial factors were observed crossculturally and correlated significantly and tangibly with improvements in erectile function.

  6. Are urge incontinence and aging risk factors of erectile dysfunction in patients with male lower urinary tract symptoms?

    Science.gov (United States)

    Amano, Toshiyasu; Earle, Carolyn; Imao, Tetsuya; Takemae, Katsuro

    2016-01-01

    Several studies have indicated that erectile dysfunction (ED) patients also suffer from lower urinary tract symptoms (LUTS). We investigated a group of men with LUTS and assessed their sexual function with the aim of being able to predict ED risk factors and introduce ED treatments earlier for this patient group. International Prostate Symptom Score (IPSS), Overactive Bladder Symptoms Score (OABSS) and Sexual Health Inventory for Men (SHIM) score were obtained from 236 men with LUTS at their first out-patients visit. Clinical parameters such as body mass index, prostate volume, residual urine volume and prostate specific antigen were also evaluated. The relationship between the SHIM score and other clinical data was analyzed. According to the SHIM score, ED in men with LUTS was severe 15%, moderate 19%, moderate to mild 28%, mild 17%, normal 7% and data was incomplete in 14%. Based on the results of a multivariate analysis, aging (p urinary incontinence was a risk factor for severe and moderate ED (p = 0.005). Aging and OAB (notably urinary urge incontinence) are risk factors for severe and moderate ED in men with LUTS.

  7. Venous surgery in erectile dysfunction. The role of dorsal-penile-vein ligation and spongiosolysis for impotence.

    Science.gov (United States)

    Gilbert, P; Sparwasser, C; Beckert, R; Treiber, U; Pust, R

    1992-01-01

    We report here on our surgical experience with venous leakage of the cavernous bodies. Out of 159 patients operated on, 134 were available for long-term follow-up. Depending on the cavernosographic findings, one of three different surgical procedures was carried out: ligation of the deep dorsal vein of the penis, spongiosolysis, or ligation of the crura. 18% of the patients undergoing ligation of the deep dorsal vein, postoperatively attained spontaneous erections, while 35% needed adjuvant corpus cavernosum autoinjection therapy. Spongiosolysis gave a more favourable result: spontaneous erections in 30% and vasoactive drug-dependent erections in 35%. Crural ligation did not prove successful. No serious complications were encountered postoperatively. Our data suggest that venous surgery should only be offered to a selected group of patients comprising young impotent men with venous leakage, maybe in combination with arterial disease, and patients suffering from distal venous leakage. Old age, neurogenic disorders causing erectile dysfunction, and diabetes mellitus should represent exclusion criteria for venous surgery.

  8. Erectile dysfunction and quality of life in men receiving methadone or buprenorphine maintenance treatment. A cross-sectional multicentre study.

    Directory of Open Access Journals (Sweden)

    Fabio Lugoboni

    Full Text Available Erectile dysfunction (ED is common among men on opioid replacement therapy (ORT, but most previous studies exploring its prevalence and determinants yielded contrasting findings. Moreover, the impact of ED on patients' quality of life (QoL has been seldom explored.To explore the prevalence and determinants of ED in men on ORT, and the impact on QoL.In a multicentre cross-sectional study, we recruited 797 consecutive male patients on methadone and buprenorphine treatment, collected data on demographic, clinical, and psychopathological factors, and explored their role as predictors of ED and QoL through univariate and multivariate analysis. ED severity was assessed with a self-assessment questionnaire.Nearly half of patients in our sample were sexually inactive or reported some degree of ED. Some demographic, clinical and psychopathological variables significantly differed according to the presence or absence of ED. Multivariate regression analysis indicated that age, employment, smoke, psychoactive drugs, opioid maintenance dosage, and severity of psychopathological factors significantly influenced the risk and severity of ED. QoL was worse in patients with ED and significantly correlated with ED severity. Age, education, employment, opioid maintenance dosage, ED score, and severity of psychopathology significantly influenced QoL in the multivariate analysis.ED complaints can be explored in male opioid users on ORT through a simple and quick self-assessment tool. ED may have important effects on emotional and social well-being, and may affect outcome.

  9. Penile prosthesis implantation for the treatment for male erectile dysfunction: clinical outcomes and lessons learnt after 955 procedures.

    Science.gov (United States)

    Chung, E; Van, C T; Wilson, I; Cartmill, R A

    2013-06-01

    To evaluate the clinical outcomes of penile prosthesis implantation for the treatment for erectile dysfunction (ED) over 3 decades in a centre of excellence. A total of 955 penile prostheses were implanted between June 1981 and June 2010. The mean age of the men was 53.2 (28-80) years, and the mean follow-up was 76 (12-355) months. A total of 771 men had primary implants. The most common implant was Ultrex cylinder (54 %), and the main cause of ED was organic (32 %). Primary implants showed higher rate of intra-operative complications than revision surgery (3.5 vs. 0.1 %) (p Prosthesis infection occurred in 0.8 % and equal incidence between diabetic and pelvic trauma patients. The average time to prosthetic revision was 102 (30-210) months. Kaplan-Meier estimates of overall penile prosthesis survival at 5 and 10 years were around 90.8 and 85.0 %. The most common mechanical failures were fluid loss (75 %). The majority of men were satisfied with the surgical outcomes, and 90 % of men would undergo penile prosthesis implant again. Penile prosthesis surgery is a safe and durable treatment option for male ED. Strict adherence to antimicrobial prophylaxis and surgical practice is paramount to ensure low complication rates and high patient satisfaction rate.

  10. Preperitoneal placement of an inflatable penile prosthesis reservoir for postoperative erectile dysfunction after radical cystoprostatectomy with orthotopic neobladder

    Directory of Open Access Journals (Sweden)

    Jung Kwon Kim

    2016-09-01

    Full Text Available Purpose: To describe a case of safe placement of an inflatable penile prosthesis reservoir for postoperative erectile dysfunction (ED with a history of radical cystoprostatectomy with an orthotopic Studer neobladder. Materials and Methods: A 55-year-old bladder cancer patient, who underwent radical cystoprostatectomy with orthotopic Studer neobladder 2 years prior, suffered from postoperative ED. A 3-piece inflatable penile prosthesis was implanted via a penoscrotal incision. The alternative reservoir placement began with a longitudinal 4-cm incision, which was 2 finger-breaths to the left and lateral to the umbilicus. Thereafter, the anterior and posterior rectus sheaths were dissected and incised. Then, the transversalis fascia entering into the preperitoneal space was incised, followed by circumferential sweeping using the forefinger, and, finally, placement of a 100 mL ‘flat’ reservoir. The reservoir was filled with 65 mL saline and then evaluated for back pressure. The reservoir tubing exited through the defect of the rectus sheaths and tunneled through the abdominal fat into the penoscrotal wound. Results: Total operative time was 105 minutes, and the estimated blood loss was minimal. The patient was discharged at postoperative day 1 and experienced no perioperative complications. At the 6-month follow-up, there was no abdominal bulging from the preperitoneal reservoir, and the reservoir was not palpable. Conclusions: The preperitoneal placement of the flat reservoir at the level of the umbilicus is a safe and acceptable surgical technique for postoperative ED after radical cystoprostatectomy with orthotopic neobladder.

  11. Nocturia and prevalence of erectile dysfunction in Japanese patients with type 2 diabetes mellitus: The Dogo Study.

    Science.gov (United States)

    Furukawa, Shinya; Sakai, Takenori; Niiya, Tetsuji; Miyaoka, Hiroaki; Miyake, Teruki; Yamamoto, Shin; Maruyama, Koutatsu; Tanaka, Keiko; Ueda, Teruhisa; Senba, Hidenori; Torisu, Masamoto; Minami, Hisaka; Onji, Morikazu; Tanigawa, Takeshi; Matsuura, Bunzo; Hiasa, Yoichi; Miyake, Yoshihiro

    2016-09-01

    Several epidemiological studies have reported a positive association between nocturia and erectile dysfunction (ED). Yet only limited evidence exists regarding the association between nocturia and ED among patients with type 2 diabetes mellitus, although nocturia and ED are common among type 2 diabetes mellitus patients. Study participants were 332 male Japanese patients with type 2 diabetes mellitus, aged 19-70 years, who had undergone blood tests at our institutions. A self-administered questionnaire was used to collect information on the variables under study. Adjustment was made for age, body mass index, hypertension, stroke, ischemic heart disease, glycated hemoglobin and diabetic neuropathy. ED, moderate to severe ED and severe ED were defined as present when a participant had a Sexual Health Inventory for Men score prevalence of nocturia was 79.8%. Nocturia was independently positively associated with ED and moderate to severe ED: the adjusted odds ratios were 7.86 (95% confidence interval 2.11-33.56) and 2.17 (95% confidence interval 1.16-4.12), respectively. The positive association between nocturia and severe ED fell just short of significance. In Japanese men with type 2 diabetes mellitus, nocturia might be associated with ED and moderate to severe ED. © 2016 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  12. Abnormal brain structure as a potential biomarker for venous erectile dysfunction: evidence from multimodal MRI and machine learning.

    Science.gov (United States)

    Li, Lingli; Fan, Wenliang; Li, Jun; Li, Quanlin; Wang, Jin; Fan, Yang; Ye, Tianhe; Guo, Jialun; Li, Sen; Zhang, Youpeng; Cheng, Yongbiao; Tang, Yong; Zeng, Hanqing; Yang, Lian; Zhu, Zhaohui

    2018-03-29

    To investigate the cerebral structural changes related to venous erectile dysfunction (VED) and the relationship of these changes to clinical symptoms and disorder duration and distinguish patients with VED from healthy controls using a machine learning classification. 45 VED patients and 50 healthy controls were included. Voxel-based morphometry (VBM), tract-based spatial statistics (TBSS) and correlation analyses of VED patients and clinical variables were performed. The machine learning classification method was adopted to confirm its effectiveness in distinguishing VED patients from healthy controls. Compared to healthy control subjects, VED patients showed significantly decreased cortical volumes in the left postcentral gyrus and precentral gyrus, while only the right middle temporal gyrus showed a significant increase in cortical volume. Increased axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) values were observed in widespread brain regions. Certain regions of these alterations related to VED patients showed significant correlations with clinical symptoms and disorder durations. Machine learning analyses discriminated patients from controls with overall accuracy 96.7%, sensitivity 93.3% and specificity 99.0%. Cortical volume and white matter (WM) microstructural changes were observed in VED patients, and showed significant correlations with clinical symptoms and dysfunction durations. Various DTI-derived indices of some brain regions could be regarded as reliable discriminating features between VED patients and healthy control subjects, as shown by machine learning analyses. • Multimodal magnetic resonance imaging helps clinicians to assess patients with VED. • VED patients show cerebral structural alterations related to their clinical symptoms. • Machine learning analyses discriminated VED patients from controls with an excellent performance. • Machine learning classification provided a preliminary demonstration of DTI

  13. Predicting erectile dysfunction following surgical correction of Peyronie's disease without inflatable penile prosthesis placement: vascular assessment and preoperative risk factors.

    Science.gov (United States)

    Taylor, Frederick L; Abern, Michael R; Levine, Laurence A

    2012-01-01

    Surgical therapy remains the gold standard treatment for Peyronie's Disease (PD). Surgical options include plication, grafting, and placement of inflatable penile prosthesis (IPP). Postoperative erectile dysfunction (ED) is a potential complication for PD surgery without IPP. We present our large series follow-up to evaluate preoperative risk factors for postoperative ED. The aim of this study is to evaluate preoperative risk factors for the development of ED following surgical correction of PD taking into account the degree of curvature, graft size, surgical approach, hypertension, hyperlipidemia, diabetes, smoking history, preoperative use of phosphodiesterase 5 inhibitors (PDE5), and preoperative duplex ultrasound findings including peak systolic and end diastolic velocities and resistive index. We identified 218 men undergoing either tunica albuginea plication (TAP) or partial plaque excision with pericardial grafting for PD following a previously published algorithm between November 1992 and April 2007. Preoperative and postoperative erectile function, curvature characteristics, presence of vascular risk factors, and duplex ultrasound findings were available on 109 patients. Our primary outcome measure is the development of ED after surgery for PD. Ten percent of TAP and 21% of plaque excision with grafting patients developed postoperative ED. Neither curve direction (P = 0.76), graft area (P = 0.78), surgical approach (P = 0.12), chronic hypertension (P = 0.51), hyperlipidemia (P = 0.87), diabetes (P = 0.69), nor smoking history (P = 0.99) were significant predictors of postoperative ED. No combination of risk factors was found to be predictive of postoperative ED. Preoperative use of PDE5 was not a significant predictor of postoperative ED (P = 0.33). Neither peak systolic, end diastolic, nor resistive index were significant predictors of ED (P = 0.28, 0.28, and 0.25, respectively). This long-term follow-up of a large published series suggests that neither

  14. Changes in erectile dysfunction over time in relation to Framingham cardiovascular risk in the Boston Area Community Health (BACH) Survey.

    Science.gov (United States)

    Fang, Shona C; Rosen, Raymond C; Vita, Joseph A; Ganz, Peter; Kupelian, Varant

    2015-01-01

    Erectile dysfunction (ED) is associated with cardiovascular disease (CVD); however, the association between change in ED status over time and future underlying CVD risk is unclear. The aim of this study was to investigate the association between change in ED status and Framingham CVD risk, as well change in Framingham risk. We studied 965 men free of CVD in the Boston Area Community Health (BACH) Survey, a longitudinal cohort study with three assessments. ED was assessed with the five-item International Index of Erectile Function at BACH I (2002-2005) and BACH II (2007-2010) and classified as no ED/transient ED/persistent ED. CVD risk was assessed with 10-year Framingham CVD risk algorithm at BACH I and BACH III (2010-2012). Linear regression models controlled for baseline age, socio-demographic and lifestyle factors, as well as baseline Framingham risk. Models were also stratified by age (≥/< 50 years). Framingham CVD risk and change in Framingham CVD risk were the main outcome measures. Transient and persistent ED was significantly associated with increased Framingham risk and change in risk over time in univariate and age-adjusted models. In younger men, persistent ED was associated with a Framingham risk that was 1.58 percentage points higher (95% confidence interval [CI]: 0.11, 3.06) and in older men, a Framingham risk that was 2.54 percentage points higher (95% CI: -1.5, 6.59), compared with those without ED. Change in Framingham risk over time was also associated with transient and persistent ED in men <50 years, but not in older men. Data suggest that even after taking into account other CVD risk factors, transient and persistent ED is associated with Framingham CVD risk and a greater increase in Framingham risk over time, particularly in younger men. Findings further support clinical assessment of CVD risk in men presenting with ED, especially those under 50 years. © 2014 International Society for Sexual Medicine.

  15. AB174. Erectile dysfunction and usage of PDE5-inhibitors in male partner of infertile couple

    OpenAIRE

    Song, Seung-Hun; Kim, Dong Suk; Kwon, Sung Won; Ahn, Tai Young

    2014-01-01

    Introduction Infertility is a major source of life stress and could be associated with male sexual dysfunction. We investigated sexual function in male partner of infertile couples during timed intercourse (TI) and the usage of PDE5-inhibitor for ED treatment Materials and methods Male partners of couples with more than 1 year of infertility period seeking medical care or an evaluation of couple infertility were enrolled. In conjunction with infertility evaluation, the participants completed ...

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

    Directory of Open Access Journals (Sweden)

    Alexander Grinshpoon

    2009-09-01

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

  17. Disinhibited Exposing Behavior, Hypersexuality, and Erectile Dysfunction as a Consequence of Posttraumatic Stress in a 42-Year-Old Male Patient.

    Science.gov (United States)

    Petri-Kelvasa, Mirja; Schulte-Herbrüggen, Olaf

    2017-10-01

    Research into sexual dysfunction and its explanations within a cognitive behavioral framework in patients with posttraumatic stress is sparse. In this report, we present the case of a 42-year-old male with severe posttraumatic stress symptoms who displayed apparent exhibitionistic behavior, hypersexual behavior in the form of excessive masturbation, and erectile dysfunction. Differential diagnostics showed that the presented exhibitionistic behavior could be more accurately classified as non-paraphilic disinhibited exposing behavior. Functional behavioral analysis of his sexual behavior suggested that disinhibited exposing and hypersexual behavior served as dysfunctional coping strategies for trauma-associated negative emotions. Erectile dysfunction seemed to be the result of trauma-associated hyperarousal and excessive masturbation. Within the context of operant learning processes, we propose that his sexual behaviors became highly automated and were used as the main strategies to regulate trauma-associated negative emotions. Implications for the diagnoses and suggestions for the conceptualization and incorporation into a cognitive behavioral therapy treatment of posttraumatic stress disorder are made.

  18. A systematic review assessing the economic impact of sildenafil citrate (Viagra) in the treatment of erectile dysfunction.

    Science.gov (United States)

    Martin, Amber L; Huelin, Rachel; Wilson, David; Foster, Talia S; Mould, Joaquin F

    2013-05-01

    Sildenafil was the first oral phosphodiesterase type 5 (PDE5) inhibitor introduced as primary therapy for erectile dysfunction (ED). In the 7 years following its market launch, sildenafil was prescribed by more than 750,000 physicians to more than 23 million men worldwide. To date, few studies have evaluated the economic impact of sildenafil in treating ED. To evaluate the cost-effectiveness and impact of sildenafil on health care costs for patients with ED in multiple countries. Economic outcomes including cost, cost-effectiveness, cost of illness, cost consequence, resource use, productivity, work loss, and willingness to pay (WTP) were investigated. Using keywords related to economic outcomes and sildenafil, we systematically searched literature published between July 2001 and July 2011 using MEDLINE and EMBASE. Included articles pertained to costs, WTP, and economic evaluations. In the last 10 years, 12 studies assessed economic outcomes associated with sildenafil for ED. Most studies were conducted in the United States and the United Kingdom, with one study identified in Canada and one from Mexico. Six studies evaluated cost of illness, cost consequence, or cost of care, and four studies evaluated WTP or drug pricing by country in the United States and the United Kingdom. In the United States and the United Kingdom, costs to health care systems have increased with demand for treatment. Cost analyses suggested that sildenafil would lower direct costs compared with other PDE5 inhibitors. U.S. and U.K. studies found that patients exhibited WTP for sildenafil. The two cost-effectiveness models we identified examined ED sub-groups, those with spinal cord injury and those with diabetes or hypertension. These models indicated favorable cost-effectiveness profiles for sildenafil compared with other active-treatment options in both Mexico and Canada. The relative value of sildenafil vs. surgically implanted prosthetic devices and other PDE5 inhibitors, is underscored

  19. Testosterone deficiency causes penile fibrosis and organic erectile dysfunction in aging men. Evaluating association among Age, TDS and ED

    Directory of Open Access Journals (Sweden)

    Iacono Fabrizio

    2012-11-01

    Full Text Available Abstract Introduction We studied the possible correlation between age, testosterone deficiency, cavernosal fibrosis and erectile dysfunction (ED. Methods 47 patients with ED were enrolled between September 2010 and October 2011. IIEF-EF score, NPTR test using the Rigiscan method, total and free testosterone levels, and cavernosum biopsy were carried out on all patients. Patients aged 65 or over were defined as Old Age (OA while patients under 65 were defined Young age (YA. The strength of the relationships found was estimated by Odds Ratio. Results 74% of patients with values of over 52% collagen fibers in the corpora cavernosa were found to have organic ED. A significant difference was found in age, percentage of collagen fibers, testosterone levels between patients with Positive Rigiscan (PR and Negative Rigiscan (NR. Hypotestosteronaemia increased the risk of ED with PR (OR: 21.4, 95% CI: 20.2-22.6 and in both young age patients (OR: 4.3, 95% CI: 2.4-6.2 and old age patients (OR: 15.5, 95% CI: 13.4-17.6. Moreover cavernosal fibrosis increased the risk of ED with PR in both young age patients (OR: 8.2, 95% CI: 6.4-10.0 and old age patients (OR: 24.6, 95% CI: 20.8-28.4. Conclusions This study demonstrates a strong association among age, testosterone deficiency, cavernosal fibrosis and ED with PR. Age, testosterone deficiency and cavernosal fibrosis are potentially correctable factors of cavernosal fibrosis and organic ED. Further, prospective studies are needed to evaluate if testosterone treatment, alone or in association with PDE5 inhibitors, may lower the risk of cavernosal fibrosis or decrease the severity the fibrosis in ED patients.

  20. Testosterone deficiency causes penile fibrosis and organic erectile dysfunction in aging men. Evaluating association among Age, TDS and ED.

    Science.gov (United States)

    Iacono, Fabrizio; Prezioso, Domenico; Ruffo, Antonio; Illiano, Ester; Romis, Leo; Di Lauro, G; Romeo, Giuseppe; Amato, Bruno

    2012-01-01

    We studied the possible correlation between age, testosterone deficiency, cavernosal fibrosis and erectile dysfunction (ED). 47 patients with ED were enrolled between September 2010 and October 2011. IIEF-EF score, NPTR test using the Rigiscan method, total and free testosterone levels, and cavernosum biopsy were carried out on all patients. Patients aged 65 or over were defined as Old Age (OA) while patients under 65 were defined Young age (YA). The strength of the relationships found was estimated by Odds Ratio. 74% of patients with values of over 52% collagen fibers in the corpora cavernosa were found to have organic ED. A significant difference was found in age, percentage of collagen fibers, testosterone levels between patients with Positive Rigiscan (PR) and Negative Rigiscan (NR). Hypotestosteronaemia increased the risk of ED with PR (OR: 21.4, 95% CI: 20.2-22.6) and in both young age patients (OR: 4.3, 95% CI: 2.4-6.2) and old age patients (OR: 15.5, 95% CI: 13.4-17.6). Moreover cavernosal fibrosis increased the risk of ED with PR in both young age patients (OR: 8.2, 95% CI: 6.4-10.0 and old age patients (OR: 24.6, 95% CI: 20.8-28.4). This study demonstrates a strong association among age, testosterone deficiency, cavernosal fibrosis and ED with PR. Age, testosterone deficiency and cavernosal fibrosis are potentially correctable factors of cavernosal fibrosis and organic ED. Further, prospective studies are needed to evaluate if testosterone treatment, alone or in association with PDE5 inhibitors, may lower the risk of cavernosal fibrosis or decrease the severity the fibrosis in ED patients.

  1. Screening for Rho-kinase 2 inhibitory potential of Indian medicinal plants used in management of erectile dysfunction.

    Science.gov (United States)

    Goswami, Sumanta Kumar; Pandre, Manoj Kumar; Jamwal, Rohitash; Dethe, Shekhar; Agarwal, Amit; Inamdar, Mohammed Naseeruddin

    2012-12-18

    Activation of Rho-kinase 2 (ROCK-II) results in contraction of corpus cavernosum smooth muscle and ROCK-II inhibitors relax corpus cavernosum in vitro and in vivo hence, plant extracts capable of inhibiting ROCK-II enzyme may be useful in management of erectile dysfunction (ED). The aim of the study was to screen selected Indian medicinal plants, having similar ethnopharmacological use for ROCK-II inhibition. Some Indian medicinal plants reported as aphrodisiacs in Ayurveda and modern scientific literature were collected, authenticated and extracted. Direct methanol and successive aqueous extracts of these plants were screened for ROCK-II inhibitory activity using HTRF(®)KinEASE™ STK S2 Kit (Cisbio Bioassays). Relaxant effect of potent extract was recorded on isolated rat corpus cavernosum. Methanolic and successive aqueous extracts of 30 plants were screened for ROCK-II inhibition and 15 herbal extracts showed inhibition ranging between 50 and 88% at 50 μg/mL. While IC(50) of Y-27632, a standard ROCK-II inhibitor, was found to be 163.8 ± 1.2 nM. The Methanolic extract of Terminalia chebula (METC) with IC(50) value of 6.09 ± 0.17 μg/mL was found to be most potent and relaxed isolated rat corpus cavernosum significantly (pChlorophytum borivilianum and Mucuna pruriens, as aphrodisiacs and for male sexual disorder (MSD) might be in part due to the ROCK II inhibitory potential of these plants. Some of the Indian medicinal plants have ROCK-II inhibitory potential and those deserve further investigation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  2. Endothelial nitric oxide synthase gene polymorphisms and risk of erectile dysfunction: An updated meta-analysis of genetic association studies.

    Science.gov (United States)

    Yao, Han-Xin; Ma, Fu-Zhe; Tan, Yu-Ying; Liu, Ling-Yun

    2018-04-11

    Endothelial nitric oxide synthase (eNOS) polymorphisms have been implicated as risk factors for erectile dysfunction (ED), but the results of genetic association studies are inconclusive. We performed a meta-analysis of published studies investigating the association between ED and three eNOS polymorphisms, intron 4 VNTR, G894T and T786C in humans. The PubMed, Web of Science, CNKI and Google Scholar databases were searched for relevant studies published up to November 2017. Association studies with case-control design were included. For each study with genotype information we calculated odds ratios (OR) and 95% confidence intervals (CI). The search identified 13 eligible studies. The G894T and T786C polymorphisms showed a significant association with ED risk in Caucasians (GT + TT versus GG for G894T: OR = 2.13, 95% CI = 1.08-4.19; CC versus CT + TT for T786C: OR = 3.29, 95% CI = 2.30-4.72) and Asians (GT + TT versus GG for G894T: OR = 2.08, 95% CI = 1.53-2.84; CC + CT versus TT for T786C: OR = 3.13, 95% CI = 1.35-7.25). In addition, the intron 4 VNTR polymorphism was associated with ED risk only among Caucasian subjects (aa versus bb + ab: OR = 2.38, 95% CI = 1.15-4.93). We found no evidence of publication bias. The robustness of overall analyses was ensured in sensitivity analyses excluding studies deviating from Hardy-Weinberg equilibrium. Our findings suggest that common genetic polymorphisms in the eNOS gene contribute to risk of ED, presumably by effects on eNOS activity and NO availability. Copyright © 2018. Published by Elsevier Ltd.

  3. When is a varicocele repair indicated: the dilemma of hypogonadism and erectile dysfunction?

    Science.gov (United States)

    Dabaja, Ali A; Goldstein, Marc

    2016-01-01

    In the past, the indications for varicocelectomy are primarily for infertility with abnormal semen parameters, testicular hypotrophy/atrophy in adolescents, and/or pain. The surgical treatment of varicocele for hypogonadism is controversial and debated. Recently, multiple reports in the literature have suggested that varicocele is associated with hypogonadism and varicocele repair can increase testosterone levels. Men with hypogonadal symptoms should have at least two serum testosterone levels. Microsurgical varicocelectomy may be beneficial for men with clinically palpable varicoceles with documented hypogonadism. In this review, we summarize the most recent literature linking varicocele to hypogonadism and sexual dysfunction and the impact of repair on serum testosterone levels. We performed a search of the published English literature. The key words used were "varicocele and hypogonadism" and "varicocele surgery and testosterone." We included published studies after 1998. We, also, evaluated the effect of surgery on the changes in the serum testosterone level regardless of the indication for the varicocele repair.

  4. 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

    2014-01-01

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

  5. 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.

  6. 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.

  7. Occurrence of erectile dysfunction, testosterone deficiency syndrome and metabolic syndrome in patients with abdominal obesity. Where is a sufficient level of testosterone?

    Science.gov (United States)

    Fillo, Juraj; Breza, Jan; Levčíkova, Michaela; Luha, Jan; Vachulova, Anna; Durdík, Štefan; Labaš, Peter

    2012-08-01

    The aim of this study was to determine the prevalence of erectile dysfunction (ED), testosterone deficiency syndrome (TDS), and metabolic syndrome in patients with abdominal obesity (AO) and the prevalence of morbidity at different levels of testosterone (TST). Male sex hormones play an important role in ED and variety of TDS and may have influence on the development of metabolic syndrome. The number of men with AO which constitutes a serious health risk is continuously growing. Currently, there are different views that TST levels are already insufficient, and the patient should benefit from treatment. This study examined the association between ED, testosterone level and metabolic syndrome in men with AO. The study was carried out in an outpatient urology center of Urology Clinic and Obesity Center of the Clinic of Internal Medicine. There were 167 participants—men with AO which were examined as part of preventive examination. Hormonal, a complete urological and internal evaluation was carried out in every patient. We found some degree of ED in 73% (122/167) in men with AO. The TST levels below 14 nmol/l had of these 122 patients 84 patients (68.9%) and 49 patients (40.2%) below 10 nmol/l. In this group of patients, we found 103/167 patients (61.7%) with metabolic syndrome. When we compared TST level and morbidity, we found significantly more patients with diabetes mellitus (DM), hypertension and dyslipidemia in group with TST below 10 nmol/l. We also found difference in the levels of HDL cholesterol and triglycerides in the group of patients with TST 10–14 and over 14 nmol/l. Patients over 40 years of age with AO and ED should also be examined for TDS and metabolic syndrome. In this group of patients we found that 113/167 patients (67.6%) had total TST below 14 nmol/l, and sufficient level of TST seems to be above this level.

  8. [Efficacy and safety of hormonal therapy with androgens (androgel) in men with erectile dysfunction, partial androgen deficiency of aging male and cardiovascular diseases].

    Science.gov (United States)

    Kalinchenko, S Iu; Vorslov, L O; Aglamazian, N L; Morgunov, L Iu

    2007-01-01

    Partial androgen deficiency of aging male (PADAM) manifests with sexual dysfunction and is associated with many diseases, primarily, cardiovascular. After the age of 30-40 a testosterone level falls 1-2% a year. The number of men with testosterone deficiency grows from 8% in 40-60-year-olds to 85% at the age over 80 years. Low testosterone correlates with such risk factors of cardiovascular diseases as dyslipidemia, atherosclerosis, low fibrinolysis, insulin resistance and abdominal obesity. Correction of androgenic deficiency can be conducted with the drug androgel which represents a new system of transdermal testosterone delivery. In contrast to vasoactive drugs, androgel affects pathogenetic mechanisms of erectile dysfunction and thus attenuates factors of cardiovascular risk. Androgel is used externally and is more effective than intramuscular and oral analogues. Also, the drug improves lipid spectrum. By activating lipolysis, testosterone reduces the amount of visceral fat thus lowering insulin resistance. A vasodilating effect of androgel positively influences cardiovascular system and penile vessels. The drug acts fast, is effective and safe. Therefore, it can be recommended for correction of erectile dysfunction in patients with old age androgen deficiency and concurrent cardiovascular diseases.

  9. Adherence to Phosphodiesterase Type 5 Inhibitors in the Treatment of Erectile Dysfunction in Long-Term Users: How Do Men Use the Inhibitors?

    Directory of Open Access Journals (Sweden)

    Ana Carvalheira, PhD

    2014-06-01

    Conclusion: The analysis of men's narratives revealed a combination of factors that influence the adherence to PDE5-i. The psychological and medication-related factors were the most prevalent. This study highlighted the importance of taking these factors into account, both at the time of prescription and during the follow-up in order to improve adherence. Carvalheira A, Forjaz V, and Pereira NM. Adherence to phosphodiesterase type 5 inhibitors in the treatment of erectile dysfunction in long-term users: How do men use the inhibitors? Sex Med 2014;2:96–102.

  10. Management options for the treatment of benign prostatic hyperplasia with or without erectile dysfunction: a focus on tadalafil and patient considerations

    Directory of Open Access Journals (Sweden)

    Alsaikhan B

    2014-06-01

    Full Text Available Bader Alsaikhan, Khalid Alrabeeah, Serge CarrierMcGill University Health Centre, Montreal, Quebec, QC, CanadaAbstract: Lower urinary tract symptoms (LUTS and erectile dysfunction increase with age. Several studies have identified a true association between these two disorders. Basic research studies have shown a significant decrease in the nitric oxide/cyclic guanosine monophosphate pathway with age that leads to decreased relaxation of the bladder wall and prostate and worsening LUTS. In this review article, we will focus on the potential use and clinical significance of phosphodiesterase-5 inhibitors in the treatment of LUTS secondary to benign prostate hyperplasia.Keywords: lower urinary tract symptoms, phosphodiesterase-5 inhibitors

  11. Treatment of erectile dysfunction with sildenafil citrate (Viagra) in parkinsonism due to Parkinson's disease or multiple system atrophy with observations on orthostatic hypotension

    Science.gov (United States)

    Hussain, I; Brady, C; Swinn, M; Mathias, C; Fowler, C

    2001-01-01

    OBJECTIVES—To assess the efficacy and safety of sildenafil citrate (Viagra) in men with erectile dysfunction and parkinsonism due either to Parkinson's disease or multiple system atrophy.
METHODS—Twenty four patients with erectile disease were recruited, 12 with Parkinson's disease and 12 with multiple system atrophy, into a randomised, double blind, placebo controlled, crossover study of sildenafil citrate. The starting dose was 50 mg active or placebo medication with the opportunity for dose adjustment depending on efficacy and tolerability. The international index of erectile function questionnaire (IIEF) was used to assess treatment efficacy and a quality of life questionnaire to assess the effect of treatment on sex life and whole life. Criteria for entry included a definite neurological diagnosis and a standing systolic blood pressure of 90-180 mm Hg and diastolic blood pressure of 50-110 mm Hg, on treatment if necessary. Blood pressure was taken at randomisation (visit 2) and crossover (visit 5) lying, sitting, and standing, before and 1 hour after taking the study medication in hospital.
RESULTS—Sidenafil citrate was efficacious in men with parkinsonism with a significant improvement, as demonstrated in questionnaire responses, in ability to achieve and maintain an erection and improvement in quality of sex life. In Parkinson's disease there was minimal change in blood pressure between active and placebo medication. In multiple system atrophy, six patients were studied before recruitment was stopped because three men showed a severe drop in blood pressure 1 hour after taking the active medication. Two were already known to have orthostatic hypotension and were receiving treatment with ephedrine and midodrine but the third had asymptomatic hypotension. However, the blood pressures in all three had been within the inclusion criterion for the study protocol. Despite a significant postural fall in blood pressure after sildenafil, all patients with

  12. Effect of Linear Low-Intensity Extracorporeal Shockwave Therapy for Erectile Dysfunction-12-Month Follow-Up of a Randomized, Double-Blinded, Sham-Controlled Study.

    Science.gov (United States)

    Fojecki, Grzegorz Lukasz; Tiessen, Stefan; Osther, Palle Jørn Sloth

    2018-03-01

    Short-term data on the effect of low-intensity extracorporeal shockwave therapy (Li-ESWT) on erectile dysfunction (ED) have been inconsistent. The suggested mechanisms of action of Li-ESWT on ED include stimulation of cell proliferation, tissue regeneration, and angiogenesis, which can be processes with a long generation time. Therefore, long-term data on the effect of Li-ESWT on ED are strongly warranted. To assess the outcome at 6 and 12 months of linear Li-ESWT on ED from a previously published randomized, double-blinded, sham-controlled trial. Subjects with ED (N = 126) who scored lower than 25 points in the erectile function domain of the International Index of Erectile Function (IIEF-EF) were eligible for the study. They were allocated to 1 of 2 groups: 5 weekly sessions of sham treatment (group A) or linear Li-ESWT (group B). After a 4-week break, the 2 groups received active treatment once a week for 5 weeks. At baseline and 6 and 12 months, subjects were evaluated by the IIEF-EF, the Erectile Hardness Scale (EHS), and the Sexual Quality of Life in Men. The primary outcome measure was an increase of at least 5 points in the IIEF-EF (ΔIIEF-EF score). The secondary outcome measure was an increase in the EHS score to at least 3 in men with a score no higher than 2 at baseline. Data were analyzed by linear and logistic regressions. Linear regression of the ΔIIEF-EF score from baseline to 12 months included 95 patients (dropout rate = 25%). Adjusted for the IIEF-EF score at baseline, the difference between groups B and A was -1.30 (95% CI = -4.37 to 1.77, P = .4). The success rate based on the main outcome parameter (ΔIIEF-EF score ≥ 5) was 54% in group A vs 47% in group B (odds ratio = 0.67, P = .28). Improvement based on changes in the EHS score in groups A and B was 34% and 24%, respectively (odds ratio = 0.47, P = .82). Exposure to 2 cycles of linear Li-ESWT for ED is not superior to 1 cycle at 6- and 12-month follow-ups. Fojecki GL, Tiessen S

  13. [Evaluation of self-esteem in males with erectile dysfunction treated with viagra. Analysis of a Spanish patients group selected from a multicenter, international study].

    Science.gov (United States)

    Martínez-Jabaloyas, J M; Moncada, I; Rodríguez-Vela, L; Gutiérrez, P R; Chaves, J

    2010-09-01

    Erectile dysfunction (ED) leads to psychological disturbances, especially anxiety and loss of self-esteem. We try to understand the emotional changes, based on self-esteem and relationships in a group of Spanish men with ED after sildenafil treatment, with the use of the the SEAR questionnaire (Self-Esteem And Relationship). The patients recruited in Spain, where selected from an international, multicenter, randomized, parallel-group, double-blind, placebo-controlled, sildenafil study designed to assess self-esteem and relationships in men with ED. We compared the changes in the different domains of the SEAR questionnaire (Self-steem, sexual activity, self-confidence and general relationships) that was administered before and after treatment; the different domains of the IIEF was evaluated as well. We also calculated the correlation between changes in self-esteem domain of the SEAR questionnaire. The statistical study was based on an analysis of covariance of change in scores and a correlation analysis. The Spanish group of researchers included 119 patients. The erectile function domain score showed significantly greater improvement for the group of sildenafil. The difference in change in total mean score of the SEAR after treatment was 16.9 (95% CI 8.9, 24.8) for sildenafil over placebo (p=0.0001), with a significantly higher score improvement in all the domains of the SEAR for Sildenafil. There was a significant correlation between the changes in the domain of self-esteem of the SEAR and the IIEF erectile function domain for both treatment groups. Emotional improvement was confirmed in patients treated with sildenafil based on improved self-esteem, self-confidence and relationships. Changes in the IIEF erectile function domain correlate with the SEAR self-esteem domain.

  14. Off-Label Use of Phosphodiesterase Type 5 Inhibitor Erectile Dysfunction Medication to Enhance Sex Among Gay and Bisexual Men in Australia: Results From the FLUX Study.

    Science.gov (United States)

    Hammoud, Mohamed A; Jin, Fengyi; Lea, Toby; Maher, Lisa; Grierson, Jeffrey; Prestage, Garrett

    2017-06-01

    Gay and bisexual men (GBM) use oral erectile dysfunction medications (EDMs) often with little evidence of medical indication necessitating their use. To investigate the prevalence, contexts, and motivations for oral EDM use and its relation to sexual risk behavior. A total of 2,250 Australian GBM completed an online survey of licit and illicit drug use and their associated behaviors. Multivariate logistic regression analysis identified factors associated with use of EDMs in the previous 6 months and, for those who had used EDMs, factors associated with use on a weekly basis. Any EDM use and at least weekly use in the previous 6 months. The median age of the sample was 33.0 years (range = 16-81). Two thirds (67.7%) reported no lifetime history of EDM use. Approximately 1 in 10 participants (11.1%) had last used an EDM more than 6 months previously. In the previous 6 months, 11.5% reported using EDMs less than monthly, 5.3% reported using EDMs approximately monthly, and 4.5% reported using EDMs at least weekly. Of men who had used EDMs in the previous 6 months, common reasons cited for its use were to maintain an erection for longer (73.3%), to make it easier to "get hard" (67.3%), and difficulty in attaining or maintain an erection (53.5%). Use of EDMs in the previous 6 months was associated with illicit drug use and higher rates of sexual risk behavior. Weekly users were more likely to have severe anxiety than less frequent users. The use of EDMs in the context of intensive sex partying, with the associated potential for increased risk of HIV transmission and illicit drug use, indicates a need to consider the use of EDMs among GBM in HIV prevention and minimizing harm. This large-scale study of drug use among GBMs includes comprehensive detailed data on their history of use and rationales for use. Our online methodology potentially decreases social desirability bias in reporting illegal or stigmatized behaviors. This volunteer online convenience sample might not

  15. SU-D-204-06: Integration of Machine Learning and Bioinformatics Methods to Analyze Genome-Wide Association Study Data for Rectal Bleeding and Erectile Dysfunction Following Radiotherapy in Prostate Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Oh, J; Deasy, J [Memorial Sloan Kettering Cancer Center, New York, NY (United States); Kerns, S [University of Rochester Medical Center, Rochester, NY (United States); Ostrer, H [Albert Einstein College of Medicine, Bronx, NY (United States); Rosenstein, B [Mount Sinai School of Medicine, New York, NY (United States)

    2016-06-15

    Purpose: We investigated whether integration of machine learning and bioinformatics techniques on genome-wide association study (GWAS) data can improve the performance of predictive models in predicting the risk of developing radiation-induced late rectal bleeding and erectile dysfunction in prostate cancer patients. Methods: We analyzed a GWAS dataset generated from 385 prostate cancer patients treated with radiotherapy. Using genotype information from these patients, we designed a machine learning-based predictive model of late radiation-induced toxicities: rectal bleeding and erectile dysfunction. The model building process was performed using 2/3 of samples (training) and the predictive model was tested with 1/3 of samples (validation). To identify important single nucleotide polymorphisms (SNPs), we computed the SNP importance score, resulting from our random forest regression model. We performed gene ontology (GO) enrichment analysis for nearby genes of the important SNPs. Results: After univariate analysis on the training dataset, we filtered out many SNPs with p>0.001, resulting in 749 and 367 SNPs that were used in the model building process for rectal bleeding and erectile dysfunction, respectively. On the validation dataset, our random forest regression model achieved the area under the curve (AUC)=0.70 and 0.62 for rectal bleeding and erectile dysfunction, respectively. We performed GO enrichment analysis for the top 25%, 50%, 75%, and 100% SNPs out of the select SNPs in the univariate analysis. When we used the top 50% SNPs, more plausible biological processes were obtained for both toxicities. An additional test with the top 50% SNPs improved predictive power with AUC=0.71 and 0.65 for rectal bleeding and erectile dysfunction. A better performance was achieved with AUC=0.67 when age and androgen deprivation therapy were added to the model for erectile dysfunction. Conclusion: Our approach that combines machine learning and bioinformatics techniques

  16. SU-D-204-06: Integration of Machine Learning and Bioinformatics Methods to Analyze Genome-Wide Association Study Data for Rectal Bleeding and Erectile Dysfunction Following Radiotherapy in Prostate Cancer

    International Nuclear Information System (INIS)

    Oh, J; Deasy, J; Kerns, S; Ostrer, H; Rosenstein, B

    2016-01-01

    Purpose: We investigated whether integration of machine learning and bioinformatics techniques on genome-wide association study (GWAS) data can improve the performance of predictive models in predicting the risk of developing radiation-induced late rectal bleeding and erectile dysfunction in prostate cancer patients. Methods: We analyzed a GWAS dataset generated from 385 prostate cancer patients treated with radiotherapy. Using genotype information from these patients, we designed a machine learning-based predictive model of late radiation-induced toxicities: rectal bleeding and erectile dysfunction. The model building process was performed using 2/3 of samples (training) and the predictive model was tested with 1/3 of samples (validation). To identify important single nucleotide polymorphisms (SNPs), we computed the SNP importance score, resulting from our random forest regression model. We performed gene ontology (GO) enrichment analysis for nearby genes of the important SNPs. Results: After univariate analysis on the training dataset, we filtered out many SNPs with p>0.001, resulting in 749 and 367 SNPs that were used in the model building process for rectal bleeding and erectile dysfunction, respectively. On the validation dataset, our random forest regression model achieved the area under the curve (AUC)=0.70 and 0.62 for rectal bleeding and erectile dysfunction, respectively. We performed GO enrichment analysis for the top 25%, 50%, 75%, and 100% SNPs out of the select SNPs in the univariate analysis. When we used the top 50% SNPs, more plausible biological processes were obtained for both toxicities. An additional test with the top 50% SNPs improved predictive power with AUC=0.71 and 0.65 for rectal bleeding and erectile dysfunction. A better performance was achieved with AUC=0.67 when age and androgen deprivation therapy were added to the model for erectile dysfunction. Conclusion: Our approach that combines machine learning and bioinformatics techniques

  17. Stage effect of chronic kidney disease in erectile function.

    Science.gov (United States)

    Costa, Márcio Rodrigues; Ponciano, Viviane Campos; Costa, Théo Rodrigues; Gomes, Caio Pereira; de Oliveira, Enio Chaves

    2018-01-01

    The study aims to assess the influence of the stage of chronic kidney disease and glomerular filtration rate on prevalence and degree of erectile dysfunction. This transversal study, conducted from May 2013 to December 2015, included patients with chronic kidney disease in conservative treatment, stages III/IV/V. Erectile dysfunction was evaluated by the International Index of Erectile Function. Data classically associated with erectile dysfunction were obtained by medical record review. Erectile dysfunction, degree of erectile dysfunction, and other main variables associated with erectile dysfunction were compared between patients with chronic kidney disease on conservative treatment stages III versus IV/V using the Chi-square test. The relationship between score of the International Index of Erectile Dysfunction and glomerular filtration rate was established by Pearson correlation coefficient. Two hundred and forty five patients with chronic kidney disease in con-servative treatment participated of the study. The prevalence of erectile dysfunction in patients with chronic kidney disease in stages IV/V was greater than in stage III. Glomerular filtration rate positively correlated with score of the International Index of Erectile Dysfunction. The study suggests that chronic kidney disease progression (glomerular filtration rate decrease and advance in chronic kidney disease stages) worsen erectile function. Hypothetically, diagnosis and treatment of erectile dysfunction may be anticipated with the analysis of chronic kidney disease progression. Copyright® by the International Brazilian Journal of Urology.

  18. Stage effect of chronic kidney disease in erectile function

    Directory of Open Access Journals (Sweden)

    Márcio Rodrigues Costa

    Full Text Available ABSTRACT Purpose The study aims to assess the influence of the stage of chronic kidney disease and glomerular filtration rate on prevalence and degree of erectile dysfunction. Materials and Methods This transversal study, conducted from May 2013 to December 2015, included patients with chronic kidney disease in conservative treatment, stages III/IV/V. Erectile dysfunction was evaluated by the International Index of Erectile Function. Data classically associated with erectile dysfunction were obtained by medical record review. Erectile dysfunction, degree of erectile dysfunction, and other main variables associated with erectile dysfunction were compared between patients with chronic kidney disease on conservative treatment stages III versus IV/V using the Chi-square test. The relationship between score of the International Index of Erectile Dysfunction and glomerular filtration rate was established by Pearson correlation coefficient. Results Two hundred and forty five patients with chronic kidney disease in conservative treatment participated of the study. The prevalence of erectile dysfunction in patients with chronic kidney disease in stages IV/V was greater than in stage III. Glomerular filtration rate positively correlated with score of the International Index of Erectile Dysfunction. Conclusions The study suggests that chronic kidney disease progression (glomerular filtration rate decrease and advance in chronic kidney disease stages worsen erectile function. Hypothetically, diagnosis and treatment of erectile dysfunction may be anticipated with the analysis of chronic kidney disease progression.

  19. Erectile Dysfunction Drugs Changed the Protein Expressions and Activities of Drug-Metabolising Enzymes in the Liver of Male Rats

    Directory of Open Access Journals (Sweden)

    Salah A. Sheweita

    2016-01-01

    Full Text Available Erectile dysfunction (ED is a major health problem and is mainly associated with the persistent inability of men to maintain sufficient erection for satisfactory sexual performance. Millions of men are using sildenafil, vardenafil, and/or tadalafil for ED treatment. Cytochrome P450s (CYPs play a central role in the metabolism of a wide range of xenobiotics as well as endogenous compounds. Susceptibility of individuals to the adverse effects of different drugs is mainly dependent on the expression of CYPs proteins. Therefore, changes in activities of phase I drug-metabolising enzymes [arylhydrocarbon hydroxylase (AHH, dimethylnitrosamine N-demethylase (DMN-dI, 7-ethoxycoumarin-O-deethylase (ECOD, and ethoxyresorufin-O-deethylase ((EROD] and the protein expression of different CYPs isozymes (CYP1A2, CYP2E1, CYP2B1/2, CYP3A4, CYP2C23, and CYP2C6 were determined after treatment of male rats with either low or high doses of sildenafil (Viagra, tadalafil (Cialis, and/or vardenafil (Levitra for 3 weeks. The present study showed that low doses of tadalafil and vardenafil increased DMN-dI activity by 32 and 23%, respectively. On the other hand, high doses of tadalafil, vardenafil, and sildenafil decreased such activity by 50, 56, and 52%, respectively. In addition, low doses of tadalafil and vardenafil induced the protein expression of CYP2E1. On the other hand, high doses of either tadalafil or sildenafil were more potent inhibitors to CYP2E1 expression than vardenafil. Moreover, low doses of both vardenafil and sildenafil markedly increased AHH activity by 162 and 247%, respectively, whereas high doses of tadalafil, vardenafil, and sildenafil inhibited such activity by 36, 49, and 57% and inhibited the EROD activity by 39, 49, and 33%, respectively. Low and high doses of tadalafil, vardenafil, and sildenafil inhibited the activity of NADPH-cytochrome c reductase as well as its protein expression. In addition, such drugs inhibited the expression of CYP

  20. Erectile dysfunction, masculinity, and psychosocial outcomes: a review of the experiences of men after prostate cancer treatment

    Science.gov (United States)

    Chung, Eric; Wittert, Gary; Hyde, Melissa K.

    2017-01-01

    Prostate cancer (PC) treatment side-effects such as erectile dysfunction (ED) can impact men’s quality of life (QoL), psychosocial and psycho-sexual adjustment. Masculinity (i.e., men’s identity or sense of themselves as being a man) may also be linked to how men respond to PC treatment and ED however the exact nature of this link is unclear. This review aims to provide a snapshot of the current state of evidence regarding ED, masculinity and psychosocial impacts after PC treatment. Three databases (Medline/PsycINFO, CINHAL, and EMBASE) were searched January 1st 1980 to January 31st 2016. Study inclusion criteria were: patients treated for PC; ED or sexual function measured; masculinity measured in quantitative studies or emerged as a theme in qualitative studies; included psychosocial or QoL outcome(s); published in English language, peer-reviewed journal articles. Fifty two articles (14 quantitative, 38 qualitative) met review criteria. Studies were predominantly cross-sectional, North American, samples of heterosexual men, with localised PC, and treated with radical prostatectomy. Results show that masculinity framed men’s responses to, and was harmed by their experience with, ED after PC treatment. In qualitative studies, men with ED consistently reported lost (no longer a man) or diminished (less of a man) masculinity, and this was linked to depression, embarrassment, decreased self-worth, and fear of being stigmatised. The correlation between ED and masculinity was similarly supported in quantitative studies. In two studies, masculinity was also a moderator of poorer QoL and mental health outcomes for PC patients with ED. In qualitative studies, masculinity underpinned how men interpreted and adjusted to their experience. Men used traditional (hegemonic) coping responses including emotional restraint, stoicism, acceptance, optimism, and humour or rationalised their experience relative to their age (ED inevitable), prolonged life (ED small price to pay

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

    Directory of Open Access Journals (Sweden)

    Luis Labairu-Huerta

    2015-09-01

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

  2. [The development of clinical application of the rejuvenator and a study of its mechanism for the treatment of functional erectile dysfunction].

    Science.gov (United States)

    Meng, Z; Zou, Y; Luo, E; Zou, L

    2001-12-01

    In this paper, we describe the development and clinical application of the Rejuvenator and report the result of our study on its mechanism for the treatment of functional erectile dysfunction (FED). The Rejuvenator, which can be used both at home and in hospitals to treat patients with FED, was developed on the basis of our clinical practice in the light of the modern theory of traditional Chinese medicine and by integrating multiple techniques of engineering science. It works by means of the paraoral use of the special herbal medicine, electro-magnetic effects, thermal moxibustion and drug-ingression. 2250 patients with FED received the treatment. Using combined electro-neurophysiological techniques, pulsed ultrasound Doppler and microcomputer image-scanning, we further studied the mechanism of the Rejuvenator for the treatment of FED. The total effective rate was 92%. The clinical data and result of study indicate that the Rejuvenator for the patients with functional erectile dysfunction is a safe, effective and scientific new method.

  3. Erectile Dysfunction and Diabetes

    Science.gov (United States)

    ... factors such as stress, anxiety, guilt, depression, low self-esteem, and fear of sexual failure cause 10 to ... Email: Sign Up Thank you for signing up ' + ' '); $('.survey-form').show(); }, success: function (data) { $('#survey-errors').remove(); $('. ...

  4. 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 (p<0.001) in both sildenafil/tadalafil treated men. Similarly mean domain of erectile function, orgasmic function, and intercourse satisfaction also showed a significantly positive improvement (p/0.001) in both the treated groups in comparison with their age matched untreated controls. Interestingly in all the cases, tadalafil group showed considerably greater positive responses than the sildenafil group but within the same significant levels. Strikingly the sexual-desire domain in sildenafil treated men with respect to their aged matched controls

  5. Ethanol-induced erectile dysfunction and increased expression of pro-inflammatory proteins in the rat cavernosal smooth muscle are mediated by NADPH oxidase-derived reactive oxygen species.

    Science.gov (United States)

    Leite, Letícia N; do Vale, Gabriel T; Simplicio, Janaina A; De Martinis, Bruno S; Carneiro, Fernando S; Tirapelli, Carlos R

    2017-06-05

    Ethanol consumption is associated with an increased risk of erectile dysfunction (ED), but the molecular mechanisms through which ethanol causes ED remain elusive. Reactive oxygen species are described as mediators of ethanol-induced cell toxicity/damage in distinctive tissues. The enzyme NADPH oxidase is the main source of reactive oxygen species in the endothelium and vascular smooth muscle cells and ethanol is described to increase NADPH oxidase activation and reactive oxygen species generation. This study evaluated the contribution of NADPH oxidase-derived reactive oxygen species to ethanol-induced ED, endothelial dysfunction and production of pro-inflammatory and redox-sensitive proteins in the rat cavernosal smooth muscle (CSM). Male Wistar rats were treated with ethanol (20% v/v) or ethanol plus apocynin (30mg/kg/day; p.o. gavage) for six weeks. Apocynin prevented both the decreased in acetylcholine-induced relaxation and intracavernosal pressure induced by ethanol. Ethanol increased superoxide anion (O 2 - ) generation and catalase activity in CSM, and treatment with apocynin prevented these responses. Similarly, apocynin prevented the ethanol-induced decreased of nitrate/nitrite (NOx), hydrogen peroxide (H 2 O 2 ) and SOD activity. Treatment with ethanol increased p47phox translocation to the membrane as well as the expression of Nox2, COX-1, catalase, iNOS, ICAM-1 and p65. Apocynin prevented the effects of ethanol on protein expression and p47phox translocation. Finally, treatment with ethanol increased both TNF-α production and neutrophil migration in CSM. The major new finding of this study is that NADPH oxidase-derived reactive oxygen species play a role on chronic ethanol consumption-induced ED and endothelial dysfunction in the rat CSM. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. [Self-concept and erectile dysfunction in 45-year-old men : Results of a corollary study of the PROBASE trial].

    Science.gov (United States)

    Kögel, A M; Dinkel, A; Marten-Mittag, B; Baron, J; Albers, P; Arsov, C; Hadaschik, B; Hohenfellner, M; Imkamp, F; Kuczyk, M; Gschwend, J E; Herkommer, K

    2016-10-01

    Self-concept consists of self-perceptions and is influenced by the life course of the person. This study investigated associations between self-concept and erectile dysfunction (ED) in 45-year-old German men. Forty-five-year-old, heterosexual men who had participated in the PROBASE-study were included. Erectile Function was evaluated using the International Index of Erectile Function (IIEF-6). The presence of ED was defined by IIEF-6 score ≤ 25. Self-concept was assessed using the facets "body image" (three items from the Dresden Body Image Inventory, DKB-35), "perception of masculinity" (three items from the Male Role Norms Scale, MRNS), "perceived social pressure with regard to sexual performance" (four newly constructed items), and "sexual self-esteem" (three newly constructed items). Scores for these facets of self-concept can range from 1 to 5. Higher scores indicate a more positive body image, higher sexual self-esteem, a more modern understanding of masculinity, and greater perceived social pressure. Differences in self-concept between men with ED and without ED were analyzed using the Mann-Whitney-U-test. Furthermore, Cohen's d effect sizes (ES d) were calculated. The responses of 3143 men were analyzed. Men with ED (16.2 %) have significantly lower scores regarding body image (mean 3.6 ± 0.6 vs 3.8 ± 0.5; p Self-concept and ED are associated in 45-year-old men. Men with ED have a more negative body image, a more traditional understanding of masculinity, more negative sexual self-esteem, and greater perceived social pressure with regard to sexual performance than men without ED.

  7. Prevalence of erectile dysfunction and associated factors among diabetic men attending diabetic clinic at Muhimbili National Hospital in Dar-es-Salaam, Tanzania.

    Science.gov (United States)

    Mutagaywa, Reuben Kato; Lutale, Janeth; Aboud, Muhsin; Kamala, Benjamin Anathory

    2014-01-01

    There has been an increase in the prevalence of erectile dysfunction (ED) in the general population especially among Diabetic patients. This seems to be neglected problem in low-income countries. This study aims at establishing the prevalence of ED and associated risk factors in diabetic patients attended at Diabetic Clinic at Muhimbili National Hospital. A cross-sectional hospital based study was conducted among 312 diabetic patients attending diabetic clinic at Muhimbili National Hospital between May and December 2011. More than half (55.1%) of the patients were found to have some form of ED (12.8% had mild dysfunction, 11.5% moderate and 27.9% severe dysfunction). The severity of ED was correlated with increased age. Multivariate logistic regression revealed that ED was significantly predicted by old age (odds ratio (OR) = 7.1, 95% CI 1.2-40.7), evidence of peripheral neuropathy (OR) =5.9, 95% CI 1.6-21.3), and evidence of peripheral vascular disease (OR =2.5, 95% CI 1.2-5.3). Also longer duration of DM was marginally associated with ED (p=0.056). Patients with ED were also more likely to suffer other sexual domains (perectile dysfunction.

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

    International Nuclear Information System (INIS)

    Wernicke, A. Gabriella; Valicenti, Richard; DiEva, Kelly; Houser, Christopher; Pequignot, Ed

    2004-01-01

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

  9. Erectile dysfunction and hormonal imbalance in morbidly obese male is reversed after gastric bypass surgery: a prospective randomized controlled trial.

    Science.gov (United States)

    Reis, L O; Favaro, W J; Barreiro, G C; de Oliveira, L C; Chaim, E A; Fregonesi, A; Ferreira, U

    2010-10-01

    The effects of weight loss on erectile function and hormones have not been well studied. The aim of this study was to measure the degree to which sexual function and in particular erectile function and hormonal environment change after substantial weight loss, surgically and non-surgically induced in the morbidly obese male in a prospective randomized long-term controlled trial. Furthermore, how surgery makes a difference when treating morbidly obese men was envisaged in this context. We prospectively studied 20 morbidly obese men for 24 months, divided into two groups: group A included 10 patients who underwent life style modifications (exercise and diet) for 4 months and subsequently gastric bypass, and another 10 patients in group B were kept on weekly follow-up. None of the men were taking phosphodiesterase type-5 inhibitors. All patients underwent International Index of Erectile Function (IIEF)-5 questionnaire, serum oestradiol, prolactin (PRL), luteinizing (LH) and follicle-stimulating (FSH) hormones, free and total testosterone (FT and TT) at baseline (time 0), surgery - 4 months latter baseline (time 1) and final evaluation - 24 months (time 2). From times 0 to 1, group A presented a mean body mass index (BMI) reduction of 12.6 (p 0.05). The BMI reductions between times 0 and 2 were 24.7 (p 0.05) for groups A and B respectively. BMI average between the two groups was similar at time 0 (p = 0.2142), and different at times 1 (p = 0.0033) and 2 (p hormonal impact verified could justify the improvement in erectile function. Lifestyle modifications impacted BMI without hormonal or sexual impact in morbidly obese. New studies are warranted in the field to support our data.

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

    Directory of Open Access Journals (Sweden)

    Boustead Gregory

    2002-04-01

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

  11. Sildenafil citrate improves self-esteem, confidence, and relationships in men with erectile dysfunction: Results from an international, multi-center, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Althof, Stanley E; O'leary, Michael P; Cappelleri, Joseph C; Hvidsten, Kyle; Stecher, Vera J; Glina, Sidney; King, Rosie; Siegel, Richard L

    2006-05-01

    Erectile dysfunction (ED) can significantly impact a man's relationships and well-being. We assessed changes in self-esteem, confidence, sexual relationship satisfaction, and overall relationship satisfaction in men with ED using the validated Self-Esteem And Relationship questionnaire (SEAR). This was a 12-week, double-blind, placebo-controlled, flexible-dose (25, 50, 100 mg, as needed) international study of sildenafil in men > or =18 years of age in Mexico, Brazil, Australia, and Japan. The primary study outcome was change in self-esteem from baseline to the end of treatment. Secondary study measures were changes in other SEAR components, International Index of Erectile Function (IIEF) domains, percentage of intercourse attempts that were successful, and the response to a global efficacy question at the end of treatment. Patients were well balanced for age and duration of ED (placebo = 149 and sildenafil = 151). Compared with placebo, sildenafil significantly improved self-esteem, confidence, sexual relationship satisfaction, and overall relationship satisfaction (P self-esteem, confidence, sexual relationship satisfaction, and overall relationship satisfaction after treatment of ED with sildenafil were consistent among countries. These data suggest a substantial cross-cultural improvement in well-being after successful treatment of ED with sildenafil.

  12. Subjective effects of Lepidium meyenii (Maca) extract on well-being and sexual performances in patients with mild erectile dysfunction: a randomised, double-blind clinical trial.

    Science.gov (United States)

    Zenico, T; Cicero, A F G; Valmorri, L; Mercuriali, M; Bercovich, E

    2009-04-01

    Lepidium meyenii (Maca) is a cultivated root belonging to the brassica family used in the Andean region for its supposed aphrodisiac properties. We carried out a double-blind clinical trial on 50 Caucasian men affected by mild erectile dysfunction (ED), randomised to treatment with Maca dry extract, 2400 mg, or placebo. The treatment effect on ED and subjective well-being was tested administrating before and after 12 weeks the International Index of Erectile Function (IIEF-5) and the Satisfaction Profile (SAT-P). After 12 weeks of treatment, both Maca- and placebo-treated patients experienced a significant increase in IIEF-5 score (P < 0.05 for both). However, patients taking Maca experienced a more significant increase than those taking placebo (1.6 +/- 1.1 versus 0.5 +/- 0.6, P < 0.001). Both Maca- and placebo-treated subjects experienced a significant improvement in psychological performance-related SAT-P score, but the Maca group higher than that of placebo group (+9 +/- 6 versus +6 +/- 5, P < 0.05). However, only Maca-treated patients experienced a significant improvement in physical and social performance-related SAT-P score compared with the baseline (+7 +/- 6 and +7 +/- 6, both P < 0.05). In conclusion, our data support a small but significant effect of Maca supplementation on subjective perception of general and sexual well-being in adult patients with mild ED.

  13. Feasibility of dynamic 3-D color Doppler ultrasound for imaging penile vascular change in renal transplant patients with erectile dysfunction responding to sildenafil.

    Science.gov (United States)

    Chatterjee, Ratna; Deng, Jing; Pellerin, Denis; Todd-Pokropek, Andrew; Neild, Guy H; Lees, William R; Rodeck, Charles H

    2008-06-01

    Renal transplant recipients (RTRs) have a high incidence of erectile dysfunction (ED). Differentiation of penile vasculogenic impotence from other causes is important for treatment. Conventional 2-D color Doppler assessment after intracavernosal stimulant injection often fails to produce reliable results because of limited views by the cross-sectional imaging and the painful procedure. In comparison to the findings in three healthy volunteers, we determined cavernosal vascular hemodynamics in eight RTRs with ED before and after oral sildenafil by using live 3-D ultrasound and dynamic 3-D color Doppler. Results showed that, before sildenafil, penile arterial flow signals could only be reliably detected in one patient. After sildenafil, all had reliably detectable flow with grades II to III erection. Our data suggest that 3-D volumetric changes of the penis and its vasculature during erection can be studied by this technique and that this method could be useful for the evaluation of new drugs and therapeutic biofeedback.

  14. Digital three-dimensional modelling of the male pelvis and bicycle seats: impact of rider position and seat design on potential penile hypoxia and erectile dysfunction.

    Science.gov (United States)

    Gemery, John M; Nangia, Ajay K; Mamourian, Alexander C; Reid, Scott K

    2007-01-01

    To digitally model (three-dimensional, 3D) the course of the pudendal arteries relative to the bony pelvis in the adult male, and to identify sites of compression with different bicycle riding positions as a potential cause of penile hypoxia and erectile dysfunction. 3D models were made from computed tomography scans of one adult male pelvis (a healthy volunteer) and three bicycle seats. Models were correlated with lateral radiographs of a seated rider to determine potential vascular compression between the bony pelvis and seats at different angles of rider positioning. Pelvis/seat models suggest that the most likely site of compression of the internal pudendal artery is immediately below the pubic symphysis, especially with the rider leaning forward. For an upright rider, the internal pudendal arteries do not appear to be compressed between the seat and the bony pelvis. Leaning partly forward with arms extended, the seat/symphysis areas were reduced to 73 mm(2) with standard seat and 259 mm(2) with a grooved seat. Leaning fully forward, the seat/symphysis areas decreased (no space with standard seat; 51 mm(2) with a grooved seat) and both the ischial tuberosities and the pubic symphysis might be in contact with the seat. A grooved seat allows better preservation of the seat/symphysis space than a standard seat, but the rider's position is more important for preserving the seat-symphysis space (and reducing compression) than is seat design alone. Any factors which influence the seat-symphysis space (including an individual's anatomy, seat design and rider position) can increase the potential for penile hypoxia and erectile dysfunction/perineal numbness.

  15. Testosterone therapy improves erectile function and libido in hypogonadal men.

    Science.gov (United States)

    Rizk, Paul J; Kohn, Taylor P; Pastuszak, Alexander W; Khera, Mohit

    2017-11-01

    Erectile dysfunction and decreased libido are common complaints in the older male population. Recent studies have elucidated the role testosterone therapy (TTh) can play in men with low testosterone levels. The aim of this review is to provide an overview of these findings and the utility of TTh. We specifically examine the role of TTh on erectile function, coadministration with phosphodiesterase type 5 inhibitors, and libido. Recent publications suggest that TTh improves mild erectile dysfunction, though may be less useful in men with more severe erectile dysfunction. In men unresponsive to phosphodiesterase type 5 inhibitors and with mild erectile dysfunction, TTh can further improve erectile function. TTh has also shown consistent benefit in improving libido in men with low testosterone levels at baseline, with no additional improvements once testosterone levels are normalized. The available literature supports a role for TTh in men with low testosterone levels, erectile dysfunction, and low libido, with symptomatic improvement in these men.

  16. Effects of 12 weeks of tadalafil treatment on ejaculatory and orgasmic dysfunction and sexual satisfaction in patients with mild to severe erectile dysfunction: integrated analysis of 17 placebo-controlled studies.

    Science.gov (United States)

    Paduch, Darius A; Bolyakov, Alexander; Polzer, Paula K; Watts, Steven D

    2013-02-01

    To compare effects of tadalafil on ejaculatory and orgasmic function in patients presenting with erectile dysfunction (ED). To determine the effects of post-treatment ejaculatory dysfunction (EjD) and orgasmic dysfunction (OD) on measures of sexual satisfaction. Data from 17 placebo-controlled 12-week trials of tadalafil (5, 10, 20 mg) as needed in patients with ED were integrated. EjD and OD severities were defined by patient responses to the International Index of Erectile Function, question 9 (IIEF-Q9; ejaculation) and IIEF-Q10 (orgasm), respectively. Satisfaction was evaluated using the intercourse and overall satisfaction domains of the IIEF and Sexual Encounter Profile question 5. Analyses of covariance were performed to compare mean ejaculatory function and orgasmic function, and chi-squared tests evaluated differences in endpoint responses to IIEF-Q9 and IIEF-Q10. A total of 3581 randomized subjects were studied. Treatment with tadalafil 10 or 20 mg was associated with significant increases in ejaculatory and orgasmic function (vs placebo) across all baseline ED, EjD, and OD severity strata. In the tadalafil group, 66% of subjects with severe EjD reported improved ejaculatory function compared with 36% in the placebo group (P reported improvement. Residual severe EjD and OD after treatment had negative impacts on sexual satisfaction. Limitations of the analysis include its retrospective nature and the use of an instrument (IIEF) with as yet unknown performance in measuring treatment responses for EjD and OD. Tadalafil treatment was associated with significant improvements in ejaculatory function, orgasmic function and sexual satisfaction. Proportions of subjects reporting improved ejaculatory or orgasmic function were ≈ twofold higher with tadalafil than with placebo. These findings warrant corroboration in prospective trials of patients with EjD or OD (without ED). © 2013 BJU International.

  17. Erectile Dysfunction in Chronic Prostatitis/Chronic Pelvic Pain Syndrome: Outcomes from a Multi-Center Study and Risk Factor Analysis in a Single Center.

    Directory of Open Access Journals (Sweden)

    Yadong Zhang

    Full Text Available The aim of this study was to investigate the prevalence of erectile dysfunction (ED in patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS and explore the influence of UPOINT domains, National Institutes of Health-CP symptom index (NIH-CPSI and other factors on ED prevalence. This was a prospective study of consecutive patients with CP/CPPS seen at 11 tertiary hospitals during January-July 2014. ED was diagnosed as a score of<21 on the International Index of Erectile Function (IIEF-5. Patients from one center were evaluated by the UPOINT system and NIH-CPSI. Each patient was assessed using clinical examination, asocio-demographic questionnaire, the Patient Health Questionnaire (PHQ, the Pain Catastrophizing Scale (PCS, NIH-CPSI and IIEF-5.1406 patients from 11 centers (mean age, 32.18 years; range 18-60 years were enrolled. ED was found in 638/1406 patients (45.4%, and was categorized as mild in 291(45.6%, moderate in 297(46.6% and severe in50(7.7%. 192 patients from one center(mean age,31.3 years; range 18-57 years were further studied.IIEF-5 score correlated negatively with NIH-CPSI(r = 0.251, PHQ (r = 0.355 and PCS (r = 0.322scores (P<0.001.PHQ score correlated positively with NIH-CPSI (r = 0.586 and PCS(r = 0.662 scores (P<0.001.NIH-CPSI, PHQ, PCS and IIEF-5 scores did not differ significantly between class IIIA and IIIB CP/CPPS. Multivariate logistic regression showed that UPOINT psychological (P domain and NIH-CPSI symptom severity were independent risk factors for ED in CP/CPPS. It is concluded that psychological factors and symptom severity are independent risk factors for ED in CP/CPPS.

  18. Increased subsequent risk of erectile dysfunction among middle and old age males with chronic osteomyelitis: a nationwide population-based cohort study.

    Science.gov (United States)

    Wang, H-Y; Chao, C-H; Lin, C-L; Tseng, C-H; Kao, C-H

    2016-07-01

    Chronic inflammation may cause endothelial dysfunction and atherosclerosis, resulting in subsequent erectile dysfunction (ED). We examined the relationship between chronic osteomyelitis, which is a chronic inflammatory disease, and ED. A retrospective cohort study was conducted using data from the National Health Insurance Research Database. After excluding patients <40 years of age, 677 male patients newly diagnosed with chronic osteomyelitis (COM) from 1 January 2000 to 31 December 2011 were identified for the study. The non-osteomyelitis comparison cohort consisted of 2706 male participants. The incidence of ED was 2.66-fold higher in the COM cohort than in the non-osteomyelitis cohort (4.01 vs 1.51 per 10 000 person-years). After adjusting for age and comorbidities of coronary heart disease, hypertension, hyperlipidemia, depression, stroke, diabetes, peripheral vascular disease, chronic kidney disease, chronic obstructive pulmonary disease and asthma, the patients with COM had a 2.82-fold risk of ED (95% confidence interval=1.44-5.56). The incidence of ED increased with that of comorbidities in both cohorts. The highest hazard ratio was in patients between 40 and 59 years of age who had COM. Our data showed, for the first time, that COM is a possible risk factor for the development of ED.

  19. Stress affects a gastrin-releasing peptide system in the spinal cord that mediates sexual function: implications for psychogenic erectile dysfunction.

    Directory of Open Access Journals (Sweden)

    Hirotaka Sakamoto

    Full Text Available Many men suffering from stress, including post-traumatic stress disorder (PTSD, report sexual dysfunction, which is traditionally treated via psychological counseling. Recently, we identified a gastrin-releasing peptide (GRP system in the lumbar spinal cord that is a primary mediator for male reproductive functions.To ask whether an acute severe stress could alter the male specific GRP system, we used a single-prolonged stress (SPS, a putative rat model for PTSD in the present study. Exposure of SPS to male rats decreases both the local content and axonal distribution of GRP in the lower lumbar spinal cord and results in an attenuation of penile reflexes in vivo. Remarkably, pharmacological stimulation of GRP receptors restores penile reflexes in SPS-exposed males, and induces spontaneous ejaculation in a dose-dependent manner. Furthermore, although the level of plasma testosterone is normal 7 days after SPS exposure, we found a significant decrease in the expression of androgen receptor protein in this spinal center.We conclude that the spinal GRP system appears to be a stress-vulnerable center for male reproductive functions, which may provide new insight into a clinical target for the treatment of erectile dysfunction triggered by stress and psychiatric disorders.

  20. Cavernous body reduction in four patients with erectile dysfunction due to insufficient venous occlusion and a deficit of elastic fibers in the tunica albugínea

    Directory of Open Access Journals (Sweden)

    Fabrizio Iacono

    2007-12-01

    Full Text Available INTRODUCTION: The corpora cavernosa are cylindrical vessels containing fluid under pressure. Thus, if cavernous wall resistance decreases, the radius increases and internal pressure decreases (LaPlace's law. We reasoned that if we decrease the corpus cavernosum radius, by excising a strip from each tunica albuginea, intracavernous pressure would increase during erection. MATERIALS AND METHODS: We treated with this procedure, four patients (mean age 41.5 with long-standing erectile dysfunction due to veno-occlusive dysfunction, non-responders to phosphodiesterase-5 inhibitors and intracavernous PGE1 injection. RESULTS: Two months post-surgery, intracavernous PGE1 (40 mcg induced a satisfactory erection in two patients and a 45% and 58% tumescence in the other two. PGE1 responders also responded to 100 mg sildenafil. After 100 mg sildenafil and 20 mg tadalafil, the two non-responders had erections that enabled penetration but were short lasting. CONCLUSION: The procedure described could be more effective than cavernous revascularization operations. The results seem to confirm the mathematical assumptions.

  1. Comparison of tamsulosin vs tamsulosin/sildenafil effectiveness in the treatment of erectile dysfunction in patients affected by type III chronic prostatitis.

    Science.gov (United States)

    Cantoro, Ubaldo; Catanzariti, Francesco; Lacetera, Vito; Quaresima, Luigi; Muzzonigro, Giovanni; Polito, Massimo

    2013-09-26

    We evaluated the effectiveness of tamsulosin monotherapy versus tamsulosin plus sildenafil combination therapy on erectile dysfunction (ED) in young patients with type III chronic prostatitis and ED by using symptom score scales. 44 male patients were divided into 2 groups: the first group (20 patients) was treated with tamsulosin 0,4 mg monotherapy and the second one 24 patients) was treated with tamsulosin 0,4 mg plus sildenafil 50 mg combination therapy. “International Prostate Symptom Score, “National Institute of Health Chronic Prostatitis Symptom Index" (NIH-CPSI) and “International Index of Erectile Function" (IIEF-5) were investigated in each group of patients, and scores calculated during the first medical examination. Both groups were treated with tamsulosin once daily for 60 days, while sildenafil 50 mg was given on demand (at least 2 times per week) for 60 days. During the second medical examination IPSS, NIH-CPSI and IIEF-5 scores were analyzed once more. Afterwards, the alterations of scores among medical examinations in each group and between both groups were statistically compared. The age average of the 44 cases included was 32.04 3.15 years. Both groups present a statistically significant decrease, between the first and the second medical examination, in IPSS, NIH-CPSI scores and statistically significant increase in IIEF-5 score. In addition, there is no statistically significant difference, in all scores, between mono and combination therapy. tamsulosin monotherapy, as well as a combination therapy (tamsulosin plus sildenafil) has an improving effect on symptoms and on ED in patients with type III prostatitis. In the near future alpha-blockers monotherapy could be used in the treatment of chronic prostatitis and ED cases instead of phosphodiesterase type 5 (PDE-5) inhibitors combination therapy.

  2. The Global Online Sexuality Survey (GOSS): the United States of America in 2011. Chapter I: erectile dysfunction among English-speakers.

    Science.gov (United States)

    Shaeer, Osama; Shaeer, Kamal

    2012-12-01

    The Global Online Sexuality Survey (GOSS) is a worldwide epidemiologic study of sexuality and sexual disorders, based on validated questionnaires and applying age adjustment to the World Standard Population (WSP) by the World Health Organization. In 2010, the first report of GOSS came from the Middle East, describing an erectile dysfunction (ED) prevalence rate of 47%. This report studies the prevalence rate of ED in the United States as of 2011-2012 and evaluates risk factors for ED. Prevalence of ED. GOSS was randomly deployed to English-speaking male web surfers in the United States via paid advertising on Facebook, comprising 146 questions including the abbreviated 5-item International Index of Erectile Function. Two thousand twenty-two males participated; with a mean age was 52.38 years ± 14.5. Prevalence of ED was 37.7%, adjusted to 33.7% according to WSP, comparable across ethnic groups. The following risk factors were associated with higher risk for ED: diabetes mellitus, hypertension with and without antihypertensive treatment, coronary heart disease, obesity (defined by body mass index), difficult micturition, subjectively reported depression, interpersonal distress, subjectively reported impotence, in addition to novel factors such as subjectively reported premature ejaculation (PE) and concerns over genital size (not a smaller penis per se), low libido, and irregular coitus. Frequency of smoking and alcohol were not associated with higher prevalence of ED, although duration of smoking was. Adjusted to WSP, prevalence rate of ED in the United States of America is 33.7% in the year 2011, in contrast to the adjusted prevalence in the Middle East (47%). Most of the classical risk factors for ED play the same role in the United States and the World, including diabetes, hypertension, and aging. Concerns over genital size and PE are emerging risk factors for ED. © 2012 International Society for Sexual Medicine.

  3. Telomerase reverse transcriptase genetically modified adipose tissue derived stem cells improves erectile dysfunction by inhibiting oxidative stress and enhancing proliferation in rat model.

    Science.gov (United States)

    Wu, Xiao-Jun; Shen, Wen-Hao; He, Peng; Zhou, Xiao-Zhou; Zhi, Yi; Dai, Qiang; Chen, Zhi-Wen; Zhou, Zhan-Song

    2017-08-01

    Erectile dysfunction (ED) is considered to be incapable of obtaining or/and keeping a sufficient erection function to receive the satisfactory during the sexual intercourse. This study aims to investigate the effects of telomerase reverse transcriptase (hTERT) modified adipose tissue derived stem cells (ADSCs) autologously injected into cavernosa of the ED rats on erectile function. The ADSCs were isolated form the rat subcutaneous adipose tissue sample, and identified by examining the CD29 and CD44 molecule. The ED model was established by using 100μg/kg apomorphine (APO). The adenovirus expressing rat hTERT (Ade-hTERT vector) was established, and transfected into ADSCs and injected into ED rat model, respectively. Telomerase activity, cell growth, cell apoptosis were analyzed by using TRAP ELISA assay, CCK8 assay and flow cytometry assay, respectively. The trophic growth factors were examined by using enzyme-linked immunosorbent assay (ELISA). The mRNA and proteins were detected by using semi-quantitative PCR and western blot assay, respectively. Ade-hTERT vector was highly expressed in both ADSCs and ED rat mode. The hTERT expression enhanced the telomerase activity, inhibits cell apoptosis and enhances proliferation of ADSCs (P<0.05). hTERT expression triggers the secretory function of ADSCs and induces differentiative potential of ADSCs. hTERT expression inhibits apoptosis and increases eNOS and nNOS levels in older ED rats compared to the Ade-vector injected ED rats (P<0.05). In conclusion, the hTERT modification could enhance the ADSCs proliferation, and hTERT modified ADSCs could increase the anti-oxidative stress capacity in the ED rat model. Copyright © 2017. Published by Elsevier Masson SAS.

  4. 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.

  5. Self-esteem, confidence and relationship satisfaction in men with erectile dysfunction: a randomized, parallel-group, double-blind, placebo-controlled study of sildenafil in Mexico.

    Science.gov (United States)

    Zonana Farca, E; Francolugo-Vélez, V; Moy-Eransus, C; Orozco Bravo, A; Tseng, L-J; Stecher, V J

    2008-01-01

    Erectile dysfunction (ED) negatively impacts self-esteem and relationship satisfaction. The Self-Esteem and Relationship (SEAR) questionnaire is a validated, ED-specific, patient-reported instrument that specifically addresses self-esteem and relationship issues within the context of ED. Effective ED treatment with sildenafil in a double-blind, placebo-controlled clinical trial conducted in Brazil, Mexico, Australia and Japan showed pooled cross-cultural improvements in self-esteem, confidence and relationship satisfaction. This report focuses on the results from the subgroup of men from nine Mexican centers who participated in the multinational study. A total of 95 men aged >or=18 years with clinically diagnosed ED and currently in a stable relationship were randomized to placebo (n=47) or sildenafil (n=48). The SEAR results for Mexican men showed that sildenafil treatment led to significant improvements in self-esteem, confidence and relationship satisfaction. These data support an earlier study showing that Latin American men taking sildenafil have similar safety and efficacy profiles compared to non-Latin counterparts.

  6. Structure elucidation of phototransformation products of unapproved analogs of the erectile dysfunction drug sildenafil in artificial freshwater with UPLC-Q Exactive-MS.

    Science.gov (United States)

    Aceña, Jaume; Pérez, Sandra; Gardinali, Piero; Abad, José Luis; Eichhorn, Peter; Heuett, Nubia; Barceló, Damià

    2014-12-01

    In this study, four unapproved analogues of Sildenafil (SDF) were photodegraded under synthetic sunlight in artificial freshwater. Homosildenafil (H-SDF), hydroxyhomo-sildenafil (HH-SDF), norneosildenafil (NR-SDF) and thiosildenafil (T-SDF) were selected because they are frequently detected as adulterants in natural herbal products. Using UPLC-Orbitrap (Q Exactive)-MS, six photoproducts common to H-SDF, HH-SDF and T-SDF and nine unique transformation products of different molecular weights were identified based on their high-resolution (+)ESI product ion spectra. Mass spectral analysis of deuterated H-SDF, labeled on the N-ethyl group, allowed to gain mechanistic insight into the fragmentation pathway of the substituted piperazine ring and to support the postulated photoproduct structures. The mass spectral fragmentation confirmed the stepwise destruction of the piperazine ring eventually producing a sulfonic acid derivative (C17 H20 N4 O5 S: 392.1151 Da). In contrast, the photodegradation of NR-SDF, which lacks a piperazine ring in its structure, formed only two prominent photoproducts originating from N,N-dealkylation of the sulfonamide followed by hydrolysis. The current work constitutes the first study on the photodegradation of analogs of erectile dysfunction drugs and the first detection of two transformation products (m/z 449 and 489) in environmental samples. Copyright © 2014 John Wiley & Sons, Ltd.

  7. Adverse side effects of 5α-reductase inhibitors therapy: persistent diminished libido and erectile dysfunction and depression in a subset of patients.

    Science.gov (United States)

    Traish, Abdulmaged M; Hassani, John; Guay, Andre T; Zitzmann, Michael; Hansen, Michael L

    2011-03-01

    5α-reductase inhibitors (5α-RIs), finasteride and dutasteride, have been approved for treatment of lower urinary tract symptoms, due to benign prostatic hyperplasia, with marked clinical efficacy. Finasteride is also approved for treatment of hair loss (androgenetic alopecia). Although the adverse side effects of these agents are thought to be minimal, the magnitude of adverse effects on sexual function, gynecomastia, depression, and quality of life remains ill-defined. The goal of this review is to discuss 5α-RIs therapy, the potential persistent side effects, and the possible mechanisms responsible for these undesirable effects. We examined data reported in various clinical studies from the available literature concerning the side effects of finasteride and dutasteride. Data reported in the literature were reviewed and discussed. Results.  Prolonged adverse effects on sexual function such as erectile dysfunction and diminished libido are reported by a subset of men, raising the possibility of a causal relationship. We suggest discussion with patients on the potential sexual side effects of 5α-RIs before commencing therapy. Alternative therapies may be considered in the discussion, especially when treating androgenetic alopecia. © 2010 International Society for Sexual Medicine.

  8. [Investigation of mechanisms of action of growth factors of autologous platelet-rich plasma used to treat erectile dysfunction].

    Science.gov (United States)

    Epifanova, M V; Chalyi, M E; Krasnov, A O

    2017-09-01

    To determine the quantitative and qualitative composition of growth factors (PDGF-AA, PDGF-BB, VEGF, VEGF-D, FGF-acid, FGF-basic) and platelets in various modifications of APRP. Blood of 12 male volunteers (control group) and 12 patients with ED was used to prepare APRP and the subsequently determine the concentration of growth factors. The growth factor concentrations (FGF acid, FGF basic, PDGF-AA, PDGF-BB, VEGF, VEGF-D) was determined using a flow cytometry-based xMAP Luminex (Gen-Probe) system. Concentration of platelets in APRP obtained by two stage centrifugation, reached 1480 (1120-1644) in the control group and 1232 (956-1502) in patients with ED. The concentration of growth factors in the samples prepared without preliminary freezing was: PDGF-AA 842 (22-3700), PDGF-BB 2837 (1460-4100), FGF-basic 7.9 (0.28-127), FGF-acid 3, 4 (0.14-11), VEGF 19 (4.6-46), VEGF-D 21 (14-38). After thawing, the concentration of all growth factors in the samples increased. The study findings suggest that the mechanism of erectile function recovery following the use of APRP is through the active substances detected in APRP, i.e. FGF-basic, PDGF-AA, PDGF-BB, VEGF, VEGF-D and FGF-acid. Also, the study showed that the content of growth factors in APRP after of freezing/thawing is higher than in APRP that has not been frozen. This is due to the cell membrane destruction at extremely low temperatures during freezing.

  9. Long-term testosterone treatment in elderly men with hypogonadism and erectile dysfunction reduces obesity parameters and improves metabolic syndrome and health-related quality of life.

    Science.gov (United States)

    Yassin, Dany-Jan; Doros, Gheorghe; Hammerer, Peter G; Yassin, Aksam A

    2014-06-01

    Late-onset hypogonadism (LOH) is diagnosed when declining testosterone concentrations in the aging male cause unwanted symptoms such as erectile dysfunction (ED), reduced bone density and muscle strength, and increased visceral obesity. Testosterone deficiency is also associated with insulin resistance and the metabolic syndrome (MetS). Restoring testosterone to physiological concentrations has beneficial effects on many of these symptoms; however, it is not known whether these effects can be sustained in the long term. To investigate whether treatment with testosterone undecanoate (TU) has a long-term and sustained effect on parameters affected by the MetS in men with LOH and ED, to determine whether long-term testosterone treatment can improve the overall health-related quality of life in these men, and to establish the safety of long-term testosterone treatment. Two hundred sixty-one patients (mean age 59.5 ± 8.4 years) diagnosed with LOH and ED were treated with long-acting TU in a prospective, observational, and longitudinal registry study. Men received intramuscular injections of 1,000 mg TU at day 1, at week 6, and every 3 months thereafter. Parameters affected by the MetS, including obesity parameters (body weight, waist circumference, and body mass index [BMI]), total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, glucose, HbA1c (glycated hemoglobin), and blood pressure, as well as total testosterone levels and health-related quality of life, were assessed. We found TU significantly improved obesity parameters (body weight, waist circumference, and BMI) and lowered total cholesterol, LDL cholesterol, triglycerides, fasting blood glucose, HbA1c , and blood pressure over the 5-year study. HDL cholesterol was increased. TU treatment resulted in a sustained improvement in erectile function and muscle and joint pain, which contributed to an improvement in long-term health-related quality of life. Furthermore

  10. Prevalence and associated risk factors of male erectile dysfunction among patients on hemodialysis and kidney transplant recipients: A cross-sectional survey from Sudan

    Directory of Open Access Journals (Sweden)

    M O Mekki

    2013-01-01

    Full Text Available Male erectile dysfunction (ED is an important issue worldwide occurring in 5-69% of men in community-based studies. It is more common in patients with chronic kidney disease (CKD and those on peritoneal as well as hemodialysis (HD, occurring in more than 80% of patients. In Sudan, there is no pre-vious report on ED among patients with CKD. A cross-sectional study was done to determine the prevalence of ED and its associated risk factors among Sudanese CKD patients on HD and those who underwent renal transplant. This was conducted in Khartoum, Sudan from October 2005 to July 2006 including all married men who were on maintenance HD for more than three months and all married men who had received renal transplantation at least three months earlier. Single, divorced/separated men, those whose wives were living away, those who were bed-bound and those with cognitive impairment were also excluded. After obtaining consent for participation, demographic and clinical data were collected by using anonymous questionnaires and the Arabic version of International Index of Erectile Function (IIEF; the Egyptian version. Patients who did not participate in full and proper manner were considered as "non-responders." A total of 146 patients, 106 HD patients, and 40 renal transplant recipients completed the IIEF questionnaire. Non-responders constituted 43.7% and 54.5% of HD and transplant recipient patients, respectively. Blood samples were taken after completion of the IIEF questionnaire to determine the required investigations. ED prevalence was high among our study patients, 83% among the HD patients and 67.5% among the renal transplant recipients. Univariate analysis showed that there was a trend, although non-significant, of older age being associated with ED in both groups. Similar association was seen in those who were under-dialyzed in the HD group and DM in the transplant recipient group. Previous history of ED was significantly associated with current

  11. Intratunical Injection of Genetically Modified Adipose Tissue-Derived Stem Cells with Human Interferon α-2b for Treatment of Erectile Dysfunction in a Rat Model of Tunica Albugineal Fibrosis.

    Science.gov (United States)

    Gokce, Ahmet; Abd Elmageed, Zakaria Y; Lasker, George F; Bouljihad, Mostafa; Braun, Stephen E; Kim, Hogyoung; Kadowitz, Philip J; Abdel-Mageed, Asim B; Sikka, Suresh C; Hellstrom, Wayne J

    2015-07-01

    Peyronie's disease (PD) has frequently been associated with erectile dysfunction (ED) and may further compromise coitus. To investigate the efficacy of intratunical injection of genetically modified rat adipose tissue-derived stem cells (ADSCs) expressing human interferon α-2b (ADSCs-IFN) in decreasing fibrosis and restoring erectile function in a rat model of tunica albugineal fibrosis (TAF). A total of 36 Sprague-Dawley rats (12 weeks old; 300-350 g) were randomly divided in six equal groups: (i) sham group (50 μL saline-injected into the tunica albuginea [TA]); (ii) TAF group (transforming growth factor [TGF]-β1 [0.5 μg/50 μL] injected into the TA); (iii) TGF-β1 plus 5 × 10(5) control ADSCs injected same day; (iv) TGF-β1 plus 5 × 10(5) ADSCs-IFN injected same day; (v) TGF-β1 plus 5 × 10(5) control ADSCs injected after 30 days; and (vi) TGF-β1 plus 5 × 10(5) ADSCs-IFN injected after 30 days. Rat allogeneic ADSCs were harvested from inguinal fat tissue. Forty-five days following the TGF-β1 injection, erectile function was assessed, and penile tissues were harvested for further evaluations. In the same-day injection groups, intratunical injection of ADSCs and ADSC-IFN improved erectile response observed upon stimulation of cavernous nerve compared with TAF group. Intratunical ADSC-IFN injection at day 30 improved erectile responses 3.1, 1.8, and 1.3 fold at voltages of 2.5, 5.0, and 7.0, respectively, when compared with TAF group. Furthermore, at voltages of 2.5 and 5.0, treatment on day 30 with ADSCs-IFN improved erectile responses 1.6- and 1.3-fold over treatment with ADSCs alone. Local injection of ADSCs or ADSCs-IFN reduced Peyronie's-like manifestations, and these effects might be associated with a decrease in the expression of tissue inhibitors of metalloproteinases. This study documents that transplantation of genetically modified ADSCs, with or without human IFN α-2b, attenuated Peyronie's-like changes and enhanced

  12. Disfunción sexual eréctil y diabetes mellitus: Aspectos etiopatogénicos Sexual erectile dysfunction and diabetes mellitus: Etiopathogenic aspects

    Directory of Open Access Journals (Sweden)

    Lizet Castelo Elías-Calles

    2003-08-01

    .Sexual erectile dysfunction is defined as the inability of man to reach and/or keep adequate erection to achieve satisfactory sexual activity. The frequency of sexual erectile dysfunction (SED is significantly higher in the diabetic population when compared to general population. The objective of this paper is to make a literature review on this topic and diabetes mellitus that includes the following aspects: penis anatomy, clinical and physiological aspects and pathogenic mechanisms. Different studies point out that prevalence of SED in persons suffering from diabetes mellitus ranges from 20 to 80 %, although this prevalence varies with the age of the patients. The prevalence of SED in subjects aged 20 to 19 years is 9% but increases up to 90 % in those who arrive at 70 years. SED is classified according to its causes into three groups: 1 organic, 2 psychogenic and 3 combined. Among the most relevant pathogenic factors we may find the neurological, the vascular and the muscular factors. Relaxation of smooth muscle of cavernous bodies and erection of penis depend on a complex balance of intracellular events and extracellular signals that control contraction and relaxation of the cavernous body smooth muscular cell tone. Hemodynamic and electrophysiological measurements allow evaluating in an accurate way the sexual function. The therapeutic management demands the strict control of glycemic values. SED is a frequent complication in persons with diabetes mellitus. The etiology of this dysfunction is generally due to multiple causes. It is required to carry out clinical and epidemiological studies in a representative sample of the population to accurately find out the size of the problem. The early detection and adequate treatment of sexual erectile dysfunction will determine a significant improvement of the quality of life of the affected persons.

  13. Lipid Profile Pattern amongst Type 2 DM subjects with Erectile ...

    African Journals Online (AJOL)

    Objective:Dyslipidaemia in patientswith diabetesmellitus leads to atherosclerosis and this contributes to erectile dysfunction (ED). This study set out to characterize the lipid profile pattern in diabetic patients with erectile dysfunction. Subject andMethods:Aprospective, cross sectional study carried out at the diabetes clinic of ...

  14. Cumulative response curves to enhance interpretation of treatment differences on the Self-Esteem And Relationship questionnaire for men with erectile dysfunction.

    Science.gov (United States)

    Cappelleri, Joseph C; Zou, Kelly H; Bushmakin, Andrew G; Carlsson, Martin O; Symonds, Tara

    2013-03-01

    What's known on the subject? and What does the study add? Studies on erectile dysfunction (ED) therapies rely heavily on patient-reported outcomes (PROs) to measure efficacy on treatment response. A challenge when using PROs is interpretation of the clinical meaning of changes in scores. A responder analysis provides a threshold score to indicate whether a change in score qualifies a patient as a responder. However, a major consideration with responder analysis is the sometimes arbitrary nature of defining the threshold for a response. By contrast, cumulative response curves (CRCs) display patient response rates over a continuum of possible thresholds, thus eliminating problems with a rigid threshold definition, allowing for a variety of response thresholds to be examined simultaneously, and encompassing all data. With respect to the psychosocial factors addressed in the Self-Esteem And Relationship questionnaire in ED, CRCs clearly, distinctly, and meaningfully highlighted the favourable profiles of responses to sildenafil compared with placebo. CRCs for PROs in urology can provide a clear, transparent and meaningful visual depiction of efficacy data that can supplement and complement other analyses. To use cumulative response curves (CRCs) to enrich meaning and enhance interpretation of scores on the Self-Esteem And Relationship (SEAR) questionnaire with respect to treatment differences for men with erectile dysfunction (ED). This post hoc analysis used data from all patients who took at least one dose of study drug and had at least one post-baseline efficacy evaluation in a previously published 12-week, multicentre, randomized, double-blind, placebo-controlled trial of flexible-dose (25, 50, or 100 mg) sildenafil citrate (Viagra) in adult men with ED who had scored ≤ 75 out of 100 on the Self-Esteem subscale of the SEAR questionnaire. CRCs were used on the numeric change in transformed SEAR scores from baseline to end-of-study for each SEAR component. The

  15. Threat of Sexual Disqualification: The Consequences of Erectile Dysfunction and Other Sexual Changes for Gay and Bisexual Men With Prostate Cancer.

    Science.gov (United States)

    Ussher, Jane M; Perz, Janette; Rose, Duncan; Dowsett, Gary W; Chambers, Suzanne; Williams, Scott; Davis, Ian; Latini, David

    2017-10-01

    Gay and bisexual (GB) men with prostate cancer (PCa) have been described as an "invisible diversity" in PCa research due to their lack of visibility, and absence of identification of their needs. This study examined the meaning and consequences of erectile dysfunction (ED) and other sexual changes in 124 GB men with PCa and 21 male partners, through an on-line survey. A sub-sample of 46 men with PCa and seven partners also took part in a one-to-one interview. ED was reported by 72 % of survey respondents, associated with reports of emotional distress, negative impact on gay identities, and feelings of sexual disqualification. Other sexual concerns included loss of libido, climacturia, loss of sensitivity or pain during anal sex, non-ejaculatory orgasms, and reduced penis size. Many of these changes have particular significance in the context of gay sex and gay identities, and can result in feelings of exclusion from a sexual community central to GB men's lives. However, a number of men were reconciled to sexual changes, did not experience a challenge to identity, and engaged in sexual re-negotiation. The nature of GB relationships, wherein many men are single, engage in casual sex, or have concurrent partners, influenced experiences of distress, identity, and renegotiation. It is concluded that researchers and clinicians need to be aware of the meaning and consequences of sexual changes for GB men when designing studies to examine the impact of PCa on men's sexuality, advising GB men of the sexual consequences of PCa, and providing information and support to ameliorate sexual changes.

  16. Erectile dysfunction in male dromedary camels: Clinical findings and changes in the nitric oxide metabolite, cardiac troponin I and testosterone concentrations.

    Science.gov (United States)

    Derar, Derar; Ali, Ahmed; Tharwat, Mohamed; Al-Sobayil, Fahd; Zeitoun, Moustafa M

    2017-02-01

    This study aimed to clarify the phenomenon of erectile dysfunction (ED) in male camels and monitor the associated changes in nitric oxide metabolite (NOM), cardiac troponin I (cTnI), and testosterone concentrations. A total 18 camels with ED and 10 controls were included in this study. The breeding history was recorded and a thorough breeding soundness examination was performed. Total nitrates and nitrites were determined in sera using the Griess assay. Serum cTnI and testosterone were assessed using ELISA. A complete blood count was also carried out. The results showed that 13/18 male camels with ED had no detectable pathologic lesions in the genital tract (ED-N), while 5/18 males showed pathology in the penis, prepuce, and testicles (ED-P). The ED-P group exhibited higher concentrations of NOMs (P = 0.003), white blood cells (P = 0.0001), and neutrophils (P = 0.001) than the ED-N and control groups. The ED-P and ED-N groups had higher concentrations of cTnI than the control group (P = 0.0001). Testosterone concentration did not differ among the groups. In conclusion, the ED in the camels was associated with a rise in cTnI, probably due to myositic damage. Most of the ED cases in the camels had apparently normal genital organs. In the cases of ED in male camels with detectable pathologic lesions on their genital organs, a rise in NOMs, white blood cells, and neutrophils was observed. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. The use of a single daily dose of tadalafil to treat signs and symptoms of benign prostatic hyperplasia and erectile dysfunction

    Directory of Open Access Journals (Sweden)

    Gacci M

    2013-04-01

    Full Text Available Mauro Gacci,1 Matteo Salvi,1 Arcangelo Sebastianelli,1 Linda Vignozzi,2 Giovanni Corona,3 Kevin T McVary,4 Steven A Kaplan,5 Mario Maggi,2 Marco Carini,1 Matthias Oelke6 1Department of Urology, University of Florence, Florence, 2Sexual Medicine and Andrology Unit, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, 3Endocrinology Unit, Maggiore-Bellaria Hospital, Bologna, Italy; 4Division of Urology, Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, 5Department of Urology, Weill Cornell Medical College, Cornell University, New York, NY, USA; 6Department of Urology, Hannover Medical School, Hannover, Germany Abstract: A strong and independent association between lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH and erectile dysfunction (ED has been widely evidenced in several clinical epidemiologic studies. Preclinical animal models have provided a great deal of information on potential common pathogenic mechanisms underlying these two clinical identities. Although the efficacy of the most commonly used treatments for LUTS/BPH is well defined, the negative impact of these treatments on sexual function – in particular, on ED – has triggered the search for new treatment options. In this regard, a new role for phosphodiesterase type 5 inhibitors in the treatment of LUTS/BPH and ED has been claimed. Tadalafil is one of the most extensively investigated phosphodiesterase type 5 inhibitors for this new indication. All evidence reported to date suggests that tadalafil 5 mg once daily is a safe and effective treatment option for both LUTS/BPH and ED. Keywords: phosphodiesterase type 5 inhibitor, LUTS/BPH, ED, sexual function, Cialis

  18. Role of methylenetetrahydrofolate reductase gene polymorphisms (C677T, A1298C, and G1793A) in the development of early onset vasculogenic erectile dysfunction.

    Science.gov (United States)

    Safarinejad, Mohammad Reza; Safarinejad, Shiva; Shafiei, Nayyer

    2010-08-01

    The methylenetetrahydrofolate reductase (MTHFR) gene plays a key role in the metabolism of folate and homocysteine (Hcy) and its mutations have been associated with high serum Hcy level. Elevated serum Hcy has been linked to impaired endothelial function and occlusive vascular disease. We studied the association among the different genotypes of all three MTHFR polymorphisms (C677T, A1298C, and G1793A) and the risk of early-onset vasculogenic erectile dysfunction (VED). We performed a case-control study of 114 men with early-onset VED and 228 age-matched controls. Genotyping of MTHFR gene polymorphisms was performed using polymerase chain reaction restriction fragment length polymorphism (PCR-RLFP) technique. We also measured plasma lipids, Hcy, folate, and vitamin B12 levels. Patients with early-onset VED had higher serum Hcy levels (12.29 ± 2.32 vs. 9.82 ± 2.35 μmol/L, p = 0.001) and higher prevalence of 677TT homozygocity compared to controls (15.8% vs. 11.4%, p = 0.01). Serum Hcy concentration was significantly higher in individuals with 677TT, 1298CC, and 1793GG genotypes. Subgroup analysis according to severity of ED (mild, moderate, and severe) showed that patients with severe VED had higher serum Hcy levels compared to patients with mild VED (13.48 ± 2.51 vs. 11.21 ± 2.32 μmol/L, p = 0.001). Odds ratio seems to demonstrate that individuals with the MTHFR 677TT genotype and the 677TT + 1298AC combined genotype had a 3.16- and 3.89-fold increased risk for developing VED, suggesting a possible association of MTHFR polymorphisms with the risk of early-onset VED. Copyright © 2010 IMSS. Published by Elsevier Inc. All rights reserved.

  19. Alcohol consumption and prevalence of erectile dysfunction in Japanese patients with type 2 diabetes mellitus: Baseline data from the Dogo Study.

    Science.gov (United States)

    Furukawa, Shinya; Sakai, Takenori; Niiya, Tetsuji; Miyaoka, Hiroaki; Miyake, Teruki; Yamamoto, Shin; Maruyama, Koutatsu; Ueda, Teruhisa; Tanaka, Keiko; Senba, Hidenori; Todo, Yasuhiko; Torisu, Masamoto; Minami, Hisaka; Onji, Morikazu; Tanigawa, Takeshi; Matsuura, Bunzo; Hiasa, Yoichi; Miyake, Yoshihiro

    2016-09-01

    Diabetes mellitus and heavy alcohol consumption are both associated with vascular disease, a category that includes erectile dysfunction (ED). However, the association between alcohol consumption and ED among patients with type 2 diabetes mellitus remains unclear. The aim of the present multicenter cross-sectional study was to investigate the relationship between drinking frequency, weekly alcohol consumption, daily alcohol consumption, and ED among Japanese patients with type 2 diabetes mellitus. Study subjects were 340 male Japanese patients with type 2 diabetes mellitus, aged 19-70 years, who had undergone blood tests at our institutions. A self-administered questionnaire was used to collect information on the variables under study. ED was defined as present when a subject had a Sexual Health Inventory for Men score diabetes mellitus, current smoking, hypertension, dyslipidemia, glycated hemoglobin, stroke, coronary artery disease, diabetic retinopathy, diabetic nephropathy, and diabetic neuropathy. The prevalence of ED was 43.2% (147/340). The frequency of alcohol consumption and weekly alcohol consumption were independently inversely associated with ED (p for trend p = 0.001 and 0.004, respectively). The relationship between daily alcohol consumption and ED was an inverted J-shaped curve: alcohol consumption of less than 60 g, but not 60 g or more, per day was independently related to a lower prevalence of ED (p for quadratic trend = 0.003). In Japanese men with type 2 diabetes mellitus, an inverted J-shaped relationship between daily alcohol consumption and ED was observed, while frequency of alcohol consumption and weekly alcohol consumption were significantly inversely associated with ED. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Dose-Volume Parameters of the Corpora Cavernosa Do Not Correlate With Erectile Dysfunction After External Beam Radiotherapy for Prostate Cancer: Results From a Dose-Escalation Trial

    International Nuclear Information System (INIS)

    Wielen, Gerard J. van der; Hoogeman, Mischa S.; Dohle, Gert R.; Putten, Wim L.J. van; Incrocci, Luca

    2008-01-01

    Purpose: To analyze the correlation between dose-volume parameters of the corpora cavernosa and erectile dysfunction (ED) after external beam radiotherapy (EBRT) for prostate cancer. Methods and Materials: Between June 1997 and February 2003, a randomized dose-escalation trial comparing 68 Gy and 78 Gy was conducted. Patients at our institute were asked to participate in an additional part of the trial evaluating sexual function. After exclusion of patients with less than 2 years of follow-up, ED at baseline, or treatment with hormonal therapy, 96 patients were eligible. The proximal corpora cavernosa (crura), the superiormost 1-cm segment of the crura, and the penile bulb were contoured on the planning computed tomography scan and dose-volume parameters were calculated. Results: Two years after EBRT, 35 of the 96 patients had developed ED. No statistically significant correlations between ED 2 years after EBRT and dose-volume parameters of the crura, the superiormost 1-cm segment of the crura, or the penile bulb were found. The few patients using potency aids typically indicated to have ED. Conclusion: No correlation was found between ED after EBRT for prostate cancer and radiation dose to the crura or penile bulb. The present study is the largest study evaluating the correlation between ED and radiation dose to the corpora cavernosa after EBRT for prostate cancer. Until there is clear evidence that sparing the penile bulb or crura will reduce ED after EBRT, we advise to be careful in sparing these structures, especially when this involves reducing treatment margins

  1. Self-reported sitting time and prevalence of erectile dysfunction in Japanese patients with type 2 diabetes mellitus: The Dogo Study.

    Science.gov (United States)

    Furukawa, Shinya; Sakai, Takenori; Niiya, Tetsuji; Miyaoka, Hiroaki; Miyake, Teruki; Yamamoto, Shin; Kanzaki, Sayaka; Maruyama, Koutatsu; Tanaka, Keiko; Ueda, Teruhisa; Senba, Hidenori; Torisu, Masamoto; Minami, Hisaka; Tanigawa, Takeshi; Matsuura, Bunzo; Hiasa, Yoichi; Miyake, Yoshihiro

    2017-01-01

    No evidence exists regarding the association between sitting time and erectile dysfunction (ED) among patients with type 2 diabetes mellitus. The aim of this study was to evaluate the association between self-reported sitting time and ED among patients with type 2 diabetes mellitus. Study subjects were 430 male Japanese patients with type 2 diabetes mellitus (mean age, 60.5years). A self-administered questionnaire was used to collect information on the variables under study. The study subjects were asked about time spent sitting during typical 24-hour periods over the past 12months. Subjects were divided into four groups according to self-reported sitting time: 1) 2) 5-7hours, 3) 7-9hours, and 4) ≥9hours. ED was defined as present when a subject had a Sexual Health Inventory for Men score type 2 diabetes, current smoking, current drinking, hypertension, coronary artery disease, stroke, glycated hemoglobin, walking habit, and diabetic neuropathy. The prevalence values of moderate to severe ED and severe ED were 36.1% and 49.8%. At least 9hours sitting was independently positively associated with severe ED but not moderate to severe ED; the adjusted OR was 1.84 (95% CI: 1.06-3.33). In the multivariate model, there was a statistically significant inverse exposure-response relationship between the self-reported sitting time and severe ED (p for trend=0.029). Self-reported sitting time may be positively associated with ED in Japanese patients with type 2 diabetes mellitus. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Visual stimulation facilitates penile responses to vibration in men with and without erectile disorder

    NARCIS (Netherlands)

    Janssen, E.; Everaerd, W.; van Lunsen, R. H.; Oerlemans, S.

    1994-01-01

    This study compared reflexogenic and psychogenic penile responses in men with and without erectile disorder. It was hypothesized that men with psychogenic erectile dysfunction respond minimally to vibrotactile stimulation. An enhancement of penile responses was expected when vibration was combined

  3. Anatomy and physiology of the clitoris, vestibular bulbs, and labia minora with a review of the female orgasm and the prevention of female sexual dysfunction.

    Science.gov (United States)

    Puppo, Vincenzo

    2013-01-01

    This review, with 21 figures and 1 video, aims to clarify some important aspects of the anatomy and physiology of the female erectile organs (triggers of orgasm), which are important for the prevention of female sexual dysfunction. The clitoris is the homologue of the male's glans and corpora cavernosa, and erection is reached in three phases: latent, turgid, and rigid. The vestibular bulbs cause "vaginal" orgasmic contractions, through the rhythmic contraction of the bulbocavernosus muscles. Because of the engorgement with blood during sexual arousal, the labia minora become turgid, doubling or tripling in thickness. The corpus spongiosum of the female urethra becomes congested during sexual arousal; therefore, male erection equals erection of the female erectile organs. The correct anatomical term to describe the erectile tissues responsible for female orgasm is the female penis. Vaginal orgasm and the G-spot do not exist. These claims are found in numerous articles that have been written by Addiego F, Whipple B, Jannini E, Buisson O, O'Connell H, Brody S, Ostrzenski A, and others, have no scientific basis. Orgasm is an intense sensation of pleasure achieved by stimulation of erogenous zones. Women do not have a refractory period after each orgasm and can, therefore, experience multiple orgasms. Clitoral sexual response and the female orgasm are not affected by aging. Sexologists should define having sex/love making when orgasm occurs for both partners with or without vaginal intercourse. Copyright © 2012 Wiley Periodicals, Inc.

  4. Treatment satisfaction among men with concurrent benign prostatic hyperplasia and erectile dysfunction treated with tadalafil or other phosphodiesterase type-5 inhibitor combinations

    Directory of Open Access Journals (Sweden)

    Lee LK

    2016-07-01

    Full Text Available Lulu K Lee,1 Amir Goren,1 Natalie N Boytsov,2 Craig F Donatucci,2 Kevin T McVary3 1Health Outcomes Practice, Kantar Health, New York, NY, 2US Real World Outcomes Research, Eli Lily & Company, Indianapolis, IN, 3Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA Objective: Erectile dysfunction (ED and benign prostatic hyperplasia (BPH frequently co-occur in men aged ≥40, along with lower urinary tract symptoms (LUTS secondary to BPH. Given little real-world evidence on treatment use or satisfaction with treatment for concurrent BPH/LUTS and/or ED, this study examined medication regimens and differences in satisfaction and health-related quality of life (HRQoL across regimens among men with concurrent BPH and ED. Methods: A cross-sectional study was conducted using an Internet survey of participants recruited through an online panel. Respondents (N=736 included men (aged ≥40 who self-reported a diagnosis of both ED and BPH with prescription treatment in the past 3 months for both conditions. Treatment satisfaction (eg, convenience and ease of planning and HRQoL (eg, International Prostate Symptom Score, sleep quality were self-reported. Generalized linear models examined the association of regimen with treatment satisfaction and HRQoL, adjusting for covariates (eg, age and comorbidities. Results: Final analyses included participants (N=507 using: tadalafil once-daily monotherapy (22%, tadalafil for ED with an alternate BPH therapy (36%, or another phosphodiesterase type-5 inhibitor (PDE5-I combination (41%. These groups represented the major categories of treatment regimens found in the sample, excluded participants with ambiguous regimens, and were aligned with current standard of care for BPH and ED. Overall, patients reported moderate levels of BPH and a moderate-to-severe degree of ED. Tadalafil monotherapy patients had higher treatment satisfaction scores and greater reported ease of treatment

  5. A comparison of radiation dose to the bulb of the penis in men with and without prostate brachytherapy-induced erectile dysfunction

    International Nuclear Information System (INIS)

    Merrick, Gregory S.; Wallner, Kent; Butler, Wayne M.; Galbreath, Robert W.; Lief, Jonathan H.; Benson, Mark L.

    2001-01-01

    Purpose: To retrospectively evaluate the relationship between the radiation dose to the bulb of the penis and the development of erectile dysfunction (ED) in patients undergoing permanent prostate brachytherapy without external beam radiation therapy. Methods and Materials: Twenty-three men who developed ED after transperineal ultrasound-guided permanent prostate brachytherapy for clinical T1/T2 adenocarcinoma of the prostate gland were paired with 23 similar men who maintained potency after implantation. Potency was defined as an erection sufficient for vaginal penetration. The mean and median follow-up for the entire group was 34.6 ± 13.7 months and 32.8 months, respectively. Patients were implanted with either 125 I (145 Gy TG-43) or 103 Pd (115 Gy, pre-NIST-99). No patient received external beam radiation therapy either before or after brachytherapy. The bulb of the penis was outlined at 0.5-cm intervals on the Day 0 postimplant CT scan. The radiation dose distribution to the bulb of the penis was defined in terms of the minimal dose delivered to 25%, 50%, 70%, 75%, 90%, and 95% of the bulb (D 25 , D 50 , D 70 , D 75 , D 90 , and D 95 ). Results: The radiation dose delivered to the bulb of the penis in men with postbrachytherapy-induced ED was statistically greater for all evaluated dosimetric parameters (D 25 , D 50 , D 70 , D 75 , D 90 , and D 95 ). Multivariate analysis indicated that dose to the bulb of the penis and patient age at the time of implant were predictive of postimplant ED, whereas choice of isotope had no effect. Among potent patients, 19/23 had D 50 ≤ 40% of prescribed minimal peripheral dose, whereas for the impotent patients, 19/23 had D 50 >40% of the minimal peripheral dose. Of the impotent patients, 17 utilized sildenafil, with 15 experiencing a favorable response (88%). Conclusion: Our data suggest that prostate brachytherapy-induced impotence is highly correlated with the radiation dose delivered to the bulb of the penis. With Day 0

  6. Genome-Wide Association Study to Identify Single Nucleotide Polymorphisms (SNPs) Associated With the Development of Erectile Dysfunction in African-American Men After Radiotherapy for Prostate Cancer

    International Nuclear Information System (INIS)

    Kerns, Sarah L.; Ostrer, Harry; Stock, Richard; Li, William; Moore, Julian; Pearlman, Alexander; Campbell, Christopher; Shao Yongzhao; Stone, Nelson; Kusnetz, Lynda; Rosenstein, Barry S.

    2010-01-01

    Purpose: To identify single nucleotide polymorphisms (SNPs) associated with erectile dysfunction (ED) among African-American prostate cancer patients treated with external beam radiation therapy. Methods and Materials: A cohort of African-American prostate cancer patients treated with external beam radiation therapy was observed for the development of ED by use of the five-item Sexual Health Inventory for Men (SHIM) questionnaire. Final analysis included 27 cases (post-treatment SHIM score ≤7) and 52 control subjects (post-treatment SHIM score ≥16). A genome-wide association study was performed using approximately 909,000 SNPs genotyped on Affymetrix 6.0 arrays (Affymetrix, Santa Clara, CA). Results: We identified SNP rs2268363, located in the follicle-stimulating hormone receptor (FSHR) gene, as significantly associated with ED after correcting for multiple comparisons (unadjusted p = 5.46 x 10 -8 , Bonferroni p = 0.028). We identified four additional SNPs that tended toward a significant association with an unadjusted p value -6 . Inference of population substructure showed that cases had a higher proportion of African ancestry than control subjects (77% vs. 60%, p = 0.005). A multivariate logistic regression model that incorporated estimated ancestry and four of the top-ranked SNPs was a more accurate classifier of ED than a model that included only clinical variables. Conclusions: To our knowledge, this is the first genome-wide association study to identify SNPs associated with adverse effects resulting from radiotherapy. It is important to note that the SNP that proved to be significantly associated with ED is located within a gene whose encoded product plays a role in male gonad development and function. Another key finding of this project is that the four SNPs most strongly associated with ED were specific to persons of African ancestry and would therefore not have been identified had a cohort of European ancestry been screened. This study demonstrates

  7. 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.

  8. Eldecalcitol prevents endothelial dysfunction in postmenopausal osteoporosis model rats.

    Science.gov (United States)

    Serizawa, Kenichi; Yogo, Kenji; Tashiro, Yoshihito; Takeda, Satoshi; Kawasaki, Ryohei; Aizawa, Ken; Endo, Koichi

    2016-02-01

    Postmenopausal women have high incidence of cardiovascular events as estrogen deficiency can cause endothelial dysfunction. Vitamin D is reported to be beneficial on endothelial function, but it remains controversial whether vitamin D is effective for endothelial dysfunction under the treatment for osteoporosis in postmenopausal women. The aim of this study was to evaluate the endothelial protective effect of eldecalcitol (ELD) in ovariectomized (OVX) rats. ELD (20  ng/kg) was orally administrated five times a week for 4 weeks from 1 day after surgery. After that, flow-mediated dilation (FMD) as an indicator of endothelial function was measured by high-resolution ultrasound in the femoral artery of living rats. ELD ameliorated the reduction of FMD in OVX rats. ELD inhibited the increase in NOX4, nitrotyrosine, and p65 and the decrease in dimer/monomer ratio of nitric oxide synthase in OVX rat femoral arteries. ELD also prevented the decrease in peroxisome proliferator-activated receptor gamma (PPARγ) in femoral arteries and cultured endothelial cells. Although PPARγ is known to inhibit osteoblastogenesis, ELD understandably increased bone mineral density of OVX rats without increase in PPARγ in bone marrow. These results suggest that ELD prevented the deterioration of endothelial function under condition of preventing bone loss in OVX rats. This endothelial protective effect of ELD might be exerted through improvement of endothelial nitric oxide synthase uncoupling, which is mediated by an antioxidative effect through normalization of vascular PPARγ/NF-κB signaling. © 2016 Society for Endocrinology.

  9. Obesity and sexual dysfunction in younger Danish men

    DEFF Research Database (Denmark)

    Andersen, Ingelise; Heitman, B. L.; Wagner, Gorm

    2008-01-01

    to height, weight, smoking status, and alcohol consumption. Erectile dysfunction (ED) was more prevalent among these younger and older men with higher BMI, but only significant among men 20-45 years old, with an odds ratio of 2.74 (95% confidence interval 1.1-6.8). The prevalence of ED was higher among......: To examine a possible association between sexual disorders (erectile dysfunction, ejaculatory disorders, and sexual desire disorders) and obesity among younger men born and living in Denmark. METHODS: A community-based cross-sectional study of sexual health among Danish younger men. Questionnaires were...... preventing obesity in younger men may benefit from informing about an almost three-fold occurrence of erectile dysfunction associated with obesity....

  10. Cardiovascular Implications of Erectile Dysfunction

    Science.gov (United States)

    ... G. Schwartz , Robert A. Kloner Download PDF https://doi.org/10.1161/CIRCULATIONAHA.110.017681 Circulation. 2011; 123: ... e609-e611 , originally published May 31, 2011 https://doi.org/10.1161/CIRCULATIONAHA.110.017681 Citation Manager Formats ...

  11. A randomized open-label trial with a crossover comparison of sexual self-confidence and other treatment outcomes following tadalafil once a day vs. tadalafil or sildenafil on-demand in men with erectile dysfunction.

    Science.gov (United States)

    Rubio-Aurioles, Eusebio; Porst, Hartmut; Kim, Edward D; Montorsi, Francesco; Hackett, Geoff; Morales, Antonio Martin; Stuckey, Bronwyn; Būttner, Hartwig; West, Teena M; Huynh, Ngan N; Lenero, Enrique; Burns, Patrick; Kopernicky, Vladimir

    2012-05-01

    To compare Sexual Self-Confidence and other treatment outcomes following 8 weeks of treatment with tadalafil 5 mg once a day (OaD) vs. tadalafil 20 mg or sildenafil 100 mg as needed (pro re nata [PRN]) in patients with erectile dysfunction (ED). A randomized, open-label, crossover study in men ≥18 years of age with history of ED and satisfactory response to current oral phosphodiesterase 5 (PDE5) inhibitor PRN. Data were analyzed with a mixed effects model for crossover design. The primary outcome measure was the Sexual Self-Confidence domain of the Psychological and Interpersonal Relationship Scales (PAIRS) between tadalafil OaD and sildenafil PRN. SECONDARY OUTCOMES INCLUDED: Time Concerns and Spontaneity domains of PAIRS, and the Self-Esteem and Relationship (SEAR) scale. Men naive to tadalafil OaD were enrolled (N = 378), with 61-69% prior PDE5 inhibitor use. There were improvements in all PAIRS domains from baseline when comparing tadalafil OaD and PRN with sildenafil PRN (P Self-Confidence domain improved from baseline and was 0.50 ± 0.78 following tadalafil OaD, 0.5 ± 0.72 for tadalafil PRN, and 0.39 ± 0.67 for sildenafil PRN. The difference in least-squares mean was 0.12 ± 0.04 (confidence interval [CI] = 0.04, 0.19; P = 0.001) between tadalafil OaD and sildenafil PRN and 0.01 ± 0.04 (CI = -0.06, 0.08; P = 0.872) between tadalafil OaD and tadalafil PRN. The Time Concerns domain score was lower with tadalafil OaD than tadalafil PRN (P Self-Confidence, Time Concerns, and Spontaneity. There was no significant difference in Sexual Self-Confidence between tadalafil OaD and tadalafil PRN. Changes in SEAR, the erectile function domain of the International Index of Erectile Function, and the Erectile Dysfunction Inventory of Treatment Satisfaction scores from baseline to end point were similar. © 2012 International Society for Sexual Medicine.

  12. An open-label, multicenter, flexible dose study to evaluate the efficacy and safety of Viagra (sildenafil citrate) in Korean men with erectile dysfunction and arterial hypertension who are taking antihypertensive agents.

    Science.gov (United States)

    Park, Hyun Jun; Park, Nam Cheol; Shim, Hong Bang; Park, Jong Kwan; Lee, Sung Won; Park, Kwangsung; Kim, Sae Woong; Moon, Ki Hak; Lee, Dong Hyeon; Yoon, Sang Jin

    2008-10-01

    Erectile dysfunction (ED) is common among men taking antihypertensive agents to control blood pressure. We evaluated the efficacy and safety of sildenafil citrate in men with ED taking antihypertensive agents. A total of 198 male subjects, aged 20 years and older were enrolled. This study was conducted for 10 weeks as an open-label, multicenter and flexible dose trial with a 2-week screening period and an 8-week treatment phase. Subjects were asked to complete Event Log Worksheets, as well as the International Index of Erectile Function (IIEF) and the Global Efficacy Assessment Questions (GEAQ) questionnaires during the study period. The average age among the 167 subjects who completed the study was 55.8 (31.7 to 77.1). The scores for questions 3 and 4 of IIEF improved from 2.3 and 1.8 at baseline to 3.7 and 3.4 at week 4 and 3.8 and 3.4 at week 8, respectively. There were 86.3% of the patients reported improved erectile function at week 8; 88.3% of the patients reported improved ability to achieve sexual intercourse at week 8. There were no significant differences observed in the responses to questions 3 and 4 of IIEF and GEAQ by the number of antihypertensive agents taken. The adverse events were facial flushing (20.1%), headache (11.7%), palpitation (5.0%), rhinitis (2.8%), URI (2.8%), dizziness (2.2%), dyspnea (2.2%), and nausea (1.7%). Sildenafil citrate is an effective treatment for ED; it is safe and well tolerated by patients with ED taking multiple antihypertensive agents for arterial hypertension.

  13. Real-world observational results from a database of 48 million men in the United States: Relationship of cardiovascular disease, diabetes mellitus and depression with age and erectile dysfunction.

    Science.gov (United States)

    Goldstein, Irwin; Chambers, Richard; Tang, WingYu; Stecher, Vera; Hassan, Tarek

    2018-03-22

    To evaluate the relationship of comorbidities (cardiovascular disease [CVD], diabetes mellitus [DM] and depression) with erectile dysfunction (ED) and age using real-world claims data from 48 million men in the United States. This was a cross-sectional, non-interventional study in men aged ≥18 years using data from the Truven Health MarketScan ® and Medicare Supplemental Research Databases from January 2010 to December 2015, with an observational period of January 2011 to December 2014 to allow for 12 months pre- and post-index. Comorbidity rate was compared between ED and non-ED groups by age using the χ 2 (bivariate) test. Comorbidity relationship to ED after controlling for categorical variables was assessed using logistic regression analysis. In all, 48 004 379 men were in the database. Of the 9 839 578 who met the inclusion criteria, 573 313 (6%) were ED patients and 9 266 265 (94%) were non-ED patients. ED diagnosis increased decade to decade from 18-29 years to 50-59 years but decreased from 60-69 years to ≥90 years. ED patients had a higher prevalence of CVD, DM and depression than non-ED patients in all periods (P < .0001). After controlling for potential demographic and baseline confounders, the association between ED and CVD, DM and depression remained significant for each age group beginning at 30-39 years (P < .0001). Conversations with patients concerning ED should be comprehensive regardless of patient age, in particular in those who have CVD, DM and/or depression. In the real-world setting, ED diagnosis was associated with CVD, DM and depression across age groups, suggesting a need for inquiry about the potential for comorbidities among these men as a preventative measure against potentially serious future events. © 2018 John Wiley & Sons Ltd.

  14. Physical Activity to Improve Erectile Function

    DEFF Research Database (Denmark)

    Gerbild, Helle Nygaard; Larsen, Camilla Marie; Areskoug Josefsson, Kristina

    2018-01-01

    , and metabolic syndrome. Physical activity (PA) has proved to be a protective factor against erectile problems, and it has been shown to improve erectile function for men affected by vascular ED. This systematic review estimated the levels of PA needed to decrease ED for men with physical inactivity, obesity......Introduction The leading cause of erectile dysfunction (ED) is arterial dysfunction, with cardiovascular disease as the most common comorbidity. Therefore, ED is typically linked to a web of closely interrelated cardiovascular risk factors such as physical inactivity, obesity, hypertension......, hypertension, metabolic syndrome, and/or manifest cardiovascular diseases. Aim To provide recommendations of levels of PA needed to decrease ED for men with physical inactivity, obesity, hypertension, metabolic syndrome, and/or cardiovascular diseases. Methods In accord with the Preferred Reporting Items...

  15. Fruit and Vegetable Intake in Relation to Lower Urinary Tract Symptoms and Erectile Dysfunction Among Southern Chinese Elderly Men: A 4-Year Prospective Study of Mr OS Hong Kong.

    Science.gov (United States)

    Liu, Zhao-min; Wong, Carmen Ka Man; Chan, Dicken; Tse, Lap Ah; Yip, Benjamin; Wong, Samuel Yeung-Shan

    2016-01-01

    The role of fruit and vegetable (FV) intake in relation to prostate health remains inconclusive. This 4-year longitudinal study aims to explore the association of FV intake and the development of lower urinary tract symptoms (LUTS, a cluster of chronic urinary symptoms occurring in bladder, prostate and urethra), incidence of symptomatic benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) in Chinese elderly men. Data were obtained from a 4 years longitudinal study (Mr OS Hong Kong, the largest prospective study on bone health in Chinese elderly). Two thousand Chinese men aged 65 years and older were recruited from the local community, of whom 1998 (99.9%) at baseline and 1564 (78.2%) at 4-year follow-up reported data on LUTS, which were evaluated by a validated International Prostate Symptoms Scale (IPSS). Erectile function was evaluated by the International Index of Erectile Dysfunction-5 (IIEF-5) questionnaires at 2- (n = 386) and 4-year (n = 475) follow-ups. Dietary intake was assessed using a validated food frequency questionnaire at baseline. Analysis was conducted using multivariate linear and logistic regression. For total FV and most of their subclasses, moderate consumption had the lowest mean changes of LUTS; we thus applied the moderate levels as the reference in the regression models. The high levels of total FV intake (>350  g/1000  kcal/day) were significantly associated with reduced IPSS by scores of -1.174 ± 0.459 (or -17.3% of basal IPSS, P = 0.011) relative to the moderate groups (250-350  g/1000  kcal/day). FV consumption had no significant association with the score change of ED or the odds of sexual activities at 4-year (all P > 0.05). High intake of dark and leafy vegetables (>50  g/1000  kcal/day) significantly reduced the risk of LUTS progression by 37.2% [odds ratio (OR) (95% confidence interval, 95% CI): 0.628 (0.466∼0.848), P = 0.002] or risk of symptomatic BPH by 34.3% [OR (95% CI): 0

  16. AB089. Impaired adenosine signaling influences erectile function in aging rats

    OpenAIRE

    Yang, Xingliang; Yuan, Jiuhong

    2017-01-01

    Background As one of the most common disorders in old adult, erectile dysfunction (ED) remains attracting andrological physicians? attention. The aim of this study is to investigate the alterations of adenosine signaling in the penis of aging rats, and the influence to erectile function. Methods According to apomorphine test, the aging rats (18 months) with ED were selected as age-related erectile dysfunction (A-ED) group, and the young rats (2 months) were selected as normal control (NC) gro...

  17. Efficacy and Safety of a Fixed-Dose Combination Therapy of Tamsulosin and Tadalafil for Patients With Lower Urinary Tract Symptoms and Erectile Dysfunction: Results of a Randomized, Double-Blinded, Active-Controlled Trial.

    Science.gov (United States)

    Kim, Sae Woong; Park, Nam Cheol; Lee, Seung Wook; Yang, Dae Yul; Park, Jong Kwan; Moon, Du Geon; Yang, Sang-Kuk; Lee, Sung Won; Moon, Ki Hak; Ahn, Tai Young; Kim, Soo Woong; Park, Kwangsung; Min, Kweon Sik; Ryu, Ji-Kan; Son, Hankil; Jung, Jina; Hyun, Jae Seog

    2017-08-01

    Phosphodiesterase type 5 inhibitors and α-adrenergic blocking agents (α-blockers) are widely used for the treatment of erectile dysfunction (ED) and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). To assess the efficacy and safety of fixed-dose combinations (FDCs) of tamsulosin and tadalafil compared with tadalafil monotherapy in patients with comorbid BPH-associated LUTS and ED. A randomized, double-blinded, active-controlled trial was conducted of 510 men with BPH-associated LUTS and ED. Patients were treated with FDCs of tamsulosin 0.4 mg plus tadalafil 5 mg (FDC 0.4/5 mg), tamsulosin 0.2 mg plus tadalafil 5 mg (FDC 0.2/5 mg), or tadalafil 5 mg for a 12-week treatment period. For a subsequent 12-week extension period, the patients were administered FDC 0.4/5 mg. The primary outcomes were changes from baseline in total International Prostate Symptom Score (IPSS) and International Index of Erectile Function erectile function domain (IIEF-EF) score at week 12 to prove superiority and non-inferiority of FDCs compared with tadalafil 5 mg. The safety assessments were adverse reactions, laboratory test results, and vital signs at week 24. The mean changes in total IPSS and IIEF-EF scores were -9.46 and 9.17 for FDC 0.4/5 mg and -8.14 and 9.49 for tadalafil 5 mg, respectively, which indicated superiority in LUTS improvement (P = .0320) and non-inferiority in ED treatment with FDC 0.4/5 mg compared with tadalafil 5 mg. However, the results from FDC 0.2/5 mg failed to demonstrate superiority in LUTS improvement. No clinically significant adverse events regarding the investigational products were observed during the 24-week period. The FDC 0.4/5 mg is the first combined formulation of an α-blocker and a phosphodiesterase type 5 inhibitor that offers benefits in patient compliance and as add-on therapy in patients with comorbid BPH-associated LUTS and ED. The study clearly demonstrated the advantage of FDC 0.4/5 mg. The main

  18. Efficacy and safety of tadalafil 20 mg on demand vs. tadalafil 5 mg once-a-day in the treatment of post-radiotherapy erectile dysfunction in prostate cancer men: a randomized phase II trial.

    Science.gov (United States)

    Ricardi, Umberto; Gontero, Paolo; Ciammella, Patrizia; Badellino, Serena; Valentino, Franco; Munoz, Fernando; Guarneri, Alessia; Rondi, Nadia; Moretto, Francesco; Filippi, Andrea Riccardo; Ragona, Riccardo; Tizzani, Alessandro

    2010-08-01

    The role of phosphodiesterase type 5 inhibitors in the treatment of post-radiotherapy erectile dysfunction (ED) has not been extensively investigated. To compare the efficacy and safety of on-demand 20-mg tadalafil (arm A) with the newly released tadalafil 5-mg once-a-day dosing (arm B) in patients with ED following radiotherapy for prostate cancer (PC). Randomized study to receive on-demand 20-mg or once-a-day 5-mg tadalafil for 12 weeks. Main Outcome Measures.  Changes in the International Index of Erectile Function (IIEF) domain scores and Sexual Encounter Profile (SEP) question 2 and 3 positive response rates. Fifty-two out of 86 screened patients were randomized. Forty-four patients were evaluable for efficacy. A significant improvement in all domains of the IIEF was observed in both arms (P = 0.0001) with mean erectile function domain scores values of 25 and 27.1 for the 20-mg and 5-mg tadalafil, respectively (P = 0.19). SEP 2 and 3 positive response rates increased from 0% in both arms at baseline to 81% and 70% in the 20-mg arm and 90% and 73% in the 5-mg arm, respectively, at the end of treatment (P = 0.27). End of treatment global efficacy question positive answers were 86% in the 20-mg arm and 95% in the 5-mg arm (P = 0.27). Higher treatment compliance was shown in arm B (100%) as compared with arm A (86%). There was a nonstatistically significant trend toward fewer side effects in favor of the 5-mg daily dose arm. In the study population, both tadalafil formulations generated significantly high response rates according to the outcome measures and were well tolerated. The once-a-day 5-mg dosing showed higher compliance and marginally reduced side effects, thus making it an attractive alternative to on-demand therapy for ED in post-radiotherapy PC patients. © 2010 International Society for Sexual Medicine.

  19. Impact of combination therapy 5-alpha reductase inhibitors (5-ARI) plus alpha-blockers (AB) on erectile dysfunction and decrease of libido in patients with LUTS/BPH: a systematic review with meta-analysis.

    Science.gov (United States)

    Favilla, Vincenzo; Russo, Giorgio Ivan; Privitera, Salvatore; Castelli, Tommaso; Giardina, Raimondo; Calogero, Aldo E; Condorelli, Rosita A; La Vignera, Sandro; Cimino, Sebastiano; Morgia, Giuseppe

    2016-09-01

    Lower urinary tract symptoms (LUTS) secondary to benign prostatic obstruction (BPO) represent one of the most common clinical complaints in adult men. Several drugs used for LUTS/BPO may strongly affect sexual function and bother. The aim of this systematic review and meta-analysis was to evaluate the impact of combination therapy with alpha-blockers (AB), 5-alpha reductase inhibitors (5-ARI) on the risk of erectile dysfunction(ED) and libido alterations (LA) from randomized clinical trial (RCT). Based on the inclusion and exclusion criteria, five RCTs involving 6131 patients were included in the analysis. According to the analysis, the overall prevalence of ED and LA were significantly greater in the combination treatment group than in the AB group (7.93% versus 4.66%; OR 1.81; p < 0.0001 and 3.69% versus 2.36%; OR 1.58; p = 0.003, respectively). The combination therapy increased the risk of ED compared to monotherapy with 5-ARI (7.93% versus 6.47%; OR 1.25; p = 0.04) but not the risk of LA (3.51% versus 3.37; OR 1.03; p = 0.84). In our systematic meta-analysis, we demonstrated that combination therapy with ABs and 5-ARIs was associated with significantly higher risk of ED and LA compared with single monotherapy. Combination therapy showed similar risk of LA compared with 5-ARI monotherapy.

  20. 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...... to a mean difference of 0.57 (0.38-0.85; p = 0.0069), versus inclusion. In contrast, incontinent men did not regain erectile function (median IIEF1/3/6 months = 5 (95% CI 5-6); mean difference 1 (95% CI 0.85-1.18), p > 0.9999). INTERPRETATION: In this phase I trial a single intracavernosal injection...

  1. Waist circumference is superior to weight and BMI in predicting sexual symptoms, voiding symptoms and psychosomatic symptoms in men with hypogonadism and erectile dysfunction.

    Science.gov (United States)

    Yassin, A A; Nettleship, J E; Salman, M; Almehmadi, Y

    2017-05-01

    Waist circumference is considered a useful predictor of obesity-associated cardiovascular risk, but its use as an indicator of sexual health status and quality of life (QoL) in hypogonadal men is unknown. We investigated whether three measurements of obesity, weight, body mass index and waist circumference, correlate with the International Index of Erectile Function-5 (IIEF-5), the Aging Males' Symptoms (AMS) and the International Prostate Symptom Score (IPSS) questionnaires. A total of 261 patients were enrolled in a prospective study on hypogonadism treatment with intramuscular long-acting testosterone undecanoate. Patients with total testosterone ≤3.5 ng ml -1 were enrolled, and baseline demographic data were recorded. Patient's response to IIEF, IPSS and AMS standardised questionnaires was recorded to evaluate health-related QoL. The mean length of treatment and follow-up was 4.7 years (max 6 years). ANOVA regression analysis showed that waist circumference was significantly inversely proportional to IIEF-5 and directly proportional to AMS and IPSS. Weight was inversely proportional to IIEF and directly proportional to IPSS but not associated with AMS. BMI had no proportionality to measurements of sexual function and quality of life. These results suggest that among weight, BMI and waist circumference, the latter is the best predictor of health-related QoL in men with hypogonadism. © 2016 Blackwell Verlag GmbH.

  2. Pharmacological Prevention and Reversion of Erectile Dysfunction After Radical Prostatectomy, by Modulation of Nitric Oxide/cGMP Pathways

    Science.gov (United States)

    2011-03-01

    of the Colombian/Venezuelan Meeting on Binational Biotechnology Projects, Cucuta, Colombia . 1986. CONICIT representative to the Biotechnology...Molecular and Cellular Targets for the Therapy of Female Sexual Arousal Disorder (FSAD)” 07/01/03-06/30/04 9. REI 11548-01. Takeda Pharmaceuticals

  3. Self-esteem, confidence, and relationships in Brazilian men with erectile dysfunction receiving sildenafil citrate: a randomized, parallel-group, double-blind, placebo-controlled study in Brazil.

    Science.gov (United States)

    Glina, Sidney; Damião, Ronaldo; Abdo, Carmita; Afif-Abdo, João; Tseng, Li-Jung; Stecher, Vera

    2009-01-01

    Psychosocial manifestations of erectile dysfunction (ED) differ across cultures. Understanding the treatment response to ED medications within cultural groups can aid in resource allocation and in developing treatment strategies. Evaluate the effect of sildenafil treatment on self-esteem, confidence, and sexual relationship satisfaction in Brazilian men with ED. The Self-Esteem and Relationship (SEAR) questionnaire, a validated, 14-question instrument developed to specifically address self-esteem and relationship issues within the context of ED. Men aged 18 years or older with a clinical diagnosis of ED (self-esteem subscale of the SEAR questionnaire. Thirteen Brazilian sites participated in a randomized, double-blind, placebo-controlled trial of sildenafil treatment for ED. Patients were randomized to receive either 50 mg of sildenafil (adjustable to 25 mg or 100 mg based on patient response) or matching placebo approximately 1 hour before anticipated sexual activity but not more than once a day. At the end of double-blind treatment, 63 and 66 patients in the placebo and sildenafil groups, respectively, from 13 Brazilian sites were assessed for efficacy. Brazilian patients receiving sildenafil had significantly greater improvements in their scores on the SEAR self-esteem subscale (42.9 [95% confidence interval 35.7-50.0]) compared with placebo (21.1 [95% confidence interval 13.7-28.6]; P self-esteem, confidence, and relationships after treatment with sildenafil.

  4. Current strategies for preventing renal dysfunction in patients with heart failure: a heart failure stage approach

    Science.gov (United States)

    Issa, Victor Sarli; Andrade, Lúcia; Bocchi, Edimar Alcides

    2013-01-01

    Renal dysfunction is common during episodes of acute decompensated heart failure, and historical data indicate that the mean creatinine level at admission has risen in recent decades. Different mechanisms underlying this change over time have been proposed, such as demographic changes, hemodynamic and neurohumoral derangements and medical interventions. In this setting, various strategies have been proposed for the prevention of renal dysfunction with heterogeneous results. In the present article, we review and discuss the main aspects of renal dysfunction prevention according to the different stages of heart failure. PMID:23644863

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

    Directory of Open Access Journals (Sweden)

    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

  6. Diabetes and sexual dysfunction: current perspectives

    Directory of Open Access Journals (Sweden)

    Maiorino MI

    2014-03-01

    Full Text Available Maria Ida Maiorino,1 Giuseppe Bellastella,1 Katherine Esposito2 1Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, Second University of Naples, Naples, Italy; 2Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy Abstract: Diabetes mellitus is one of the most common chronic diseases in nearly all countries. It has been associated with sexual dysfunction, both in males and in females. Diabetes is an established risk factor for sexual dysfunction in men, as a threefold increased risk of erectile dysfunction was documented in diabetic men, as compared with nondiabetic men. Among women, evidence regarding the association between diabetes and sexual dysfunction are less conclusive, although most studies have reported a higher prevalence of female sexual dysfunction in diabetic women as compared with nondiabetic women. Female sexual function appears to be more related to social and psychological components than to the physiological consequence of diabetes. Hyperglycemia, which is a main determinant of vascular and microvascular diabetic complications, may participate in the pathogenetic mechanisms of sexual dysfunction in diabetes. Moreover, diabetic people may present several clinical conditions, including hypertension, overweight and obesity, metabolic syndrome, cigarette smoking, and atherogenic dyslipidemia, which are themselves risk factors for sexual dysfunction, both in men and in women. The adoption of healthy lifestyles may reduce insulin resistance, endothelial dysfunction, and oxidative stress – all of which are desirable achievements in diabetic patients. Improved well-being may further contribute to reduce and prevent sexual dysfunction in both sexes. Keywords: diabetes mellitus, diabetes complications, erectile dysfunction, female sexual dysfunction, lifestyle changes

  7. A survey on the experience of 136 Italian urologists in the treatment of erectile dysfunction with PDE5 inhibitors and recommendations for the use of Avanafil in the clinical practice

    Directory of Open Access Journals (Sweden)

    Vincenzo Mirone

    2016-07-01

    Full Text Available Introduction: PDE5 inhibitors are the firstline treatment for erectile dysfunction. Although all these drugs share the same mechanism of action, each agent could have different characteristics in terms of selectivity, pharmacokinetics and tolerability profile. Materials and Methods: This manuscript illustrates a project, undertaken by the Italian Society of Urology in order to obtain a “snapshot” of the experience of Italian urologists with the use of PDE5 inhibitors in the clinical practice. This project included a survey, targeting a sample of 136 Italian urologists experienced in the treatment of ED, and the organization of a conference of experts who, based on the findings of the survey, the scientific literature and the clinical experience, would define some recommendations for the use of PDE5 inhibitors in clinical practice with a particular focus on Avanafil, the most recent drug in this class. Results: The following recommendations on the use of Avanafil were issued: 1 In patients who are candidates for the use of Avanafil, it is advisable to use the 200-mg dose from the first administration; 2 When used at the highest dose (200 mg, Avanafil shows a favourable tolerability profile with an efficacy similar to that of other agents; 3 The patient should be instructed to take Avanafil on an empty stomach, i.e., 30-45 minutes before or 2 hours after a meal; 4 The efficacy window of Avanafil is between 30 minutes and 6 hours after dosing, which qualifies this molecule as a new drug with an intermediate duration of action; 5 Avanafil at a dose of 50-100 mg/day may be a therapeutic option in chronic rehabilitation. Conclusions: Among PDE5 inhibitors, Avanafil is a new agent with an intermediate duration of action, characterized by high efficacy and good tolerability even at the highest dose (200 mg.

  8. When science meets culture: the prevention and management of ...

    African Journals Online (AJOL)

    2013-05-13

    May 13, 2013 ... Review Article: When science meets culture: the prevention and management of erectile dysfunction in the 21st century. 2014;27(1). S Afr J Clin Nutr. Introduction. It is now well recognised ..... Traditional Asian folklore medicines in sexual health. Indian J Urol. 2006;22(3):241-245. 3. Lim PH, Moorthy P, Tan ...

  9. A method for preventive intervention regarding temporomandibular pain and dysfunction.

    Science.gov (United States)

    Ellie, Saghafi; Christina, Mejersjö

    2018-02-15

    Adolescent girls frequently suffer from temporomandibular disorder (TMD) symptoms and associated headache. A program aimed at informing about risk behavior for TMD symptoms, how to influence harmful habits and about general relaxation was tested. Eighty girls at two high schools, 16 years of age, with or without symptoms, were invited to the health information on two occasions and 60 girls participated. Firstly, a questionnaire regarding symptoms and oral parafunctional habits was administrated. Structured information was given about the normal anatomy and function of muscles and joints, about the occlusion, oral habits and symptoms of orofacial pain/dysfunction and headache. General relaxation was instructed and trained. At a three-month follow-up, the same questionnaire regarding symptoms as at baseline was completed. The information provided was perceived as useful and instructive. At the follow-up, 77% reported that they used what they had learned. Headache once a week or more decreased from 49% at baseline to 35% and headache 'never/rarely' changed from 11% to 25% (p = .002). Reported joint sounds had decreased by the follow-up (p = .053), as had the use of chewing gum (p = .002). A majority of the girls suggested that the information should be scheduled during school hours. Health information about the jaw system can influence risk factors for TMD symptoms and the frequency of symptoms among adolescent girls.

  10. 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

  11. 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.

  12. The Effect of Endovascular Revascularization of Common Iliac Artery Occlusions on Erectile Function

    Energy Technology Data Exchange (ETDEWEB)

    Gur, Serkan, E-mail: mserkangur@yahoo.com [Sifa Hospital, Department of Radiology (Turkey); Ozkan, Ugur [Baskent University, Department of Radiology, Faculty of Medicine (Turkey); Onder, Hakan; Tekbas, Gueven [Dicle University, Department of Radiology, Faculty of Medicine (Turkey); Oguzkurt, Levent [Baskent University, Department of Radiology, Faculty of Medicine (Turkey)

    2013-02-15

    To determine the incidence of erectile dysfunction in patients with common iliac artery (CIA) occlusive disease and the effect of revascularization on erectile function using the sexual health inventory for males (SHIM) questionnaire. All patients (35 men; mean age 57 {+-} 5 years; range 42-67 years) were asked to recall their sexual function before and 1 month after iliac recanalization. Univariate and multivariate analyses were performed to determine variables effecting improvement of impotence. The incidence of impotence in patients with CIA occlusion was 74% (26 of 35) preoperatively. Overall 16 (46%) of 35 patients reported improved erectile function after iliac recanalization. The rate of improvement of impotence was 61.5% (16 of 26 impotent patients). Sixteen patients (46%), including seven with normal erectile function before the procedure, had no change. Three patients (8%) reported deterioration of their sexual function, two of whom (6%) had normal erectile function before the procedure. The median SHIM score increased from 14 (range 4-25) before the procedure to 20 (range 1-25) after the procedure (P = 0.005). The type of recanalization, the age of the patients, and the length of occlusion were related to erectile function improvement in univariate analysis. However, these factors were not independent factors for improvement of erectile dysfunction in multivariate analysis (P > 0.05). Endovascular recanalization of CIA occlusions clearly improves sexual function. More than half of the patients with erectile dysfunction who underwent endovascular recanalization of the CIA experienced improvement.

  13. The Effect of Endovascular Revascularization of Common Iliac Artery Occlusions on Erectile Function

    International Nuclear Information System (INIS)

    Gur, Serkan; Ozkan, Uğur; Onder, Hakan; Tekbas, Güven; Oguzkurt, Levent

    2013-01-01

    To determine the incidence of erectile dysfunction in patients with common iliac artery (CIA) occlusive disease and the effect of revascularization on erectile function using the sexual health inventory for males (SHIM) questionnaire. All patients (35 men; mean age 57 ± 5 years; range 42–67 years) were asked to recall their sexual function before and 1 month after iliac recanalization. Univariate and multivariate analyses were performed to determine variables effecting improvement of impotence. The incidence of impotence in patients with CIA occlusion was 74% (26 of 35) preoperatively. Overall 16 (46%) of 35 patients reported improved erectile function after iliac recanalization. The rate of improvement of impotence was 61.5% (16 of 26 impotent patients). Sixteen patients (46%), including seven with normal erectile function before the procedure, had no change. Three patients (8%) reported deterioration of their sexual function, two of whom (6%) had normal erectile function before the procedure. The median SHIM score increased from 14 (range 4–25) before the procedure to 20 (range 1–25) after the procedure (P = 0.005). The type of recanalization, the age of the patients, and the length of occlusion were related to erectile function improvement in univariate analysis. However, these factors were not independent factors for improvement of erectile dysfunction in multivariate analysis (P > 0.05). Endovascular recanalization of CIA occlusions clearly improves sexual function. More than half of the patients with erectile dysfunction who underwent endovascular recanalization of the CIA experienced improvement.

  14. Associations of unhealthy lifestyle factors with sexual inactivity and sexual dysfunctions in Denmark

    DEFF Research Database (Denmark)

    Christensen, Birgitte S; Grønbaek, Morten; Pedersen, Bo V

    2011-01-01

    Studies have linked obesity, a sedentary lifestyle, and tobacco smoking to erectile dysfunction, but the evidence linking unhealthy lifestyle factors to other sexual dysfunctions or to sexual inactivity is conflicting.......Studies have linked obesity, a sedentary lifestyle, and tobacco smoking to erectile dysfunction, but the evidence linking unhealthy lifestyle factors to other sexual dysfunctions or to sexual inactivity is conflicting....

  15. Avanafil Liposomes as Transdermal Drug Delivery for Erectile ...

    African Journals Online (AJOL)

    Conclusion: The developed avanafil liposomes represent a promising transdermal drug delivery system for the treatment of erectile dysfunction. ... skin, in recent years, transdermal drug delivery has been used to overcome the problems ... Drugs Technology Co., Ltd. [Hangzhou, China]. The egg phosphatidylcholine (PC), ...

  16. SILDENAFIL (VIAGRA) IN THE TREATMENT OF MALE ERECTILE ...

    African Journals Online (AJOL)

    hi-tech

    2000-02-02

    Feb 2, 2000 ... Objective: To evaluate the effectiveness of sildenafil (Viagra) in the treatment of male erectile dysfunction in Nairobi. Design: Prospective open label extension study. Setting: Urology clinics at the Nairobi Hospital, Kenyatta National Hospital and the author's private clinic in Hurlingham, Nairobi. Participants: ...

  17. Sildenafil citrate (VIAGRA™) in the treatment of male Erectile ...

    African Journals Online (AJOL)

    Background: Erectile dysfunction (ED) is a major health concern which in some communities has been estimated to affect about half of men aged 40 years and above. Due to the high social stigma and its co-morbid nature, ED still remains highly under-diagnosed and hence untreated. Equally important is the lack of ...

  18. Effects of Aerobic Exercise in the Management of Erectile ...

    African Journals Online (AJOL)

    BACKGROUND: Penile erection is a hemodynamic process involving increased arterial inflow and restricted venous outflow, coordinated with corpus cavernosum and penile arterial smooth muscle relaxation. Any problem in this mechanism results in Erectile Dysfunction and its etiology is generally multifactorial. This study ...

  19. Thyroid hormone: the modulator of erectile function in the rabbit ...

    African Journals Online (AJOL)

    The possible role of thyroid hormones in the Nitric Oxide (NO)- mediated response to sexual stimulation, and on prostaglandin E1 (PGE1) and Sildenafil in the treatment of erectile dysfunction was investigated using the corpus cavernosum of the New Zealand rabbit animal model. The parameters studied were penile ...

  20. Disfunção erétil: resultados do estudo da vida sexual do brasileiro Erectile dysfunction: results of the Brazilian sexual life study

    Directory of Open Access Journals (Sweden)

    Carmita Helena Najjar Abdo

    2006-12-01

    .01. Level of education was inversely proportional to risk of ED. Yellow race, unemployment, religious affiliation, prostate tumor, hypertension and depression were variables that increased ED risk. CONCLUSION: The prevalence of ED was high and comparable to that found in other studies. Subjects with ED suffer from less sexual activity and poorer quality of life. Age and lower socioeconomic level are directly proportional to ED risk. Therapeutic and preventive measures should be implemented to minimize the negative impact of this condition, especially in developing countries.

  1. Mitochondria-Targeted Antioxidant Prevents Cardiac Dysfunction Induced by Tafazzin Gene Knockdown in Cardiac Myocytes

    Directory of Open Access Journals (Sweden)

    Quan He

    2014-01-01

    Full Text Available Tafazzin, a mitochondrial acyltransferase, plays an important role in cardiolipin side chain remodeling. Previous studies have shown that dysfunction of tafazzin reduces cardiolipin content, impairs mitochondrial function, and causes dilated cardiomyopathy in Barth syndrome. Reactive oxygen species (ROS have been implicated in the development of cardiomyopathy and are also the obligated byproducts of mitochondria. We hypothesized that tafazzin knockdown increases ROS production from mitochondria, and a mitochondria-targeted antioxidant prevents tafazzin knockdown induced mitochondrial and cardiac dysfunction. We employed cardiac myocytes transduced with an adenovirus containing tafazzin shRNA as a model to investigate the effects of the mitochondrial antioxidant, mito-Tempo. Knocking down tafazzin decreased steady state levels of cardiolipin and increased mitochondrial ROS. Treatment of cardiac myocytes with mito-Tempo normalized tafazzin knockdown enhanced mitochondrial ROS production and cellular ATP decline. Mito-Tempo also significantly abrogated tafazzin knockdown induced cardiac hypertrophy, contractile dysfunction, and cell death. We conclude that mitochondria-targeted antioxidant prevents cardiac dysfunction induced by tafazzin gene knockdown in cardiac myocytes and suggest mito-Tempo as a potential therapeutic for Barth syndrome and other dilated cardiomyopathies resulting from mitochondrial oxidative stress.

  2. Erectile Dysfunction Among Men Attending Surgical Outpatients ...

    African Journals Online (AJOL)

    LTFUP: Lost to follow-up, PDE5-I: Phosphodiesterase Type 5 inhibitor, ORX: Other therapy such as modification of antihypertensives, anxiolytics, physiotherapy, intramuscular testosterone, varicocelctomy rehydration, and analgesics of study, there were 16 patients, and this dropped to seven at the last year of study with an ...

  3. Erectile Dysfunction Among Men Attending Surgical Outpatients ...

    African Journals Online (AJOL)

    sildenafil, vardenafil, or tadalafil of which 25 of them had improvement of their symptoms, 13 were lost to follow‑up and no improvement in three. The success rate of PDE5‑I alone was 89% (25 of 28). Eleven men had a combination of PDE5‑I and other treatment such as modification of anti‑hypertensives, psychotherapy ...

  4. Erectile Dysfunction: MedlinePlus Health Topic

    Science.gov (United States)

    ... Specifics See, Play and Learn Videos and Tutorials Research Clinical Trials Journal Articles Resources Find an Expert For You Patient Handouts ... Bent Penis (Mayo Foundation for Medical Education and Research) ... Journal Articles References and abstracts from MEDLINE/PubMed (National Library ...

  5. The pharmacological management of erectile dysfunction

    African Journals Online (AJOL)

    Health Inventory for Men questionnaires are commonly used in the initial assessment of ED.2. Several risk factors have been linked to the pathophysiology of ED. Endothelial damage has been the focus of many recent studies. An evaluation of the cardiovascular status, in addition to the administration of questionnaires to ...

  6. Exercise Training Prevents Arterial Baroreflex Dysfunction in Rats Treated With Central Angiotensin II

    OpenAIRE

    Pan, Yan-Xia; Gao, Lie; Wang, Wei-Zhong; Zheng, Hong; Liu, Dongmei; Patel, Kaushik P.; Zucker, Irving H.; Wang, Wei

    2007-01-01

    Angiotensin II (Ang II)–induced arterial baroreflex dysfunction is associated with superoxide generation in the brain. Exercise training (EX) improves baroreflex function and decreases oxidative stress in cardiovascular diseases linked to elevated central Ang II. The aim of this study was to determine whether previous EX prevents baroreflex impairment caused by central administration of exogenous Ang II via an Ang II–superoxide mechanism. Four groups of rats were used: non-EX artificial cereb...

  7. Male sexual dysfunction and infertility associated with neurological disorders

    DEFF Research Database (Denmark)

    Fode, Mikkel; Krogh-Jespersen, Sheila; Brackett, Nancy L

    2012-01-01

    Normal sexual and reproductive functions depend largely on neurological mechanisms. Neurological defects in men can cause infertility through erectile dysfunction, ejaculatory dysfunction and semen abnormalities. Among the major conditions contributing to these symptoms are pelvic and retroperito......Normal sexual and reproductive functions depend largely on neurological mechanisms. Neurological defects in men can cause infertility through erectile dysfunction, ejaculatory dysfunction and semen abnormalities. Among the major conditions contributing to these symptoms are pelvic...... and retroperitoneal surgery, diabetes, congenital spinal abnormalities, multiple sclerosis and spinal cord injury. Erectile dysfunction can be managed by an increasingly invasive range of treatments including medications, injection therapy and the surgical insertion of a penile implant. Retrograde ejaculation...

  8. Retrograde ejaculation and sexual dysfunction in men with diabetes mellitus

    DEFF Research Database (Denmark)

    Fedder, J; Kaspersen, Maja Døvling; Brandslund, I

    2013-01-01

    Retrograde ejaculation (RE) and erectile dysfunction may be caused by diabetes mellitus (DM), but the prevalence of RE among DM patients is unknown. A prospective, blinded case-control study comparing men with DM with matched controls according to RE and erectile dysfunction was performed. Twenty...

  9. Renal Dysfunction after Off-Pump Coronary Artery Bypass Surgery- Risk Factors and Preventive Strategies

    Directory of Open Access Journals (Sweden)

    Gaurab Maitra

    2009-01-01

    Full Text Available Postoperative renal dysfunction is a relatively common and one of the serious complications of cardiac surgery. Though off-pump coronary artery bypass surgery technique avoids cardiopulmonary bypass circuit induced adverse effects on renal function, multiple other factors cause postoperative renal dysfunction in these groups of patients. Acute kidney injury is generally defined as an abrupt and sustained decrease in kidney function. There is no consen-sus on the amount of dysfunction that defines acute kidney injury, with more than 30 definitions in use in the literature today. Although serum creatinine is widely used as a marker for changes in glomerular filtration rate, the criteria used to define renal dysfunction and acute renal failure is highly variable. The variety of definitions used in clinical studies may be partly responsible for the large variations in the reported incidence. Indeed, the lack of a uniform definition for acute kidney injury is believed to be a major impediment to research in the field. To establish a uniform definition for acute kidney injury, the Acute Dialysis Quality Initiative formulated the Risk, Injury, Failure, Loss, and End-stage Kidney (RIFLE classification. RIFLE , defines three grades of increasing severity of acute kidney injury -risk (class R, injury (class I and failure (class F - and two outcome classes (loss and end-stage kidney disease. Various perioperative risk factors for postoperative renal dysfunction and failure have been identified. Among the important preoperative factors are advanced age, reduced left ventricular function, emergency surgery, preoperative use of intraaortic balloon pump, elevated preoperative serum glucose and creatinine. Most important intraoperative risk factor is the intraoperative haemodynamic instability and all the causes of postoperative low output syndrome com-prise the postoperative risk factors. The most important preventive strategies are the identification of the

  10. Nitro-Oleic Acid Prevents Hypoxia- and Asymmetric Dimethylarginine-Induced Pulmonary Endothelial Dysfunction.

    Science.gov (United States)

    Koudelka, Adolf; Ambrozova, Gabriela; Klinke, Anna; Fidlerova, Tana; Martiskova, Hana; Kuchta, Radek; Rudolph, Tanja K; Kadlec, Jaroslav; Kuchtova, Zdenka; Woodcock, Steven R; Freeman, Bruce A; Kubala, Lukas; Pekarova, Michaela

    2016-12-01

    Pulmonary hypertension (PH) represents a serious health complication accompanied with hypoxic conditions, elevated levels of asymmetric dimethylarginine (ADMA), and overall dysfunction of pulmonary vascular endothelium. Since the prevention strategies for treatment of PH remain largely unknown, our study aimed to explore the effect of nitro-oleic acid (OA-NO 2 ), an exemplary nitro-fatty acid (NO 2 -FA), in human pulmonary artery endothelial cells (HPAEC) under the influence of hypoxia or ADMA. HPAEC were treated with OA-NO 2 in the absence or presence of hypoxia and ADMA. The production of nitric oxide (NO) and interleukin-6 (IL-6) was monitored using the Griess method and ELISA, respectively. The expression or activation of different proteins (signal transducer and activator of transcription 3, STAT3; hypoxia inducible factor 1α, HIF-1α; endothelial nitric oxide synthase, eNOS; intercellular adhesion molecule-1, ICAM-1) was assessed by the Western blot technique. We discovered that OA-NO 2 prevents development of endothelial dysfunction induced by either hypoxia or ADMA. OA-NO 2 preserves normal cellular functions in HPAEC by increasing NO production and eNOS expression. Additionally, OA-NO 2 inhibits IL-6 production as well as ICAM-1 expression, elevated by hypoxia and ADMA. Importantly, the effect of OA-NO 2 is accompanied by prevention of STAT3 activation and HIF-1α stabilization. In summary, OA-NO 2 eliminates the manifestation of hypoxia- and ADMA-mediated endothelial dysfunction in HPAEC via the STAT3/HIF-1α cascade. Importantly, our study is bringing a new perspective on molecular mechanisms of NO 2 -FAs action in pulmonary endothelial dysfunction, which represents a causal link in progression of PH. Graphical Abstract ᅟ.

  11. Erectile function after permanent prostate brachytherapy

    International Nuclear Information System (INIS)

    Merrick, Gregory S.; Butler, Wayne M.; Galbreath, Robert W.; Stipetich, Robin L.; Abel, Laurie J.; Lief, Jonathan H.

    2002-01-01

    Purpose: To determine the incidence of potency preservation after permanent prostate brachytherapy using a validated patient-administered questionnaire and to evaluate the effect of multiple clinical and treatment parameters on penile erectile function. Methods and Materials: Four hundred twenty-five patients underwent permanent prostate brachytherapy from April 1995 to October 1999. Two hundred nine patients who were potent before brachytherapy and who at the time of the survey were not receiving hormonal therapy were mailed the specific erectile questions of the International Index of Erectile Function (IIEF) questionnaire with a self-addressed stamped envelope. The questionnaire consisted of 5 questions, with a maximal score of 25. Of the 209 patients, 181 (87%) completed and returned the questionnaire. The mean and median follow-up was 40.4±14.9 and 40.6 months, respectively (range 19-75). Preimplant erectile function was assigned using a three-tiered scoring system (2 = erections always or nearly always sufficient for vaginal penetration; 1 = erections sufficient for vaginal penetration but considered suboptimal; 0 = the inability to obtain erections and/or erections inadequate for vaginal penetration). Postimplant potency was defined as an IIEF score ≥11. The clinical parameters evaluated for erectile function included patient age, preimplant potency, clinical T-stage, pretreatment prostate-specific antigen level, Gleason score, elapsed time after implantation, hypertension, diabetes mellitus, and tobacco consumption. Treatment parameters included radiation dose to the prostate gland, use of hormonal manipulation, use of supplemental external beam radiotherapy (EBRT), choice of isotope, prostate volume, and planning volume. The efficacy of sildenafil citrate in brachytherapy-induced erectile dysfunction (ED) was also evaluated. Results: Pretreatment erectile function scores of 2 and 1 were assigned to 125 and 56 patients, respectively. With a 6-year follow

  12. 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...

  13. Statins prevent cognitive impairment after sepsis by reverting neuroinflammation, and microcirculatory/endothelial dysfunction.

    Science.gov (United States)

    Reis, Patricia A; Alexandre, Pedro C B; D'Avila, Joana C; Siqueira, Luciana D; Antunes, Barbara; Estato, Vanessa; Tibiriça, Eduardo V; Verdonk, Franck; Sharshar, Tarek; Chrétien, Fabrice; Castro-Faria-Neto, Hugo C; Bozza, Fernando A

    2017-02-01

    Acute brain dysfunction is a frequent condition in sepsis patients and is associated with increased mortality and long-term neurocognitive consequences. Impaired memory and executive function are common findings in sepsis survivors. Although neuroinflammation and blood-brain barrier dysfunction have been associated with acute brain dysfunction and its consequences, no specific treatments are available that prevent cognitive impairment after sepsis. Experimental sepsis was induced in Swiss Webster mice by intraperitoneal injection of cecal material (5mg/kg, 500μL). Control groups (n=5/group each experiment) received 500μL of saline. Support therapy recover (saline 0.9%, 1mL and imipenem 30mg/kg) were applied (6, 24 and 48h post injection, n=5-10/group, each experiment), together or not with additive orally treatment with statins (atorvastatin/simvastatin 20mg/kg b.w.). Survival rate was monitored at 6, 24 and 48h. In a setting of experiments, animals were euthanized at 6 and 24h after induction for biochemical, immunohistochemistry and intravital analysis. Statins did not prevented mortality in septic mice, however survivors presented lower clinical score. At another setting of experiments, after 15days, mice survivors from fecal supernatant peritoneal sepsis presented cognitive dysfunction for contextual hippocampal and aversive amygdala-dependent memories, which was prevented by atorvastatin/simvastatin treatment. Systemic and brain tissue levels of proinflammatory cytokines/chemokines and activation of microglial were lower in septic mice treated with statins. Brain lipid peroxidation and myeloperoxidase levels were also reduced by statins treatment. Intravital examination of the brain vessels of septic animals revealed decreased functional capillary density and increased rolling and adhesion of leukocytes, and blood flow impairment, which were reversed by treatment with statins. In addition, treatment with statins restored the cholinergic vasodilator response

  14. Prevention of paracentesis-induced circulatory dysfunction: midodrine vs albumin. A randomized pilot study.

    Science.gov (United States)

    Appenrodt, Beate; Wolf, Andrea; Grünhage, Frank; Trebicka, Jonel; Schepke, Michael; Rabe, Christian; Lammert, Frank; Sauerbruch, Tilman; Heller, J

    2008-08-01

    Large-volume paracentesis in patients with cirrhosis and ascites induces arterial vasodilatation and decreases effective arterial blood volume, termed paracentesis-induced circulatory dysfunction (PICD), which can be prevented by costly intravenous albumin. Vasoconstrictors, e.g. terlipressin, may also prevent PICD. The aim was to compare the less expensive vasoconstrictor midodrine, an alpha-adrenoceptor agonist, with albumin in preventing PICD. Twenty-four patients with cirrhosis and ascites were randomly assigned to be treated with either midodrine (n=11) (12.5 mg three times per day; over 2 days) or albumin (n=13) (8 g/L of removed ascites) after large-volume paracentesis. Effective arterial blood volume was assessed indirectly by measuring plasma renin and aldosterone concentration on days 0 and 6 after paracentesis; renal function and haemodynamic changes were also measured. PICD was defined as an increase in plasma renin concentration on day 6 by more than 50% of the baseline value. PICD developed in six patients of the midodrine group (60%) and in only four patients (31%) of the albumin group. Six days after paracentesis, the aldosterone concentration increased significantly in the midodrine group, but not in the albumin group. This pilot study suggests that midodrine is not as effective as albumin in preventing circulatory dysfunction after large-volume paracentesis in patients with cirrhosis and ascites.

  15. Probiotics (VSL#3 prevent endothelial dysfunction in rats with portal hypertension: role of the angiotensin system.

    Directory of Open Access Journals (Sweden)

    Sherzad K Rashid

    Full Text Available AIMS: Portal hypertension characterized by generalized vasodilatation with endothelial dysfunction affecting nitric oxide (NO and endothelium-dependent hyperpolarization (EDH has been suggested to involve bacterial translocation and/or the angiotensin system. The possibility that ingestion of probiotics prevents endothelial dysfunction in rats following common bile duct ligation (CBDL was evaluated. METHODS: Rats received either control drinking water or the probiotic VSL#3 solution (50 billion bacteria.kg body wt⁻¹.day⁻¹ for 7 weeks. After 3 weeks, rats underwent surgery with either resection of the common bile duct or sham surgery. The reactivity of mesenteric artery rings was assessed in organ chambers, expression of proteins by immunofluorescence and Western blot analysis, oxidative stress using dihydroethidium, and plasma pro-inflammatory cytokine levels by flow cytometry. RESULTS: Both NO- and EDH-mediated relaxations to acetylcholine were reduced in the CBDL group compared to the sham group, and associated with a reduced expression of Cx37, Cx40, Cx43, IKCa and SKCa and an increased expression of endothelial NO synthase (eNOS. In aortic sections, increased expression of NADPH oxidase subunits, angiotensin converting enzyme, AT1 receptors and angiotensin II, and formation of ROS and peroxynitrite were observed. VSL#3 prevented the deleterious effect of CBDL on EDH-mediated relaxations, vascular expression of connexins, IKCa, SKCa and eNOS, oxidative stress, and the angiotensin system. VSL#3 prevented the CBDL-induced increased plasma TNF-α, IL-1α and MCP-1 levels. CONCLUSIONS: These findings indicate that VSL#3 ingestion prevents endothelial dysfunction in the mesenteric artery of CBDL rats, and this effect is associated with an improved vascular oxidative stress most likely by reducing bacterial translocation and the local angiotensin system.

  16. Nicorandil prevents sirolimus-induced production of reactive oxygen species, endothelial dysfunction, and thrombus formation

    Directory of Open Access Journals (Sweden)

    Ken Aizawa

    2015-03-01

    Full Text Available Sirolimus (SRL is widely used to prevent restenosis after percutaneous coronary intervention. However, its beneficial effect is hampered by complications of thrombosis. Several studies imply that reactive oxygen species (ROS play a critical role in endothelial dysfunction and thrombus formation. The present study investigated the protective effect of nicorandil (NIC, an anti-angina agent, on SRL-associated thrombosis. In human coronary artery endothelial cells (HCAECs, SRL stimulated ROS production, which was prevented by co-treatment with NIC. The preventive effect of NIC on ROS was abolished by 5-hydroxydecanoate but not by 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one. NIC also inhibited SRL-induced up-regulation of NADPH oxidase subunit p22phox mRNA. Co-treatment with NIC and SRL significantly up-regulated superoxide dismutase 2. NIC treatment significantly improved SRL-induced decrease in viability of HCAECs. The functional relevance of the preventive effects of NIC on SRL-induced ROS production and impairment of endothelial viability was investigated in a mouse model of thrombosis. Pretreatment with NIC inhibited the SRL-induced acceleration of FeCl3-initiated thrombus formation and ROS production in the testicular arteries of mice. In conclusion, NIC prevented SRL-induced thrombus formation, presumably due to the reduction of ROS and to endothelial protection. The therapeutic efficacy of NIC could represent an additional option in the prevention of SRL-related thrombosis.

  17. Mineralocorticoid receptor blockade prevents Western diet-induced diastolic dysfunction in female mice.

    Science.gov (United States)

    Bostick, Brian; Habibi, Javad; DeMarco, Vincent G; Jia, Guanghong; Domeier, Timothy L; Lambert, Michelle D; Aroor, Annayya R; Nistala, Ravi; Bender, Shawn B; Garro, Mona; Hayden, Melvin R; Ma, Lixin; Manrique, Camila; Sowers, James R

    2015-05-01

    Overnutrition/obesity predisposes individuals, particularly women, to diastolic dysfunction (DD), an independent predictor of future cardiovascular disease. We examined whether low-dose spironolactone (Sp) prevents DD associated with consumption of a Western Diet (WD) high in fat, fructose, and sucrose. Female C57BL6J mice were fed a WD with or without Sp (1 mg·kg(-1)·day(-1)). After 4 mo on the WD, mice exhibited increased body weight and visceral fat, but similar blood pressures, compared with control diet-fed mice. Sp prevented the development of WD-induced DD, as indicated by decreased isovolumic relaxation time and an improvement in myocardial performance (diet-induced DD in women. Mineralocorticoid antagonism; low-dose spironolactone; aldosterone;high-fat diet; high-fructose diet; oxidative stress; inflammation; cardiac hypertrophy; myocardial compliance. Copyright © 2015 the American Physiological Society.

  18. Update on corpus cavernosum smooth muscle contractile pathways in erectile function: a role for testosterone?

    Science.gov (United States)

    Zhang, Xin-Hua; Melman, Arnold; Disanto, Michael E

    2011-07-01

    Normal erectile function (EF) involves a coordinated relaxation of the arteries that supply the penis and the corpus cavernosum smooth muscle (CCSM), resulting in expansion of the sinusoids and increased intracavernous pressure. But the CCSM spends the majority of its time in the contracted state which is mediated by norepinephrine released from nerve endings and other vasoconstrictors like endothelins released from the endothelium. These agents cause smooth muscle myosin (SMM) phosphorylation by elevating intracellular calcium. When calcium returns to basal levels, the calcium sensitivity increases and prevents myosin dephosphorylation, which involves the RhoA/Rho-kinase (ROK) mechanism, thus maintaining force. Although mounting evidences demonstrate that androgens have a major influence on EF that is not just centrally mediated, this notion remains quite controversial. To summarize the current knowledge on CCSM contractile pathways, the role they play in modulating EF, and the influence of androgens. The article reviews the literature and contains some previously unpublished data on CCSM contraction signaling including the role that androgens are known to play in modulating these pathways. Data from peer-reviewed publications and previously unpublished observations. In addition to downregulation of many pro-erectile molecular mechanisms, decreased testosterone (T) levels upregulate CCSM contractility, including hyperresponsiveness to α-adrenergic agonists, increased SMM phosphorylation, alteration of SMM isoform composition, activation of RhoA/ROK signaling and modulation of sphingosine-1-phosphate regulation of CCSM tone. Decreased T levels upregulate CCSM contractile signaling. Meanwhile, it downregulates CCSM relaxation pathways synergizing to produce erectile dysfunction (ED). Although some urologists and researchers are still skeptical of the influence of androgens on penile erection, understanding these molecular control mechanisms as well as the influence

  19. Humanin prevents brain mitochondrial dysfunction in a cardiac ischaemia-reperfusion injury model.

    Science.gov (United States)

    Kumfu, Sirinart; Charununtakorn, Savitree T; Jaiwongkam, Thidarat; Chattipakorn, Nipon; Chattipakorn, Siriporn C

    2016-06-01

    What is the central question of this study? Myocardial ischaemia-reperfusion (I/R) injury causes interference in the systemic circulation and damages not only the heart but also several vital organs, including the brain. Recently, a novel peptide called humanin has been shown to exert potent neuroprotective effects. However, the effect of humanin on the brain during cardiac I/R injury has not yet been investigated. What is the main finding and its importance? The I/R injury caused blood-brain barrier breakdown, increased brain oxidative stress and resulted in mitochondrial dysfunction. Only the humanin treatment before ischaemia attenuated brain mitochondrial dysfunction, but it did not prevent blood-brain barrier breakdown or brain oxidative stress. Humanin treatment during ischaemia and in the reperfusion period provided no neuroprotection. These findings indicate that humanin exerted neuroprotection during cardiac I/R injury via improved brain mitochondrial function. Myocardial ischaemia-reperfusion (I/R) injury causes interference in the systemic circulation and damages not only the heart but also several vital organs, including the brain. Nevertheless, limited information is available regarding the effect of cardiac I/R injury on the brain, including blood-brain barrier (BBB) breakdown, brain oxidative stress and mitochondrial function. Recently, a novel peptide called humanin has been shown to exert potent neuroprotective effects. However, the effect of humanin on the brain during cardiac I/R injury has not yet been investigated. Forty-two male Wistar rats were divided into the following two groups: an I/R group, which was subjected to a 30 min left anterior descending coronary artery occlusion followed by 120 min reperfusion (I/R group; n = 36); and a sham group (n = 6). The I/R group was divided into six subgroups. Each subgroup was given either vehicle or humanin analogue (84 μg kg(-1) , i.v.) at three different time points, namely before

  20. Ursolic acid protects monocytes against metabolic stress-induced priming and dysfunction by preventing the induction of Nox4

    Directory of Open Access Journals (Sweden)

    Sarah L. Ullevig

    2014-01-01

    Conclusion: UA protects THP-1 monocytes against dysfunction by suppressing metabolic stress-induced Nox4 expression, thereby preventing the Nox4-dependent dysregulation of redox-sensitive processes, including actin turnover and MAPK-signaling, two key processes that control monocyte migration and adhesion. This study provides a novel mechanism for the anti-inflammatory and athero- and renoprotective properties of UA and suggests that dysfunctional blood monocytes may be primary targets of UA and related compounds.

  1. Burden of Sexual Dysfunction.

    Science.gov (United States)

    Balon, Richard

    2017-01-02

    Similar to the burden of other diseases, the burden of sexual dysfunction has not been systematically studied. However, there is growing evidence of various burdens (e.g., economic, symptomatic, humanistic) among patients suffering from sexual dysfunctions. The burden of sexual dysfunction has been studied a bit more often in men, namely the burden of erectile dysfunction (ED), premature ejaculation (PE) and testosterone deficiency syndrome (TDS). Erectile dysfunction is frequently associated with chronic conditions such as cardiovascular disease, diabetes, and depression. These conditions could go undiagnosed, and ED could be a marker of those diseases. The only available report from the United Kingdom estimated the total economic burden of ED at £53 million annually in terms of direct costs and lost productivity. The burden of PE includes significant psychological distress: anxiety, depression, lack of sexual confidence, poor self-esteem, impaired quality of life, and interpersonal difficulties. Some suggest that increase in female sexual dysfunction is associated with partner's PE, in addition to significant interpersonal difficulties. The burden of TDS includes depression, sexual dysfunction, mild cognitive impairment, and osteoporosis. One UK estimate of the economic burden of female sexual dysfunctions demonstrated that the average cost per patient was higher than the per annum cost of ED. There are no data on burden of paraphilic disorders. The burden of sexual dysfunctions is underappreciated and not well studied, yet it is significant for both the patients and the society.

  2. APOE Stabilization by Exercise Prevents Aging Neurovascular Dysfunction and Complement Induction.

    Directory of Open Access Journals (Sweden)

    Ileana Soto

    2015-10-01

    Full Text Available Aging is the major risk factor for neurodegenerative diseases such as Alzheimer's disease, but little is known about the processes that lead to age-related decline of brain structures and function. Here we use RNA-seq in combination with high resolution histological analyses to show that aging leads to a significant deterioration of neurovascular structures including basement membrane reduction, pericyte loss, and astrocyte dysfunction. Neurovascular decline was sufficient to cause vascular leakage and correlated strongly with an increase in neuroinflammation including up-regulation of complement component C1QA in microglia/monocytes. Importantly, long-term aerobic exercise from midlife to old age prevented this age-related neurovascular decline, reduced C1QA+ microglia/monocytes, and increased synaptic plasticity and overall behavioral capabilities of aged mice. Concomitant with age-related neurovascular decline and complement activation, astrocytic Apoe dramatically decreased in aged mice, a decrease that was prevented by exercise. Given the role of APOE in maintaining the neurovascular unit and as an anti-inflammatory molecule, this suggests a possible link between astrocytic Apoe, age-related neurovascular dysfunction and microglia/monocyte activation. To test this, Apoe-deficient mice were exercised from midlife to old age and in contrast to wild-type (Apoe-sufficient mice, exercise had little to no effect on age-related neurovascular decline or microglia/monocyte activation in the absence of APOE. Collectively, our data shows that neurovascular structures decline with age, a process that we propose to be intimately linked to complement activation in microglia/monocytes. Exercise prevents these changes, but not in the absence of APOE, opening up new avenues for understanding the complex interactions between neurovascular and neuroinflammatory responses in aging and neurodegenerative diseases such as Alzheimer's disease.

  3. Aldolase B knockdown prevents high glucose-induced methylglyoxal overproduction and cellular dysfunction in endothelial cells.

    Directory of Open Access Journals (Sweden)

    Jianghai Liu

    Full Text Available We used cultured endothelial cells as a model to examine whether up-regulation of aldolase B and enhanced methylglyoxal (MG formation play an important role in high glucose-induced overproduction of advanced glycosylation endproducts (AGEs, oxidative stress and cellular dysfunction. High glucose (25 mM incubation up-regulated mRNA levels of aldose reductase (an enzyme converting glucose to fructose and aldolase B (a key enzyme that catalyzes MG formation from fructose and enhanced MG formation in human umbilical vein endothelial cells (HUVECs and HUVEC-derived EA. hy926 cells. High glucose-increased MG production in EA. hy926 cells was completely prevented by siRNA knockdown of aldolase B, but unaffected by siRNA knockdown of aldolase A, an enzyme responsible for MG formation during glycolysis. In addition, inhibition of cytochrome P450 2E1 or semicarbazide-sensitive amine oxidase which produces MG during the metabolism of lipid and proteins, respectively, did not alter MG production. Both high glucose (25 mM and MG (30, 100 µM increased the formation of N(ε-carboxyethyl-lysine (CEL, a MG-induced AGE, oxidative stress (determined by the generation of oxidized DCF, H(2O(2, protein carbonyls and 8-oxo-dG, O-GlcNAc modification (product of the hexosamine pathway, membrane protein kinase C activity and nuclear translocation of NF-κB in EA. hy926 cells. However, the above metabolic and signaling alterations induced by high glucose were completely prevented by knockdown of aldolase B and partially by application of aminoguanidine (a MG scavenger or alagebrium (an AGEs breaker. In conclusion, efficient inhibition of aldolase B can prevent high glucose-induced overproduction of MG and related cellular dysfunction in endothelial cells.

  4. Tempol prevents cardiac oxidative damage and left ventricular dysfunction in the PPAR-α KO mouse.

    Science.gov (United States)

    Guellich, Aziz; Damy, Thibaud; Conti, Marc; Claes, Victor; Samuel, Jane-Lise; Pineau, Thierry; Lecarpentier, Yves; Coirault, Catherine

    2013-06-01

    Peroxisome proliferator-activated receptor (PPAR)-α deletion induces a profound decrease in MnSOD activity, leading to oxidative stress and left ventricular (LV) dysfunction. We tested the hypothesis that treatment of PPAR-α knockout (KO) mice with the SOD mimetic tempol prevents the heart from pathological remodelling and preserves LV function. Twenty PPAR-α KO mice and 20 age-matched wild-type mice were randomly treated for 8 wk with vehicle or tempol in the drinking water. LV contractile parameters were determined both in vivo using echocardiography and ex vivo using papillary muscle mechanics. Translational and posttranslational modifications of myosin heavy chain protein as well as the expression and activity of major antioxidant enzymes were measured. Tempol treatment did not affect LV function in wild-type mice; however, in PPAR-α KO mice, tempol prevented the decrease in LV ejection fraction and restored the contractile parameters of papillary muscle, including maximum shortening velocity, maximum extent of shortening, and total tension. Moreover, compared with untreated PPAR-α KO mice, myosin heavy chain tyrosine nitration and anion superoxide production were markedly reduced in PPAR-α KO mice after treatment. Tempol also significantly increased glutathione peroxidase and glutathione reductase activities (~ 50%) in PPAR-α KO mice. In conclusion, these findings demonstrate that treatment with the SOD mimetic tempol can prevent cardiac dysfunction in PPAR-α KO mice by reducing the oxidation of contractile proteins. In addition, we show that the beneficial effects of tempol in PPAR-α KO mice involve activation of the glutathione peroxidase/glutathione reductase system.

  5. The effects of false physiological feedback on tumescence and cognitive domains in sexually functional and dysfunctional men.

    Science.gov (United States)

    Stone, Jay M; Clark, Robert; Sbrocco, Tracy; Lewis, Evelyn L

    2009-08-01

    A false feedback paradigm was used to produce a discrepancy between expected and "actual" tumescence among 57 sexually dysfunctional and 58 sexually functional men randomly assigned to one of four false tumescence feedback conditions: negative (NEG), neutral (NEU), positive (POS), or no (NO) feedback. Participants predicted an erection score before viewing an erotic film and then received false tumescence feedback based on this score. Tumescence and cognitive ratings were obtained before and after the feedback. It was predicted that discrepancies would differ between dysfunctional and functional participants such that functional participants would have the ability to overcome discrepancies, whereas dysfunctional participants would not. As expected, POS decreased tumescence for dysfunctional participants and NO did not influence tumescence for either group. Unexpectedly, NEU decreased tumescence for dysfunctional participants and NEG decreased tumescence for functional participants. Despite tumescence changes, cognitive ratings generally followed the feedback that was given. These results only partially support current models of sexual dysfunction and behavioral regulation. Anxiety, self-focused attention, cognitive interference, and unexpectedness of the feedback could not account for the partial support. However, most feedback that was outside of the realm of the status quo for both functional and dysfunctional participants did decrease tumescence, despite outcome expectancies. These results suggest that both functional and dysfunctional men may be at risk for erectile failure should feedback about their performance be discrepant from what they expect. Prevention and treatment should focus on preparing men for occasional erectile failure and on helping them overcome discrepant feedback.

  6. Garlic activates SIRT-3 to prevent cardiac oxidative stress and mitochondrial dysfunction in diabetes.

    Science.gov (United States)

    Sultana, Md Razia; Bagul, Pankaj K; Katare, Parameshwar B; Anwar Mohammed, Soheb; Padiya, Raju; Banerjee, Sanjay K

    2016-11-01

    Cardiac complications are major contributor in the mortality of diabetic people. Mitochondrial dysfunctioning is a crucial contributor for the cardiac complications in diabetes, and SIRT-3 remains the major mitochondrial deacetylase. We hypothesized whether garlic has any role on SIRT-3 to prevent mitochondrial dysfunction in diabetic heart. Rats with developed hyperglycemia after STZ injection were divided into two groups; diabetic (Dia) and diabetic+garlic (Dia+Garl). Garlic was administered at a dose of 250mg/kg/day, orally for four weeks. An additional group was maintained to evaluate the effect of raw garlic administration on control rat heart. We have observed altered functioning of cardiac mitochondrial enzymes involved in metabolic pathways, and increased levels of cardiac ROS with decreased activity of catalase and SOD in diabetic rats. Cardiac mRNA expression of TFAM, PGC-1α, and CO1 was also altered in diabetes. In addition, reduced levels of electron transport chain complexes that observed in Dia group were normalized with garlic administration. This indicates the presence of increased oxidative stress with mitochondrial dysfunctioning in diabetic heart. We have observed reduced activity of SIRT3 and increased acetylation of MnSOD. Silencing SIRT-3 in cells also revealed the same. However, administration of garlic improved the SIRT-3 and MnSOD activity, by deacetylating MnSOD. Increased SOD activity was correlated with reduced levels of ROS in garlic-administered rat hearts. Collectively, our results provide an insight into garlic's protection to T1DM heart through activation of SIRT3-MnSOD pathway. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Tongxinluo Prevents Endothelial Dysfunction Induced by Homocysteine Thiolactone In Vivo via Suppression of Oxidative Stress

    Directory of Open Access Journals (Sweden)

    Yi Zhang

    2015-01-01

    Full Text Available Aim. To explore whether Chinese traditional medicine, tongxinluo (TXL, exerts beneficial effects on endothelial dysfunction induced by homocysteine thiolactone (HTL and to investigate the potential mechanisms. Methods and Results. Incubation of cultured human umbilical vein endothelial cells with HTL (1 mM for 24 hours significantly reduced cell viabilities assayed by MTT, and enhanced productions of reactive oxygen species. Pretreatment of cells with TXL (100, 200, and 400 μg/mL for 1 hour reversed these effects induced by HTL. Further, coincubation with GW9662 (0.01, 0.1 mM abolished the protective effects of TXL on HTL-treated cells. In ex vivo experiments, exposure of isolated aortic rings from rats to HTL (1 mM for 1 hour dramatically impaired acetylcholine-induced endothelium-dependent relaxation, reduced SOD activity, and increased malondialdehyde content in aortic tissues. Preincubation of aortic rings with TXL (100, 200, and 400 μg/mL normalized the disorders induced by HTL. Importantly, all effects induced by TXL were reversed by GW9662. In vivo analysis indicated that the administration of TXL (1.0 g/kg/d remarkably suppressed oxidative stress and prevented endothelial dysfunction in rats fed with HTL (50 mg/kg/d for 8 weeks. Conclusions. TXL improves endothelial functions in rats fed with HTL, which is related to PPARγ-dependent suppression of oxidative stress.

  8. Sexual dysfunctions after prostate cancer radiation therapy

    International Nuclear Information System (INIS)

    Droupy, S.

    2010-01-01

    Sexual dysfunctions are a quality of life main concern following prostate cancer treatment. After both radiotherapy and brachytherapy, sexual function declines progressively, the onset of occurrence of erectile dysfunction being 12-18 months after both treatments. The pathophysiological pathways by which radiotherapy and brachytherapy cause erectile dysfunction are multi-factorial, as patient co-morbidities, arterial damage, exposure of neurovascular bundle to high levels of radiation, and radiation dose received by the corpora cavernosa at the crurae of the penis may be important in the aetiology of erectile dysfunction. Diagnosis and treatment of postradiation sexual dysfunctions must integrate pre-therapeutic evaluation and information to provide to the patient and his partner a multidisciplinary sexual medicine management. (authors)