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1

All men with vasculogenic erectile dysfunction require a cardiovascular workup.  

PubMed

An association between erectile dysfunction and cardiovascular disease has long been recognized, and studies suggest that erectile dysfunction is an independent marker of cardiovascular disease risk. Therefore, assessment and management of erectile dysfunction may help identify and reduce the risk of future cardiovascular events, particularly in younger men. The initial erectile dysfunction evaluation should distinguish between predominantly vasculogenic erectile dysfunction and erectile dysfunction of other etiologies. For men believed to have predominantly vasculogenic erectile dysfunction, we recommend that initial cardiovascular risk stratification be based on the Framingham Risk Score. Management of men with erectile dysfunction who are at low risk for cardiovascular disease should focus on risk-factor control; men at high risk, including those with cardiovascular symptoms, should be referred to a cardiologist. Intermediate-risk men should undergo noninvasive evaluation for subclinical atherosclerosis. A growing body of evidence supports the use of emerging prognostic markers to further understand cardiovascular risk in men with erectile dysfunction, but few markers have been prospectively evaluated in this population. In conclusion, we support cardiovascular risk stratification and risk-factor management in all men with vasculogenic erectile dysfunction. PMID:24423973

Miner, Martin; Nehra, Ajay; Jackson, Graham; Bhasin, Shalender; Billups, Kevin; Burnett, Arthur L; Buvat, Jacques; Carson, Culley; Cunningham, Glenn; Ganz, Peter; Goldstein, Irwin; Guay, Andre; Hackett, Geoff; Kloner, Robert A; Kostis, John B; LaFlamme, K Elizabeth; Montorsi, Piero; Ramsey, Melinda; Rosen, Raymond; Sadovsky, Richard; Seftel, Allen; Shabsigh, Ridwan; Vlachopoulos, Charalambos; Wu, Frederick

2014-03-01

2

Measurement of endothelial dysfunction via peripheral arterial tonometry predicts vasculogenic erectile dysfunction.  

PubMed

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. The aim of the study was to determine whether measurement of endothelial dysfunction differentiates men with vasculogenic ED identified by duplex ultrasound from those without. 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(-1) at 15?min 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. Penile duplex US was used to categorize men into those with ED (n=111) and those without ED (n=31). The cohort with ED had a PSV of 21±1?cm?s(-1) (left cavernous artery) and 22±1?cm?s(-1) (right cavernous artery). The control group without ED had values of 39±2?cm?s(-1) (left) and 39±2?cm?s(-1) (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. 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

Kovac, J R; Gomez, L; Smith, R P; Coward, R M; Gonzales, M A; Khera, M; Lamb, D J; Lipshultz, L I

2014-11-01

3

Does regular consumption of green tea influence expression of vascular endothelial growth factor and its receptor in aged rat erectile tissue? Possible implications for vasculogenic erectile dysfunction progression  

PubMed Central

Erectile dysfunction (ED) is a highly prevalent disease affecting millions of men worldwide with a tendency for widespread increase. ED is now considered an early manifestation of atherosclerosis and, consequently, a precursor of systemic vascular disease. Atherosclerosis and ED share potentially modifiable risk factors, as smoking or high-fat food intake, but it is unclear how regular consumption of anti-oxidant rich drinks, which exhibit recognised anti-atherosclerotic features, affects ED progression. The objective of this study was to evaluate the modulating effects of chronic consumption of catechin-rich beverages on the vascular structure of the rat corpus cavernosum, and how this could contribute to delay or prevention of the onset of ED. Male Wistar rats aged 12 months were treated with green tea (GT) or a green tea extract solution (GTE) as the only liquid source for 6 months. Consumption of GT and GTE led to decreased plasma androgen levels without any significant change in plasma lipid levels. A reduction in corpus cavernosum intracellular storage of lipids, associated with decreased expression of vascular endothelial growth factor (VEGF) and its receptor VEGFR2 in endothelial cells, was observed. Taken together, these results suggest diminished atherosclerotic progression in cavernous tissue. However, functional studies will be necessary to elucidate if catechin-rich beverages are useful compounds in the prevention of deleterious vascular events associated with ED. It was also demonstrated that regular consumption of catechins reduces atherosclerotic progression and mortality due to cardiovascular disease. The results reported here suggest diminished atherosclerotic progression in cavernous tissue in aged rats following chronic ingestion of catechin-rich beverages. PMID:19424845

Assuncao, M.; Marques, F.; Andrade, J. P.; Almeida, H.

2008-01-01

4

ED: Non-Surgical Management (Erectile Dysfunction)  

MedlinePLUS

... Management Hormone Health Network's Erectile Dysfunction Fact Sheet Urology Care Foundation Patient Brochure: Sexual Health Series: Erectile Dysfunction Urology Care Foundation Fact Sheets: Erectile Dysfunction Diagnosing Erectile ...

5

Erectile dysfunction: management update  

PubMed Central

DRAMATIC ADVANCES IN THE MANAGEMENT of erectile dysfunction have occurred over the past decade. Oral therapy with vasoactive agents has emerged as first-line treatment and has transformed both the manner in which the public views erectile dysfunction and the way health care providers deliver care. Whereas an extensive investigation was previously common in the management of erectile dysfunction, recent treatment guidelines promote a more minimalist, goal-oriented approach. In this article, we review the physiology of erection, and the pathophysiology, diagnosis and clinical management of erectile dysfunction. We also present the existing evidence for the efficacy of 3 phosphodiesterase inhibitors, the most widely used class of agents for erectile dysfunction. PMID:15111479

Fazio, Luke; Brock, Gerald

2004-01-01

6

Shockwave treatment of erectile dysfunction  

PubMed Central

Low-intensity extracorporeal shock wave therapy (LI-ESWT) is a novel modality that has recently been developed for treating erectile dysfunction (ED). Unlike other current treatment options for ED, all of which are palliative in nature, LI-ESWT is unique in that it aims to restore the erectile mechanism in order to enable natural or spontaneous erections. Results from basic science experiments have provided evidence that LI-ESWT induces cellular microtrauma, which in turn stimulates the release of angiogenic factors and the subsequent neovascularization of the treated tissue. Extracorporeal shock wave therapy (ESWT) has been clinically investigated and applied in several medical fields with various degrees of success. High-intensity shock wave therapy is used for lithotripsy because of its focused mechanical destructive nature, and medium-intensity shock waves have been shown to have anti-inflammatory properties and are used for treating a wide array of orthopedic conditions, such as non-union fractures, tendonitis, and bursitis. In contrast, LI-ESWT has angiogenetic properties and is therefore used in the management of chronic wounds, peripheral neuropathy, and in cardiac neovascularization. As a result of these characteristics we initiated a series of experiments evaluating the effect of LI-ESWT on the cavernosal tissue of patients with vasculogenic ED. The results of our studies, which also included a double-blind randomized control trial, confirm that LI-ESWT generates a significant clinical improvement of erectile function and a significant improvement in penile hemodynamics without any adverse effects. Although further extensive research is needed, LI-ESWT may create a new standard of care for men with vasculogenic ED. PMID:23554844

Appel, Boaz; Kitrey, Noam D.; Vardi, Yoram

2013-01-01

7

Epidemiology of Erectile Dysfunction  

Microsoft Academic Search

Erectile dysfunction (ED) is a highly prevalent condition among men all over world. It has a significant negative impact on\\u000a the quality of life of the patients and partners. Its prevalence and incidence are associated with aging as well as important\\u000a comorbidities, such as cardiovascular disease, diabetes, metabolic syndrome, hyperlipidemia, depression, pelvic surgery, side\\u000a effects of medications, neurological disorders, trauma,

Ridwan Shabsigh

8

[Hormonal etiology in erectile dysfunction].  

PubMed

The proper function of erection mechanisms depend on correct interrelationship between psychological, vascular, neurological and hormonal factors. Endocrine diseases affect sexual function, and sexual dysfunction may be one of the symptoms of some hormonal anomalies. Diabetes mellitus is the endocrine disease most frequently causing erectile dysfunction due to the frequent vascular and neurological complications associated. It is important to determine blood glucose in the initial evaluation of a male with erectile dysfunction, as well as to try an adequate control of blood glucose levels to avoid worsening. Diabetic male erectile dysfunction is multifactorial, more severe and has worse response to oral treatment. Hyperprolactinemia causes disorders of the sexual sphere because it produces a descent of testosterone. In these cases, sexual symptoms are treated by correcting the levels of prolactin. Routine determination of prolactin is not clear and it seems it should be determined when testosterone levels are diminished. Thyroid hormone disorders (both hyper and hypotyroidism) are associated with erectile dysfunction, which will subside in half the patients with thyroid hormone normalization. The role of adrenal hormones in erectile function is not clear and their routine determination is not considered in the diagnostic evaluation of erectile dysfunction. The role of estradiol in the regulation of the erection mechanism is not well known either, although it is known that high levels may cause erectile dysfunction. Among endocrine-metabolic disorders we point out dyslipemias, with hypercholesterolemia as an important risk factor for erectile dysfunction and, though its correction may prevent vascular system deterioration, the role of statins in erectile dysfunction is not clear. PMID:20978293

Jabaloyas, José María Martínez

2010-10-01

9

Investigation of erectile dysfunction  

PubMed Central

Erectile dysfunction (ED) represents a common and debilitating condition with a wide range of organic and non-organic causes. Physical aetiologies can be divided into disorders affecting arterial inflow, the venous occlusion mechanism or the penile structure itself. Various imaging modalities can be utilised to investigate the physical causes of ED, but penile Doppler sonography (PDS) is the most informative technique, indicated in those patients with ED who do not respond to oral pharmacological agents (e.g. phosphodiesterase type 5 inhibitors). This review will examine the anatomical and physiological basis of penile erection, the method for performing PDS and features of specific causes of ED, and will also consider the alternative imaging modalities available. PMID:23118101

Patel, D V; Halls, J; Patel, U

2012-01-01

10

Gene Therapy for Erectile Dysfunction  

Microsoft Academic Search

Our current understanding of the underlying mechanisms of erectile dysfunction suggests that gene therapy will become a therapeutic\\u000a treatment in the near future. Over the past decade, erectile dysfunction has been ameliorated in animal models using viral-and\\u000a plasmid-based vectors. Genes that stimulate smooth muscle cell relaxation, such as neuronal, inducible, and endothelial nitric\\u000a oxide synthase, or that inhibit smooth muscle

Thomas R. Magee; Jacob Rajfer; Nestor F. Gonzalez-Cadavid

11

The Treatment of Erectile Dysfunction  

Microsoft Academic Search

Erectile dysfunction (ED) is a common age-related sexual dysfunction. It can be a treatment challenge for the therapist because it is notoriously associated with psychological, physical and relational risk factors. Typically, ED adversely impacts the man's self esteem, partner satisfaction and the couple's intimate relationship. This sexual dysfunction is often co-morbid with physical risk factors such as diabetes and cardiovascular

Nancy Gambescia; Shelley Kara Sendak

2009-01-01

12

Erectile dysfunction in patients with cardiovascular disease  

PubMed Central

Erectile dysfunction is a highly prevalent disease, especially in cardiovascular-compromised men. Many of the well-established risk factors for cardiovascular disease are also risk factors for erectile dysfunction. A correlation between erectile dysfunction and endothelial dysfunction is well established. It is postulated that erectile dysfunction with an arteriovascular aetiology can predate and be an indicator of potential coronary artery disease. In this paper we will attempt to increase awareness among cardiologists for the predictive value of erectile dysfunction for future cardiovascular disease in order to optimise cardiovascular risk management. The treatment of erectile dysfunction and cardiovascular interactions is also discussed in detail. ImagesFigure 1AFigure 1B

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

2006-01-01

13

Evaluation and Therapeutic Regulation of Erectile Dysfunction with Visual Stimulation Test  

Microsoft Academic Search

Aim: An objective evaluation of the psychogenic cause of erectile dysfunction by performing the visual stimulation tumescence and rigidity (VSTR) test and sildenafil citrate test, together with the effectiveness of sildenafil citrate medication on impotence caused by different etiologies. Material and Methods: Between 1998 and 2000, a total of 36 men (12 patients with diabetic etiology, 5 patients with vasculogenic

Faruk Yagci; Kemal Sarica; Emin Ozbek; Oguzkan Topcu

2002-01-01

14

Markers of erectile dysfunction  

PubMed Central

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. PMID:19468461

Davies, Kelvin P.; Melman, Arnold

2008-01-01

15

Metabolic Syndrome and Erectile Dysfunction  

PubMed Central

OBJECTIVE To study the relation between metabolic syndrome (MS), cavernosal morphological vasculopathy, and peripheral vascular alterations (carotid and femoral wall) in patients with erectile dysfunction. RESEARCH DESIGN AND METHODS A total of 207 patients and 50 control subjects were evaluated for cardiovascular risk factors, physical examination, reproductive hormones, ultrasound analysis of cavernosal, carotid and femoral arteries (intima-media thickness), and cavernosal flow measurement (peak systolic velocity). RESULTS A total of 28% of patients had MS, and they presented with a high prevalence of cavernosal alterations (70.3%) and systemic vascular impairment (59.3%), whereas patients with cavernosal alterations (44%) showed the higher prevalence of MS (48.9%). The number of MS components was related to the prevalence of penile vasculopathy. However, multivariate analysis showed that MS is not an independent predictor for cavernosal vasculopathy. CONCLUSIONS Patients with cavernosal vasculopathy have an increased cardiometabolic risk, and screening for MS components might identify individuals with a higher risk for cavernosal and systemic atherosclerosis. PMID:21730283

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

2011-01-01

16

Tadalafil in the treatment of erectile dysfunction  

Microsoft Academic Search

Oral phosphodiesterase-5 inhibitors have emerged as the preferred first-line treatment for erectile dysfunction worldwide\\u000a because of patient convenience, efficacy, and safety. Clinical trials have shown that tadalafil significantly enhances erectile\\u000a function across a wide range of etiologies and provides a prolonged period of effectiveness independent of food or alcohol.\\u000a In this review, the pharmacokinetic and pharmacodynamic characteristics, efficacy, and safety

Anthony J. Bella; Gerald B. Brock

2003-01-01

17

Erectile Dysfunction - Impotence: Questions to Discuss with Your Doctor  

MedlinePLUS

... Health Men’s Health Heart & Circulatory Health contact us Erectile Dysfunction ? Impotence Questions to Discuss with Your Doctor: Do ... medications (prescription or over-the-counter)? Has your erectile dysfunction worsened since starting any new medications? What effect ...

18

A comparison of Nocturnal Penile Tumescence and penile response to erotic stimulation during waking states in comprehensively diagnosed groups of males experiencing erectile difficulties  

Microsoft Academic Search

The erectile responses of 13 nondysfunctional males and 48 dysfunctional males were compared during Nocturnal Penile Tumescence (NPT) and during exposure to erotic videotapes. The results showed distinct patterns of NPT and daytime responding that could differentiate the various subgroups: those displaying (i) no dysfunction; (ii) vasculogenic erectile dysfunction; (iii) high risk for erectile dysfunction (organic and psychogenic); (iv) psychogenic

John P. Wincze; Sudhir Bansal; Chander Malhotra; Alex Balko; Jacques G. Susset; Mark Malamud

1988-01-01

19

Treatment of erectile dysfunction with sildenafil  

Microsoft Academic Search

Objectives. To determine the efficacy of sildenafil for the treatment of erectile dysfunction (ED) in a clinical practice setting; to evaluate the correlation between patient and partner perceptions of treatment outcomes; and to assess the relation between the severity of ED and response to treatment.Methods. Among the first 100 men to receive sildenafil in a urology practice setting, 74 (mean

Leonard S Marks; Catherine Duda; Frederick J Dorey; Maria Luz Macairan; Paul Bryan Santos

1999-01-01

20

Erectile dysfunction in heart disease patients  

Microsoft Academic Search

Atherosclerosis is a general health problem that not only affects the coronary arteries but also (in men) the penile arteries, thus contributing to organic causes of erectile dysfunction (ED) in heart disease patients. These organic causes are intertwined with psychological and pharmacological causes because medication prescribed for heart disease patients may also cause ED. The incidence of ED after myocardial

I Sainz; J Amaya; M Garcia

2004-01-01

21

EAU Guidelines on Erectile Dysfunction: An Update  

Microsoft Academic Search

The introduction of new oral therapies has completely changed the diagnostic and therapeutic approach to erectile dysfunction. A panel of experts in this field has developed guidelines for the clinical evaluation and treatment based on the review of available scientific information.

Eric Wespes; Edouard Amar; Dimitrios Hatzichristou; Kosta Hatzimouratidis; Francesco Montorsi; John Pryor; Yoram Vardi

2006-01-01

22

Specific aspects of erectile dysfunction in endocrinology  

Microsoft Academic Search

Prominent diseases of the endocrine system, such as diabetes mellitus, hypogonadism, and hyperprolactinemia, may cause erectile dysfunction (ED). ED affects about 50% of male diabetic patients possibly due to the vascular and neuropathic complications. Metabolic control and selective phosphodiesterase type 5 inhibitors are therapies of choice for controlling ED. By correcting hypogonadism, testosterone levels are restored. This, and the use

J M Miralles-García; L C García-Díez

2004-01-01

23

The Penile Prosthesis Option for Erectile Dysfunction  

Microsoft Academic Search

\\u000a Erectile dysfunction (ED) treatment can be divided into three main categories. These are oral agents, intracavernosal and\\u000a intraurethral therapies, and local devices, such as vacuum and penile prosthesis. The first-line treatment for ED is oral\\u000a phosphodiesterase type 5 inhibitors (PDE5Is); second-line treatment options include any combination of intracavernosal agents,\\u000a such as papaverine, phentolamine, PGE1, or transurethral alprostadil. For this reason,

Fikret Erdemir; Andrew Harbin; Wayne J. G. Hellstrom

24

Erectile dysfunction in the aging male  

Microsoft Academic Search

Erectile dysfunction (ED) affects a significant proportion of men, starting in middle age, with a substantial increase with\\u000a each passing decade of life. This troubling condition is often not addressed in the geriatric population because of the common\\u000a misconception that older men are no longer sexually active. Much of the literature regarding treatment of ED focuses on middle-aged\\u000a men; however,

Lizette J. Smith

2005-01-01

25

Hormonal Evaluation and Therapy in Erectile Dysfunction  

Microsoft Academic Search

\\u000a Although endocrine causes of erectile dysfunction (ED) have been well recognized for decades, historically there has been\\u000a little emphasis on endocrine evaluation or treatment for men with ED. Endocrine abnormalities as a cause or contributing factor\\u000a for ED are important to recognize since these may be associated with significant additional medical problems, and also because\\u000a correction of the endocrinopathy often

Sergio A. Moreno; Abraham Morgentaler

26

Recreational Use of Erectile Dysfunction Medications and Its Adverse Effects on Erectile Function in Young Healthy Men  

E-print Network

Recreational Use of Erectile Dysfunction Medications and Its Adverse Effects on Erectile Function A C T Introduction. Oral erectile dysfunction medications (EDMs) have become an increasingly popular these variables. Harte CB and Meston CM. Recreational use of erectile dysfunction medications and its adverse

Meston, Cindy

27

ORIGINAL PAPER Recreational Use of Erectile Dysfunction Medications  

E-print Network

ORIGINAL PAPER Recreational Use of Erectile Dysfunction Medications in Undergraduate Men,and lifetimenumberof``one-nightstands.''RecreationalEDMusers also reported a 2.5-fold rate of erectile difficulties not solely occur within the environments of venues that cater to men having sex with men. Keywords Erectile

Meston, Cindy

28

Chronic kidney disease and erectile dysfunction.  

PubMed

Erectile dysfunction (ED) is a common condition among male chronic kidney disease (CKD) patients. Its prevalence is estimated to be approximately 80% among these patients. It has been well established that the production of nitric oxide from the cavernous nerve and vascular endothelium and the subsequent production of cyclic GMP are critically important in initiating and maintaining erection. Factors affecting these pathways can induce ED. The etiology of ED in CKD patients is multifactorial. Factors including abnormalities in gonadal-pituitary system, disturbance in autonomic nervous system, endothelial dysfunction, anemia (and erythropoietin deficiency), secondary hyperparathyroidism, drugs, zinc deficiency, and psychological problems are implicated in the occurrence of ED. An improvement of general conditions is the first step of treatment. Sufficient dialysis and adequate nutritional intake are necessary. In addition, control of anemia and secondary hyperparathyroidism is required. Changes of drugs that potentially affect erectile function may be necessary. Further, zinc supplementation may be necessary when zinc deficiency is suspected. Phosphodiesterase type 5 inhibitors (PDE5Is) are commonly used for treating ED in CKD patients, and their efficacy was confirmed by many studies. Testosterone replacement therapy in addition to PDE5Is may be useful, particularly for CKD patients with hypogonadism. Renal transplantation may restore erectile function. ED is an early marker of cardiovascular disease (CVD), which it frequently precedes; therefore, it is crucial to examine the presence of ED in CKD patients not only for the improvement of the quality of life but also for the prevention of CVD attack. PMID:25374815

Suzuki, Etsu; Nishimatsu, Hiroaki; Oba, Shigeyoshi; Takahashi, Masao; Homma, Yukio

2014-11-01

29

Chronic kidney disease and erectile dysfunction  

PubMed Central

Erectile dysfunction (ED) is a common condition among male chronic kidney disease (CKD) patients. Its prevalence is estimated to be approximately 80% among these patients. It has been well established that the production of nitric oxide from the cavernous nerve and vascular endothelium and the subsequent production of cyclic GMP are critically important in initiating and maintaining erection. Factors affecting these pathways can induce ED. The etiology of ED in CKD patients is multifactorial. Factors including abnormalities in gonadal-pituitary system, disturbance in autonomic nervous system, endothelial dysfunction, anemia (and erythropoietin deficiency), secondary hyperparathyroidism, drugs, zinc deficiency, and psychological problems are implicated in the occurrence of ED. An improvement of general conditions is the first step of treatment. Sufficient dialysis and adequate nutritional intake are necessary. In addition, control of anemia and secondary hyperparathyroidism is required. Changes of drugs that potentially affect erectile function may be necessary. Further, zinc supplementation may be necessary when zinc deficiency is suspected. Phosphodiesterase type 5 inhibitors (PDE5Is) are commonly used for treating ED in CKD patients, and their efficacy was confirmed by many studies. Testosterone replacement therapy in addition to PDE5Is may be useful, particularly for CKD patients with hypogonadism. Renal transplantation may restore erectile function. ED is an early marker of cardiovascular disease (CVD), which it frequently precedes; therefore, it is crucial to examine the presence of ED in CKD patients not only for the improvement of the quality of life but also for the prevention of CVD attack. PMID:25374815

Suzuki, Etsu; Nishimatsu, Hiroaki; Oba, Shigeyoshi; Takahashi, Masao; Homma, Yukio

2014-01-01

30

Restless Legs Syndrome and Erectile Dysfunction  

PubMed Central

Study Objectives: Dopaminergic hypofunction in the central nervous system may contribute to restless legs syndrome (RLS) and erectile dysfunction (ED). We therefore examined whether men with RLS have higher prevalences of ED. Design: RLS was assessed using a set of standardized questions. Men were considered to have RLS if they met 4 RLS diagnostic criteria recommended by the International RLS Study Group, and had restless legs ? 5 times/month. Erectile function was assessed by a questionnaire. Setting: Community-based. Participants: 23,119 men who participated in the Health Professional Follow-up Study free of diabetes and arthritis. Results Multivariate-adjusted odds ratios for ED were 1.16 and 1.78 (95% confidence interval: 1.4, 2.3; P trend < 0.0001) for men with RLS symptoms 5–14 times/mo, and 15+ times/mo, respectively, relative to those without RLS, after adjusting for age, smoking, BMI, antidepressant use, and other covariates. The associations between RLS and ED persisted in subgroup analysis according to age, obesity, and smoking status. Conclusions: Men with RLS had a higher likelihood of concurrent ED, and the magnitude of the observed association was increased with a higher frequency of RLS symptoms. These results suggest that ED and RLS share common determinants. Citation: Gao X; Schwarzschild MA; O'Reilly EJ; Wang H; Ascherio A. Restless legs syndrome and erectile dysfunction. SLEEP 2010;33(1):75-79. PMID:20120623

Gao, Xiang; Schwarzschild, Michael A.; O'Reilly, Eilis J.; Wang, Hao; Ascherio, Alberto

2010-01-01

31

Management of erectile dysfunction in hypertension: Tips and tricks.  

PubMed

Arterial hypertension is a major risk factor for cardiovascular disease and affects approximately one third of the adult population worldwide. The vascular origin of erectile dysfunction is now widely accepted in the vast majority of cases. Erectile dysfunction is frequently encountered in patients with arterial hypertension and greatly affects their quality of life of hypertensive patients and their sexual partners. Therefore, the management of erectile dysfunction in hypertensive patients is of paramount importance. Unfortunately, erectile dysfunction remains under-reported, under-recognized, and under-treated in hypertensive patients, mainly due to the lack of familiarity with this clinical entity by treating physicians. This review aims to discuss the more frequent problems in the management of hypertensive patients with erectile dysfunction and propose ways to overcome these problems in everyday clinical practice. PMID:25276292

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

2014-09-26

32

Management of erectile dysfunction in hypertension: Tips and tricks  

PubMed Central

Arterial hypertension is a major risk factor for cardiovascular disease and affects approximately one third of the adult population worldwide. The vascular origin of erectile dysfunction is now widely accepted in the vast majority of cases. Erectile dysfunction is frequently encountered in patients with arterial hypertension and greatly affects their quality of life of hypertensive patients and their sexual partners. Therefore, the management of erectile dysfunction in hypertensive patients is of paramount importance. Unfortunately, erectile dysfunction remains under-reported, under-recognized, and under-treated in hypertensive patients, mainly due to the lack of familiarity with this clinical entity by treating physicians. This review aims to discuss the more frequent problems in the management of hypertensive patients with erectile dysfunction and propose ways to overcome these problems in everyday clinical practice. PMID:25276292

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

2014-01-01

33

Diagnosing erectile dysfunction could save your patient's life  

PubMed Central

Erectile dysfunction and coronary artery disease are increasingly recognized as different clinical manifestations of the same process. Because the smaller vessels of the penis may be affected by plaque burden much earlier than the larger coronary, internal carotid, and femoral arteries, men may present with symptoms of erectile dysfunction long before signs of cardiovascular disease manifest. This presents an opportunity for the urologist to not only treat the sexual dysfunction and uncover occult coronary disease, but also to screen for cardiac risk, as even men with mild arteriogenic erectile dysfunction may be at risk for cardiovascular disease.

Brock, Gerald

2014-01-01

34

Diagnosis and management of endocrine disorders of erectile dysfunction.  

PubMed

Organic causes of erectile dysfunction with androgen deficiency may be associated with aging, systemic illness, and a number of specific endocrine disorders stemming from pituitary, thyroid, and adrenal dysfunction. Central hypogonadism is the main mechanism in the majority. Erectile dysfunction in diabetes mellitus is caused by chronic complications due to poor metabolic control. Diagnosis and management of these disorders are discussed, as is the need for tight glycemic control in men with diabetes. PMID:7483129

Zonszein, J

1995-11-01

35

Penile Low-Intensity Shock Wave Therapy: A Promising Novel Modality for Erectile Dysfunction  

PubMed Central

Penile extracorporeal low-intensity shock wave therapy (LIST) to the penis has recently emerged as a novel and promising modality in the treatment of erectile dysfunction (ED). LIST has angiogenic properties and stimulates neovascularization. If applied to the corpora cavernosa, LIST can improve penile blood flow and endothelial function. In a series of clinical trials, including randomized double-blind sham-controlled studies, LIST has been shown to have a substantial effect on penile hemodynamics and erectile function in patients with vasculogenic ED. LIST is effective in patients who are responsive to phosphodiesterase 5 inhibitors (PDE5i) and can also convert PDE5i nonresponders to responders. The response to LIST wanes gradually over time, and after 2 years, about half of the patients maintain their function. Extensive research is needed to understand the effect of LIST on erectile tissue, to modify the treatment protocol to maximize its outcomes, and to identify the patients who will benefit the most from this treatment. PMID:24868332

Kitrey, Noam D.; Gruenwald, Ilan; Appel, Boaz; Vardi, Yoram

2014-01-01

36

Erectile dysfunction in hemodialysis: A systematic review  

PubMed Central

Men with chronic renal failure (CRF) on hemodialysis have been frequently associated with erectile dysfunction (ED), with an of between 20% to 87.7%. As a result of the multi-system disease processes present in many uremic men, it is apparent that the pathogenesis of ED is most probably multifactorial. Factors to be considered include peripheral vascular disease, neurogenic abnormalities, hormonal disturbances and medications used for treatment of conditions associated with CRF. These physiological abnormalities may be supplemented by significant psychological stresses and abnormalities resulting from chronic illness. Treatment must start with the determination and treatment of the underlying causes. In addition to psychological treatment, further lines of treatment of ED in CRF can be classified as 1st line (medical treatment which includes oral phosphodiesterase-5 inhibitors and hormone regulation), 2nd line (intracavernosal injection, vacuum constriction devices and alprostadil urethral suppositories) or 3rd line (surgical treatment). Renal transplantation improves the quality of life for some patients with CRF and subsequently it may improve erectile function in a significant number of them, however still there is high incidence of ED after transplantation. PMID:24175255

El-Assmy, Ahmed

2012-01-01

37

New directions for erectile dysfunction therapies.  

PubMed

Research in the field of erectile function and dysfunction has continued to expand rapidly. Based on the information available, some directions for future erectile dysfunction therapies can be identified. The first direction is improvement of current therapeutic principles. A second generation of orally active phosphodiesterase (PDE) inhibitors is being introduced, and further developments within this field can be expected. The recent introduction of apomorphine has opened the way for new dopamine receptor agonists. The second direction is combinations of existing therapeutic principles. Combinations of apomorphine and sildenafil and apomorphine and alpha(1)-adrenoceptor (AR) antagonists, for example, seem attractive and may have a therapeutic potential in patients not responding satisfactorily to single-drug treatment. Nitrosylated alpha(1)-AR antagonists, combining nitric oxide donation and alpha(1)- or alpha(2)-AR antagonism, are currently being evaluated. The third direction is new targets within the central nervous system. Melanocortin receptor agonists have shown promise not only in animal models, but also in preliminary studies in humans. Other possible targets, such as growth hormone-releasing peptide receptors, are being explored. The fourth direction is new peripheral targets. Rho-kinase antagonism and non-nitric oxide-mediated stimulation of soluble guanylyl cyclase have been suggested as possible new principles for drug development. The fourth direction is gene therapy. Progress has been made in intracavernosal somatic gene therapy and will probably continue. Still, problems remain, and advantages over conventional pharmacological therapies have to be demonstrated. The final direction is prevention strategies. Strategies to prevent cavernosal degeneration and/or to restore cavernosal function will be one of the most exciting challenges for future research. PMID:11850740

Andersson, K E; Hedlund, P

2002-02-01

38

Vardenafil reverses erectile dysfunction induced by paroxetine in rats  

Microsoft Academic Search

Selective serotonin reuptake inhibitors (SSRIs) are associated with a high incidence of impotence. Paroxetine is an extensively used SSRI that has been shown to impair erectile function in patients, to induce erectile dysfunction and to inhibit nitric oxide synthase (NOS) activity and NO production in animal models. NO is a key mediator of penile erection. Vardenafil is a type 5

J Angulo; E Bischoff; S Gabancho; P Cuevas; I Sáenz de Tejada

2003-01-01

39

Erectile dysfunction and its correlates among the Ariaal of northern Kenya  

Microsoft Academic Search

To expand our crosscultural understanding of erectile dysfunction, we investigated erectile dysfunction among Ariaal men, pastoral nomads of northern Kenya. To measure erectile dysfunction, we administered the International Index of Erectile Function (IIEF-5) to 198 men aged 20 y and older during interviews. Marital status and anthropometric measures of body composition were also obtained. Men were classified into 10-y age

P Gray; B Campbell

2005-01-01

40

The anocavernosal erectile dysfunction syndrome. II Anal fissure and erectile dysfunction.  

PubMed

A previous study has demonstrated that the bulbocavernosus muscle (BCM) is a part of the external anal sphincter (EAS) [Shafik, Arch Androl, 1999]. It aids erection by compressing the penile bulb and the dorsal penile vein, and acts as a 'suction-ejection' pump in the ejaculatory process. Being a part of the EAS, the BCM is assumed to be involved in the different EAS pathologies. A recent study showed that erectile (ED) and ejaculatory dysfunction in 16 men with fecal incontinence (FI) after an anal fistula operation was cured after sphincteroplasty [Shafik, in press]. This article investigates the erectile and ejaculatory status in patients with anal fissure. The study comprised 32 men with acute anal fissure (mean age 36.7 +/- 8.2 s.d. years), 21 with chronic anal fissure (mean age 38.8 +/- 10.3 s.d. years), and 10 healthy volunteers (mean age 35.2 +/- 7.3 s.d. years). Erectile dysfunction occurred in all men with an acute fissure and in 16 of the chronic fissure patients; erection had been normal before fissure occurrence. The volunteers had normal erection. The anal pain radiated to the penis and was exaggerated on erection and penile thrusting. Erectile dysfunction investigations showed normal results. The electromyographic (EMG) activity of the external and internal (IAS) anal sphincters and the BCM as well as anal, penile bulb and cavernosal pressures were recorded. The acute fissures were treated conservatively and chronic ones by internal anal sphincterotomy. The patients were followed for mean periods of 17.3 +/- 3.6 s.d. months. The bulbocavernosus reflex as well as EMG activity of EAS and BCM were normal, while the resting EMG activity of the IAS was increased. The anal pressure in the acute and chronic anal fissure was increased (P < 0.01, P < 0.05, respectively), while the bulbar and cavernosal pressures showed no significant changes. Fissure treatment effected cure of the fissure and the ED in 30/32 of the acute and in 19/21 of the chronic cases. Erectile dysfunction persisted in the four patients in whom the fissures did not heal. In conclusion, a relationship is suggested to exist between anal fissure and ED. The ED occurred in the presence of anal fissure and was normalized with fissure cure. The BCM and anal pain seem to play a role in the etiology of ED associated with anal fissure. PMID:11424966

Shafik, A; El-Sibai, O

2000-10-01

41

Erectile dysfunction in primary care: a focus on cardiometabolic risk evaluation and stratification for future cardiovascular events.  

PubMed

An association between erectile dysfunction (ED) and cardiovascular disease has long been recognized, and studies suggest that ED is an independent marker of cardiovascular disease risk and even further, a marker for the burden of both obstructive and non-obstructive coronary artery disease. Therefore, the primary care physician (PCP) must assess the presence or absence of ED in every man > 39 years of age, especially if that man is asymptomatic of signs and symptoms of coronary artery disease. Assessment and management of ED may help identify and reduce the risk of future cardiovascular events, particularly in younger middle-aged men. The initial ED evaluation should distinguish between predominantly vasculogenic ED and ED of other etiologies. For men believed to have predominantly vasculogenic ED, we recommend that initial cardiovascular risk stratification be based on the Framingham Risk Score. Management of men with ED who are at low risk for cardiovascular disease should focus on risk factor control; men at high risk, including those with cardiovascular symptoms, should be referred to a cardiologist. Intermediate risk men should undergo noninvasive evaluation for subclinical atherosclerosis. A growing body of evidence supports the use of selected prognostic markers to further understand cardiovascular risk in men with ED, particularly CT calcium scoring. In conclusion, we support cardiovascular risk stratification and risk factor management in all men with vasculogenic ED. PMID:24978630

Miner, Martin; Rosenberg, Matt T; Barkin, Jack

2014-06-01

42

Smooth muscle pathology and erectile dysfunction.  

PubMed

Penile erection is a vascular phenomenon that results from smooth muscle relaxation, arterial dilation and venous restriction. The atherosclerosis of the penis that occurs with aging causes a decrease in penile oxygen tension. A reduction of smooth muscle cells has been demonstrated in relation with this change in oxygen tension. Changes in the ratio of penile collagen have also been observed and could explain the decrease in penile elasticity and compliance. Chronic ischemia is, therefore, associated with fibrosis but also with nitric oxide (NO)-cyclic guanosine monophosphate. The sensitivity of the alpha-adrenoceptors on the smooth muscle cells increases with aging. All those modifications can explain the prevalence of erectile dysfunction with aging. Low oxygen tension in prostanoid production may also play a role in the mechanism of ischemia-induced cavernosal fibrosis; however, intracavernous injections of prostaglandin E(1) do not seem to modify the intracavernous structures by reducing muscular atrophy. The effects of androgen on libido and sexual behavior are well established, but their role in the human erectile mechanism remains unclear. Several studies performed on animals have demonstrated impacts directly on both the physiological function and the trabecular structure of the corpora cavernosa in rats, dogs and rabbits. However, in humans, no study seems to demonstrate a role of testosterone on muscular atrophy or penile neurologic control. Testosterone treatment alters the human behavior but not penile physiologic processes. Further studies are necessary to explain the real role of testosterone not only on the peripheral mechanism of erection but also on the central control. PMID:11850730

Wespes, E

2002-02-01

43

Epidemiology of erectile dysfunction in four countries: cross-national study of the prevalence and correlates of erectile dysfunction  

Microsoft Academic Search

ObjectivesTo measure the prevalence of erectile dysfunction (ED) in community-based populations in Brazil, Italy, Japan, and Malaysia and to study its association with the demographic characteristics, medical conditions, and health-related behavior.

Alfredo Nicolosi; Edson D Moreira; Masafumi Shirai; Mohd Ismail Bin Mohd Tambi; Dale B Glasser

2003-01-01

44

Evaluation and treatment of erectile dysfunction in men with diabetes mellitus.  

PubMed

Diabetic men have a more than 3-fold increased prevalence of erectile dysfunction (ED) compared with nondiabetic men. Erectile function is primarily a vascular phenomenon, triggered by neurologic controls and facilitated by appropriate hormonal and psychological components. Recent advances in the understanding of the physiology of penile vasculature and its role in male sexual performance have influenced the clinical approach to ED. The pathophysiological alterations leading to impotence in diabetic men include vasculogenic, neurogenic, and hormonal etiologies. A clinical work-up, including a thorough history and physical examination, is an important aspect of ED management. Biochemical evaluations to rule out secondary causes like hypogonadism and thyroid abnormalities are suggested. Oral medications acting through phosphodiesterase inhibition in penile vasculature have revolutionized treatment of impotence in diabetic men. Because of a high success rate in treating ED of various etiologies, these agents are the treatment of choice for most patients. Safety and efficacy of vacuum-constriction devices, intraurethral suppositories, intracavernosal injections, and other therapies are discussed. A clinical algorithm for the evaluation and management of ED is provided for use in the primary care setting. PMID:11888032

Dey, Jayant; Shepherd, Mark Devin

2002-03-01

45

Monitoring of Erectile and Urethral Sphincter Dysfunctions in a Rat Model Mimicking Radical Prostatectomy Damage  

E-print Network

1 Monitoring of Erectile and Urethral Sphincter Dysfunctions in a Rat Model Mimicking Radical post-RP urethral sphincter and erectile dysfunctions, and non-invasive methods to assess erectile of Sexual Medicine 2012;9(11):2827-37" DOI : 10.1111/j.1743-6109.2012.02905.x #12;2 Keywords: erectile

Paris-Sud XI, Université de

46

Erectile dysfunction, microangiopathy and UKPDS risk in type 2 diabetes  

Microsoft Academic Search

BackgroundErectile dysfunction (ED) is a frequent comorbidity in patients with type 2 diabetes mellitus (T2DM), and is now increasingly considered a surrogate marker of endothelial dysfunction as well as a sentinel predictor of new-onset macroangiopathic events. Less attention, however, has been directed at the potential association of ED and microangiopathy in hyperglycaemic states.

Michel P. Hermans; Sylvie A. Ahn; Michel F. Rousseau

2009-01-01

47

Emerging Role for TNF-? in Erectile Dysfunction  

PubMed Central

Introduction A role for cytokines in the pathophysiology of erectile dysfunction (ED) has emerged. Cytokines induce genes that synthesize other peptides in the cytokine family and several mediators, such as prostanoids, leukotrienes, nitric oxide, bradykinin, reactive oxygen species, and platelet-activating factor, all of which can affect vascular function. Consistent with the fact that the cavernosal tissue is a complex extension of the vasculature, risk factors that affect the vasculature have been shown to affect cavernosal function as well. Accordingly, the penile tissue has been recognized as an early sentinel for atherosclerosis that underlies coronary artery disease and cardiovascular diseases (CVD). Aim To review the literature pertaining to the role of tumor necrosis factor-alpha (TNF-?) in ED. Methods PubMed search for pertinent publications on the role of cytokines, particularly TNF-?, in CVD and ED. Main Outcome Measures Clinical and experimental evidence demonstrates that TNF-? may play a role in ED. Results TNF-? has been shown to play an important role in CVD, mainly due to its direct effects on the vasculature. In addition, high levels of TNF-? were demonstrated in patients with ED. In this review, we present a short description of the physiology of erection and the cytokine network. We focus on vascular actions of TNF-? that support a role for this cytokine as a potential candidate in the pathophysiology of ED, particularly in the context of CVD. A brief overview of its discovery, mechanisms of synthesis, receptors, and its main actions on the systemic and penile vasculature is also presented. Conclusions Considering that ED results from a systemic arterial defect not only confined to the penile vasculature, implication of TNF-? in the pathophysiology of ED offers a humoral linking between CVD and ED. PMID:20345734

Carneiro, Fernando S.; Webb, Robert Clinton; Tostes, Rita C.

2011-01-01

48

Udenafil for the treatment of erectile dysfunction  

PubMed Central

Erectile dysfunction (ED) is often perceived by both patients and sexual partners as a serious problem that can jeopardize quality of life, psychosocial or emotional well-being, and the partnership in the long term. Since their introduction, oral phosphodiesterase type 5 inhibitors (PDE5Is) have been found to be highly effective and well tolerated, and are available as the first-line therapy for the treatment of ED. Udenafil is one of the selective PDE5Is made available in recent years for the treatment of ED. Udenafil has clinical properties of both relatively rapid onset and long duration of action due to its pharmacokinetic profile, thereby providing an additional treatment option for ED men to better suit individual needs. There is positive evidence that udenafil is effective and well tolerated in the treatment of ED of a broad spectrum of etiologies or severity. Udenafil is as effective in the treatment of diabetes mellitus-associated ED as other PDE5Is. Due to the clinical property of relatively long duration of action, udenafil may be another option in daily dosing treatment for ED, as suggested by its favorable efficacy and safety profile. Most adverse effects reported from clinical trials are mild or moderate in severity, without any serious adverse event, with headache and flushing being the most common. Also, the concomitant use of anti-hypertensive drugs or alpha-1-blockers does not significantly affect the efficacy and safety profile of udenafil. However, additional studies with larger cohorts including prospective, multicenter, comparative studies with patients of different ethnicities are needed to further validate the favorable findings of udenafil in the treatment of ED. PMID:24868160

Cho, Min Chul; Paick, Jae-Seung

2014-01-01

49

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

MedlinePLUS

... Cialis (Tadalafil) Does Not Prevent Erectile Dysfunction in Prostate Cancer Patients Article date: April 4, 2014 By Stacy ... men avoid erectile dysfunction after radiation therapy for prostate cancer . Erection problems are common in men who’ve ...

50

4 National Kidney and Urologic Diseases Information Clearinghouse What causes erectile dysfunction?  

E-print Network

4 National Kidney and Urologic Diseases Information Clearinghouse What causes erectile dysfunction? Erectile dysfunction often has more than one cause. Many diseases can damage nerves, arteries, and muscles in the penis #12;What I need to know about Erectile Dysfunction 5 Unhealthy lifestyle choices, such as smoking

Baker, Chris I.

51

Erectile dysfunction as a predictor of cardiovascular disease RA Kloner1,2  

E-print Network

REVIEW Erectile dysfunction as a predictor of cardiovascular disease RA Kloner1,2 1 Heart Institute been recognized that erectile dysfunction (ED) and coronary artery disease share many of the same risk May 2008 Keywords: erectile dysfunction; coronary artery disease; cardiovascular risk factors

Cai, Long

52

The dual control model of male sexual response: a theoretical approach to centrally mediated erectile dysfunction  

E-print Network

erectile dysfunction John Bancroft*, Erick Janssen The Kinsey Institute for Research in Sex, Gender Science Ltd. All rights reserved. Keywords: Sexual response; Erectile dysfunction; Inhibition; Theoretical and explores how the model might help to throw light on the etiology of psychogenic erectile dysfunction

53

Residual renal function and erectile dysfunction in patients on hemodialysis  

Microsoft Academic Search

Introduction  Residual renal function and erectile dysfunction are important parameters of quality of life in dialysis patients.\\u000a \\u000a \\u000a \\u000a Goal  The purpose of our investigation was to determine correlations between erectile dysfunction and residual diuresis in patients\\u000a on hemodialysis.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  The survey was organized as a cross-sectional study in men aged up to 65 years on hemodialysis. All respondents voluntarily\\u000a completed the questionnaire of the International

Radojica V. StolicZoran; Zoran M. Bukumiric; Aleksandar N. Jovanovic; Vladan M. Peric; Sasa R. Sovtic; Branislav P. Belic; Nebojsa B. Mitic

54

Erectile dysfunction and its correlates among the Ariaal of northern Kenya.  

PubMed

To expand our crosscultural understanding of erectile dysfunction, we investigated erectile dysfunction among Ariaal men, pastoral nomads of northern Kenya. To measure erectile dysfunction, we administered the International Index of Erectile Function (IIEF-5) to 198 men aged 20 y and older during interviews. Marital status and anthropometric measures of body composition were also obtained. Men were classified into 10-y age groups. ANOVA revealed that erectile dysfunction increases with age (P<0.0005), with men 60 y and older showing significantly higher erectile dysfunction compared with men in their 20s, 40s and 50s. In a MANCOVA model, erectile dysfunction increased with age group (P<0.001), was negatively related to right-hand grip strength (P<0.01) and negatively related to number of wives (P<0.05). In addition, there was a significant interaction between age group and marital status (P<0.01). Erectile dysfunction showed no independent relationship to measures of body composition, including body mass index, fat free mass and percentage body fat. These findings provide further evidence of age-related increases in erectile dysfunction, even when factors commonly associated with erectile dysfunction (eg, metabolic complications of obesity, use of medicines causing erectile dysfunction) are absent. The finding that number of wives is negatively related to erectile dysfunction may represent the specific cultural conditions (political power and wealth) associated with polygyny among the Ariaal. PMID:16015378

Gray, P; Campbell, B

2005-01-01

55

Assessment of erectile dysfunction in diabetic patients.  

PubMed

Erectile dysfunction (ED) aetiology is multifactorial, including endocrine, neurological, vascular, systemic disease, local penile disorders, nutrition, psychogenic factors, and drug-related. This study was performed to compare the relevant comprehensive biochemical parameters as well as the clinical characteristics in diabetic ED and healthy control subjects and to assess the occurrence of penile neuropathy in diabetic patients and thus the relationship between ED and diabetes. A total of 56 patients accepted to undergo assessment for penile vasculature using intracavernosal injection and colour Doppler ultrasonography. Of the 56 diabetic patients, 38 patients were found with normal blood flow and thus they were considered as the diabetic-ED group, whereas, ED diabetic patients with an arteriogenic component were excluded. These patients with an age range between 17 and 58 years, complaining of ED, with duration of diabetic illness ranging from 2 to 15 years. The Control group comprised of 30 healthy subject aged between 19 and 55 years. Peripheral venous levels of testosterone, prolactin, follicle stimulating hormone (FSH), luteinizing hormone (LH), thyroid stimulating hormone (TSH), malondialdehyde and glycosylated haemoglobin (HbA(1)c) were obtained in all subjects. Valsalva manoeuvre and neurophysiological tests were also determined. Testosterone, prolactine, FSH, LH, and TSH hormones of the diabetic patients were not significantly different from those of the control group. Diabetic patients with ED have higher HbA(1)c and oxidative stress levels while the R-R ratio was significantly decreased. Bulbocavernosus reflex latency was significantly prolonged, whereas its amplitude, the conduction velocity and amplitude of dorsal nerve of penis were significantly reduced in the diabetic patients. We concluded that although ED is a multifactorial disorder, yet, the present study revealed that in ED patients without arteriogenic ED a neurogenic component is present. Furthermore, the complex effect of the Valsalva manoeuvre on cardiovascular function is the basis of its usefulness as a measure of autonomic function. Thus, it can be of value in the diagnosis of ED although these hypotheses require follow-up in a large study cohort. PMID:18298568

Hamdan, Farqad B; Al-Matubsi, Hisham Y

2009-04-01

56

ERECTILE DYSFUNCTION IN PRIMARY CARE SETTING  

Microsoft Academic Search

A total of 1435 men aged 40-76 years participated in this cross-sectional study, with response rate of 85%. ED was assessed using a standard validated questionnaire, 5 Item Version International Index Of Erectile Function (IIEF- 5, in 4 languages). The data was collected by either self administered questionnaire ( for those who can read\\/write in English or Malay ) or

Asnida Anjang; Ab Rahman; Nabilla Al-Sadat

57

The worldwide prevalence and epidemiology of erectile dysfunction  

Microsoft Academic Search

This paper: (i) describes the worldwide prevalence of erectile dysfunction (ED); (ii) presents age-specific incidence rates for ED in the US; (iii) summarizes some key epidemiologic correlates of ED in the general population; and (iv) considers the possibility that ED may be a biobehavioral marker (sentinel event) of subsequent cardiovascular disease in men. Clinical, anthropometric, life style and hormonal data

JB McKinlay

2000-01-01

58

Erectile dysfunction in general medicine practice: prevalence and clinical correlates  

Microsoft Academic Search

Erectile dysfunction (ED) is a common problem in general medical practice affecting especially the elderly and those with cardiovascular disease and diabetes mellitus. A study was undertaken by questionnaire distributed to consecutive adult male attendees at 62 general medical practices. 1240 completed questionnaires were available for analysis. The mean age of participants was 56.4 y (range 18 – 91 y).

KK Chew; CM Earle; BGA Stuckey; K Jamrozik; EJ Keogh

2000-01-01

59

Increased incidence of depressive symptoms in men with erectile dysfunction  

Microsoft Academic Search

Objectives. To investigate the hypothesis that men with erectile dysfunction (ED) have a higher incidence of depressive symptoms compared with age-matched control subjects. We also hypothesized that depressive symptoms impact on the level of libido and on the success of treatment of ED.Methods. One hundred twenty men with ED or benign prostatic hyperplasia (BPH) were divided into three groups. Group

Ridwan Shabsigh; Lonnie T Klein; Stuart Seidman; Steven A Kaplan; Bernard J Lehrhoff; Joseph S Ritter

1998-01-01

60

Frequency and Determinants of Erectile Dysfunction in Italy  

Microsoft Academic Search

Objective: To analyze the prevalence and risk factors for erectile dysfunction (ED) in Italy in a cross–sectional study.Methods: Eligible for the study were men aged 18 years or more, randomly identified by 143 general practitioners among their registered patients during the period January 1996 to February 1997. ED was defined as the impossibility to achieve and maintain an erection sufficient

Fabio Parazzini; Fabrizio Menchini Fabris; Angela Bortolotti; Antonino Calabrò; Liliane Chatenoud; Enrico Colli; Marina Landoni; Maurizio Lavezzari; Paolo Turchi; Aurelio Sessa; Vincenzo Mirone

2000-01-01

61

Postprostatectomy Erectile Dysfunction: The Role of Penile Rehabilitation  

PubMed Central

Radical prostatectomy has become the gold standard for the treatment of prostate cancer in patients who have a longer than 10-year life expectancy. Surgical treatment has led to severe quality-of-life issues in these patients, especially urinary incontinence and erectile dysfunction (ED). This article reviews the etiology and pathophysiology of postprostatectomy ED, and current management strategies for these patients. PMID:21826123

DeFade, Brian P; Carson, Culley C; Kennelly, Michael J

2011-01-01

62

Erectile Dysfunction Medication Use Among Men Seeking Substance Abuse Treatment  

Microsoft Academic Search

Few studies of erectile dysfunction (ED) medications use among heterosexual drug using or abusing men have been conducted. The aims of this study were to provide information on ED medication use prevalence, method of acquisition, and sexual effects among men seeking substance abuse treatment. A single time point cross-sectional anonymous survey was completed by 297 men over the age of

Keith J. Horvath; Donald A. Calsyn; Christeine Terry; Ann Cotton

2007-01-01

63

Erectile dysfunction: from biochemical pharmacology to advances in medical therapy  

Microsoft Academic Search

Research on penile smooth muscle physiology has increased the number of drugs available for treating erectile dysfunction (ED). Penile erection involves the relaxation of smooth muscle in the corpus cavernosum. The key mediator of smooth muscle relaxation is nitric oxide (NO), which acts by increasing the cellular level of cGMP. Another cyclic nucleotide, cAMP, is involved in smooth muscle cell

M Maggi; S Filippi; F Ledda; A Magini; G Forti

2000-01-01

64

Endothelial function in patients with metabolic syndrome and erectile dysfunction: a question of angiopoietin imbalance?  

PubMed

Erectile dysfunction (ED) is a highly prevalent disease whose aetiology is mostly vasculogenic. It is nowadays considered a marker of future cardiovascular events reflecting the underlying endothelial dysfunction, the common link with the metabolic syndrome (MetS). The recent association between MetS, endothelial dysfunction and peripheral artery disease, but not with coronary artery disease (CAD), suggests that the pathophysiologies of CAD and peripheral artery disease may be distinct. Moreover, several recent studies support an emerging role for an imbalance of angiogenic growth factor levels like Angiopoietin 1 and 2 in cardiovascular disease, considering its intimate association with chronic low-grade inflammation. We aim to find a correlation between Angiopoietins levels and systemic and local endothelial function in MetS and ED patients. Forty-five MetS patients with ED were enrolled. ED severity was assessed by International Index of Erectile Function questionnaire (IIEF5) and penile duplex Doppler ultrasound (PDDU). Endothelial function was assessed by Peripheral arterial tonometry (PAT), and serum asymmetric dimethylarginine (ADMA), Ang1 and Ang2 levels. Obesity and hypertension were the most frequent MetS parameters (91.1 and 88.9% respectively). Severe ED was present in 35.6% of patients. Penile haemodynamic was impaired in 77.5%. Endothelial dysfunction (PAT criteria) was present in 40.9% of patients. Ang2 levels were significantly higher in men with abdominal obesity. We observed an inverse correlation between Ang1 and peak systolic velocity, and in patients with penile arterial dysfunction, Ang1 levels were significantly higher and Ang2/Ang1 ratio significantly lower, than patients with normal arterial function. Neither ADMA nor PAT parameters were correlated with ED severity evaluated by IIEF5 or PDDU exam. In conclusion, there is an imbalance of angiopoietins in MetS and ED patients. The absence of correlation with PAT or ADMA levels suggests that angiopoietins may be early markers of endothelial dysfunction in this population of higher cardiovascular risk. PMID:23785018

Tomada, N; Tomada, I; Botelho, F; Pacheco-Figueiredo, L; Lopes, T; Negrão, R; Pestana, M; Cruz, F

2013-07-01

65

[Relationship between erectile dysfunction and thyroid disorders: a review of current knowledge].  

PubMed

Several factors can disrupt the normal physiologic mechanisms involved in penile erection. Although thyroid disorders as the sole or predominant etiology of erectile dysfunction are uncommon, their detection is easy, seldom requiring more than a single blood sample. Furthermore, the restoration of euthyroid state may improve erectile function. On the other hand, most patients with a chronic thyroid disease experience some sexual symptoms. Therefore, discussion on erectile dysfunction should be considered a basic part of the medical evaluation for men with thyroid disorders. The physiopathology and diagnosis of erectile dysfunction, and the current knowledge on the relationship between thyroid disorders and erectile dysfunction are reviewed. PMID:17580522

Mascitelli, Luca

2007-06-01

66

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

Microsoft Academic Search

IC351 (Cialis™) is a selective inhibitor of PDE5. The efficacy and safety of on-demand dosing of IC351 in men with erectile dysfunction was assessed in a multicenter, double-blind, placebo-controlled study. One hundred seventy-nine men (mean age: 56 y) were randomized to receive placebo or IC351 at doses of 2, 5, 10 or 25 mg, taken on demand over a 3-week

H Padma-Nathan; JG McMurray; WE Pullman; JS Whitaker; JB Saoud; KM Ferguson; RC Rosen

2001-01-01

67

Testosterone Replacement Therapy: Should It Be Performed in Erectile Dysfunction?  

PubMed Central

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

Celik, Orcun; Yucel, Selcuk

2013-01-01

68

Erectile dysfunction. Are you prepared to discuss it?  

PubMed

Erectile dysfunction is more common than previously thought in men older than 40 years, perhaps because contributing medical risk factors increase with age. The medical history is of prime importance in outlining these factors, the most common of which are diabetes, hypertension, and smoking. Nocturnal penile tumescence and rigidity testing with a portable home monitor may be helpful in determining whether the cause of erectile dysfunction is primarily organic or psychological. Specific therapeutic measures include sex therapy, psychotherapy, treatment for alcohol or tobacco dependency, replacement of offending medications, improved glycemic control, constriction rings, vascular surgery, androgen replacement therapy, bromocriptine mesylate (Parlodel), and thyroid, adrenal, or pituitary replacement therapy. Nonspecific therapies include yohimbine hydrochloride (Yocon), use of vacuum tumescence devices, intracorporeal injections, and penile implants. PMID:7716086

Guay, A T

1995-04-01

69

Diagnosis and treatment of erectile dysfunction- a practical update  

PubMed Central

During the last decades, erectile dysfunction was considered a direct consequence of aging and, although of a great concern for the affected patient, little was available to evaluate and treat this problem. If aging could not be invoked in all cases, than the psychogenic etiology was the only explanation. Over the coming years, a better understanding of the physiology involved in the penile process of tumescence and detumescence has allowed for better approach of each disease asociated with erectile dysfunction so that adequate treatment modalities can be applied to the pacient. As we all know, every pacient is a particular case. The development of modern PDE–5 inhibiters, along with other more or less invasive therapies, puts a new light on the medical approach of ED. PMID:20108753

Cauni, V; Gutue, S; Albu, ES; Jinga, V; Geavlete, P

2009-01-01

70

Epidemiology of Erectile Dysfunction and Key Risk Factors  

Microsoft Academic Search

\\u000a Erectile dysfunction (ED) is a common, age-related disorder in men, which has been associated with multiple medical and psychosocial\\u000a risk factors. In addition to the well-known association with age, cardiovascular risk factors have been associated with ED\\u000a in multiple studies. Based upon these findings, ED has been proposed as a sentinel event or harbinger of future cardiovascular\\u000a risk for younger

Ray C. Rosen; Varant Kupelian

71

Vardenafil: A new approach to the treatment of erectile dysfunction  

Microsoft Academic Search

Vardenafil is a phosphodiesterase type-5 (PDE-5) inhibitor developed as an oral therapy for erectile dysfunction (ED). Multiple\\u000a phase 3 clinical trials have been completed and vardenafil is expected to launch worldwide in 2003. Two pivotal, randomized,\\u000a double-blind, multicenter studies have evaluated the use of vardenafil in men with ED. Vardenafil improved the rate of achieving\\u000a and maintaining an erection during

Wayne J. G. Hellstrom

2003-01-01

72

Phosphodiesterase type 5 as a pharmacologic target in erectile dysfunction  

Microsoft Academic Search

The scientific rationale of pharmacologically inhibiting phosphodiesterase type 5 (PDE5) in the treatment of erectile dysfunction (ED) is reviewed. Published literature on the nitric oxide-cyclic guanosine monophosphate (cGMP) pathway for penile erection and on PDE5 inhibition using sildenafil as the model for pharmacologic PDE5 inhibition are assessed. The key second messenger in the mediation of penile erection is cGMP. PDE5

Jackie D Corbin; Sharron H Francis; David J Webb

2002-01-01

73

Drug Insight: oral phosphodiesterase type 5 inhibitors for erectile dysfunction  

Microsoft Academic Search

Erectile dysfunction (ED) is a common medical condition that affects the sexual life of millions of men. At present, first-line oral pharmacotherapy for most patients with ED is a phosphodiesterase type 5 (PDE-5) inhibitor, of which three are currently available worldwide. Sildenafil (Viagra®, Pfizer) has a very satisfactory efficacy–safety profile in all patient categories. The first PDE-5 inhibitor to reach

Alberto Briganti; Andrea Salonia; Andrea Gallina; Antonino Saccà; Piero Montorsi; Patrizio Rigatti; Francesco Montorsi

2005-01-01

74

Self-Injection, Transurethral and Topical Therapy in Erectile Dysfunction  

Microsoft Academic Search

\\u000a Currently there are three main agents for intracavernosal injection (ICI) therapy and one agent for intraurethral therapy\\u000a approved by the FDA for the treatment of erectile dysfunction (ED). These effective agents were the focus of intense interest\\u000a in the mid1990s, but were quickly relegated to second line therapy after the appearance of sildenafil. Indeed, while sildenafil\\u000a prescriptions nearly doubled to

Herbert J. Wiser; Tobias S. Köhler

75

Extending the Rationale of Combination Therapy to Unresponsive Erectile Dysfunction  

PubMed Central

Combination therapies aim to overcome the limitations of individual drugs by selecting diverse targets of action to enhance effectiveness synergistically. This article reviews the principles of combination therapy and its applications for benign prostatic hyperplasia and overactive bladder. It then examines pathophysiological, pharmacological, and clinical evidence for currently available drug and device combinations for erectile dysfunction that has not responded to first-line, single-agent therapy. PMID:18231616

Reece, Christopher; Kumar, Rajeev; Nienow, Diedre; Nehra, Ajay

2007-01-01

76

Urological and Medical Evaluation of Men with Erectile Dysfunction  

PubMed Central

As the medical understanding of erectile dysfunction has evolved, the approach to its evaluation must also change. A good doctor/patient rapport is crucial to making patients more comfortable talking about their sexual function. Questionnaires help elicit specific information on which to base the diagnosis and find the etiology, along with examination of the genitals and hormone and other assays. If oral therapy is unsuccessful, other studies may find underlying conditions, leading to appropriate treatment. PMID:16986011

Carson, Culley C

2002-01-01

77

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

Microsoft Academic Search

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

Eric Perttula

1999-01-01

78

The importance of risk factor reduction in erectile dysfunction.  

PubMed

Erectile dysfunction (ED) is associated with modifiable risk factors. Obesity, physical inactivity, and the metabolic syndrome increase the incidence of ED and markers of low-grade inflammation, which in turn are associated with endothelial dysfunction. Intensive intervention with lifestyle advice focusing on a healthy diet, weight loss, and increased physical activity benefits men with ED, reducing the markers of inflammation and improving endothelial function. Though phosphodiesterase type 5 inhibitors are highly effective in treating ED, lifestyle advice and aggressive risk reduction remain fundamental to the overall vascular good health of the individual. PMID:18042325

Jackson, Graham

2007-11-01

79

Effect of enhanced external counterpulsation on medically refractory angina patients with erectile dysfunction  

Microsoft Academic Search

SUMMARY Patients with refractory angina often suffer from erectile dysfunction. Enhanced external counterpulsation (EECP) decreases symptoms of angina, and increases nitric oxide release. This study evaluated the effect of EECP on sexual function in men with severe angina.The International Index of Erectile Function (IIEF) was used to assess erectile function of severe angina patients enroled in the International EECP Patient

W. E. Lawson; J. C. K. Hui; E. D. Kennard; O. Soran; P. A. McCullough; S. F. Kelsey

2007-01-01

80

Comparison of Satisfaction Rates and Erectile Function in Patients Treated with Sildenafil, Intracavernous Prostaglandin E1 and Penile Implant Surgery for Erectile Dysfunction in Urology Practice  

Microsoft Academic Search

PurposeWe compared erectile function status and satisfaction rates in patients who received treatment for erectile dysfunction (ED) with sildenafil, intracavernous prostaglandin E1 (ICI) and penile implant surgery (IPP).

ATUL RAJPURKAR; CHIRPRIYA B. DHABUWALA

2003-01-01

81

Treatment of Erectile Dysfunction in Men With Depressive Symptoms: Results of a Placebo-Controlled Trial With Sildenafil Citrate  

Microsoft Academic Search

Objective: Depressed men commonly have erectile dysfunction, and men with erectile dysfunction are frequently de- pressed. Since the etiologic and modula- tory relationships between depression and erectile dysfunction have been poorly characterized, a 12-week, randomized, double-blind, placebo-controlled trial was conducted at 20 urologic clinics to evalu- ate the effects of sildenafil treatment in men with erectile dysfunction and mild-to- moderate

Stuart N. Seidman; Steven P. Roose; Matthew A. Menza; Ridwan Shabsigh; Raymond C. Rosen

2001-01-01

82

HEALTH OUTCOMES VARIABLES IMPORTANT TO PATIENTS IN THE TREATMENT OF ERECTILE DYSFUNCTION  

Microsoft Academic Search

PurposeErectile dysfunction is underreported and the rate of noncompliance with therapy is high. The National Institutes of Health Consensus Conference on Impotence endorsed the need for outcomes research of the various approaches to treatment. The purpose of our exploratory study was to begin that process through identification of erectile dysfunction treatment outcomes variables that are important to men.

CHRISTINE HANSON-DIVERS; SUE ELLEN JACKSON; TOM F. LUE; STEPHANIE Y. CRAWFORD; RAYMOND C. ROSEN

1998-01-01

83

Clinical safety of oral sildenafil citrate (VIAGRATM) in the treatment of erectile dysfunction  

Microsoft Academic Search

Sildenafil citrate has been shown to be effective in a wide range of patients with erectile dysfunction and has been approved in the United States for this indication. The overall clinical safety of oral sildenafil, a potent inhibitor of phosphodiesterase type 5, in the treatment of erectile dysfunction was evaluated in more than 3700 patients (with a total of 1631

A Morales; C Gingell; M Collins; PA Wicker; IH Osterloh

1998-01-01

84

Treatment of erectile dysfunction after radical prostatectomy with sildenafil citrate (Viagra)  

Microsoft Academic Search

Objectives. To determine whether the response to the new oral medication, sildenafil citrate (Viagra), was influenced by the presence or absence of the neurovascular bundles, as recent reports on its success did not specify the efficacy of the drug in patients with erectile dysfunction after radical prostatectomy.Methods. Baseline and follow-up data from 28 healthy patients presenting with erectile dysfunction after

Craig D Zippe; Anurag W Kedia; Kalish Kedia; David R Nelson; Ashok Agarwal

1998-01-01

85

Duration of Erectile Dysfunction: Correlation with Clinical and Laboratory Variables in Nigerians  

Microsoft Academic Search

We evaluated the clinical data (age, systolic and diastolic blood pressures, duration of erectile dysfunction, height, weight and Body Mass Index (BMI)) and relevant laboratory data (total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, triglyceride, testosterone, gonadotrophins, prolactin, thyroid hormones, and blood glucose) of our patients with Erectile Dysfunction (ED) and correlated it with the duration of their

Simeon Adelani Adebisi; Suleiman Alege Kuranga

86

Spontaneous Erections in a Patient with Erectile Dysfunction after Palliative Chemotherapy for Non-Small Cell Lung Cancer  

Microsoft Academic Search

Erectile dysfunction is a common problem, especially among older men. It is often caused by psychological problems, and is also the reason for pronounced impairment of psychosocial well-being. Many systemic diseases, genitourinary surgery, drugs, particularly antihypertensive and psychotropic drugs, and also chemotherapeutic agents and dexamethasone are attributed as being causes of erectile dysfunction. In our case, severe erectile dysfunction was

Michael Hejna; Wolfgang C. C. Fiebiger; Werner J. Reiter; Markus Raderer

2001-01-01

87

[Penile Doppler ultrasound: contribution to the management of erectile dysfunction].  

PubMed

Erectile dysfunction (ED) is a common multifactorial disease, in most situations arising from an organic or mixed cause. Most cases of ED classified as arterial are linked to endothelial dysfunction in relation to the key factors of cardiovascular risk. ED is an indicator of vascular health in general. It is also a predictor of cardiovascular events, including coronary heart disease. It has also been associated with lower peripheral arterial disease and stroke. At the present time, penile Doppler ultrasound examination is relatively little used in the management of ED, knowledge of the etiologic factors being most often not necessary for therapeutic management, but also because of the absence of standardization. Nonetheless, recent large-scale studies have shown that the vascular nature of ED, based on Doppler parameters recorded after intracavernous injection of vasoactive drugs, was also predictive of cardiovascular events and cardiovascular mortality, warranting greater interest in this test. PMID:21177055

Bonnin, C; Bouilly, P

2011-02-01

88

The triad of erectile dysfunction, hypogonadism and the metabolic syndrome  

PubMed Central

Aim To identify the relationship of erectile dysfunction, hypogonadism and the metabolic syndrome in the context of men's health. Methods An Expert Panel Meeting was held in December 2006 in Vienna, Austria. In addition a comprehensive literature search was conducted. Results Men have a higher incidence of cardiovascular events than women of similar ages which has led to the belief that testosterone is a risk factor for cardiovascular disease in men. The latter hypothesis is no longer tenable. On the contrary, low testosterone levels are associated with (visceral) obesity, the metabolic syndrome, diabetes mellitus, cardiovascular disease and erectile dysfunction (ED). Testosterone therapy does not lead to an increased incidence of cardiovascular disease or events such as myocardial infarction, stroke or angina. Until recently (visceral) obesity, the metabolic syndrome, diabetes mellitus, cardiovascular disease and ED were viewed as more or less independent entities affecting the ageing male. It was not recognised that hypogonadism is a common denominator. With a more integrative approach to the health situation of middle-aged and elderly men, these conditions appear closely interrelated in their manifestations, hypothetically in their aetiology, diagnostic strategy and also their treatment. Conclusion Improving sexual health is a portal to identify health hazards and improving men's health. Appropriate diagnosis and medical work up of men presenting with sexual symptoms may have the benefit of the diagnosing and treating other important conditions, such as obesity, diabetes, hypertension and hyperlipidaemia. PMID:18266714

Shabsigh, R; Arver, S; Channer, K S; Eardley, I; Fabbri, A; Gooren, L; Heufelder, A; Jones, H; Meryn, S; Zitzmann, M

2008-01-01

89

Erectile dysfunction and central obesity: an Italian perspective  

PubMed Central

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. PMID:24713832

Corona, Giovanni; Rastrelli, Giulia; Filippi, Sandra; Vignozzi, Linda; Mannucci, Edoardo; Maggi, Mario

2014-01-01

90

Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction  

Microsoft Academic Search

An abridged five-item version of the 15-item International Index of Erectile Function (IIEF) was developed (IIEF-5) to diagnose the presence and severity of erectile dysfunction (ED). The five items selected were based on ability to identify the presence or absence of ED and on adherence to the National Institute of Health's definition of ED. These items focused on erectile function

RC Rosen; JC Cappelleri; J Lipsky; BM Peña

1999-01-01

91

Combination therapy for erectile dysfunction: an update review  

PubMed Central

The introduction of oral phosphodiesterase-5 inhibitors (PDE5Is) in the late 1990s and early 2000s revolutionized the field of sexual medicine and PDE5Is are currently first-line monotherapy for erectile dysfunction (ED). However, a significant proportion of patients with complex ED will be therapeutic non-responders to PDE5I monotherapy. Combination therapy has recently been adopted for more refractory cases of ED, but a critical evaluation of current combination therapies is lacking. A thorough PubMed and Cochrane Library search was conducted focusing on the effectiveness of combination therapies for ED in therapeutic non-responders to PDE5I therapy. Journal articles spanning the time period between January 1990 and December 2010 were reviewed. Criteria included all pertinent review articles, randomized controlled trials, cohort studies and retrospective analyses. References from retrieved articles were also manually scanned for additional relevant publications. Published combination therapies include PDE5I plus vacuum erectile device (VED), intraurethral medication, intracavernosal injection (ICI), androgen supplement, ?-blocker or miscellaneous combinations. Based on this review, some of these combination treatments appeared to be quite effective in preliminary testing. Caution must be advised, however, as the majority of combination therapy articles in the last decade have numerous limitations including study biases and small subject size. Regardless of limitations, present combination therapy research provides a solid foundation for future studies in complex ED management. PMID:21423198

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

2011-01-01

92

Randomised controlled trial of pelvic floor muscle exercises and manometric biofeedback for erectile dysfunction  

PubMed Central

Background: The pelvic floor muscles are active in normal erectile function. Therefore, it was hypothesised that weak pelvic floor muscles could be a cause of erectile dysfunction. Aims: To compare the efficacy of pelvic floor muscle exercises and manometric biofeedback with lifestyle changes for men with erectile dysfunction. Design of study: Randomised controlled trial. Setting: The Somerset Nuffield Hospital, Taunton, United Kingdom. Method: Fifty-five men with erectile dysfunction (median age 59.2 years; range 22–78 years) were enrolled from a local urology clinic. Of these, 28 participants were randomised to an intervention group and engaged in pelvic floor exercises, as well as receiving biofeedback and suggestions for lifestyle changes. Twenty-seven controls were solely advised on lifestyle changes. Baseline, 3- and 6-month assessments were: erectile function domain of International Index of Erectile Function (IIEF), Partner's International Index of Erectile Function (PIIEF), Erectile Dysfunction-Effect on Quality of Life (ED-EQoL), anal manometry, digital anal measurements, and clinical assessment by an assessor blind to treatment allocation. After 3 months, the control group were transferred to the active arm. Results: At 3 months, compared with controls, men in the intervention group showed significant mean increases in the erectile function domain of the IIEF (6.74 points, P = 0.004); anal pressure (44.16 cmH2O, P<0.001); and digital anal grades (1.5 grades, P<0.001). All showed further improvement in these outcomes at 6 months. Similar benefits were seen in men of the control arm after transfer to active treatment. A total of 22 (40.0%) participants attained normal function, 19 (34.5%) participants had improved erectile function, and 14 (25.5%) participants failed to improve. Conclusion: Pelvic floor muscle exercises and biofeedback are an effective treatment for men with erectile dysfunction. PMID:15527607

Dorey, Grace; Speakman, Mark; Feneley, Roger; Swinkels, Annette; Dunn, Christopher; Ewings, Paul

2004-01-01

93

Oral and Non-Oral Combination Therapy for Erectile Dysfunction  

PubMed Central

An estimated 30 million men in the United States suffer from varying degrees of erectile dysfunction. Increasing age and comorbidities are likely to increase the number of men who are initially refractory or become refractory to phosphodiesterase (PDE)-5 inhibitors, the most popular oral therapy. Combination therapy, a concept well proved in other areas of medicine, is therefore of increasing importance. Combination oral and non-oral (intracavernosal injection and intraurethral application) therapies have been shown to salvage monotherapy. The early introduction of combination therapy has been shown to expedite both the return of natural function and PDE-5 inhibitor responsiveness in post-prostatectomy patients with no reports of serious adverse events. Larger controlled studies are needed to corroborate those encouraging findings. PMID:17934566

Nehra, Ajay

2007-01-01

94

Stem cell therapy for voiding and erectile dysfunction  

PubMed Central

Voiding dysfunction comprises a variety of disorders, including stress urinary incontinence and overactive bladder, and affects millions of men and women worldwide. Erectile dysfunction (ED) also decreases quality of life for millions of men, as well as for their partners. Advanced age and diabetes are common comorbidities that can exacerbate and negatively impact upon the development of these disorders. Therapies that target the pathophysiology of these conditions to halt progression are not currently available. However, stem cell therapy could fill this therapeutic void. Stem cells can reduce inflammation, prevent fibrosis, promote angiogenesis, recruit endogenous progenitor cells, and differentiate to replace damaged cells. Adult multipotent stem cell therapy, in particular, has shown promise in case reports and preclinical animal studies. Stem cells have also enabled advances in urological tissue engineering by facilitating ex vivo construction of bladder wall and urethral tissue (using a patient's own cells) prior to transplantation. More recent studies have focused on bioactive factor secretion and homing of stem cells. In the future, clinicians are likely to utilize allogeneic stem cell sources, intravenous systemic delivery, and ex vivo cell enhancement to treat voiding dysfunction and ED. PMID:22710667

Vaegler, Martin; Lenis, Andrew T; Daum, Lisa; Renninger, M; Bastian, Amend; Stenzl, Arnulf; Damaser, Margot S; Sievert, Karl-Dietrich

2013-01-01

95

Change in symptoms of erectile dysfunction in depressed men initiating buprenorphine therapy?  

PubMed Central

Aims The aim of this study is to describe the change in erectile dysfunction (ED) symptoms in the first 12 weeks of outpatient buprenorphine therapy. Background Erectile dysfunction is highly prevalent in men who use illicit opioids when compared with the general population. To date, no study has examined ED symptoms over time in men initiating buprenorphine therapy for opioid dependence. Methods A randomized, double blind, placebo-controlled trial was conducted to determine whether escitalopram treatment of depressive symptoms begun 1 week prior to buprenorphine induction would improve treatment retention. Male patients completed the International Index of Erectile Function scale at baseline prior to induction and monthly thereafter. A score of 25 or less on the erectile function domain (range 1–30) is considered indicative of erectile dysfunction. Findings A total of 111 male subjects enrolled: mean age 38.5 (± 9.7) years, 80.1% non-Hispanic Caucasian; 67.3% reported heroin as their opioid of choice. Mean IIEF at baseline was 20.4 (± 10.5). At baseline, 44.1% of the entire cohort had erectile dysfunction; among those who identified as sexually active at baseline, 26.1% had ED. Baseline erectile function was inversely and significantly correlated with age (r = ?.27, p = .006), but was not associated significantly with race, heroin use, years of opioid use, smoking, or hazardous use of alcohol. Compared to baseline, mean erectile function was significantly improved (p = .001) at 3 months, and sexual desire (p = .002) improved significantly at both 2- and 3-month assessments. Conclusion Erectile dysfunction is highly prevalent in depressed males using illicit opioids. Men who remain in buprenorphine treatment for 3 months show improvement in erectile function and sexual desire. PMID:23891461

Cioe, Patricia A.; Anderson, Bradley J.; Stein, Michael D.

2014-01-01

96

Elucidating the Etiology of Erectile Dysfunction After Definitive Therapy for Prostatic Cancer  

Microsoft Academic Search

Purpose: To determine the etiology of treatment-induced erectile dysfunction among patients who underwent surgery or radiotherapy for prostatic cancer.Methods and Materials: Ninety-eight patients were evaluated for erectile dysfunction after definitive therapy for prostate cancer with Duplex ultrasonography before and after intracorporal prostaglandin injection. Patients were classified as having arteriogenic, cavernosal, mixed (arteriogenic\\/cavernosal), or neurogenic impotence based upon the results of

Michael J Zelefsky; J. Francois Eid

1998-01-01

97

Impact of erectile dysfunction and its subsequent treatment with sildenafil: qualitative study  

PubMed Central

Objectives To determine the effects of erectile dysfunction and to explore the impact of treatment with sildenafil (Viagra). Design An exploratory qualitative study with semistructured interviews. Setting Men's health clinic in NHS hospital. Participants 40 men who had had erectile dysfunction and had attended the clinic during the year before interview. Main outcome measures Impact of erectile dysfunction on men, their expectations of sildenafil, and impact of treatment on men and their relationships. Issues explored with exploratory qualitative approach. Results Erectile dysfunction caused serious distress to all those men who experienced it, with marked effects on their self esteem and their relationships. Sildenafil, when it worked, caused a great improvement in wellbeing. The expectations raised by media hyperbole with the launch of sildenafil had an adverse effect on the morale of those who found it did not work. When, according to the patient, treatment did not work, the distress was severe and for many confirmed their lack of self worth. Conclusions Further study is needed to explore the feelings of men affected by erectile dysfunction and their perception of treatment. Health professionals should be aware of the extreme distress erectile dysfunction can cause. PMID:15051618

Tomlinson, John; Wright, David

2004-01-01

98

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

PubMed Central

Objectives Hypotestosteronemia has been reported in approximately half of type 2 diabetic men in general. This study aims to assess serum total testosterone levels in type 2 diabetics with erectile dysfunction and to correlate the degree of improvement between sildenafil citrate and testosterone levels. Methods A cross sectional and prospective comparative interventional study was conducted at the Diabetic Clinic of Assalam Teaching Hospital in Mosul, during the period from January 1, 2009 through to December 31, 2011. The study enrolled 120 type 2 diabetic males with erectile dysfunction who were analyzed with regard to age, duration of diabetes, duration and severity of erectile dysfunction, serum total testosteron levels and the degree of response to sildenafil citrate in terms of testosterone levels. The data were statistically analyzed using the independent two-sample Student t test, ?2 test and Pearson correlation test. A p-value of <0.05 was considered statistically significant. Results Thirty six percent of type 2 diabetic males with erectile dysfunction were found to have low serum testosterone levels. The hypotestosteronemic and normotestosteronemic subgroups were not significantly different in terms of mean age, duration of diabetes, reduction of libido, and reduction in erectile function. The rate and the degree of improvement of erection by sildenafil in the normo-and-hypotestosteronemic respondents were not significantly different, but the degree of improvement by sildenafil was significantly correlated to testosterone levels among the hypotestosteronemic group. Conclusion Hypotestosteronemia was found in 36% of type 2 diabetic males with erectile dysfunction. The degree of improvement of erectile dysfunction by sildenafil was directly proportional to the serum testosterone levels among the hypotestosteronemic group. Therapeutic supplement with testosterone preparation in the hypotestosteronemic diabetics with erectile dysfunction may improve their response to sildenafil. PMID:24498482

Hadeed, Nabeel Najib Fadhil; Thanoon, Imad Abdul-Jabar; Al-Mukhtar, Samir Burhanaldin

2014-01-01

99

The management of erectile dysfunction: innovations and future perspectives.  

PubMed

Phosphodiesterase 5 (PDE5) inhibitors are recommended as first line therapy for the treatment of erectile dysfunction (ED). To date, three PDE5 inhibitors are on the market: sildenafil, vardenafil and tadalafil. These compounds are available as oral tablets; they are rapidly absorbed in the gastrointestinal tract and are excreted mainly in the fces and to a lexer extent in the urine. Recently, an orodisnersible formulation of feces and, to a lesser extent, in the urine. Recently, an orodispersible formulation of vardenafil (vardenafil ODT) has been developed, which is able to dissolve in the mouth within seconds, releasing a minty flavor, without the need of being swallowed with water. The clinical studies so far performed showed that vardenafil ODT has a bioavailability superior to the traditional film-coated tablet. Among the other PDE5 inhibitors under development we report mirodenafil, lodenafil carbonate, avalafil and SLx-2101 It is likely that in the future molecules that act on pathways other than the one of NO/cGMP will be available. Such as Rho-kinase inhibitors, which inhibit the mechanism that leads to smooth muscle contraction thus allowing erection and hydrogen sulphide (H2S), an endogenous molecule synthesized from cysteine that can be both a vasodilator and a vasoconstrictor according to its concentration. PMID:21585174

Leonardi, Rosario; Alemanni, Matteo

2011-03-01

100

Does vitamin D deficiency contribute to erectile dysfunction?  

PubMed Central

Erectile dysfunction (ED) is a multifactorial disease, and its causes can be neurogenic, psychogenic, hormonal and vascular. ED is often an important indicator of cardiovascular disease (CVD) and a powerful early marker for asymptomatic CVD. Erection is a vascular event, and ED is often a vascular disease caused by endothelial damage and subsequent inhibition of vasodilation. We show here that risk factors associated with a higher CVD risk also associate with a higher ED risk. Such factors include diabetes mellitus, hypertension, arterial calcification and Inflammation in the vascular endothelium. Vitamin D deficiency is one of several dynamics that associates with increased CVD risk, but to our knowledge, it has not been studied as a possible contributor to ED. Here we examine research linking ED and CVD and discuss how vitamin D influences CVD and its classic risk factors—factors that also associate to increased ED risk. We also summarize research indicating that vitamin D associates with reduced risk of several nonvascular contributing factors for ED. We conclude that VDD contributes to ED. This hypothesis should be tested through observational and intervention studies. PMID:22928068

Sorenson, Marc; Grant, William B.

2012-01-01

101

Erectile dysfunction in robotic radical prostatectomy: Outcomes and management  

PubMed Central

Robot-assisted laparoscopic prostatectomy (RALP) has emerged as the most common treatment for localized prostate cancer. With improved surgical precision, RALP has produced hope of improved potency rates, especially with the advent of nerve-sparing and other modified techniques. However, erectile dysfunction (ED) remains a significant problem for many men regardless of surgical technique. To identify the functional outcomes of robotic versus open and laparoscopic techniques, new robotic surgical techniques and current treatment options of ED following RALP. A Medline search was performed in March 2014 to identify studies comparing RALP with open retropubic radical prostatectomy (RRP) and laparoscopic radical prostatectomy, modified RALP techniques and treatment options and management for ED following radical prostatectomy. RALP demonstrates adequate potency rates without compromising oncologic benefit, with observed benefit for potency rates compared with RRP. Additionally, specific surgical technical modifications appear to provide benefit over traditional RALP. Phosphodiesterase-5 inhibitors (PDE5I) demonstrate benefit for ED treatment compared with placebo. However, long-term benefit is often lost after use. Other therapies have been less extensively studied. Additionally, correct patient identification is important for greatest clinical benefit. RALP appears to provide beneficial potency rates compared with RRP; however, these effects are most pronounced at high-volume centers with experienced surgeons. No optimal rehabilitation program with PDE5Is has been identified based on current data. Additionally, vacuum erection devices, intracavernosal injections and other techniques have not been well validated for post RALP ED treatment. PMID:25378827

Whelan, Patrick; Ekbal, Shahid; Nehra, Ajay

2014-01-01

102

The dosimetry of brachytherapy-induced erectile dysfunction  

SciTech Connect

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{sub 50}) and 25% (D{sub 25}) of the bulb of the penis should be maintained below 40% and 60% mPD, respectively, while the crura D{sub 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.

Merrick, Gregory S.; Butler, Wayne M

2003-12-31

103

VARDENAFIL IMPROVED PATIENT SATISFACTION WITH ERECTILE HARDNESS, ORGASMIC FUNCTION AND SEXUAL EXPERIENCE IN MEN WITH ERECTILE DYSFUNCTION FOLLOWING NERVE SPARING RADICAL PROSTATECTOMY  

Microsoft Academic Search

Purpose:Nerve sparing radical retropubic prostatectomy (NS-RRP) results in erectile dysfunction in a significant number of patients. Vardenafil, a potent and selective phosphodiesterase type 5 inhibitor, is generally safe. It improves International Index of Erectile Function erectile function domain scores, and penetration and erection maintenance success rates in patients who have undergone NS-RRP. We report additional parameters important to patient perceptions

AJAY NEHRA; JOHN GRANTMYRE; ANDREA NADEL; MARC THIBONNIER; GERALD BROCK

2005-01-01

104

Testosterone Deficiency with Erectile Dysfunction in Mongolian Men  

PubMed Central

Purpose To detect the testosterone deficiency syndrome in Mongolian men over 40 years old with erectile dysfunction (ED). Materials and Methods Total of 309 males over 40 years of age who received medical care at the ADAM Urology and Andrology Clinic from 2010 to 2011 were included in this study. An approval from the Ethics Committee of the Ministry of Health of Mongolia was obtained, and each study participant signed a consent form at the beginning of the study. The participants were assigned to either an ED group or a control group, depending on the results of the international index of erectile function (IIEF)-5 questionnaire. The ED group was further divided into three groups (moderate, severe, and very severe) based on the level of ED. The total testosterone (TT) levels were determined in the blood serum using a competitive enzyme-linked immunesorbent assay (ELISA) analytical system UBI Magiwel™ Testosterone Quantitative test, and free testosterone (FT) calculated as described by the Vermeulen calculation. Test samples were collected between 8:00 and 11:00 am in the mornings and testosterone deficiency syndrome was diagnosed based on the International Society for the Study of the Aging Male guidelines, particularly, if TT was ?3.46 ng/ml or free testosterone FT was ?0.072 ng/ml. Results ED of moderate, severe, and very severe levels was diagnosed in 199 (64.41%) out of 309 participants. There was an inverse relationship between the main IIEF-5 score and age (r=-0.380, p<0.01). The average TT was 5.75±2.316 ng/ml and FT was 0.091±0.0084 ng/ml. Compared to the ED group, the control group had a higher TT level: 5.6440±1.177 ng/ml and 5.812±2.316 ng/ml, respectively. In the control group, the FT level was 0.061±0.0084 ng/ml, whereas it was 0.041±0.0076 ng/ml in the ED group. Conclusions Our study showed that most of the aging males who came to the clinic had moderate to very severe ED (64.55%). The levels of TT (5.644±1.177 ng/ml) and FT (0.041±0.0036 ng/ml) were significantly lower in ED patients (p<0.05). The testosterone deficiency syndrome was detected in 24.27% of the ED group. PMID:24044113

Naidan, Nansalmaa; Rivaad, Oyun-Erdene; Muukhai, Namsrai

2013-01-01

105

Tadalafil Improved Erectile Function at Twenty-Four and Thirty-Six Hours After Dosing in Men With Erectile Dysfunction: US Trial  

Microsoft Academic Search

In a previous study assessing tadalafil for the treat- ment of erectile dysfunction (ED), tadalafil 20 mg was shown to im- prove erectile function for up to 36 hours vs placebo. This study sought to demonstrate the effectiveness of both 10- and 20-mg tad- alafil vs placebo at 2 prespecified assigned times of 24 and 36 hours postdosing. This double-blind,

JAY M. YOUNG; ROBERT A. FELDMAN; STEPHEN M. AUERBACH; JOEL M. KAUFMAN; CARMEN S. GARCIA; WEI SHEN; AILEEN M. MURPHY; CHARLES M. BEASLEY; JAYNE A. HAGUE; SANJEEV AHUJA

106

To evaluate the etiology of erectile dysfunction: What should we know currently?  

PubMed

Erectile dysfunction (ED) is the inability to develop normal erection or an hardening problem at various extent that causes inability to maintain the erection for the sufficient time required for a complete sexual activity. It can be the result of neurologic, psychogenic, vascular, urogenital and hormonal abnormalities. It is reported that it affects 52-67% of men between 40 and 70 years old. Numerous theories and opinions are issued in the literature in order to explain the hemodynamic changea that occur during erection and detumescence. Especially the effects of chronic diseases and psychogenic factors on the pathophysiology of erectile dysfunction are common matters of discussion in recent years. In this review, we will evaluate the current developments in the literature about the etiology of erectile dysfunction. PMID:25308583

Celik, Orcun; Ipekci, Tumay; Akarken, Ilker; Ekin, Gokhan; Koksal, Turker

2014-09-01

107

Efficacy and safety of sildenafil citrate in the treatment of erectile dysfunction in patients with ischemic heart disease  

Microsoft Academic Search

Erectile dysfunction is a common condition in men with cardiovascular disease, probably as a result of shared factors that impair hemodynamic mechanisms in the penile and ischemic vasculature. Sildenafil citrate, an orally active, selective inhibitor of phosphodiesterase type 5 (PDE5), has demonstrated excellent efficacy and safety profiles in men with erectile dysfunction of various etiologies. Sildenafil administration is contraindicated in

C. Richard Conti; Carl J Pepine; Michael Sweeney

1999-01-01

108

Molecular Targets for Diabetes Mellitus-associated Erectile Dysfunction*  

PubMed Central

Protein expression profiles in rat corporal smooth muscle tissue were compared between animal models of streptozotocin-induced diabetes mellitus (STZ-DM) and age-matched controls (AMCs) at 1 week and 2 months after induction of hyperglycemia with STZ treatment. At each time point, protein samples from four STZ-DM and four AMC rat corpora tissues were prepared independently and analyzed together across multiple quantitative two-dimensional gels using a pooled internal standard sample to quantify expression changes with statistical confidence. A total of 170 spots were differential expressed among the four experimental groups. A subsequent mass spectrometry analysis of the 170 spots identified a total of 57 unique proteins. Network analysis of these proteins using MetaCoreTM suggested altered activity of transcriptional factors that are of too low abundance to be detected by the two-dimensional gel method. The proteins that were down-regulated with diabetes include isoforms of collagen that are precursors to fibril-forming collagen type 1; Hsp47, which assists and mediates the proper folding of procollagen; and several proteins whose abundance is controlled by sex hormones (e.g. CRP1 and A2U). On the other hand, proteins seen or predicted to be up-regulated include proteins involved in cell apoptosis (e.g. p53, 14-3-3-?, Serpinf1, Cct4, Cct5, and Sepina3n), proteins that neutralize the biological activity of nerve growth factor (e.g. anti-NGF 30), and proteins involved in lipid metabolism (e.g. apoA-I and apoA-IV). Subsequent Western blot validation analysis of p53, 14-3-3-?, and Hsp47 confirmed increased p53 and 14-3-3-? and decreased Hsp47 levels in separate samples. According to the results from the Western blot analysis, Hsp47 protein showed a ?3-fold decrease at 1 week and was virtually undetectable at 2 months in diabetic versus control. Taken together, our results identify novel candidate proteins playing a role in erectile dysfunction in diabetes resulting from STZ treatment. PMID:20007950

Yohannes, Elizabeth; Chang, Jinsook; Tar, Moses T.; Davies, Kelvin P.; Chance, Mark R.

2010-01-01

109

Prognostic Factors for Response to Sildenafil in Patients with Erectile Dysfunction  

Microsoft Academic Search

Objective: To assess the clinical efficacy of sildenafil as treatment for erectile dysfunction (ED) the factors associated with treatment failure were investigated. Methods: Open, prospective study including 244 patients suffering from ED who were evaluated by anamnesis, physical exploration, blood test, dynamic penile color duplex ultrasonography and Sexual Health Inventory for Male (SHIM). The efficacy of sildenafil was assessed by

2001-01-01

110

DISAPPOINTING INITIAL RESULTS WITH TRANSURETHRAL ALPROSTADIL FOR ERECTILE DYSFUNCTION IN A UROLOGY PRACTICE SETTING  

Microsoft Academic Search

PurposeWe evaluate the response to intraurethral alprostadil administration using the Medicated Urethral System for Erection (MUSE*) in unselect men with a history of erectile dysfunction. We determine the effects on blood pressure during in office monitoring and assess safety of this form of treatment. We compare the efficacy of MUSE in an office setting with the placebo controlled pivotal study.

PAT F. FULGHAM; JAMES S. COCHRAN; JOHN L. DENMAN; BRIAN A. FEAGINS; MICHAEL B. GROSS; KEITH T. KADESKY; MELVIN C. KADESKY; ANGELA R. CLARK; CLAUS G. ROEHRBORN

1998-01-01

111

12 National Kidney and Urologic Diseases Information Clearinghouse How is erectile dysfunction treated?  

E-print Network

12 National Kidney and Urologic Diseases Information Clearinghouse How is erectile dysfunction to the medical treatment by making their relationship stronger. #12;14 National Kidney and Urologic Diseases and Urologic Diseases Information Clearinghouse of your penis to keep the blood from flowing back into your

Baker, Chris I.

112

The mutually reinforcing triad of depressive symptoms, cardiovascular disease, and erectile dysfunction  

Microsoft Academic Search

The conditions of depression, erectile dysfunction (ED), and cardiovascular disease may seem at a superficial level as independent medical problems managed by 3 separate and unrelated healthcare disciplines. Various studies, however, have revealed significant associations between depression and cardiovascular disease, ED and cardiovascular disease, and depression and ED. The purpose of this research was to identify whether the 3 medical

Irwin Goldstein

2000-01-01

113

Erectile dysfunction is a marker for cardiovascular complications and psychological functioning in men with hypertension  

Microsoft Academic Search

The aim of this study was to investigate the incidence of cardiovascular complications in hypertensive patients with erectile dysfunction (ED). An anonymous questionnaire was mailed to 467 and received from 104 hypertensive male patients. Despite the low response rate of 22%, the following interesting findings could be observed: 70.6% of the patients who responded suffered from ED. The hypertensive patients

M Burchardt; T Burchardt; AG Anastasiadis; AJ Kiss; A Shabsigh; A de La Taille; RV Pawar; L Baer; R Shabsigh

2001-01-01

114

Modifiable risk factors and erectile dysfunction: can lifestyle changes modify risk?  

Microsoft Academic Search

Objectives. To prospectively examine whether changes in smoking, heavy alcohol consumption, sedentary lifestyle, and obesity are associated with the risk of erectile dysfunction.Methods. Data were collected as part of a cohort study of a random sample of men 40 to 70 years old, selected from street listings in the Boston Metropolitan Area, Massachusetts. In-home interviews were completed by 1709 men

Carol A Derby; Beth A Mohr; Irwin Goldstein; Henry A Feldman; Catherine B Johannes; John B McKinlay

2000-01-01

115

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

ERIC Educational Resources Information Center

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

Ackerman, Mark D.; Carey, Michael P.

1995-01-01

116

Screening of ischemic heart disease with cavernous artery blood flow in erectile dysfunctional patients  

Microsoft Academic Search

Erection is a hemodynamic event and accordingly, erectile dysfunction (ED) is closely related with ischemic heart disease. We should confirm that the cardiac condition of the ED patient is safe enough to perform sexual intercourse prior to beginning treatment for ED. Asymptomatic ischemic heart disease cannot be diagnosed only in an interview, but it's difficult to perform cardiac exercise tests

Y Kawanishi; KS Lee; K Kimura; T Koizumi; H Nakatsuji; K Kojima; A Yamamoto; A Numata; T Sogou

2001-01-01

117

Prevalence and Correlates of Erectile Dysfunction in a Population-based Study in Belgium  

Microsoft Academic Search

Objectives: This study aims to estimate the prevalence of erectile dysfunction (ED) in the male population of Belgium, and to study its correlation with education, the international prostate symptom scale (IPSS), sexual activity, depression, body mass index, alcohol, smoking, easiness to discuss ED with a doctor, current health index, physical activity, hypertension, diabetes, cardiovascular disease, professional status, residence and whether

Rudolf Mak; Guy De Backer; Marcel Kornitzer; Jean Marie De Meyer

2002-01-01

118

Prevalence of erectile dysfunction: a systematic review of population-based studies  

Microsoft Academic Search

A systematic review was conducted on the prevalence of erectile dysfunction (ED) in the general population. Studies were retrieved which reported prevalence rates of ED in the general population. Using a specially developed criteria list, the methodological quality of these studies was assessed and data on prevalence rates were extracted. We identified 23 studies from Europe (15), USA (5), Asia

J Prins; M H Blanker; A M Bohnen; S Thomas; J L H R Bosch

2002-01-01

119

Current and Future Strategies for Preventing and Managing Erectile Dysfunction Following Radical Prostatectomy  

Microsoft Academic Search

Introduction and objectives: As radical prostatectomy remains a commonly used procedure in the treatment of clinically localized prostate cancer, we critically analyzed current and future strategies for preventing and managing postoperative erectile dysfunction.Methods: Systematic literature review using Medline and CancerLit from January 1997 to June 2003. Abstracts published in the journals European Urology, The Journal of Urology and the International

Francesco Montorsi; Alberto Briganti; Andrea Salonia; Patrizio Rigatti; Arthur L Burnett

2004-01-01

120

Erectile Dysfunction in the Cardiac Patient: How Common and Should We Treat?  

Microsoft Academic Search

PurposeRisk factors for erectile dysfunction (ED) (hypertension, diabetes, smoking, lipid abnormality) are also risk factors for coronary artery disease. However, most cardiologists do not routinely ask about ED and patients often are reluctant or embarrassed to discuss it. We determined how common ED was in a group of patients with chronic stable coronary artery disease.

ROBERT A. KLONER; STEPHANIE H. MULLIN; THOMAS SHOOK; RAY MATTHEWS; GUY MAYEDA; STEVE BURSTEIN; HARRY PELED; CHARLES POLLICK; RANJI CHOUDHARY; RAYMOND ROSEN; HARIN PADMA-NATHAN

2003-01-01

121

Relationship between erectile dysfunction and silent myocardial ischemia in apparently uncomplicated type 2 diabetic patients  

Microsoft Academic Search

Background—Erectile dysfunction (ED) is associated with coronary artery disease (CAD). In diabetic patients, CAD is often silent. Among diabetic patients with silent CAD, the prevalence of ED has never been evaluated. We investigated whether ED is associated with asymptomatic CAD in type 2 diabetic patients. Methods and Results—We evaluated the prevalence of ED in 133 uncomplicated diabetic men with angiographically

Carmine Gazzaruso; Stefano Giordanetti; Emanuela De Amici

2004-01-01

122

Effect of sildenafil in patients with erectile dysfunction taking antihypertensive therapy  

Microsoft Academic Search

Oral sildenafil is an effective treatment for erectile dysfunction (ED), which is a common complaint for patients with hypertension and those taking antihypertensive agents. This post hoc subanalysis assessed the efficacy and safety of sildenafil in men with ED who were receiving concomitant antihypertensive medication. Efficacy was assessed in 3414 men (1218 of whom were taking antihypertensive medication) who received

Robert A. Kloner; Morris Brown; L. Michael Prisant; Mike Collins

2001-01-01

123

Erectile Dysfunction Is Associated with a High Prevalence of Hyperlipidemia and Coronary Heart Disease Risk  

Microsoft Academic Search

Objectives: Erectile dysfunction (ED) is frequently of vascular origin. An association between ED and ischemic heart disease has been suggested as a consequence of endothelial disease of penile and coronary arteries. The role of serum lipid levels has been demonstrated in coronary heart disease (CHD), but the relationship with ED is poorly documented. We evaluated undiagnosed hyperlipidemia in ED patients

Th Roumeguère; E Wespes; Y Carpentier; P Hoffmann; C. C Schulman

2003-01-01

124

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

PubMed

Due to high efficiency, prompt action and low incidence of side effects, phosphodiesterase type 5 inhibitors are the drugs of first choice in the treatment of erectile dysfunction (ED). One of the most widely used drugs in this group currently is vardenafil. Vardenafil has a number of properties that distinguish it from other drugs in this group: high selectivity and the highest inhibitory activity. Recently, new form of this drug, an oral-dispersible tablet (Levitra ODT) was developed. It dissolves in the mouth for a few seconds and does not required to drink water. This feature Levitra ODT enables easy administration of the drug, which provides the desired effect at any time and in any circumstances. Studies have shown that of simplicity of drug intake is one of the most important characteristics of the "ideal" treatment for erectile dysfunction from the point of view of patients. Currently, Levitra ODT is available at a dose of 10 mg. Two large, randomized, double-blind placebo-controlled studies, POTENT I and POTENT II, with participation of more than 700 patients with erectile dysfunction divided into 2 age groups, have shown a high efficacy and good tolerability of Levitra ODT in both groups. Thus, Levitra ODT is a new and promising form of the drug vardenafil, more convenient to use. There is no doubt that Levitra ODT will occupy an important place in the arsenal of modern methods of treatment of erectile dysfunction due to its high efficacy, good tolerability and usability. PMID:23987060

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

2013-01-01

125

Vardenafil (Levitra) for erectile dysfunction: a systematic review and meta-analysis of clinical trial reports  

Microsoft Academic Search

Trials of the efficacy and safety of vardenafil in the treatment of male erectile dysfunction (ED) were meta-analysed. All available databases were searched (January 1, 2001–November 30, 2003). Trials were eligible if they included men with ED, compared vardenafil with placebo, were randomized, were at least of 12 weeks duration, and assessed clinically relevant outcomes. Two reviewers independently evaluated study

S Markou; P Perimenis; K Gyftopoulos; A Athanasopoulos; G Barbalias

2004-01-01

126

Penile Vascular Impairment in Erectile Dysfunction Patients with Metabolic Syndrome: Penile Doppler Ultrasound Findings  

Microsoft Academic Search

Background: The constellation of truncal obesity, glucose intolerance, dyslipidemia (high triglycerides, low HDL cholesterol), and hypertension has been recognized as metabolic syndrome. However, the pathophysiological association between metabolic syndrome and erectile dysfunction (ED) has not yet been clearly determined. This study aimed to evaluate the penile Doppler ultrasound (PDU) findings of ED patients with metabolic syndrome. Patients and Methods: Sixty-one

Omer Demir; Tevfik Demir; Aykut Kefi; Mustafa Secil; Abdurrahman Comlekci; Sena Yesil; Ahmet Adil Esen

2009-01-01

127

Enhanced External Counterpulsation as a New Treatment Modality for Patients with Erectile Dysfunction  

Microsoft Academic Search

Enhanced external counterpulsation (EECP) is a noninvasive treatment modality which can increase arterial blood flow in peripheral and coronary arterial disease. Several studies have demonstrated an increase in the flow of the internal iliacal artery and in carotid and renal perfusion during EECP treatment. We investigated the effect of EECP in patients with erectile dysfunction (ED). Thirteen patients were treated

S. E. Froschermaier; D. Werner; S. Leike; M. Schneider; J. Waltenberger; W. G. Daniel; M. P. Wirth

1998-01-01

128

Incidence of extragenital vascular disease in patients with erectile dysfunction of arterial origin  

Microsoft Academic Search

This research was carried out to evaluate the prevalence of carotid and\\/or lower limb artery abnormalities in patients with arterial erectile dysfunction (ED). To this end, patients with ED (Andrology Unit) or suspected peripheral atherosclerosis (Angiology Unit) underwent an independent and parallel echo-Duplex examination. The Andrology Unit examined 167 patients with ED of different etiologies: 52 of them had penile

E Vicari; G Arcidiacono; L Di Pino; S Signorelli; A Arancio; F Sorrentino; C Battiato; R D'Agata; A E Calogero

2005-01-01

129

Interactions of sildenafil and tacrolimus in men with erectile dysfunction after kidney transplantation  

Microsoft Academic Search

Objectives. To study the pharmacokinetics of the combined use of sildenafil (which may provide an effective treatment for patients with erectile dysfunction after kidney transplantation) and tacrolimus, as interactions between them are expected because of a common elimination pathway.Methods. Ten male patients (age 29 to 52 years) were included. Because of its importance in transplant recipients, medication remained unchanged. On

Birgit Christ; Dierk Brockmeier; Ekkehard W Hauck; Schirin Friemann

2001-01-01

130

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

PubMed Central

Introduction Polycythemia vera is a polyglobular myeloproliferative syndrome related to the mutation of multipotent hemopoietic stem cells. This case report describes a patient whose bladder tumor was associated with polycythemia vera and erectile dysfunction. The association of bladder neoplasia with polycythemia vera and erectile dysfunction has not previously been reported in the literature. Case presentation A 40-year-old Moroccan man was followed up for a bladder tumor which manifested with coagulant hematuria and a facial erythrosis with a hemoglobin level of 20.3g/L suggesting polycythemia vera. The patient also suffered from an erectile disorder. Considering the anesthesia difficulty due to polyglobulia, the patient was treated by bleeding. This treatment enabled the patient’s sexual performance to be improved and adjustment of his hemoglobin to a level allowing anesthesia, and hence surgical resection of his bladder tumor. Conclusion Erectile dysfunction associated with polycythemia vera is elucidated by rheological disorders. Bleeding contributed to satisfactory sexual performance and facilitated treatment of polycythemia vera because it enabled anesthesia to be performed and hence the surgical resection of the bladder tumor. PMID:23537044

2013-01-01

131

De novo erectile dysfunction after anterior urethroplasty: a systematic review and meta-analysis  

PubMed Central

Objective To evaluate the likelihood of developing de novo erectile dysfunction (ED) after anterior urethroplasty and to determine if this likelihood is influenced by age, stricture length, number of previous procedures or timing of evaluation. Materials and Methods PubMed, Embase, Cochrane, and Google Scholar databases were searched for the terms `urethroplasty', `urethral obstruction', `urethral stricture', `sexual function', `erection', `erectile function', `erectile dysfunction', `impotence' and `sexual dysfunction'. Two reviewers evaluated articles for inclusion based on predetermined criteria. Results In a meta-analysis of 36 studies with a total of 2323 patients, de novo ED was rare, with an incidence of 1%. In studies that assessed postoperative erectile function at more than one time point, ED was transient and resolved at between 6 and 12 months in 86% of cases. Conclusions Men should be counselled regarding the possibility of transient or permanent de novo ED after anterior urethroplasty procedures. Increasing mean age was associated with an increased likelihood of de novo ED, but this was not statistically significant. PMID:23924424

Blaschko, Sarah D.; Sanford, Melissa T.; Cinman, Nadya M.; McAninch, Jack W.; Breyer, Benjamin N.

2013-01-01

132

Management of Erectile Dysfunction in the Hypogonadal Man: A Case-Based Review  

PubMed Central

Erectile dysfunction (ED) has emerged as an important marker of cardiovascular and overall health, independent of other known conventional risk factors. ED often precedes coronary artery disease in half of affected subjects, and could indicate the presence of cardiovascular pathology. The pathophysiology and role of androgens in sexual function are described, along with the relevant literature on the effects of aging in erectile and gonadal function. The concept of testosterone supplementation (TST) in men with ED is reviewed. The authors utilize clinical vignettes to discuss the appropriate management of two clinical cases of men at different life stages who have ED in the setting of hypogonadism and propose a treatment algorithm. In patients of all ages, proper identification of the underlying pathophysiology of decreased libido and erectile function is paramount in choosing between the use of TST, phosphodiesterase type 5 inhibitors, or both, in the management of these disorders. PMID:25337039

Ramasamy, Ranjith; Scovell, Jason M; Wilken, Nathan A; Kovac, Jason R; Lipshultz, Larry I

2014-01-01

133

Penile erectile dysfunction after brachial plexus root avulsion injury in rats  

PubMed Central

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

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

2014-01-01

134

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

Microsoft Academic Search

It is of great importance to investigate an effective and reliable medication against chronic renal failure (CRF)-related\\u000a erectile dysfunction (ED), which aims to improve patients’ life qualities. The concentrations of cyclic guanosine monophosphate\\u000a (cGMP) in the corpus cavernosal smooth muscle of both CRF and control rabbits were measured. The effects of various concentrations\\u000a of tadalafil, papaverine, and sodium nitroprusside on

Meng-yuan Zhang; Qiang Fu; Wei Bian

2011-01-01

135

A new surrogate variable for erectile dysfunction status in the Massachusetts male aging study  

Microsoft Academic Search

Erectile dysfunction (ED) is the subject of a vast clinical literature, but little information has been gathered from random samples of the general public. The Massachusetts Male Aging Study (MMAS) addressed this important aspect of men's health. The MMAS was conducted in two waves, with baseline data collection in 1987–1989 and follow-up in 1995–1997. Subsequent to the baseline MMAS survey,

Ken P. Kleinman; Henry A. Feldman; Catherine B. Johannes; Carol A. Derby; John B. McKinlay

2000-01-01

136

Erectile Dysfunction and Coronary Risk Factors: Prospective Results from the Massachusetts Male Aging Study  

Microsoft Academic Search

Background. Erectile dysfunction (ED), a wide spread and troublesome condition among middle-aged men, is partly vascular in origin. In the Massachusetts Male Aging Study, a random-sample cohort study, we investigated the relationship between baseline risk factors for coronary heart disease and subsequent ED, on the premise that subclinical arterial insufficiency might be manifested as ED.Methods. Men ages 40–70, selected from

Henry A. Feldman; Catherine B. Johannes; Carol A. Derby; Ken P. Kleinman; Beth A. Mohr; Andre B. Araujo; John B. McKinlay

2000-01-01

137

Blunt Trauma: The Pathophysiology of Hemodynamic Injury Leading to Erectile Dysfunction  

Microsoft Academic Search

A 9 1\\/2-year pharmaco-cavernosometry\\/pharmaco-cavernosography and pharmaco-arteriography study was performed in 131 men with persistent changes in erectile function following blunt pelvic or perineal trauma. The goal was to determine the incidence of hemodynamic impairment, and to characterize the location and pattern of abnormal venous drainage. Corporeal veno-occlusive dysfunction was identified in 62 percent of the cases and cavernous artery insufficiency

Ricardo M. Munarriz; Qingwei Robert Yan; Ajay Nehra; Daniel Udelson; Irwin Goldstein

1995-01-01

138

Efficacy of sildenafil citrate in prostate brachytherapy patients with erectile dysfunction  

Microsoft Academic Search

Objectives. To ascertain the efficacy of sildenafil citrate (Viagra) in patients with erectile dysfunction (ED) either before or after prostate brachytherapy by an open-label, nonrandomized study.Methods. Sixty-two patients who underwent prostate brachytherapy between March 1995 and July 1998, had ED either before or after brachytherapy, and were interested in treatment with sildenafil comprised the patient population. Clinical and treatment parameters

Gregory S Merrick; Wayne M Butler; Jonathan H Lief; Robin L Stipetich; Laurie J Abel; Anthony T Dorsey

1999-01-01

139

Efficacy of Vardenafil in Men with Erectile Dysfunction: A Flexible-Dose Community Practice Study  

Microsoft Academic Search

Objective: To determine the efficacy and tolerability of flexible dosing with vardenafil in a broad population of men with erectile dysfunction (ED).Methods: 10-week, open-label, flexible-dose study starting with vardenafil 10mg, titrating to 5mg or 20mg at weeks 2 and 6 based on efficacy and tolerability, set in 78 community practice centers in Germany and France. Participants comprised 398 men aged

Axel-Jürg Potempa; Ernst Ulbrich; Ingo Bernard; Manfred Beneke

2004-01-01

140

Vardenafil Increases Penile Rigidity and Tumescence in Men with Erectile Dysfunction after a Single Oral Dose  

Microsoft Academic Search

Objectives: To evaluate the effect of two doses of vardenafil hydrochloride on penile rigidity and tumescence while determining the pharmacokinetics.Methods: Twenty–one patients with erectile dysfunction completed three oral single–dose regimens (placebo, 20 and 40 mg vardenafil) in a randomized, placebo–controlled, 3–way cross–over study. Penile rigidity and tumescence were measured at the base and tip with a Rigiscan™ for up to

S. Stark; R. Sachse; T. Liedl; J. Hensen; G. Rohde; G. Wensing; R. Horstmann; K. M. Schrott

2001-01-01

141

Safety and efficacy of sildenafil citrate in the treatment of male erectile dysfunction  

Microsoft Academic Search

Sildenafil citrate, an oral therapy for erectile dysfunction, is a selective inhibitor of cyclic guanosine monophosphate (cGMP)—specific phosphodiesterase type 5 (PDE5), the predominant isozyme metabolizing cGMP in the corpus cavernosum. Chemically, it is a compound of the pyrazolo-pyrimidinyl-methylpiperazine class. Sildenafil has no direct relaxant effect on human corpus cavernosum but enhances the relaxant effect of nitric oxide (NO) on the

Marvin M. Goldenberg

1998-01-01

142

JNJ-10280205 and JNJ-10287069: novel PDE5 inhibitors as clinical candidates for erectile dysfunction  

Microsoft Academic Search

Phosphodiesterase 5 (PDE5) inhibitors are efficacious in treating patients with erectile dysfunction. New PDE5 inhibitors with different selectivity and pharmacokinetic profiles have been vigorously pursued. Here we report two novel, potent, and selective PDE5 inhibitors, JNJ-10280205 and JNJ-10287069, with Ki values of 0.05 and 0.12 nM, respectively. Both compounds displayed superior selectivity against PDE1-4 and -6 when compared to sildenafil.

Y Qiu; S Bhattacharjee; P Kraft; T Mathew John; D Haynes-Johnson; W Jiang; Z Sui; S Lundeen

2006-01-01

143

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

PubMed

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. PMID:18649679

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

2008-01-01

144

Efficacy of tadalafil in Egyptian and Turkish men with erectile dysfunction  

PubMed Central

A randomised, double-blind, parallel, placebo-controlled, 12-week study was carried out to evaluate the efficacy and safety of 20-mg tadalafil taken ‘as needed’ in a population of men with erectile dysfunction (ED) from Egypt and Turkey. One hundred and thirty-two patients were randomised in this study. Tadalafil was superior to placebo on all three co-primary efficacy end points. The mean change from baseline for the erectile function domain of the International Index of Erectile Function was 9.3 ± 0.8 for the tadalafil group and 2.3 ± 1.6 for the placebo group. Tadalafil-treated patients reported a significantly greater improvement in the mean percentage of successful penetrations (tadalafil: 34.5 ± 4.1; placebo: ?4.6 ± 8.1) and successful intercourse attempts (tadalafil: 52.2 ± 3.8; placebo: 16.8 ± 7.8) than placebo-treated patients as measured by the Sexual Encounter Profile. Tadalafil was generally well tolerated with 82% of adverse events being mild in severity. Tadalafil 20-mg taken ‘as needed’ significantly improved the erectile function in Egyptian and Turkish men with ED. PMID:16846400

SAYLAN, M; KHALAF, I; KADIOGLU, A; SHOAIR, KZ; BEHEIRY, A; WANG, WC; KOPERNICKY, V; ESEN, A

2006-01-01

145

The relationship between uric acid and erectile dysfunction in hypertensive subjects.  

PubMed

Abstract Background. Endothelial dysfunction plays a major role in erectile dysfunction (ED). Uric acid (UA) is a marker of endothelial dysfunction. We hypothesized that increased UA levels may be associated with ED and aimed to investigate whether there is a relationship between, UA and ED in hypertensive patients. Methods. A total of 200 hypertensive patients who have a normal treadmill exercise test were divided into two groups based on the Sexual Health Inventory for Men (SHIM) test (< 21 defined as ED n = 110, and ? 21 defined as normal erectile function n = 90). The differences between the ED and normal erectile function groups were compared and determinants of ED were analyzed. Main results. The prevalence of ED was found to be 55.0%. Office blood pressure level was comparable between groups. UA levels were significantly increased in the ED group (6.20 ± 1.56 vs 5.44 ± 1.32, p = 0.01). In a regression model, age [odds ratio (95% confidence interval): 1.08 (1.04-1.14), p = 0.001], smoking [odds ratio: 2.33 (1.04-5.20), p = 0.04] and UA [odds ratio: 1.76 (1.28-2.41), p = 0.04] were independent determinants of ED. An UA level of > 5.2 mg/dl had 76.2% sensitivity, 43.7% specificity, 62.9% positive and 59.4% negative predictive value for determining ED. Conclusion. UA is an independent determinant of ED irrespective of blood pressure control and questioning erectile function for hypertensive patients with increased UA levels may be recommended. PMID:25029530

Aribas, Alpay; Kayrak, Mehmet; Ulucan, Seref; Keser, Ahmet; Demir, Kenan; Alibasic, Hayrudin; Akilli, Hakan; Solak, Yalcin; Avci, Ahmet; Turan, Yasar; Kaya, Zeynettin; Katlandur, Huseyin; Kanbay, Mehmet

2014-12-01

146

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

PubMed Central

Objective To assess the prevalence and risk factors of erectile dysfunction (ED) in HIV patients from the HIV clinic of a tertiary referral center in Mexico City. Design Prevalence was obtained from cross-sectional studies, and the International Index of Erectile Function (IIEF), a standardized method, was used to assess ED. Methods A cross-sectional study was performed in the HIV clinic. Participants completed the IIEF to allow ED assessment. Information on demographics, clinical and HIV-related variables was retrieved from their medical records. Results One hundred and nine patients were included, with a mean age of 39.9 ± 8.8 years. ED was present in 65.1% of the individuals. Patients had been diagnosed with HIV for a mean of 92.7 ± 70.3 months and had undergone a mean 56.4 ± 45.5 months of HAART. The only variable associated with ED in the univariate analysis was dyslipidemia, and this association was also found in the multivariate analysis (P = 0.01). 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. PMID:25356298

Romero-Velez, Gustavo; Lisker-Cervantes, Andres; Villeda-Sandoval, Christian I; Sotomayor de Zavaleta, Mariano; Olvera-Posada, Daniel; Sierra-Madero, Juan Gerardo; Arreguin-Camacho, Lucrecia O; Castillejos-Molina, Ricardo A

2014-01-01

147

Low nitric oxide bioavailability is associated with better responses to sildenafil in patients with erectile dysfunction.  

PubMed

Erectile dysfunction (ED) is a multifactorial disease associated with vascular dysfunction, low nitric oxide (NO) bioavailability, and oxidative stress. However, it is not known whether low NO bioavailability and oxidative stress affect the responsiveness of ED patients to sildenafil. We tested this hypothesis by studying 28 healthy subjects (control group), 26 patients with ED without comorbidities (ED group), and 18 patients with ED and diabetes mellitus (ED/DM group). The International Index for Erectile Function (IIEF) questionnaire was used to assess the erectile function of all participants, and their responsiveness to sildenafil was assessed as the percentage of change in the five-item version of IIEF score before and after sildenafil treatment. Levels of whole blood nitrite, antioxidants markers (ferric reducing ability of plasma (FRAP) and reduced glutathione), and oxidative stress markers (thiobarbituric acid reactive substance and protein carbonyl) were determined. We found a negative correlation between whole blood nitrite levels and the responses to sildenafil in both ED groups (P<0.05). FRAP correlated negatively with the responses to sildenafil in the ED/DM group (P<0.05). No other significant associations were found. Our findings show evidence that low NO bioavailability is associated with better responses to sildenafil in patients with ED (with or without DM). PMID:23685845

Muniz, Jaqueline J; Lacchini, Riccardo; Sertório, Jonas T C; Jordão, Alceu A; Nobre, Yuri T D A; Tucci, Silvio; Martins, Antônio C P; Tanus-Santos, Jose E

2013-09-01

148

Erectile dysfunction and sex hormone changes in chronic obstructive pulmonary disease patients  

PubMed Central

Background The prevalence of sexual dysfunction in patients with COPD is high and its significance has not been sufficiently stressed. The aim of this study is to investigate the incidence of erectile dysfunction (ED) and the factors affecting its frequency in COPD patients. Methods Seventy patients with COPD and 68 healthy volunteers were included in the study. The International Index of Erectile Function questionnaire was used to evaluate ED, and the Beck Depression Inventory was used to evaluate depression. Results The smoking rate was higher and oxygen saturation (SaO2) and body mass index (BMI) were lower in the COPD group. Blood tests revealed higher levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol. Testosterone level was lower but it was not statistically significant. Various degrees of ED were detected in 78.6% of COPD patients and 55.8% of the controls. Depression was more common in the COPD group. There was a negative correlation between forced expiratory volume in 1 sec (FEV1) level and ED and between SaO2 and ED in the COPD group. A positive correlation was noted between age and ED in both groups. No significant correlation was found among hormonal status and FEV1, ED, depression, SaO2, or BMI. Conclusions The present study provides further confirmation that COPD is a risk factor for erectile dysfunction. When establishing a treatment plan for improving the pulmonary function of COPD patients, sexual dysfunction and depression, which are usually neglected but diminish quality of life, should also be addressed. PMID:24103191

2013-01-01

149

Erectile dysfunction and premature ejaculation in men who have sex with men  

PubMed Central

Introduction Quantitative research into sexual function and dysfunction in men who have sex with men (MSM) has been sparse due in large part to a lack of validated, quantitative instruments for the assessment of sexuality in this population. Aim To assess prevalence and associations of erectile problems and premature ejaculation in MSM. Methods MSM were invited to complete an online survey of sexual function. Ethnodemographic, sexuality, and health related factors were assessed. Main Outcome Measure Participants completed a version of the International Index of Erectile Function modified for use in MSM (IIEF-MSM) and the Premature Ejaculation Diagnostic Tool. Total score on the erectile function domain of the IIEF-EF (IIEF-MSM-EF) was used to stratify erectile dysfunction (ED) severity (25–30=no ED, 16–24 mild or mild moderate ED, 11–15 moderate ED, and ? 10 severe ED). PEDT scores were used to stratify risk of premature ejaculation (PE, diagnosed as PEDT score ?9). Results Nearly 80% of the study cohort of 2,640 men resided in North America. The prevalence of ED was higher in older men whereas the prevalence of PE was relatively constant across age groups. Multivariate logistic regression revealed that increasing age, HIV seropositivity, prior use of erectogenic therapy, lower urinary tract symptoms (LUTS), and lack of a stable sexual partner were associated with greater odds of ED. A separate multivariate analysis revealed that younger age, LUTS, and lower number of lifetime sexual partners were associated with greater odds of PE. Conclusions Risk factors for sexual problems in MSM are similar to what has been observed in quantitative studies of non-MSM males. Urinary symptoms are associated with poorer sexual function in MSM. PMID:22214402

Shindel, Alan W.; Vittinghoff, Eric; Breyer, Benjamin N.

2011-01-01

150

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

PubMed Central

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). No significant differences in sex hormone levels were found between patients with sexual dysfunction and healthy controls (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. PMID:25080932

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

2014-01-01

151

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

PubMed

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). No significant differences in sex hormone levels were found between patients with sexual dysfunction and healthy controls (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. PMID:25080932

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

2014-01-01

152

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

PubMed Central

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. PMID:24969064

Incrocci, Luca

2014-01-01

153

Obstructive sleep apnea and erectile dysfunction: still a neglected risk factor?  

Microsoft Academic Search

Introduction  Erectile dysfunction (ED) is a well-known entity with determined risk factors, which generally has a negative impact on quality\\u000a of life. Obstructive sleep-disordered breathing (SDB), often referred to as obstructive sleep apnea, stands among the possible\\u000a risk factors for ED.\\u000a \\u000a \\u000a \\u000a \\u000a Discussion  Literature review suggests that SDB induces a spectrum of abnormalities in neural, hormonal, and vascular regulation that\\u000a may contribute to

Nikolaos Zias; Vishnu Bezwada; Sean Gilman; Alexandra Chroneou

2009-01-01

154

Self-esteem, confidence, and relationships in men treated with sildenafil citrate for erectile dysfunction  

Microsoft Academic Search

BACKGROUND: Men with erectile dysfunction (ED) often have low self-esteem, confidence, and sexual relationship satisfaction.\\u000a \\u000a \\u000a OBJECTIVE: We evaluated the impact of sildenafil citrate and its generalizability across cultures on self-esteem, confidence, and sexual\\u000a relationship satisfaction in men with ED using the Self-Esteem And Relationship (SEAR) questionnaire.\\u000a \\u000a \\u000a \\u000a \\u000a DESIGN: Pooled analysis of 2 double-blind, placebo-controlled, flexible-dose trials of sildenafil with identical protocols:

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

2006-01-01

155

The connection between type 2 diabetes and erectile dysfunction in Taiwanese aboriginal males.  

PubMed

Type 2 diabetes mellitus (DM) is a growing global epidemic, especially among aboriginal Taiwanese. This study aimed to identify the relationship between erectile dysfunction (ED), markers of endothelial function, serum testosterone level and type 2 DM in aboriginal Taiwanese. Data were obtained from a baseline survey of 240 aboriginal adults. Their demographic data, presence of type 2 DM, markers of endothelial function, serum testosterone and ED status were assessed. The mean age of the samples was 51.62±7.76 years. The International Index of Erectile Function-5 total score had a mean of 21.99±2.34 and a median of 23; 134 participants had ED (55.8%). The results showed an increased risk of ED for participants with type 2 DM and lower serum testosterone level. Among the predictors of ED, type 2 DM, lower serum free testosterone and high-sensitivity C-reactive protein were significantly independent factors. Interleukin-6 had a negative relationship with ED. The study results suggest there is a strong association between type 2 DM and erectile function among aboriginal Taiwanese that is similar to the general population. This study also supports the idea that type 2 DM, markers of endothelial function and serum testosterone may provide warning signs of ED and, at the same time, an opportunity for early intervention for aboriginal adult male. PMID:25078051

Shi, M-D; Chao, J-K; Ma, M-C; Chiang, S-K; Chao, I-C

2014-11-01

156

l-Arginine and tetrahydrobiopterin, but not sodium nitrite partially restored erectile dysfunction in aged rats.  

PubMed

Abstract Aging is associated with erectile dysfunction (ED), in which nitric oxide synthase (NOS) activity and NO bioavailability are reduced due to deficiencies of NOS cofactor (tetrahydrobiopterin, BH4) and substrate (l-arginine). We determined whether the prolonged treatment with sodium nitrite (NaNO2) as a storage form of NO ameliorates ED in aged rats. Male Sprague-Dawley rats were divided: younger, aged and NaNO2-treated (20?mg/kg per day) aged groups. The erectile (intracavernosal pressure [ICP]/mean arterial pressure [MAP]) and corpus cavernous (CC) responses were evaluated after 12 weeks. The ICP/MAP in aged rats was lower than in young controls, which was not improved by the NaNO2 treatment. Immunohistochemical (IHC) staining for endothelial NOS and collagen deposition was performed. We assayed NO indirectly by measuring the level of its stable end products, nitrite/nitrate, using the Griess reagent. The relaxations to ACh and EFS in the aged group were considerably less than in the younger group, which were normalized by acute incubations of l-arginine or BH4 of aged CC. In conclusion, NaNO2 treatment did not restore erectile response while nitrate levels were enhanced in aged penis. The cofactor or substrate administrations, but not chronic exogenous modulation of NO system may be beneficial in aged men with ED. PMID:24898570

Un, Ozge; Yilmaz, Didem; Bayatli, Nur; Kaya, Ecem; Gur, Serap

2014-12-01

157

Medical management of erectile dysfunction in aging males: Is it too late to treat?  

PubMed Central

Erectile dysfunction (ED) is a common disorder among aging males. However, most aging males refuse to seek medical help and believe that ED is an irreversible event in the aging process. The purpose of this study was to describe the current medical management of ED in aging males and to examine whether it is too late to treat this disorder in these elderly men. From 2007 to 2008, 4507 patients diagnosed with ED were gathered from 46 centers in China; 4241 completed the study, 3837 of whom were treated with sildenafil. The 3837 patients were divided into five groups based on age (group A: 20–30 years; group B: 31–40 years; group C: 41–50 years; group D: 51–60 years; and group E: >60 years). After comparing pre- and posttreatment International Index of Erectile Function-Erectile Function domain (IIEF-EF) questionnaires, Erection Hardness Scale (EHS), and IIEF Q13 (“How satisfied have you been with your overall sex life?”), we discovered that the aging males had worse erectile function, erection hardness, and sexual satisfaction than the younger males (P < 0.001). After treatment, the improvement rates in the IIEF-EF, EHS, and IIEF Q13 scores were 107.0%, 83.1%, and 116.5%, respectively. The magnitude of these changes demonstrated significant differences among groups (P < 0.001). Accordingly, aging males are likely to benefit more from medical treatment. We propose that aging males should be informed that age is not a limiting factor for medical ED management, and it is never too late to treat. PMID:24369150

Zhang, Kai; Xu, Ben; Liu, De-Feng; Wang, Xiao-Feng; Zhu, Ji-Chuan; Jin, Jie; Jiang, Hui

2014-01-01

158

How to treat erectile dysfunction in men with diabetes: from pathophysiology to treatment.  

PubMed

Erectile dysfunction (ED) is highly prevalent affecting at least 50 % of men with diabetes mellitus (DM). DM may cause ED through a number of pathophysiological pathways. These include neuropathy, endothelial dysfunction, cavernosal smooth muscle structural/functional changes, and hormonal changes. Lifestyle changes, diabetes control, and treatment of hypogonadism are important as the first step in ED management since there is no curative treatment for ED. Phosphodiesterase type 5 inhibitors (PDE5i) are the first-line treatment option. Intracavernous administration of vasoactive drugs is commonly used as a second-line medical treatment when PDE5i have failed. Alprostadil is the most widely used drug in this second-line setting. The combination of papaverine, phentolamine, and alprostadil represents the most efficacious intracavernous pharmacologic treatment option that may save non-responders to alprostadil. Penile prosthesis implantation can be considered in treatment refractory cases, with excellent functional and safety results in the properly informed patients. PMID:25193347

Hatzimouratidis, Konstantinos; Hatzichristou, Dimitrios

2014-11-01

159

Correlation between nNOS Expression and Erectile Dysfunction in Experimental Diabetes Mellitus Rats of Different Ages  

Microsoft Academic Search

Objective: To assess the correlation between neuronal nitric oxide synthase (nNOS) expression in the brain, lumbosacral spinal cord, sympathetic trunk, prostate and penis, and erectile dysfunction (ED) associated with diabetes mellitus (DM). Methods: DM was induced in adult male Sprague-Dawley rats by injecting streptozotocin. After 1, 2, 3 and 4 months, apomorphine was injected to test the penile reflex. The

Jin-Jia Hu; Hong-Yu Gu; Wen-Long Ding; Shu-juan Yuan; Mei-Fang Zhong; Li Liu

2008-01-01

160

ENDOCRINE SCREENING IN 1,022 MEN WITH ERECTILE DYSFUNCTION: CLINICAL SIGNIFICANCE AND COST-EFFECTIVE STRATEGY  

Microsoft Academic Search

PurposeWe reviewed the results of serum testosterone and prolactin determination in 1,022 patients referred because of erectile dysfunction and compared the data with history, results of physical examination, other etiological investigations and effects of endocrine therapy to refine the rules of cost-effective endocrine screening and to pinpoint actual responsibility for hormonal abnormalities.

Jacques Buvat; Antoine Lemaire

1997-01-01

161

Prevalence of Erectile Dysfunction in France: Results of an Epidemiological Survey of a Representative Sample of 1004 Men  

Microsoft Academic Search

Objective: Several recent studies have reported prevalence rates for erectile dysfunction (ED) displaying considerable variation from country to country. We report here the results of a survey carried out in France in 2001.Methods: This study was carried out by means of telephone interviews, on a representative sample of 1004 men aged 40 years or over. The prevalence of ED was

François Giuliano; Marie Chevret-Measson; Anne Tsatsaris; Caroline Reitz; Michel Murino; Patrick Thonneau

2002-01-01

162

Safety and Efficacy of Vardenafil for the Treatment of Men With Erectile Dysfunction After Radical Retropubic Prostatectomy  

Microsoft Academic Search

PurposeMore than one-third of men may experience erectile dysfunction (ED) after nerve sparing radical retropubic prostatectomy. The efficacy and safety of vardenafil, a potent, selective, phosphodiesterase 5 inhibitor, was assessed for the treatment of ED after radical prostatectomy.

GERALD BROCK; AJAY NEHRA; LARRY I. LIPSHULTZ; GARY S. KARLIN; MARTIN GLEAVE; MONICA SEGER; HARIN PADMA-NATHAN

2003-01-01

163

Penile Weight and Cell Subtype Specific Changes in a Post-Radical Prostatectomy Model of Erectile Dysfunction  

Microsoft Academic Search

PurposeWe evaluated neurogenic erectile dysfunction, focusing on the post-radical prostatectomy model. We investigated changes in DNA, protein and apoptotic cells of the rat penis after denervation. Gross morphometry was measured to elucidate the impact of chemical changes.

JOHN H. HAIRSTON; DAVID J. ZELNER; KEVIN E. McKENNA; KEVIN T. McVARY

2003-01-01

164

Efficacy of sildenafil in male dialysis patients with erectile dysfunction unresponsive to erythropoietin and\\/or testosterone treatments  

Microsoft Academic Search

The aim of this study was to evaluate the effects of recombinant human erythropoietin (Epo), testosterone (T) or a combination of them in the treatment of erectile dysfunction (ED) in hemodialysis patients, as well as the efficacy of sildenafil in patients unresponsive to combination treatment. A total of 23 patients with ED were divided into two groups. The international index

A Tas; A Ersoy; C Ersoy; M Gullulu; M Yurtkuran

2006-01-01

165

Cardiovascular Parameter Changes in Patients With Erectile Dysfunction Using Pde5 Inhibitors: A Study With Sildenafil and Vardenafil  

Microsoft Academic Search

Sildenafil is the most prescribed oral agent for patients with erectile dysfunction (ED). Vardenafil is a new phosphodiester- ase type 5 (Pde-5) inhibitor that was approved by the US Food and Drug Administration last year to treat patients with ED of various causes. Both of these Pde-5 inhibitors have vasodilating properties and effects on blood pressure (BP), and like nitrates,

GIORGIO POMARA; GIROLAMO MORELLI; SALVATORE POMARA; STEFANO TADDEI; LORENZO GHIADONI; NICOLA DINELLI; FABRIZIO TRAVAGLINI; MAURO DICUIO; NICOLA MONDAINI; ANTONIO SALVETTI; CESARE SELLI

166

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

ERIC Educational Resources Information Center

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

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

2011-01-01

167

Prevalence of erectile dysfunction in thyroid disorders: comparison with control subjects and with obese and diabetic patients  

Microsoft Academic Search

Diagnosis of erectile dysfunction (ED) requires anamnestic investigation, being rarely spontaneously declared by patients. ED occurs frequently in diabetes mellitus, and anecdotal evidence suggests that ED occurs in obesity and in hypothyroidism. The aim of this study was to evaluate the prevalence of ED in patients affected by thyroid disorders (hypothyroidism and hyperthyroidism), in comparison with control subjects and with

A Veronelli; A Masu; R Ranieri; C Rognoni; M Laneri; A E Pontiroli

2006-01-01

168

Erectile Dysfunction  

MedlinePLUS

... Health Treatment & Care Blood Glucose Testing Medication Doctors, Nurses & More Oral Health & Hygiene Women A1C Insulin Pregnancy ... the Experts Common diabetes questions answered by doctors, nurses, nutritionists, and more. GET ANSWERS We Can Help - ...

169

Erectile Dysfunction  

MedlinePLUS Videos and Cool Tools

... sex drive) and do not affect the orgasm. History Viagra was approved in 1998. Levitra and Cialis ... the side effects. Viagra is better taken without food on an empty stomach. Levitra and Cialis can ...

170

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

PubMed Central

To evaluate the effect of statins for erectile dysfunction (ED), a systematic review of the literature was conducted in the Cochrane Library, Embase and PubMed from the inception of each database to June 2013. Only randomized controlled trials (RCTs) comparing treatment for ED with statins were identified. Placebo RCTs with the International Index of Erectile Function (IIEF) as the outcome measure were eligible for meta-analysis. A total of seven RCTs including two statins with a total of 586 patients strictly met our criteria for systematic review and five of them qualified for the meta-analysis. A meta-analysis using a random effects model showed that statins were associated with a significant increase in IIEF-5 scores (mean difference (MD): 3.27; 95% confidential interval (CI):1.51 to 5.02; P < 0.01) and an overall improvement of lipid profiles including total cholesterol (MD: ?1.08; 95% CI: ?1.68 to ?0.48; P < 0.01), low-density lipoprotein (LDL) cholesterol (MD: ?1.43; 95% CI: ?2.07 to ?0.79; P < 0.01), high-density lipoprotein (HDL) cholesterol (MD: 0.24; 95% CI: 0.13 to 0.35; P < 0.01) and triglycerides (TGs) (MD: ?0.55; 95% CI: ?0.61 to ?0.48; P < 0.01). In summary, our study revealed positive consequences of these lipid-lowering drugs on erectile function, especially for nonresponders to phosphodiesterase type 5 inhibitors (PDE5Is). However, it has been reported that statin therapy may reduce levels of testosterone and aggravate symptoms of ED. Therefore, larger, well-designed RCTs are needed to investigate the double-edged role of statins in the treatment of ED. PMID:24556747

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

2014-01-01

171

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

PubMed Central

[Purpose] Our objective was to assess the effect of salat and mimicking salat movements and postures on subjects with erectile dysfunction. [Methods] Ten volunteers were recruited in this study. Subjects who were Muslims (Group I) were asked to perform their daily salat and a new intervention of an additional 12 movement cycles of salat for three sessions a week. Non-Muslim subjects (Group II) were taught to mimic salat movements, and were asked to perform a total of 12 movement cycles without reading the recitation for three sessions a week. An International Index for Erectile Function 5 (IIEF-5) questionnaire was given to the subjects before and after the intervention of performing salat or mimicking salat movements and postures. A nocturnal electrobioimpedance volume assessment (NEVA) device was used to measure the nocturnal penile tumescence (NPT) parameters over two consecutive nights. A nonparametric test was conducted to find the significant NPT parameters. [Results] The results showed that all measured parameters improved significantly, with the largest change observed in the maximum percent volumetric change over the baseline (from 138 to 222%). [Conclusion] This preliminary study suggests that the alternative approach of salat and mimicking salat movements and postures, may have beneficial effects for ED patients. PMID:24259921

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

2013-01-01

172

Hormonal Modulation in Aging Patients with Erectile Dysfunction and Metabolic Syndrome  

PubMed Central

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. PMID:24459467

Costa, Ines Campos; Carvalho, Hugo Nogueira; Pacheco-Figueiredo, Luis; Tomada, Ines; Tomada, Nuno

2013-01-01

173

[Safety of long-term replacement hormonal therapy in patients with erectile dysfunction and androgen deficiency].  

PubMed

Safety of testosterone undecanoate in relation to initiation of cancer and prostatic adenoma (PA) in patients with androgenic deficiency and erectile dysfunction (ED) was studied for 12 months in 49 patients aged 57 to 73 years treated with intramuscular testosteron injections. The size of the prostate in patients with adenoma was 46.34 +/- 21.12 cm3 while in adenoma-free patients--19.11 +/- 6.57 sm3. Diabetes mellitus of type 2 (DM-2) was diagnosed in 46.9% patients. All the patients had documented hypogonadism and ED. Tests for PSA and transrectal ultrasound investigation was made in all the patients. 12 month testosterone therapy produced normalization of a mean level of testosterone in both groups, index of erectile function increased. In one patient PSA rose higher than normal value. None of the patients developed obstruction of the urinary tract. Body mass index, lipid spectrum and carbohydrate metabolism also improved. Thus, long-term therapy with testosterone undecanoate has no effect on PSA level, does not induce urinary obstruction with enlarged prostate. The presence of DM-2 is not a contraindication for androgen therapy in adenoma patients. By reducing body mass index, total cholesterol, triglycerides and LDLP, testosterone therapy lowers the risk of prostatic cancer. PMID:18254226

Morgunov, L Iu; Vertkin, A L; Pushkar', D Iu

2007-01-01

174

Is erectile dysfunction a sentinel symptom for cardiovascular autonomic neuropathy in patients with type 2 diabetes?  

PubMed

The study investigated whether there is a significant association between erectile dysfunction (ED) secondary to autonomic failure, and cardiovascular autonomic neuropathy (CAN) in male patients suffering from type 2 diabetes. Twenty-two patients suffering from type 2 diabetes were recruited for this study after satisfying the stringent exclusion criteria used in the first stage. They had no evidence of overt cardiovascular disease, hypertension, neurological, renal or thyroid disease. Each subject was assessed for ED and CAN using standardized tests. Six patients were suffering from CAN while 10 patients were suffering from ED. There was no significant association between CAN and autonomic ED (P = 1). Three patients with normal erectile function had CAN, whilst three patients with ED had CAN. Further analysis demonstrates a significant increase in association between ED and CAN with age (P = 0.036). These results show that ED secondary to autonomic neuropathy is not significantly associated with CAN in this specific group of patients. Nonetheless, the study reveals that ED is a sentinel symptom for future development of CAN. PMID:18211294

Debono, M; Cachia, E; Cassar, A; Calleja, N; Mallia, M; Vassallo, J

2008-02-01

175

Toward a new 'EPOCH': optimising treatment outcomes with phosphodiesterase type 5 inhibitors for erectile dysfunction  

PubMed Central

Despite the marked adverse impacts of erectile dysfunction (ED) on quality of life and well-being, many patients (and/or their partners) do not seek medical attention for this problem, do not receive treatment or discontinue such treatment even when it has effectively restored erectile responses to sexual stimulation. Phosphodiesterase type 5 (PDE5) inhibitors are considered first-line therapies for men with ED. To help physicians maximise the likelihood of treatment success with these agents, we conducted an English-language PubMed search of articles involving approved PDE5 inhibitors dating from 1 January 1998 (the year in which sildenafil citrate was introduced), through 31 August 2008. In addition to sildenafil, tadalafil and vardenafil, search terms included ‘adhere*’, ‘couple*’, ‘effect*’, ‘effic*’, ‘partner*’, ‘satisf*’, ‘succe*’ and ‘treatment outcome.’ Based on our analysis, physician activities to promote favourable treatment outcomes may be captured under the mnemonic ‘EPOCH’: (i) Evaluating and educating patients and partners to ensure realistic expectations of therapy; (ii) Prescribing a treatment individualised to the couple’s lifestyle needs and other preferences; (iii) Optimising treatment outcomes by scheduling follow-up visits with the patient to ‘fine-tune’ dosages and revisit key educational messages; (iv) Controlling comorbidities via lifestyle counselling, medications and/or referrals and (v) Helping patients and their partners to meet their health and psychosocial needs, potentially referring them to a specialist for other forms of therapy if they are not satisfied with PDE5 inhibitors. PMID:19624789

Sadovsky, R; Brock, G B; Gutkin, S W; Sorsaburu, S

2009-01-01

176

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

PubMed Central

The treatment of erectile dysfunction (ED) has been revolutionized in the last 15 years with the introduction of type 5 phosphodiesterase (PDE5) inhibitors. Their efficacy, safety, and ease of administration have made them first-line treatment for ED. This article reviews the current therapies available for ED, and the new PDE5 inhibitors that are being investigated. Furthermore, it examines all the current ED treatment options that are in different phases of development (including oral and topical pharmacotherapy, gene therapy, and tissue engineering). A special emphasis is on avanafil, a new PDE5 inhibitor that has been studied extensively in Phase I and II clinical trials and has undergone several Phase III trials. Avanafil is a promising medication for ED due to its favorable pharmacokinetics, safety, and efficacy. PMID:22087063

Alwaal, Amjad; Al-Mannie, Raed; Carrier, Serge

2011-01-01

177

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

PubMed Central

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

Srilatha, Balasubramanian; Adaikan, P Ganesan

2011-01-01

178

Korean Society for Sexual Medicine and Andrology (KSSMA) Guideline on Erectile Dysfunction  

PubMed Central

In February 2011, the Korean Society for Sexual Medicine and Andrology (KSSMA) realized the necessity of developing a guideline on erectile dysfunction (ED) appropriate for the local context, and established a committee for the development of a guideline on ED. As many international guidelines based on objective evidence are available, the committee decided to adapt these guidelines for local needs instead of developing a new guideline. Considering the extensive research activities on ED in Korea, data with a high level of evidence among those reported by Korean researchers have been collected and included in the guideline development process. The latest KSSMA guideline on ED has been developed for urologists. The KSSMA hopes that this guideline will help urologists in clinical practice. PMID:24044105

Ryu, Ji Kan; Cho, Kang Su; Kim, Su Jin; Oh, Kyung Jin; Kam, Sung Chul; Seo, Kyung Keun; Shin, Hong Seok

2013-01-01

179

A Proteomic Analysis Using an Animal Model for Hyperlipidemia-related Erectile Dysfunction.  

PubMed

To investigate the pathogenesis of hyperlipidemia-related erectile dysfunction and the effects of DA-8159, a new phosphodiesterase-5 inhibitor, on protein expression, we performed a proteomic analysis of differentially expressed proteins in the corpus cavernosum of hyperlipidemic rats by two-dimensional electrophoresis-mass spectrometry. Rats were fed high-cholesterol diet and treated with 5?mg·kg(-1)·day(-1) DA-8159 concurrently. After 5 months apparent hyperlipidemia and significantly decreased maximal intra-cavernous pressure were observed in the control group with the alteration of 8 proteins, which were restored by DA-8159 treatment. The proteins whose levels decreased >2-fold and attenuated by DA-8?159 were determined alcohol dehydrogenase, aldolase A, annexin 1, and tropomyosin-rat, whereas proteins increased>2-fold and recovered by DA-8159 were found to be aldehyde dehydrogenase complex, guanine deaminase, creatine kinase-B, and phosphoglycerate mutase type B subunit. PMID:24452518

Hwang, Y-G; Lee, H; Lee, S; Chung, H K; Kang, K K; Kim, S H

2014-10-01

180

Oral Pharmacotherapy and the Contemporary Evaluation and Management of Erectile Dysfunction  

PubMed Central

The introduction of phosphodiesterase-5 (PDE-5) inhibitor therapy for the treatment of erectile dysfunction (ED) marked the beginning of a much greater awareness of this condition and its effects on quality of life. Resulting research has provided much data on the etiologies of ED, the risk factors involved, and the connection between ED and atherosclerotic disease. With the ED patient more frequently seeking treatment from his primary care physician, it behooves both urologists and non-urologist physicians to be familiar with the properties of the PDE-5 inhibitors, as well as those of other oral, sublingual, intracavernosal, and intraurethral ED drugs. This article reviews the diagnostic approach to the ED patient and the mechanisms of PDE-5 inhibition and discusses data from trials of PDE-5 inhibitors and the erectogenic dopaminergic agonist apomorphine. PMID:16985983

Broderick, Gregory A

2003-01-01

181

Preserved fertility despite erectile dysfunction in mice lacking the nitric oxide receptor  

PubMed Central

Nitric oxide (NO) and cGMP have been shown to be important mediators of penile erection. Erectile dysfunction may result from reduced or non-functional signal transduction within this cascade. There is, however, some inconsistency in the available data as mice lacking NO synthases (endothelial and neuronal nitric oxide synthase, or both) appear to be fertile whereas mice deficient in cGMP-dependent protein kinase I (PKGI) suffer from erectile dysfunction. To clarify this discrepancy we performed studies on mice lacking the NO receptor NO-sensitive guanylyl cyclase (NO-GC). In addition, we generated cell-specific NO-GC knockout (KO) lines to investigate the function of NO in individual cell types. NO-GC was specifically deleted in smooth muscle or endothelial cells (SM-guanylyl cyclase knockout (SM-GCKO) and EC-GCKO, respectively) and these KO lines were compared with total knockouts (GCKO) and wild-type animals. We investigated expression of NO-GC, NO-induced relaxation of corpus cavernosum smooth muscle and their ability to generate offspring. NO-GC-positive immunostaining was detected in smooth muscle and endothelial cells of murine corpus cavernosum but not in interstitial cells of Cajal. NO released from NO donors as well as from nitrergic neurons failed to relax precontracted corpus cavernosum from GCKO mice in organ bath experiments. Similar results were obtained in corpus cavernosum from SM-GCKO mice whereas deletion of NO-GC in endothelial cells did not affect relaxation. The lack of NO-induced relaxation in GCKO animals was not compensated for by guanosine 3?,5?-cyclic monophosphate (cGMP) signalling. To our surprise, GCKO males were fertile although their ability to produce offspring was decreased. Our data show that deletion of NO-GC specifically in smooth muscle cells abolishes NO-induced corpus cavernosum relaxation but does not lead to infertility. PMID:23129789

Groneberg, Dieter; Lies, Barbara; Konig, Peter; Jager, Ronald; Friebe, Andreas

2013-01-01

182

Valproic Acid Prevents Penile Fibrosis and Erectile Dysfunction in Cavernous Nerve Injured Rats  

PubMed Central

Introduction Bilateral cavernous nerve injury (BCNI) causes profound penile changes such as apoptosis and fibrosis leading to erectile dysfunction (ED). Histone deacetylase (HDAC) has been implicated in chronic fibrotic diseases. Aims This study will characterize the molecular changes in penile HDAC after BCNI and determine if HDAC inhibition can prevent BCNI-induced ED and penile fibrosis. Methods Five groups of rats (8–10 wks, n=10/group) were utilized: 1) sham, 2&3) BCNI 14 and 30 days following injury, and 4&5) BCNI treated with HDAC inhibitor valproic acid (VPA 250mg/kg; 14 and 30 days). All groups underwent cavernous nerve stimulation (CNS) to determine intracavernosal pressure (ICP). Penile HDAC3, HDAC4, fibronectin, and transforming growth factor-?1 (TGF-?1) protein expression (Western blot) were assessed. Trichrome staining and the fractional area of fibrosis were determined in penes from each group. Cavernous smooth muscle content was assessed by immunofluorescence to alpha smooth muscle actin (?-SMA) antibodies. Main Outcome Measures ICP; HDAC3, HDAC4, fibronectin and TGF-?1 protein expression; penile fibrosis; penile ?-SMA content. Results There was a voltage-dependent decline (p<0.05) in ICP to CNS 14 and 30 days after BCNI. Penile HDAC3, HDAC4, and fibronectin were significantly increased (P<0.05) 14 days after BCNI. There was a slight increase in TGF-?1 protein expression after BCNI. Histological analysis showed increased (P<0.05) corporal fibrosis after BCNI at both time points. VPA treatment decreased (P<0.05) penile HDAC3, HDAC4, and fibronectin protein expression as well as corporal fibrosis. There was no change in penile ?-SMA between all groups. Furthermore, VPA-treated BCNI rats had improved erectile responses to CNS (P<0.05). Conclusion HDAC-induced pathological signaling in response to BCNI contributes to penile vascular dysfunction after BCNI. Pharmacological inhibition of HDAC prevents penile fibrosis, normalizes fibronectin expression, and preserves erectile function. The HDAC pathway may represent a suitable target in preventing the progression of ED occurring post-RP. PMID:24636283

Hannan, Johanna L.; Kutlu, Omer; Stopak, Bernard L.; Liu, Xiaopu; Castiglione, Fabio; Hedlund, Petter; Burnett, Arthur L.; Bivalacqua, Trinity J.

2014-01-01

183

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

PubMed Central

Korean ginseng and mountain ginseng (Panax ginseng CA Meyer) are important traditional herbal plants whose ginsenosides are generally accepted as serving to improve sexual functions, such as penile erection. We investigated the effects of tissue-cultured mountain ginseng extract (TMGE) on male patients with erectile dysfunction (ED). A double-blind, placebo-controlled study was conducted with 143 patients experiencing ED. Over the course of 8 weeks, one group took 1 000 mg of TMGE twice a day, and the other group took 1 000 mg of placebo twice a day. The effects of the TMGE and the placebo were analyzed using the Korean version of the International Index of Erectile Function (IIEF) questionnaire. A total of 86 patients completed 8 weeks of treatment. The scores on the five domains of the IIEF after medication were significantly higher than the baseline scores in the group treated with TMGE (P < 0.05), whereas no significant improvement was observed in the placebo group (P > 0.05). Erectile function and overall satisfaction scores after medication were significantly higher in the TMGE group than in the placebo group (P < 0.05). Erectile function of patients in the TMGE-treated group significantly improved, suggesting that TMGE could be utilized for improving erectile function in male patients. PMID:19234482

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

2009-01-01

184

Therapeutic Effectiveness and Patient Satisfaction after 6 Months of Treatment with Tadalafil, Sildenafil, and Vardenafil: Results from the Erectile Dysfunction Observational Study (EDOS)  

Microsoft Academic Search

ObjectiveThis observational study was conducted across Europe to assess health outcomes in men with erectile dysfunction (ED) who took tadalafil, sildenafil citrate (sildenafil), or vardenafil HCl (vardenafil) for 6 mo.

Antonio Martin-Morales; Josep Maria Haro; Anthony Beardsworth; Jordan Bertsch; Stathis Kontodimas

2007-01-01

185

EDITS: development of questionnaires for evaluating satisfaction with treatments for erectile dysfunction 1 1 Requests for copies of the EDITS should be directed to S.E. Althof  

Microsoft Academic Search

Objectives. To develop Patient and Partner versions of a psychometrically sound questionnaire, the EDITS (Erectile Dysfunction Inventory of Treatment Satisfaction), to assess satisfaction with medical treatments for erectile dysfunction.Methods. Treatment satisfaction differs from treatment efficacy as it focuses on a person’s subjective evaluation of treatment received. Twenty-nine items representing the domain of treatment satisfaction for men and 20 representing partner

Stanley E Althof; Eric W Corty; Stephen B Levine; Frederic Levine; Arthur L Burnett; Kevin McVary; Vera Stecher; Allen D Seftel

1999-01-01

186

Masculinity and emotion in Mexican men's understandings of erectile dysfunction aetiology and treatment.  

PubMed

This paper investigates the role that emotions related to local gender norms play in urban Mexican men's understandings of erectile dysfunction (ED) aetiology and drug treatment by analysing semi-structured interviews with 28 male urology patients. Analysing narrative data from our interviews, the paper examines how these men drew differently from locally intelligible ways of understanding health and masculinity to develop context-specific understandings of causes and potential treatment outcomes. Study participants' feelings of success or failure in life areas relating to the performance of 'responsible' masculinity, especially work and romance, strongly influenced understandings of ED aetiology and goals for drug treatment. Those who felt successful at being men collaborated with loved ones to adopt purely biological understandings of ED causation, while those who expressed negative emotions about their performances of masculinity viewed these feelings, as well as the structural and interpersonal problems that caused them, as key causes and consequences of dysfunction. I discuss how these different emotional experiences led to different ways of using medication, and the relevance of these findings for clinical practice. PMID:24387630

Wentzell, Emily

2014-01-01

187

Low-Intensity Shock Wave Therapy and Its Application to Erectile Dysfunction  

PubMed Central

Although phosphodiesterase type 5 inhibitors (PDE5Is) are a revolution in the treatment of erectile dysfunction (ED) and have been marketed since 1998, they cannot restore pathological changes in the penis. Low-energy shock wave therapy (LESWT) has been developed for treating ED, and clinical studies have shown that LESWT has the potential to affect PDE5I non-responders with ED with few adverse effects. Animal studies have shown that LESWT significantly improves penile hemodynamics and restores pathological changes in the penis of diabetic ED animal models. Although the mechanisms remain to be investigated, recent studies have reported that LESWT could partially restore corpus cavernosum fibromuscular pathological changes, endothelial dysfunction, and peripheral neuropathy. LESWT could be a novel modality for treating ED, and particularly PDE5I non-responders with organic ED, in the near future. However, further extensive evidence-based basic and clinical studies are needed. This review intends to summarize the scientific background underlying the effect of LESWT on ED. PMID:24459653

Lei, Hongen; Liu, Jing; Li, Huixi; Wang, Lin; Xu, Yongde; Tian, Wenjie; Lin, Guiting

2013-01-01

188

Sildenafil in the treatment of erectile dysfunction: an overview of the clinical evidence  

PubMed Central

Erectile dysfunction (ED) is a highly prevalent disease associated with aging as well as with several risk factors including hypertension, heart disease, obesity, dyslipidemia, diabetes, hypogonadism, drugs-related, and pelvic surgery. Many of these factors are components of the metabolic syndrome, a multiplex risk factor for cardiovascular disease (CVD). ED shares common risk factors with CVD. Endothelial dysfunction seems to be the early underlying pathophysiology across both conditions. The efficacy, tolerability and cardiovascular safety of sildenafil has been evaluated in numerous large, randomized, double-blind, placebo-controlled clinical studies in the broad population of men with ED including men with several co-morbid conditions. Sildenafil is effective in several specific patient populations including the difficult-to-treat subpopulations such as diabetes mellitus and after radical prostatectomy. It is associated with rapid onset of action – within 14 minutes for some men – and an extended duration of action for up to 12 hours. Sildenafil improves quality of life and satisfaction for treated men and is well tolerated with a favorable safety profile. New data suggest that sildenafil has beneficial effects in several chronic conditions. It has been approved for the treatment of idiopathic pulmonary hypertension. Numerous articles have suggested that it improves endothelial function and a possible role on premature ejaculation or treatment of lower urinary tract symptoms has been suggested. PMID:18046917

Hatzimouratidis, Konstantinos

2006-01-01

189

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

PubMed Central

Introduction Thirty million men in the United States suffer from erectile dysfunction (ED) and this number is expected to double by 2025. Considered a major public health problem, which seriously affects the quality of life of patients and their partners, ED becomes increasingly prevalent with age and chronic smoking is a major risk factor in the development of ED. Aim To review available evidence concerning the effects of cigarette smoking on vascular changes associated with decreased nitric oxide (NO) bioavailability and increased reactive oxygen species (ROS) generation. Methods We examined epidemiological and clinical data linking cigarette smoking and ED, and the effects of smoking on vascular NO bioavailability and ROS generation. Main Outcome Measures There are strong parallels between smoking and ED and considerable evidence supporting the concept that smoking-related ED is associated with reduced bioavailability of NO because of increased ROS. Results Cigarette smoking-induced ED in human and animal models is associated with impaired arterial flow to the penis or acute vasospasm of the penile arteries. Long-term smoking produces detrimental effects on the vascular endothelium and peripheral nerves and also causes ultrastructural damage to the corporal tissue, all considered to play a role in chronic smoking-induced ED. Clinical and basic science studies provide strong indirect evidence that smoking may affect penile erection by the impairment of endothelium-dependent smooth muscle relaxation or more specifically by affecting NO production via increased ROS generation. Whether nicotine or other products of cigarette smoke mediate all effects related to vascular damage is still unknown. Conclusions Smoking prevention represents an important approach for reducing the risk of ED. The characterization of the components of cigarette smoke leading to ED and the mechanisms by which these components alter signaling pathways activated in erectile responses are necessary for a complete comprehension of cigarette smoking-associated ED. PMID:18331273

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

2010-01-01

190

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

PubMed Central

Background Erectile dysfunction is an emerging risk marker for future cardiovascular disease (CVD) events; however, evidence on dose response and specific CVD outcomes is limited. This study investigates the relationship between severity of erectile dysfunction and specific CVD outcomes. Methods and Findings We conducted a prospective population-based Australian study (the 45 and Up Study) linking questionnaire data from 2006–2009 with hospitalisation and death data to 30 June and 31 Dec 2010 respectively for 95,038 men aged ?45 y. Cox proportional hazards models were used to examine the relationship of reported severity of erectile dysfunction to all-cause mortality and first CVD-related hospitalisation since baseline in men with and without previous CVD, adjusting for age, smoking, alcohol consumption, marital status, income, education, physical activity, body mass index, diabetes, and hypertension and/or hypercholesterolaemia treatment. There were 7,855 incident admissions for CVD and 2,304 deaths during follow-up (mean time from recruitment, 2.2 y for CVD admission and 2.8 y for mortality). Risks of CVD and death increased steadily with severity of erectile dysfunction. Among men without previous CVD, those with severe versus no erectile dysfunction had significantly increased risks of ischaemic heart disease (adjusted relative risk [RR]?=?1.60, 95% CI 1.31–1.95), heart failure (8.00, 2.64–24.2), peripheral vascular disease (1.92, 1.12–3.29), “other” CVD (1.26, 1.05–1.51), all CVD combined (1.35, 1.19–1.53), and all-cause mortality (1.93, 1.52–2.44). For men with previous CVD, corresponding RRs (95% CI) were 1.70 (1.46–1.98), 4.40 (2.64–7.33), 2.46 (1.63–3.70), 1.40 (1.21–1.63), 1.64 (1.48–1.81), and 2.37 (1.87–3.01), respectively. Among men without previous CVD, RRs of more specific CVDs increased significantly with severe versus no erectile dysfunction, including acute myocardial infarction (1.66, 1.22–2.26), atrioventricular and left bundle branch block (6.62, 1.86–23.56), and (peripheral) atherosclerosis (2.47, 1.18–5.15), with no significant difference in risk for conditions such as primary hypertension (0.61, 0.16–2.35) and intracerebral haemorrhage (0.78, 0.20–2.97). Conclusions These findings give support for CVD risk assessment in men with erectile dysfunction who have not already undergone assessment. The utility of erectile dysfunction as a clinical risk prediction tool requires specific testing. Please see later in the article for the Editors' Summary PMID:23382654

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

2013-01-01

191

Vardenafil increases penile rigidity and tumescence in erectile dysfunction patients: a RigiScan and pharmacokinetic study  

Microsoft Academic Search

The pharmacodynamic effect on penile rigidity and tumescence and the pharmacokinetic properties of single oral doses of 10\\u000a and 20?mg vardenafil, a new PDE5-inhibitor, were investigated in 21 erectile dysfunction patients. Patients were evaluated\\u000a with RigiScan on three occasions in a randomized, placebo-controlled, double-blind crossover fashion, while receiving visual\\u000a sexual stimulation. Relative to placebo, a single dose of 10?mg vardenafil

T. Klotz; R. Sachse; A. Heidrich; F. Jockenhövel; G. Rohde; G. Wensing; R. Horstmann; R. Engelmann

2001-01-01

192

Efficacy and safety of Vardenafil, a selective phosphodiesterase 5 inhibitor, in men with erectile dysfunction on antihypertensive therapy  

Microsoft Academic Search

Background: Vardenafil is being evaluated for the treatment of erectile dysfunction (ED). Since ED frequently develops in men with hypertension, the efficacy and safety of vardenafil in men who received antihypertensive therapy (aHT) was examined.Methods: In this pooled analysis of two randomized, double-blind pivotal Phase III studies, men with ED for ?6 months received vardenafil 5, 10, or 20 mg

Harin Padma-Nathan; Hartmut Porst; Ian Eardley; Marc Thibonnier

2002-01-01

193

Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time  

Microsoft Academic Search

Sildenafil is one of two oral drugs approved for first-line treatment of erectile dysfunction (ED). Anecdotally, some young healthy men who wish to enhance their sexual performance are requesting or abusing sildenafil. In this randomized double-blind, placebo-controlled clinical study, we investigated the effect of sildenafil in young men without ED. A total of 60 young healthy men age 20–40 y

N Mondaini; R Ponchietti; G H Muir; F Montorsi; F Di Loro; G Lombardi; M Rizzo

2003-01-01

194

Men with hyperthyroidism or hypothyroidism commonly have erectile dysfunction that often spontaneously improves after restoration to euthyroidism  

Microsoft Academic Search

ED (SHIM ?10) was found in 21 patients (37.5%), 13 (29.5%) with hypothyroidism and 8 (29.6%) with hyperthyroidism, as compared with 6 controls (25%) (Figure 1). ED was found in a significantly larger number of patients with hyperthyroidism (71%) and hypothyroidism (85%) as compared with controls (25%) (P<0.001 for both) (Figure 1). SHIM scores in the SUMMARY BACKGROUND Erectile dysfunction

Krassas GE; Tziomalos K; Papadopoulou F

2008-01-01

195

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

PubMed Central

Introduction Prostate cancer (PCa) treatments are associated with a high incidence of erectile dysfunction (ED). Interventions to help men with iatrogenic ED have largely focused on penile tumescence adequate for vaginal penetration. Less research has been undertaken on sex practices other than penile/vaginal intercourse. Aim The aim of this study was to explore forms of sexual practice engaged in by men following treatment for PCa. We focused in particular on anal intercourse (AI) as practiced by both nonheterosexual (i.e., gay-identified men and other men who have sex with men) and heterosexual men. We sought to determine how common AI was subsequent to PCa treatment and how flexible AI practitioners were in their modes (e.g., from insertive to receptive) when faced with iatrogenic ED. Methods An international online survey was conducted in 2010–2011 of men treated for PCa, where participants (N = 558) were asked explicitly about their sexual practices before and after PCa treatment. Main Outcome Measures The outcome measures were the numbers and percentages of men who practiced AI before and after PCa treatment as well as the percentage who changed AI practice after PCa treatment. Results Five hundred twenty-six men (90 nonheterosexual men; 436 heterosexual men) answered questions on AI practices. A proportion of nonheterosexual (47%) and heterosexual men (7%) practiced AI following PCa treatment, and did so in all modes (insertive, receptive, and “versatile”). Many nonheterosexual men continued to be sexually active in the face of iatrogenic ED by shifting from the insertive to receptive modes. A few men, both heterosexual and nonheterosexual, adopted AI for the first time post-PCa treatment. Conclusions Flexibility in sexual practice is possible for some men, both nonheterosexual and heterosexual, in the face of iatrogenic ED. Advising PCa patients of the possibilities of sexual strategies that include AI may help them in reestablishing a sex life that is not erection dependent. Dowsett GW, Lyons A, Duncan D, and Wassersug RJ. Flexibility in men's sexual practices in response to iatrogenic erectile dysfunction after prostate cancer treatment. Sex Med 2014;2:115–120. PMID:25356308

Dowsett, Gary W; Lyons, Anthony; Duncan, Duane; Wassersug, Richard J

2014-01-01

196

The GAy MEn Sex StudieS: erectile dysfunction among Belgian gay men  

PubMed Central

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 indicated having more ED. PMID:23861591

Vansintejan, Johan; Vandevoorde, Jan; Devroey, Dirk

2013-01-01

197

Plasma Chitotriosidase Activity and Arteriogenic Erectile Dysfunction: Association with the Presence, Severity, and Duration.  

PubMed

ABSTRACT Introduction. Plasma chitotriosidase (ChT) activity is associated with the presence of atherosclerosis and is a new cardiovascular risk marker. Although available evidence supports its role in atherogenesis, there is a lack of an obvious correlation between plasma ChT activity and erectile dysfunction (ED). Aim. Our aim was to investigate the association of the level of serum ChT activity with ED. Main Outcome Measures. Erectile function was assessed using Sexual Health Inventory for Men (SHIM). Serum fasting lipid profile (plasma total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and triglycerides); sex hormones (luteinizing hormone, follicle-stimulating hormone, prolactin, total testosterone, and estradiol); and thyroid-stimulating hormone were measured. Plasma ChT activity, as well as K(m), V(max), optimum pH, and heat stability of the ChT were also assessed. Penile duplex ultrasound examination before and after intracavernous injection of 20 microg prostaglandin E1 (PGE(1)), pudendal nerve conduction tests and sensory-evoked potential studies were done to identify patients with arteriogenic ED. Intima-media thickness (IMT) and plaque formation of common carotid artery were determined bilaterally using B-mode ultrasonography. Methods. A total of 124 normolipidemic patients with ED and 120 healthy controls were recruited for this study. Results. Serum ChT activity in patients with ED (116 +/- 18 nmol/h/mL) was significantly higher than in normal control subjects (51 +/- 12 nmol/h/mL) (P < 0.001). There was a significant positive correlation between plasma ChT activity and (i) severity of ED and (ii) duration of ED (r = 0.68, P = 0.004; and r = 0.62, P = 0.01 respectively).We also found that all ChT kinetic parameters assessed (K(m), V(max), and optimum pH) in plasma of ED patients were significantly different from those of normal controls (all P < 0.001). The results of heat stability analysis, demonstrated that plasma ChT activity in the normal individuals was more stable than in the patients with arteriogenic ED (P < 0.001). A significant correlation was seen between the plasma ChT activity and the mean common carotid IMT (r = 0.78, P = 0.002). Moreover, a significant correlation was seen between the severity of ED and mean common carotid IMT (r = 0.74, P = 0.003). We did not address chitotriosidase genotype. Conclusions. Our results indicate that plasma ChT activity is increased in normolipidemic patients with arteriogenic ED, suggesting its possible role in the pathophysiology of arteriogenic ED. The clinical significance of this increase should be assessed in further studies. Safarinejad MR, and Safarinejad SH. Plasma chitotriosidase activity and arteriogenic erectile dysfunction: Association with the presence, severity, and duration. J Sex Med **;**:**-**. PMID:20136708

Safarinejad, Mohammad Reza; Safarinejad, Shiva

2010-02-01

198

Usage of neck circumference as novel indicator of erectile dysfunction: a pilot study in Turkish population.  

PubMed

Erectile dysfunction (ED) is the most common male sexual problem worldwide. The association between ED and components of metabolic syndrome (MtS) is well established. This study examined neck circumference (NC) as a possible indicator of MtS and also of ED. Ninety-two patients were included and divided into two groups. Group 1 consisted of 47 patients with ED and Group 2 consisted of 45 healthy volunteers. Questionnaires, differences in anthropometric and laboratory measurements between patients with ED and the control group, and a cut-off value for NC were investigated. The mean NC in ED patients was higher in Group 1 than in Group 2 (P = 0.001), and Group 1 also demonstrated more MtS criteria than Group 2 (P < 0.001). The cut-off point of NC was defined as 34.75 cm for ED and MtS. The cut-off values of waist circumference for ED and MtS were 105.5 and 102.5 cm respectively. In the light of these findings, NC may be a new component of MtS in ED patients. Additionally, NC may be a novel indicator of central obesity and ED. We suggest that NC values of 35 cm and over may predict ED in patients with MtS. PMID:24147908

Akin, Y; Gulmez, H; Bozkurt, A; Nuhoglu, B; Usta, M F

2014-11-01

199

Avanafil for the treatment of erectile dysfunction: initial data and clinical key properties.  

PubMed

Orally active, selective inhibitors of phosphodiesterase type 5 (PDE 5, cyclic GMP PDE), such as sildenafil, tadalafil and vardenafil, are currently the first-choice treatment options for the clinical management of erectile dysfunction (ED) of various etiologies and severities. However, a significant number of patients remain dissatisfied with the available therapies due a lack of efficacy or discomfort arising from adverse events. Several new PDE5 inhibitors, among which are avanafil (TA-1790), lodenafil, mirodenafil, udenafil, SLX-2101, JNJ-10280205 and JNJ-10287069, have recently been approved and introduced into the market or are in the final stages of their clinical development. Avanafil (marketed in the US under the brand name STENDRA(™)) has been developed by VIVUS Inc. (Mountain View, CA, USA) and has recently received approval from the US Food and Drug Administration (FDA) for use in the treatment of male ED. The drug has demonstrated improved selectivity for PDE5, is rapidly absorbed after oral administration with a fast onset of action and a plasma half-life that is comparable to sildenfil and vardenafil. In phase II and phase III clinical trials that included a large number of patients, avanafil has been shown to be effective and well tolerated. Owing to its favorable pharmacodynamic and pharmacokinetic profile, avanafil is considered as a promising new option in the treatment of ED. The present article summarizes the initial data and clinical key properties of avanafil. PMID:23372609

Kedia, George T; Uckert, Stefan; Assadi-Pour, Farhang; Kuczyk, Markus A; Albrecht, Knut

2013-02-01

200

Long-term safety and effectiveness of sildenafil citrate in men with erectile dysfunction  

PubMed Central

Because sildenafil citrate is a treatment, not a cure, for erectile dysfunction (ED), many men may choose to use it for an extended period. Men with ED who had previously completed 1 of 4 double-blind trials with short-term open-label extension (combined duration, 0.9–1.2 years) were eligible for this 4-year, open-label, extension study, which assessed the safety and effectiveness of flexible doses (25, 50, and 100 mg sildenafil) used as needed. Adverse events that were serious or led to dosing changes or discontinuation (temporary or permanent) were recorded. Many of the 979 participants (mean age, 58 [range, 27–82] years; mean ED duration, 4.5 years) had concomitant hypertension (28%), diabetes (22%), or hyperlipidemia (14%). Overall, 37 (3.8%) had treatment-related adverse events (none serious) requiring dosage change or discontinuation and 62 (6.3%) discontinued because of insufficient response. At each yearly assessment, more than 94% of participants responded affirmatively to the questions: “Are you satisfied with the effect of treatment on your erections?” and “If yes, has treatment improved your ability to engage in sexual activity?” These results argue against the loss of tolerability or the development of tachyphylaxis over a prolonged period of as needed, flexible-dose sildenafil treatment of men with ED. PMID:18516312

McMurray, James G; Feldman, Robert A; Auerbach, Stephen M; DeRiesthal, Herb; Wilson, Neal

2007-01-01

201

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

PubMed Central

Many men with erectile dysfunction (ED) also have associated underlying cardiovascular and metabolic conditions, for which they are likely to be taking medication. Therefore, cardiovascular safety and potential drug interactions are two of the major concerns when using PDE-5 inhibitors in these patients. The PDE-5 inhibitor, vardenafil, is characterized by a rapid onset of action, increased duration of erection, high rates of first-dose success and reliable efficacy that can be maintained with continued use. In both clinical trials and real-life observational studies, vardenafil has demonstrated a favorable efficacy and safety profile in men with ED, including those with associated underlying conditions such as diabetes, hypertension and dyslipidemia. Importantly, the concomitant use of medication for these conditions is not associated with any noteworthy changes in the efficacy and safety of vardenafil. The evidence presented in this review supports the use of vardenafil as a first-line treatment for men with ED, including those with underlying conditions. PMID:20054411

Morales, Antonio Martín; Mirone, Vincenzo; Dean, John; Costa, Pierre

2009-01-01

202

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

PubMed Central

Objective To investigate factors associated with demographic/clinical characteristics and drug selection in patients with erectile dysfunction (ED). The prevalence of ED is increasing worldwide. Studies have shown that ED is associated with age, lifestyle and comorbidities. However, the factors associated with patient characteristics as well as drug selection are incompletely understood. Setting A tertiary medical centre in Kuala Lumpur, Malaysia. Participants A total of 219 patients (range 23–80?years) who had received phosphodiesterase type-5 (PDE-5) inhibitors as ED treatment were evaluated. Inclusion criteria Adult patients aged ?18?years, diagnosed with ED, and prescribed with sildenafil, tadalafil or vardenafil. Exclusion criteria Patients diagnosed with ED but who did not receive any PDE-5 inhibitor, or those with missing data. Primary and secondary outcome measures Factors associated with demographic and clinical characteristics as well as drug selection were assessed. Results Ischaemic heart disease (p=0.025), benign prostatic hyperplasia (p<0.001), obesity (p=0.005), lower urinary tract symptoms (LUTS) (p=0.006) and ?-blockers (p<0.001) were significantly associated with elderly patients with ED. Additionally, LUTS (p=0.038) and ?-blockers (p=0.008) were significantly associated with the selection of PDE-5 inhibitor. Conclusions These data showed that elderly patients with ED were significantly associated with comorbidities and ?-blockers, whereas LUTS and ? blockers were associated with drug selection. PMID:25001396

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

2014-01-01

203

Erectile dysfunction following Nd-YAG visual laser-assisted prostatectomy (VLAP).  

PubMed

We investigated if side fire Nd-YAG visual laser prostatectomy (VLAP) causes erectile dysfunction (ED) in patients who were sexually active prior to the procedure. The 36 study patients gave a detailed medical/sexual history: physical examination included bulbo-cavernous reflex (BCR) on rectal examination and routine blood tests. Lasing time, power of the applied laser beam (in watts), coagulation site and energy intensity were recorded. Patients with new onset ED during the one year study period underwent pudendal nerve conduction (PNC), color duplex Doppler ultrasonography, and NPT/RigiScan testing. In 6 out of 36 (16.7%) patients reporting significant post-operative ED, there was a tendency towards higher energy applied and longer lasing time but no correlation between prostate size or the site of energy application. Patients reported loss of night and/or morning erections (n = 5), retrograde ejaculations (n = 2), loss of ejaculate (n = 2), and decreased sensation of orgasm (n = 3). Three had abnormal PNC, duplex Doppler showed abnormal blood supply in four, and all six had abnormal NPT/RigiScan. We believe this is the first demonstration that VLAP may be associated with a high rate of ED and that the lasing time and intensity of applied laser energy may play a role in this outcome. PMID:9542689

Chen, J; Laufer, M; Kaver, I; Braf, Z; Matzkin, H

1998-03-01

204

Peak systolic velocity in patients with arterial erectile dysfunction and peripheral arterial disease.  

PubMed

The aim of this study is to evaluate whether penile peak systolic velocity (PSV) varies in patients with erectile dysfunction (ED) due to artery insufficiency associated with abnormalities in other arterial districts or not. To accomplish this, cavernous artery PSV was determined 10, 20 and 30 min after intracavernously administering alprostadil by means of echo-color Doppler to a total of 65 consecutive patients (age range 52-78 years). In all, 18 patients had ED alone (group A) and served as controls, 15 had ED plus atheroma plaques and/or marked intima-media thickness of the common carotid artery (group B); 17 had ED plus lower limb artery abnormalities; 17 had ED plus carotid and lower limb artery abnormalities (group D). Group B and C patients had a similar PSV, which turned out to be significantly lower than that in group A. Group D patients had the lowest PSV, which proved to be significantly lower than that in groups A, B and C. This study shows that a more generalized peripheral atherosclerotic process is associated with a severer penile artery insufficiency. Therefore, ED patients with a severe arterial insufficiency should undergo an extensive echo-duplex examination. PMID:16163371

Vicari, E; Di Pino, L; La Vignera, S; Fratantonio, E; Signorelli, S; Battiato, C; Calogero, A E

2006-01-01

205

Measurement of erectile dysfunction in population-based studies: the use of a single question self-assessment in the Massachusetts Male Aging Study  

Microsoft Academic Search

A concise, reliable means of assessing erectile dysfunction (ED) in large, multidisciplinary population-based studies is needed. A single, direct question for self-assessed ED was assessed in the population-based sample of the Massachusetts Male Aging Study (MMAS). Of the 1156 respondents to the 1995–97 MMAS follow-up evaluation, 505 were randomly selected to complete either the International Index of Erectile Function (IIEF)

CA Derby; AB Araujo; CB Johannes; HA Feldman; JB McKinlay

2000-01-01

206

Lower Urinary Tract Symptoms and Erectile Dysfunction: CoMorbidity or Typical “Aging Male” Symptoms? Results of the “Cologne Male Survey”  

Microsoft Academic Search

Objectives: Due to demographic developments in industrial nations, age-correlated diseases are becoming more important. From many epidemiological studies we know that the prevalence of benign prostatic hyperplasia (BPH) and the loss of erectile function (= erectile dysfunction or ED) increase with advancing age. Are these two illnesses related or\\/and independent?Methods: We mailed our newly developed and validated questionnaire on male

M. H. Braun; F. Sommer; G. Haupt; M. J. Mathers; B. Reifenrath; U. H. Engelmann

2003-01-01

207

Erectile and ejaculatory dysfunction in a community-based sample of men 50 to 78 years old: prevalence, concern, and relation to sexual activity  

Microsoft Academic Search

Objectives. To determine the prevalence rates of erectile and ejaculatory dysfunction, associated bother, and their relation to sexual activity in a population-based sample of elderly men.Methods. Data were collected from 1688 men by way of self-administered questionnaires (including the International Continence Society male sex questionnaire) and measurements at a health center and urology outpatient department.Results. The prevalence of significant erectile

Marco H Blanker; J. L. H. Ruud Bosch; Frans P. M. J Groeneveld; Arthur M Bohnen; Ad Prins; Siep Thomas; Wim C. J Hop

2001-01-01

208

[Cytoflavin in the treatment of patients with chronic abacterial prostatitis and erectile dysfunction].  

PubMed

The problem of chronic prostatitis (CP) and erectile dysfunction (ED) involves not only their high prevalence, but also the insufficient effectiveness of their treatments. In this regard, there is need for administration the pathogenetic drugs with antihypoxic, antioxidant and neuroprotective effects and improving blood flow to the genitals. The study included 60 men with CP associated with ED, aged 22 to 60 years. Patients were randomized into 2 groups of 30 people. Patients of comparison group received baseline therapy (alpha1-adrenoblockers, non-specific anti-inflammatory drugs, digital prostate massage and vacuum phallostimulation). Antibiotics were applied on the basis of their potential effectiveness in chronic abacterial prostatitis. In addition to the above treatment, patients of main group received step-down therapy with cytoflavin (in infusion, then oral administration). Positive dynamics was noted in both groups of patients; however, according to the indicators of the severity of pain and dysuria, as well as quality of life, positive dynamics in the main group of patients was more significant. Similarly, the dynamics of objective criteria for inflammation in the prostate gland was more pronounced when using cytoflavin. After treatment, the rigid phase of erection during vacuum fallotest occurred within 2-3 min from the beginning of the procedure in 16 (53.3%) patients of main group and only in 9 (30%) patients of comparison group. During follow-up examination at 6 months after treatment, stable remission was found in 75% of patients of main group. Thus, the inclusion of cytoflavin in the scheme of complex treatment of patients with abacterial CP associated with ED is pathogenetically justified, makes it more efficient and provides good DFS. PMID:23342619

Churakov, A A; Kolesnikov, A I; Bliumberg, B I; Popkov, V M

2012-01-01

209

Fibrotic Protein Expression Profiles in Penile Tissue of Patients With Erectile Dysfunction  

PubMed Central

Objective To characterize transforming growth factor beta1 (TGF?1) and related signaling pathway proteins in a large cohort of human penile tissue (HPT) samples. Methods HPT was collected from patients undergoing penile prosthesis implantation (PPI) for erectile dysfunction (ED) and divided into 2 groups: post-radical prostatectomy ED (RP-ED; n=57) or organic ED (O-ED; n=30). HPT from patients undergoing partial penectomy without ED was used as controls (CON; n=6). Western blot analysis was performed to investigate the protein expressions of TGF?1, thrombospondin 1 (TSP1; an activator of TGF?1), fibronectin (FN; an extracellular matrix glycoprotein induced by TGF?1) and a family of transcriptional factors activated by TGF?1 [Smad2, phospho-Smad2-serine-465/467 (pSmad2), Smad3, phospho-Smad3-serine-423/425 (pSmad3)]. Results Expressions of TGF?1 and TSP1 were significantly higher in both RP-ED (p<0.05) and O-ED (p<0.05) groups compared to that of the CON group, and were not different between either ED groups. Expressions of Smad2, pSmad2, Smad3, pSmad3 and FN were similar among all groups. Within the RP-ED group, a subgroup analysis showed that time from RP to PPI was related to increased expression of pSmad2 (p<0.05) and previous history of intracavernosal injection was related to increased expression of TGF?1 (p<0.05) . Conclusion Our results demonstrate that TSP1 and TGF?1-dependent fibrotic changes occur in penile tissue in patients with ED regardless of etiology. The unchanged expression of the Smad transcriptional factors may be reconciled by a Smad-independent downstream signaling pathway transmitting TGF?1 signals. PMID:24075003

Cabrini, Marcelo R.; Sezen, Sena F.; Lagoda, Gwen; Segal, Robert L.; Feng, Zhaoyong; Andreoni, Cassio; Burnett, Arthur L.

2013-01-01

210

Avanafil for male erectile dysfunction: a systematic review and meta-analysis  

PubMed Central

Avanafil, a potent new selective phosphodiesterase type 5 (PDE5) inhibitor, has been developed for the treatment of erectile dysfunction (ED). We carried out a systematic review and meta-analysis to assess the efficacy and safety of this drug for the treatment of ED. A literature review was performed to identify all published randomized, double-blind, placebo-controlled trials of avanafil for the treatment of ED. The search included the following databases: MEDLINE, EMBASE and the Cochrane Controlled Trials Register. The reference lists of the retrieved studies were also investigated. Four publications, involving a total of 1381 patients, were used in the analysis, including four randomized controlled trials (RCTs) that compared avanafil with a placebo. Among the co-primary efficacy end points indicating that avanafil 100 mg was more effective than a placebo were successful vaginal penetration (SEP2) (the odds ratio (OR) =5.06, 95% confidence interval (CI) =3.29–7.78, P< 0.00001) and successful intercourse (SEP3) (OR = 3.99, 95% CI = 2.80–5.67, P< 0.00001). Men randomized to receive avanafil were less likely than those receiving the placebo to drop out due to an adverse event (AE) (OR = 1.48, 95% CI = 0.54–4.08, P = 0.44). Specific AEs with avanafil included headache and flushing, which were significantly less likely to occur with placebo. This meta-analysis indicates that avanafil 100 or 200 mg is an effective and well-tolerated treatment for ED. Compared with avanafil 100 mg, patients who take avanafil 200 mg are more likely to experience headaches. PMID:24589460

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

2014-01-01

211

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

SciTech Connect

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

Rayt, H. S., E-mail: hsrayt@hotmail.com; Bown, M. J.; Lambert, K. V. [University of Leicester, Division of Cardiovascular Sciences, Vascular Surgery Research Group (United Kingdom); Fishwick, N. G. [University Hospitals of Leicester NHS Trust, Department of Radiology (United Kingdom); McCarthy, M. J.; London, N. J. M.; Sayers, R. D. [University of Leicester, Division of Cardiovascular Sciences, Vascular Surgery Research Group (United Kingdom)

2008-07-15

212

The history of ginseng in the management of erectile dysfunction in ancient China (3500-2600 BCE)  

PubMed Central

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. PMID:22557711

Nair, Rajesh; Sellaturay, Senthy; Sriprasad, Seshadri

2012-01-01

213

A Holistic Treatment Approach to Male Erectile Disorder.  

ERIC Educational Resources Information Center

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)

Millner, Vaughn S.; Ullery, Elizabeth K.

2002-01-01

214

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

PubMed Central

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. PMID:25157340

Osmonov, Daniar Kurmanbekovich; Aksenov, Aleksey; Guerra Sandoval, Andrea Nathaly; Kalz, Almut; Juenemann, Klaus Peter

2014-01-01

215

Arterial erectile dysfunction: reliability of penile Doppler evaluation integrated with serum concentrations of late endothelial progenitor cells and endothelial microparticles.  

PubMed

We recently showed the diagnostic value of a new immunophenotype of blood endothelial progenitor cells (EPC) (CD45(-)/CD34(+)/CD144(+)) and endothelial microparticles (EMP) (CD45(-)/CD144(+)/annexin V(+)) in patients with arterial erectile dysfunction (AED), particularly in patients with associated late-onset hypogonadism and/or metabolic syndrome. In addition, we evaluated the effects of androgen replacement therapy, aerobic physical activity, and tadalafil administration on these markers. The aim of this study was to evaluate the serum concentrations of EPCs and EMPs in a large cohort of patients with AED according to severity of cavernous arterial insufficiency evaluated by penile Doppler. A total of 120 patients (aged 58.0 ± 6.0 years) with AED were enrolled in this study. Patients were classified into 3 groups based on value of peak systolic velocity (PSV). Group A: 37 patients with PSV <25 cm/s (severe arterial insufficiency); group B: 40 patients with PSV between 25 and 29 cm/s (moderate arterial insufficiency); group C: 43 patients with PSV between 30 and 34 cm/s (mild arterial insufficiency). Twenty patients (aged 60.0 ± 3.0 years) with psychogenic erectile dysfunction (PED) represented the control group. EPC and EMP blood concentrations were evaluated by flow cytometry. Patients with AED had significantly higher blood pressure, triglyceride levels, homeostasis model assessment index of insulin resistance, cavernous artery acceleration time, and intima-media thickness than those with PED, whereas International Index of Erectile Function score, high-density lipoprotein cholesterol level, and cavernous artery PSV were lower than those in PED. Both EPC and EMP levels were significantly higher in patients with AED compared with patients with PED. Among 3 groups of patients with AED, there were no significant differences in metabolic parameters examined, but group A showed significantly higher values of cavernous artery acceleration time and intima-media thickness than group B and group C. Finally, group A showed serum concentrations of EPCs and EMPs significantly higher compared with other groups with AED. Patients with AED showed worse metabolic parameters, cavernous artery parameters, and EPC and EMP levels compared with patients with PED. Among patients with AED, those with PSV <25 cm/s showed worse findings of endothelial dysfunction. This suggests that AED is an expression of endothelial damage and that this original immunophenotype of EPCs and EMPs may be considered a predictor of endothelial dysfunction in patients with AED. Finally, this study confirmed the reliability of penile Doppler evaluation integrated with these serum markers of endothelial dysfunction. PMID:21868743

La Vignera, Sandro; Vicari, Enzo; Condorelli, Rosita A; Di Pino, Luigi; Calogero, Aldo E

2012-01-01

216

Immunization Associated with Erectile Dysfunction Based on Cross-Sectional and Genetic Analyses  

PubMed Central

Erectile dysfunction (ED) is a global disease affecting a large number of people. Some studies have found a relationship between low-grade inflammation and ED. We hypothesized that the immune system might play a key role in the outcome of ED. Five immune agents (C3, C4, IgA, IgM, and IgG) were collected based on the Fangchenggang Area Male Health and Examination Survey (FAMHES), using methods of a traditional cross-sectional analysis. Our results repeated the significant association between ED and metabolic syndrome, obesity, and so forth. However, there seemed to be no positive relation between the tested indexes and ED risk in the baseline analysis (C3: P?=?0.737; C4: P?=?0.274; IgA: P?=?0.943; IgG: P?=?0.069; IgM: P?=?0.985). Then, after adjusting for age and multivariate covariates, a potentially significant association between ED and IgG was discovered (P?=?0.025 and P?=?0.034, respectively). Meanwhile, in order to describe the development of ED on a gene level, SNP–set kernel-machine association test (SKAT) was applied with the known humoral immune genes involved. The outcomes suggested that PTAFR (binary P value: 0.0096; continuous P value: 0.00869), IL27 (0.0029; 0.1954), CD37 (0.0248; 0.5196), CD40 (0.7146; 0.0413), IL7R (0.1223; 0.0222), PSMB9 (0.1237; 0.0212), and CXCR3 (0.0849; 0.0478) might be key genes in ED, especially IL27, when we restricted the family-wise error rate (FWER) to 0.5. Our study shows that IgG and seven genes (PTAFR, CD37, CD40, IL7R, PSMB9, CXCR3, and especially IL27) might be key factors in the pathogenesis of ED, which could pave the way for future gene and immune therapies. PMID:25343742

Xu, Jianfeng; Gao, Yong; Tan, Aihua; Yang, Xiaobo; Qin, Xue; Hu, Yanling; Mo, Zengnan

2014-01-01

217

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

PubMed Central

Hypercholesterolemia is one of the most important risk factors for erectile dysfunction, mostly due to the impairment of oxidative stress and endothelial function in the penis. The cannabinoid system might regulate peripheral mechanisms of sexual function; however, its role is still poorly understood. We investigated the effects of CB2 activation on oxidative stress and fibrosis within the corpus cavernosum of hypercholesterolemic mice. Apolipoprotein-E-knockout mice were fed with a western-type diet for 11 weeks and treated with JWH-133 (selective CB2 agonist) or vehicle during the last 3 weeks. CB2 receptor expression, total collagen content, and reactive oxygen species (ROS) production within the penis were assessed. In vitro corpus cavernosum strips preparation was performed to evaluate the nitric oxide (NO) bioavailability. CB2 protein expression was shown in cavernosal endothelial and smooth muscle cells of wild type and hypercholesterolemic mice. Treatment with JWH-133 reduced ROS production and NADPH-oxidase expression in hypercholesterolemic mice penis. Furthermore, JWH-133 increased endothelial NO synthase expression in the corpus cavernosum and augmented NO bioavailability. The decrease in oxidative stress levels was accompanied with a reduction in corpus cavernosum collagen content. In summary, CB2 activation decreased histological features, which were associated with erectile dysfunction in hypercholesterolemic mice. PMID:24302957

Fraga-Silva, Rodrigo Araujo; Costa-Fraga, Fabiana Pereira; Faye, Younouss; Savergnini, Silvia Quintao; Lenglet, Sébastien; Mach, François; Steffens, Sabine; Stergiopulos, Nikolaos; Souza dos Santos, Robson Augusto; da Silva, Rafaela Fernandes

2013-01-01

218

Treatment with CB2 agonist JWH-133 reduces histological features associated with erectile dysfunction in hypercholesterolemic mice.  

PubMed

Hypercholesterolemia is one of the most important risk factors for erectile dysfunction, mostly due to the impairment of oxidative stress and endothelial function in the penis. The cannabinoid system might regulate peripheral mechanisms of sexual function; however, its role is still poorly understood. We investigated the effects of CB2 activation on oxidative stress and fibrosis within the corpus cavernosum of hypercholesterolemic mice. Apolipoprotein-E-knockout mice were fed with a western-type diet for 11 weeks and treated with JWH-133 (selective CB2 agonist) or vehicle during the last 3 weeks. CB2 receptor expression, total collagen content, and reactive oxygen species (ROS) production within the penis were assessed. In vitro corpus cavernosum strips preparation was performed to evaluate the nitric oxide (NO) bioavailability. CB2 protein expression was shown in cavernosal endothelial and smooth muscle cells of wild type and hypercholesterolemic mice. Treatment with JWH-133 reduced ROS production and NADPH-oxidase expression in hypercholesterolemic mice penis. Furthermore, JWH-133 increased endothelial NO synthase expression in the corpus cavernosum and augmented NO bioavailability. The decrease in oxidative stress levels was accompanied with a reduction in corpus cavernosum collagen content. In summary, CB2 activation decreased histological features, which were associated with erectile dysfunction in hypercholesterolemic mice. PMID:24302957

Fraga-Silva, Rodrigo Araujo; Costa-Fraga, Fabiana Pereira; Montecucco, Fabrizio; Faye, Younouss; Savergnini, Silvia Quintao; Lenglet, Sébastien; Mach, François; Steffens, Sabine; Stergiopulos, Nikolaos; dos Santos, Robson Augusto Souza; da Silva, Rafaela Fernandes

2013-01-01

219

Chromatographic analysis of some drugs employed in erectile dysfunction therapy: Qualitative and quantitative studies using calixarene stationary phase.  

PubMed

In this study, the effect of change in chromatographic process variables on the retention behavior of four drugs employed in erectile dysfunction therapy on a calixarene stationary phase is described. Three of these drugs are known to treat erectile dysfunction, namely, sildenafil citrate, tadalafil, and apomorphine hydrochloride, and one drug that is used as opioid analgesic, tramadol hydrochloride, which is quiet widely misused to treat premature ejaculation. The results indicate the importance of considering the structure and pKa values of drugs to be separated along with mobile phase composition. A new optimized, rapid, and accurate liquid chromatography method is also established for simultaneous determination of sildenafil citrate, tadalafil, and apomorphine hydrochloride in pharmaceutical preparations and bulk powders. The chromatographic separation of the three pharmaceuticals was achieved on a calixarene column in less than 10 min using a binary mobile phase of 35% acetonitrile and 65% 50 mM sodium perchlorate pH2.5 at 1 mL/min flow rate. The method was validated for system efficiency, linearity, accuracy, precision, limits of detection and quantitation, specificity, stability, and robustness. Statistical analysis proved that the method enabled reproducible and selective quantification of all three analytes in bulk drugs and in pharmaceutical preparations. PMID:25175553

Hashem, Hisham; Ibrahim, Adel Ehab; Elhenawee, Magda

2014-10-01

220

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

PubMed Central

Purpose A rapid growth in the socioeconomic status of Koreans has triggered an unprecedented explosion of health information for the general population. Despite its obvious benefits, this increase in information could also result in potentially harmful effects for both consumers and professionals who do not use it appropriately. Thus, this study was conducted to evaluate the quality and accuracy of health information on erectile dysfunction from 10 nationwide daily newspapers. Materials and Methods This study analyzed health information from 10 nationwide daily newspapers in Korea from January 2011 through December 2011. We reviewed the health information for quality by using evidence-based medicine tools and evaluated the accuracy of the information provided. Articles that simply summarized scientific congresses or journal articles and that did not include direct quotations were excluded, as were advertisements. Results A total of 47 articles were gathered. Among them, 27 (57.4%) contained inaccurate or misleading statements on the basis of an evidence-based medicine evaluation. These statements included using inappropriate surrogate outcomes as clinical endpoints (three cases, 6.4%), extrapolating nonhuman results to humans (two cases, 4.3%), exaggerating the significance of results (eight cases, 17.0%), and using incorrect words (14 cases, 29.8%). The rate of error was higher in the information from Korean sources than in that from international sources (22 cases vs. 5 cases). Conclusions Approximately 57% of all articles on erectile dysfunction from 10 nationwide daily newspapers were found to contain inaccuracies. PMID:24255761

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

2013-01-01

221

Prevalence of erectile dysfunction in thyroid disorders: comparison with control subjects and with obese and diabetic patients.  

PubMed

Diagnosis of erectile dysfunction (ED) requires anamnestic investigation, being rarely spontaneously declared by patients. ED occurs frequently in diabetes mellitus, and anecdotal evidence suggests that ED occurs in obesity and in hypothyroidism. The aim of this study was to evaluate the prevalence of ED in patients affected by thyroid disorders (hypothyroidism and hyperthyroidism), in comparison with control subjects and with patients at risk for ED, such as patients with obesity and with type II diabetes mellitus, and the role of age. Spontaneous deposition and International Index of Erectile Dysfunction (IIEF)-5 questionnaire were considered for control subjects and for all patients. Spontaneous deposition of ED occurred for three diabetic patients, never for obese patients, thyroid patients and controls, confirming the value of IIEF-5 in detecting ED. ED was more frequent in obese subjects (42%), and in patients affected by thyroid diseases (59%), than in controls (30%), although less frequent than in type II diabetes mellitus (81%). Both below and above the age of 50 years, ED score was worse in thyroid patients than in control subjects, while ED was more frequent in obese patients than in control subjects only below the age of 50 years. PMID:16079903

Veronelli, A; Masu, A; Ranieri, R; Rognoni, C; Laneri, M; Pontiroli, A E

2006-01-01

222

Erectile Dysfunction Prevalence, Time of Onset and Association with Risk Factors in 300 Consecutive Patients with Acute Chest Pain and Angiographically Documented Coronary Artery Disease  

Microsoft Academic Search

Objectives: The aim of this study was to assess erectile dysfunction prevalence, time of onset and association with risk factors in patients with acute chest pain and angiographically documented coronary artery disease.Methods: 300 consecutive patients with acute chest pain and angiographically documented coronary artery disease were assessed using a semi-structured interview investigating their medical and sexual histories, the International Index

Francesco Montorsi; Alberto Briganti; Andrea Salonia; Patrizio Rigatti; Alberto Margonato; Andrea Macchi; Stefano Galli; Paolo M Ravagnani; Piero Montorsi

2003-01-01

223

Sildenafil (VIAGRA TM), a potent and selective inhibitor of type 5 cGMP phosphodiesterase with utility for the treatment of male erectile dysfunction  

Microsoft Academic Search

5-(2?-Alkoxyphenyl)pyrazolo[4,3-d]pyrimidin-7-ones, and in particular our preferred compound, sildenafil (VIAGRATM), discovered through a rational drug design programme, are potent and selective inhibitors of the type 5 cGMP phosphodiesterase from both rabbit platelets and human corpus cavernosum. Sildenafil is currently in the clinic for the oral treatment of male erectile dysfunction.

Nicholas K. Terrett; Andrew S. Bell; David Brown; Peter Ellis

1996-01-01

224

Relationship Between Vascular Damage Degrees and Endothelial Progenitor Cells in Patients with Erectile Dysfunction: Effect of Vardenafil Administration and PDE5 Expression in the Bone Marrow  

Microsoft Academic Search

ObjectivesTo evaluate the levels of circulating progenitor cells (PCs) and the effect of a single dose of vardenafil 20mg on the number of these cells in men with erectile dysfunction (ED) and various degree of vascular injury at the carotid artery level.

Carlo Foresta; Nicola Caretta; Andrea Lana; Luca De Toni; Andrea Biagioli; Cinzia Vinanzi; Alberto Ferlin

2007-01-01

225

Enhanced External Counterpulsation in Patients with Coronary Artery Disease-Associated Erectile Dysfunction. Part II: Impact of Disease Duration and Treatment Courses  

Microsoft Academic Search

Introduction. Enhanced external counterpulsation (EECP) is a noninvasive outpatient treatment used for patients with intractable angina refractory to aggressive surgical and medical treatment. Recent results have demonstrated a positive impact of EECP on patients with ischemic heart disease (IHD)-associated erectile dysfunction (ED). Aim. To assess the effect of IHD duration and number of EECP courses on efficacy and satisfaction rate

Ahmed I. El-Sakka; Ayman M. Morsy; Bassam I. Fagih

2007-01-01

226

Informing our psychosexual practice for treating erectile dysfunction in gay and bisexual men living with HIV: a response to the 2006 NHS Greater Glasgow HIV needs assessment report  

Microsoft Academic Search

There is strong evidence to suggest that Highly Active Anti-Retroviral Therapy (HAART) used to treat HIV may directly affect sexual performance in men living with HIV. Opponents suggest that age, advanced HIV and general chronic ill health often associated with HIV might account for the high prevalence of reported erectile dysfunction in this group. Regarding gay and bisexual men, a

Jacob Jacobson

2007-01-01

227

THE STAMP TEST DELIVERS THE MESSAGE ON ERECTILE DYSFUNCTION FOLLOWING HIGH DOSE IMRT FOR PROSTATE CANCER  

PubMed Central

Objectives To evaluate erectile function following high dose radiotherapy for prostate cancer using the international index of erectile function (IIEF), expanded prostate cancer index composite (EPIC), and stamp test. Methods Men with favorable and intermediate risk prostate cancer were assigned to receive prostate intensity modulated radiotherapy (IMRT) vs. an erectile tissue-sparing IMRT technique on a phase III randomized prospective study. The stamp test, IIEF, and EPIC questionnaires were completed at baseline, 6 months, one year, and two years after IMRT. Sexual Health Inventory for Men (SHIM) scores were abstracted from IIEF questionnaires. A partner questionnaire, designated IIEF-P, modeled after the IIEF but from the perspective of the partner, was collected. Results Ninety four men enrolled on the trial who completed at least one questionnaire or one stamp test were analyzed. The median age of the patient population was 62.5 years. The median RT dose was 76 Gy (range: 74–80 Gy). At 6-months and one year after high-dose IMRT, a positive stamp result significantly correlated with median EPIC sexual summary, sexual function (EF), and bother subscale scores. Additionally, 6-months after IMRT the stamp test correlated with median IIEF, IIEF EF domain, and SHIM scores. Robust concordance for the IIEF and SHIM results was appreciated between responding patients: partner pairs. Conclusions Nocturnal tumescence indicated by a positive stamp test correlates well with established quality of life questionnaires after IMRT. The stamp test should strongly be considered as an objective measure of erectile function in future studies of ED in prostate cancer patients. PMID:22749428

Keller, Lanea M. M.; Buyyounouski, Mark K.; Sopka, Dennis; Ruth, Karen; Klayton, Tracy; Pollack, Alan; Watkins-Bruner, Deborah; Greenberg, Richard; Price, Robert; Horwitz, Eric M

2012-01-01

228

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

PubMed Central

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

Udeoji, Dioma U; Schwarz, Ernst R

2014-01-01

229

Synergetic effect of testosterone and phophodiesterase-5 inhibitors in hypogonadal men with erectile dysfunction: A systematic review  

PubMed Central

Testosterone deficiency seems to impair the clinical response to phophodiesterase-5 (PDE-5) inhibitors in patients with erectile dysfunction (ED). In hypogonadal men, testosterone repletion was associated with enhanced sexual function in patients who failed initial treatment with sildenafil or tadalafil. We conducted a systematic review of studies that evaluated combination therapy of testosterone and PDE-5 inhibitors in patients with ED and low, low-normal testosterone levels who failed monotherapy. The studies we examine are heterogeneous with several methodological drawbacks and that, overall, the addition of testosterone to PDE-5 inhibitors might benefit patients with ED associated with testosterone <300 ng/dL (10.4 nmol/L) who failed monotherapy. Further studies, with a randomized placebo-controlled and double blind design, are needed to describe the appropriate target patient group, testosterone cut-off and to define the optimal dose and duration of combination therapy. PMID:23093538

Alhathal, Naif; Elshal, Ahmed M.; Carrier, Serge

2012-01-01

230

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

PubMed

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. PMID:19936151

Raheem, Amr Abdel; Kell, Philip

2009-01-01

231

[Alopecia totalis, hypotension and erectile dysfunction in a 34 year old patient. Difficult clarification of a common cause].  

PubMed

The occurrence of both autoimmune endocrinopathies and endocrinopathies caused by other reasons is called polyglandular autoimmune syndrome (PAS-syndrome). In a 34 years old man with weakness, weight loss and erectile dysfunction we found low cortisol caused by an autoimmune adrenalitis and low testosterone caused by a hypophysitis with impaired gonadotropin secretion. Thyroid autoantibodies and islet cell autoantibodies without any hormone deficiencies were further signs of a broad endocrine autoimmune syndrome. In the following 11 years the patient developed three autoimmune disorders: paradrenal glandular insufficiency, hypogonadism caused by hypophysitis, Diabetes mellitus type 1. In the same time several non endocrine autoimmune diseases became manifest: alopecia totalis, vitiligo, retrobulbar neuritis and keratoconjunctivitis. PMID:15800777

Hunger-Dathe, W; Braun, A; Müller, U A

2005-06-01

232

Erectile Dysfunction in Qatar: Prevalence and Risk Factors in 1,052 Participants--A Pilot Study  

PubMed Central

Aim The aim of this study is to investigate the prevalence of erectile dysfunction (ED) in Qatar and to determine the risk factors associated with it. Materials and Methods This is a cross-sectional survey study of men attending the outpatient department at Hamad Medical Corporation in Qatar between February 2012 and February 2013. The International Index of Erectile Function (IIEF)-5 questionnaire was used for data collection. In addition to the IIEF-5 score, each participant's medical history was taken, with special emphasis on risk factors for ED, including diabetes mellitus (DM), hypertension (HTN), dyslipidemia, coronary artery disease (CAD), and smoking habits, and on their body mass index. Results One thousand fifty-two participants were randomly selected to fill out the IIEF-5 questionnaire. The participants' mean age (±SD) was 41.87 ± 13.24 years. Analysis of replies to the IIEF-5 showed that ED was present in 573 out of 1,052 participants (54.5%). Fifty-six (5%) participants had severe ED, 61 (6%) had moderate ED, 173 (16%) had mild to moderate ED, and 283 (27%) had mild ED. Risk factors for ED that held statistical significance were age (odds ratio [OR] = 2.9, 95% confidence interval [CI] 2.1–4.1, P < 0.001), DM (OR = 2.6, 95% CI 1.7–3.9, P < 0.001), HTN (OR = 1.6, 95% CI 1.1–2.5, P = 0.012), dyslipidemia (OR = 1.5, 95% CI 1.1–2.4, P = 0.024), and CAD (OR = 3.2, 95% CI 1.3–7.5, P = 0.009). Conclusion We found that the prevalence rate of ED in Qatar is quite similar to the regional reported rates. Overall, we demonstrated that nearly more than half of our participants suffered from ED. Besides age, DM, HTN, CAD, and dyslipidemia were found to be the most important risk factors for ED. Al Naimi A, Majzoub AA, Talib RA, Canguven O, and Al Ansari A. Erectile dysfunction in Qatar: Prevalence and risk factors in 1,052 participants—A pilot study. Sex Med 2014;2:91–95. PMID:25356303

Al Naimi, Abdulla; Majzoub, Ahmad A; Talib, Raidh A; Canguven, Onder; Al Ansari, Abdulla

2014-01-01

233

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

SciTech Connect

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

Macdonald, A. Graham [Department of Radiation Oncology, Vancouver Cancer Centre, BC Cancer Agency, Vancouver, BC (Canada)]. E-mail: gmacdonald@easynet.co.uk; Keyes, Mira [Department of Radiation Oncology, Vancouver Cancer Centre, BC Cancer Agency, Vancouver, BC (Canada); Kruk, Alexandra [Department of Radiation Therapy, Vancouver Cancer Centre, BC Cancer Agency, Vancouver, BC (Canada); Duncan, Graeme [Department of Radiation Oncology, Vancouver Cancer Centre, BC Cancer Agency, Vancouver, BC (Canada); Moravan, Veronika [Population and Preventive Oncology, BC Cancer Agency, Vancouver, BC (Canada); Morris, W. James [Department of Radiation Oncology, Vancouver Cancer Centre, BC Cancer Agency, Vancouver, BC (Canada)

2005-09-01

234

Sildenafil Citrate Improves Self-Esteem, Confidence, and Relationships in Men with Erectile Dysfunction: Results from an International, MultiCenter, Double-Blind, Placebo-Controlled Trial  

Microsoft Academic Search

Introduction. Erectile dysfunction (ED) can significantly impact a man's relationships and well-being. Aim. 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). Methods. This was a 12-week, double-blind, placebo-controlled, flexible-dose (25, 50, 100 mg, as needed) interna- tional study of sildenafil in men ?18

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

2006-01-01

235

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

Microsoft Academic Search

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

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

2001-01-01

236

The efficacy and tolerability of vardenafil, a new, oral, selective phosphodiesterase type 5 inhibitor, in patients with erectile dysfunction: the first at-home clinical trial  

Microsoft Academic Search

Vardenafil, a novel selective phosphodiesterase type 5 inhibitor, was evaluated in its first large-scale at-home trial. A total of 601 men with mild to severe erectile dysfunction (ED) were enrolled in this multi-centre, randomized, double-blind, placebo-controlled trial of 12 weeks of treatment with either placebo or 5, 10 and 20 mg of vardenafil. Primary endpoints were Q3 (vaginal penetration) and

H Porst; R Rosen; H Padma-Nathan; I Goldstein; F Giuliano; E Ulbrich

2001-01-01

237

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

Microsoft Academic Search

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

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

2008-01-01

238

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

PubMed

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

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

2010-07-01

239

Prevention and management of cardiovascular disease and erectile dysfunction: toward a common patient-centered, care model.  

PubMed

Erectile dysfunction (ED) is highly prevalent in men with cardiovascular disease (CVD), yet it is frequently underrecognized and underdiagnosed in clinical practice. Even among clinicians who acknowledge the relevance of addressing sexual issues in their patients, there is a general lack of awareness of the optimal approach for sexual problem identification and management. Additionally, cardiac rehabilitation programs typically neglect the role of sexual function. The trajectory of CVD and ED may necessitate continuous adjustment by both patients and their partners as they adapt to the chronicity of heart disease and the changing reality of their sexual lives. Health professionals typically approach management of these disorders from a disease-centered perspective, which often fails to incorporate the patient's needs and perspectives. In turn, patients frequently complain of a lack of sensitivity or awareness on the part of their physicians. From a patient-centered perspective, greater emphasis is placed on life satisfaction and quality of life as primary outcomes of treatment. Finally, a patient-centered framework is relevant for both treatment and prevention of cardiac risk in men with ED, in addition to ED management in patients with or without overt CVD. PMID:16387574

Hatzichristou, Dimitrios; Tsimtsiou, Zoi

2005-12-26

240

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

PubMed Central

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

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

2010-01-01

241

Condom attitudes of heterosexual men ages 50 and older using prescribed drugs (Viagra, Cialis, Levitra) to treat erectile dysfunction.  

PubMed

The purpose of this study was to explore attitudes about condoms that may affect condom use by heterosexual men ages 50 and older who were sexually active and currently using prescribed oral phosphodiesterase type 5 inhibitor medications (Viagra(®), Cialis(®), or Levitra(®)) for treatment of erectile dysfunction. The study was part of a larger study that explored the need for safer-sex health promotion and education for these men. Fifty men completed factor subscales of the Condom Attitude Scale. Subscales were scored and analyzed. Positive factors were found with regard to the Interpersonal Impact, Inhibition, Perceived Risk, Perceived Seriousness, and Global Attitudes subscales. Factors with negative or neutral responses included the Effect on Sexual Experience, Relationship Safety, and Promiscuity subscales. Independent t tests revealed no differences between married and nonmarried men for the mean score on any of the subscales, but there was a difference on the Global Attitude Scale, with younger men having a more positive global attitude than older men. Study findings can be used in the development of health promotion educational activities on condom use as a safer-sex practice. PMID:23620541

Jones, Sande Gracia; Fenkl, Eric A; Patsdaughter, Carol A Pat; Chadwell, Katherine

2013-11-01

242

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

PubMed

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

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

2014-03-25

243

Arterial erectile dysfunction and peripheral arterial disease: reliability of a new phenotype of endothelial progenitor cells and endothelial microparticles.  

PubMed

The aim of this study was to evaluate whether the blood concentrations of a new immunophenotype of circulating late endothelial progenitor cells (EPC) and endothelial microparticles (EMP) varies in patients with arterial erectile dysfunction (aED) and abnormalities in other arterial districts. To accomplish this, cavernous artery peak systolic velocity (PSV), acceleration time (AT), and intima-media thickness (IMT) were determined after intracavernous administration of alprostadil by echo-color Doppler in 80 consecutive patients (age range, 50-75 years). Fifteen patients had aED alone (group A) and served as controls; 22 had aED plus atheroma plaques and/or increased IMT of the common carotid artery (group B); 20 had aED plus lower limb artery abnormalities (group C); and 23 had aED plus carotid and lower limb artery abnormalities (group D). EPC and EMP blood concentrations were evaluated by flow cytometry. Blood mononuclear cells with the immunophenotype CD45(neg)/CD34(pos)/CD144(pos) were defined as EPCs, whereas CD45(neg)/CD144(pos)/annexin V(pos) cells were defined as EMPs. Group B and C patients had a similar PSV, AT, and IMT at the level of the cavernous arteries. Their PSV values were significantly lower and mean values of AT and IMT significantly higher compared with group A patients. Patients of group D had a significantly lower PSV and significantly higher AT and IMT compared with all other groups. As far as serum concentrations of EPCs and EMPs, group D patients had significantly higher EPC and EMP mean values compared with all other groups. Group B and C patients had similar EPC and EMP values. This study showed that a more generalized peripheral atherosclerotic process is associated with a more severe penile artery insufficiency and endothelial dysfunction. Moreover, this study confirms the diagnostic reliability of the immunophenotype of EPCs and EMPs chosen in the clinical practice. PMID:22362078

Condorelli, Rosita A; Calogero, Aldo E; Vicari, Enzo; di Pino, Luigi; Giacone, Filippo; Mongioì, Laura; la Vignera, Sandro

2012-01-01

244

The use of drugs Impaza and Nebido in the treatment of erectile dysfunction in patients with type 2 diabetes mellitus of reproductive age.  

PubMed

The main objective of the study was to investigate the efficacy of using a mono and combined therapy drugs Impaza and Nebido for secondary prevention and treatment of ED. It was examined 79 diabetic patients with ED. The age of patients within 18-60 years, duration of diabetes - from 6 months to 29 years, ED - from 6 months to 12 years. To identify the ED was used International index of erectile function (IIEF). The patients were divided into 3 groups: I - patients with organic ED, II - with psychogenic ED and III group - with mixed ED. Drags Impaza and Nebido used in all three groups, as mono or as complex therapy. It was using routine (anamnesis, clinico- biochemical data) and special (pharmacodopplerography) methods of study. The study did not include patients with increased level of prostate-specific antigen (PSA), polycythemia, obstruction of the urinary tract with the prostate size increasing and prostate cancer. Statistical data was studed by using Pearson's ?2-test. The results showed the following. Indicators of glycohemoglobin above normal reduces the effectiveness of the treatment of erectile dysfunction in patients with diabetes mellitus.The combined use of drugs Impaza and Nebido in patients with ED had a positive resultes in 41,4-91,7% of the cases. These drugs are effective in diabetic patients with mild and moderate form of erectile dysfunction. PMID:23863213

Mehtiyev, T

2013-06-01

245

Double-blind, placebo-controlled evaluation of the safety, pharmacokinetic properties and pharmacodynamic effects of intranasal PT141, a melanocortin receptor agonist, in healthy males and patients with mild-to-moderate erectile dysfunction  

Microsoft Academic Search

PT-141, a cyclic heptapeptide melanocortin analog, was evaluated following intranasal administration in healthy male subjects and in Viagra-responsive erectile dysfunction (ED) patients. Erectile response was assessed by RigiScan™ in healthy subjects without visual sexual stimulation (VSS) and in Viagra®-responsive ED patients with VSS. In healthy subjects, mean Cmax and AUC(0–t) increased in a dose-dependent manner. Median Tmax was 0.50 h

L E Diamond; D C Earle; R C Rosen; M S Willett; P B Molinoff

2004-01-01

246

Intracavernous administration of bone marrow mononuclear cells: a new method of treating erectile dysfunction?  

PubMed Central

While PDE5 inhibitors have revolutionized treatment of ED, approximately 30% of patients are non-responsive. A significant cause of this is vascular and smooth muscle dysfunction, as well as nerve atrophy. Autologous administration of bone marrow mononuclear cells (BMMC) has been performed in over 2000 cardiac patients without adverse effects, for stimulation of angiogenesis/regeneration. Despite its ease of access, and dependence on effective vasculature for function, comparatively little has been perform in terms of BMMC therapy for ED. Here we outline the rationale for use of autologous BMMC in patients with ED, as well as provide early safety data on the first use of this procedure clinically. PMID:23758954

2013-01-01

247

Human Urine-Derived Stem Cells Alone or Genetically-Modified with FGF2 Improve Type 2 Diabetic Erectile Dysfunction in a Rat Model  

PubMed Central

Aim The aim of this study was to determine the possibility of improving erectile dysfunction using cell therapy with either human urine-derived stem cells (USCs) or USCs genetically-modified with FGF2 in a type 2 diabetic rat model. Methods Human USCs were collected from 3 healthy donors. USCs were transfected with FGF2 (USCs-FGF2). Sixty-five SD male rats were divided into five groups (G). A control group of normal rats (G1, n?=?10), and four other test groups of type 2 diabetic erectile dysfunction rats: PBS as a negative control (G2, n?=?10), USCs (G3, n?=?15), lentivirus-FGF2 (G4, n?=?15), and USCs-FGF2 (G5, n?=?15). Diabetes was induced in the rats via a high fat diet for 28 days and a subsequent intraperitoneal injection of streptozotocin (35 mg/kg). Erectile dysfunction was screened with apomorphine (100 ?g/kg). Cell injections in the test groups (G2–G5) occurred directly into the corpora cavernosa. The implanted cells were tracked at 7 days (n?=?5 animals/G) and 28 days (n?=?10 animals/G) post injection. Mean arterial pressure (MAP), intracavernosal pressure (ICP), expression of endothelial markers (CD31, VEGF and eNOS), smooth muscle markers (desmin and smoothelin), histological changes and erectile function were assessed for each group. Results USCs expressed mesenchymal stem cell markers, and secreted a number of proangiogenic growth factors. USCs expressed endothelial cell markers (CD31 and vWF) after transfection with FGF2. Implanted USCs or USCs-FGF2 displayed a significantly raised ICP and ICP/MAP ratio (p<0.01) 28 days after intracavernous injection. Although few cell were detected within the implanted sites, histological and western blot analysis demonstrated an increased expression of endothelial and smooth muscle markers within the cavernous tissue following USC or USC-FGF2 injection. Conclusions The paracrine effect of USCs or USCs-FGF2 induced improvement of erectile function in type 2 diabetic rats by recruiting resident cells and increasing the endothelial expression and contents of smooth muscle. PMID:24663037

Han, Dayu; Chen, Shenfu; Yao, Bing; Gao, Yong; Bian, Jun; Huang, Yanping; Zhang, Yadong; Wan, Zi; Yang, Bin; Xiao, Haipeng; Songyang, Zhou; Liu, Guihua; Zhang, Yuanyuan; Deng, Chunhua

2014-01-01

248

Sexual Dysfunction and Infertility  

MedlinePLUS

... common type of sexual problem in men is erectile dysfunction, which is when your penis does not become or stay firm. Many medical conditions can cause erectile dysfunction: high blood pressure, diabetes, blood vessel diseases, surgery ...

249

Erectile Dysfunction and Risk of End Stage Renal Disease Requiring Dialysis: A Nationwide Population-Based Study  

PubMed Central

Background Previous studies have suggested that erectile dysfunction (ED) is an independent risk factor for macrovascular disease. Very few studies have evaluated the relationship between ED and risk of end stage renal disease (ESRD) requiring dialysis. Methods A random sample of 1,000,000 individuals from Taiwan's National Health Insurance database was collected. We selected the control group by matching the subjects and controls by age, diabetes, hypertension, coronary heart disease, hyperlipidemia, area of residence, monthly income and index date. We identified 3985 patients with newly-diagnosed ED between 2000 and 2008 and compared them with a matched cohort of 23910 patients without ED. All patients were tracked from the index date to identify which patients subsequently developed a need for dialysis. Results The incidence rates of dialysis in the ED cohort and comparison groups were 10.85 and 9.06 per 10000 person-years, respectively. Stratified by age, the incidence rate ratio for dialysis was greater in ED patients aged <50 years (3.16, 95% CI: 1.62–6.19, p?=?0.0008) but not in aged 50–64 (0.94, 95% CI: 0.52–1.69, p?=?0.8397) and those aged ?65 (0.69, 95% CI: 0.32–1.52, p?=?0.3594). After adjustment for patient characteristics and medial comorbidities, the adjusted HR for dialysis remained greater in ED patients aged <50 years (adjusted HR: 2.08, 95% CI: 1.05–4.11, p<0.05). The log-rank test revealed that ED patients <50-years-old had significantly higher cumulative incidence rates of dialysis than those without (p?=?0.0004). Conclusion Patients with ED, especially younger patients, are at an increased risk for ESRD requiring dialysis later in life. PMID:25013905

Shen, Yuan-Chi; Weng, Shih-Feng; Wang, Jhi-Joung; Tien, Kai-Jen

2014-01-01

250

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

PubMed Central

Background There are no randomised and properly blinded trials directly comparing one PDE-5 inhibitor with another in a normal home setting. Valid indirect comparisons with a common comparator must examine equivalent doses, similar duration, similar populations, with the same outcomes reported in the same way. Methods Published randomised, double-blind trials of oral PDE-5 inhibitors for erectile dysfunction were sought from reference lists in previous reviews and electronic searching. Analyses of efficacy and harm were carried out for each treatment, and results compared where there was a common comparator and consistency of outcome reporting, using equivalent doses. Results Analysis was limited by differential reporting of outcomes. Sildenafil trials were clinically and geographically more diverse. Tadalafil and vardenafil trials tended to use enriched enrolment. Using all trials, the three interventions were similar for consistently reported efficacy outcomes. Rates of successful intercourse for sildenafil, tadalafil and vardenafil were 65%, 62%, and 59%, with placebo rates of 23–28%. The rates of improved erections were 76%, 75% and 71%, respectively, with placebo rates of 22–24%, and NNTs of 1.9 or 2.0. Reporting of withdrawals was less consistent, but all-cause withdrawals for sildenafil, tadalafil and vardenafil were 8% 13% and 20%. All three drugs were well tolerated, with headache being the most commonly reported event at 13–17%. There were few serious adverse events. Conclusion There were differences between trials in outcomes reported, limiting comparisons, and the most useful outcomes were not reported. For common outcomes there was similar efficacy between PDE-5 inhibitors. PMID:16354303

Moore, R Andrew; Derry, Sheena; McQuay, Henry J

2005-01-01

251

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

PubMed Central

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. PMID:24959092

Alsaikhan, Bader; Alrabeeah, Khalid; Carrier, Serge

2014-01-01

252

Testosterone undecanoate improves erectile dysfunction in hypogonadal men with the metabolic syndrome refractory to treatment with phosphodiesterase type 5 inhibitors alone.  

PubMed

At least 30-35% of men with erectile dysfunction (ED) fail to respond to treatment with phosphodiesterase type 5 (PDE-5) inhibitors. Testosterone (T) has effects not only on sexual desire, but also on the anatomical and physiological substrate of erection. This study analysed the effects of T administration to men unsuccessfully treated for ED with PDE-5 inhibitors only. Twenty-nine men aged 36-75?years (mean 59?years) with ED were studied. They suffered from ED for a mean of 2.7?years and had subnormal plasma T levels (total T <3.5?ng?ml(-1) ). They received parenteral testosterone undecanoate for 102?weeks. Changes of the domains of the International Index of Erectile Function (IIEF) were assessed. After 6?weeks of T treatment, the sexual desire domain of IIEF had improved (from 4.1?±?1.4 to 7.2?±?1.7) and erectile function as measured by IIEF started to improve, reaching a plateau after 30?weeks (from 9.1?±?2.1 to 26.5?±?2.3). Features of the metabolic syndrome also improved. There were no adverse effects of T administration. Addition of T to treatment of hypogonadal men unsuccessfully treated with PDE-5 inhibitors only, appeared useful and acceptably safe. PMID:21919947

Garcia, J A; Sanchez, P E; Fraile, C; Escovar, P

2011-10-01

253

Randomized, Double-Blinded, Placebo-Controlled Crossover Trial of Treating Erectile Dysfunction with Sildenafil After Radiotherapy and Short-Term Androgen Deprivation Therapy: Results of RTOG 0215  

PubMed Central

Introduction Erectile dysfunction (ED) may be the most commonly observed adverse event (AE) associated with the combination of radiation therapy (RT) and androgen deprivation therapy (ADT). A significant number of men are trying phosphodiesterase type 5 inhibitors (PDE5s) such as sildenafil to treat ED, yet sildenafil studies to date shed little light on the response to ED after ADT. Aim The purpose of this trial was to evaluate sildenafil in the treatment of ED in prostate cancer patients previously treated with external beam RT and neoadjuvant and concurrent ADT. Methods In this randomized, double-blinded crossover trial, eligible patients received RT/ADT for intermediate risk prostate cancer and currently had ED as defined by the International Index of Erectile Function (IIEF). Patients were randomized to 12 weeks of sildenafil or placebo followed by 1 week of no treatment then 12 weeks of the alternative. Treatment differences were evaluated using a marginal model for binary crossover data. Main Outcome Measures The primary end point was improved erectile function, as measured by the IIEF. Results The study accrued 115 patients and 61 (55%) completed all three IIEF assessments. Sildenafil effect was significant (P = 0.009) with a difference in probabilities of erectile response of 0.17 (95% confidence interval: 0.06, 0.29), and 0.21 (0.06, 0.38) for patients receiving ?120 days of ADT. However, as few as 21% of patients had a treatment-specific response, only improving during sildenafil but not during the placebo phase. Conclusions This is the first controlled trial to suggest a positive sildenafil response for ED treatment in patients previously treated with RT/ADT, however, only a minority of patients responded to treatment. ADT duration may be associated with response and requires further study. The overall low response rate suggests the need for study of additional or preventative strategies for ED after RT/ADT for prostate cancer. PMID:21235716

Bruner, Deborah Watkins; James, Jennifer L.; Bryan, Charlene J.; Pisansky, Thomas M.; Rotman, Marvin; Corbett, Thomas; Speight, Joycelyn; Byhardt, Roger; Sandler, Howard; Bentzen, S?ren; Kachnic, Lisa; Berk, Lawrence

2013-01-01

254

Erectile dysfunction is frequent in systemic sclerosis and associated with severe disease: a study of the EULAR Scleroderma Trial and Research group  

PubMed Central

Introduction Erectile dysfunction (ED) is common in men with systemic sclerosis (SSc) but the demographics, risk factors and treatment coverage for ED are not well known. Method This study was carried out prospectively in the multinational EULAR Scleroderma Trial and Research database by amending the electronic data-entry system with the International Index of Erectile Function-5 and items related to ED risk factors and treatment. Centres participating in this EULAR Scleroderma Trial and Research substudy were asked to recruit patients consecutively. Results Of the 130 men studied, only 23 (17.7%) had a normal International Index of Erectile Function-5 score. Thirty-eight per cent of all participants had severe ED (International Index of Erectile Function-5 score ? 7). Men with ED were significantly older than subjects without ED (54.8 years vs. 43.3 years, P < 0.001) and more frequently had simultaneous non-SSc-related risk factors such as alcohol consumption. In 82% of SSc patients, the onset of ED was after the manifestation of the first non-Raynaud's symptom (median delay 4.1 years). ED was associated with severe cutaneous, muscular or renal involvement of SSc, elevated pulmonary pressures and restrictive lung disease. ED was treated in only 27.8% of men. The most common treatment was sildenafil, whose efficacy is not established in ED of SSc patients. Conclusions Severe ED is a common and early problem in men with SSc. Physicians should address modifiable risk factors actively. More research into the pathophysiology, longitudinal development, treatment and psychosocial impact of ED is needed. PMID:22348608

2012-01-01

255

Tadalafil treatment had a modest effect on endothelial cell damage and repair ability markers in men with erectile dysfunction and vascular risk  

PubMed Central

The number of the circulating angiogenic cells (CACs) and colony forming units (CFUs) derived from cultured circulating mononuclear cells (MNCs) represents a laboratory surrogate for endothelial cell repair ability. The serum of men with erectile dysfunction (ED) and vascular risk factors (VRFs) showed an increased level of endothelial cell damage/dysfunction markers and reduced the numbers of CACs and CFUs derived from the cells of healthy men. We analyzed whether treating men with ED and VRFs with the selective phosphodiesterase type 5 inhibitor tadalafil improved the endothelial cell repair ability and reduced the levels of the serum markers of endothelial cell damage/dysfunction. MNCs from healthy men were cultured with 20% serum from 36 ED patients to obtain CACs and CFUs. The ED patients were evaluated before and after 4 weeks of treatment with tadalafil (20 mg every other day) or with a placebo. The tadalafil treatment improved erectile function (P = 0.0028), but had no effect on the inhibitory effects of serum from ED patients on the CACs and CFUs derived from healthy men. The levels of endothelin-1 (P = 0.011) and tissue type plasminogen activator (P = 0.005) were reduced after treatment compared to baseline and those of the placebo group, whereas no changes were observed in the E-selectin levels. The tadalafil treatment in the ED patients with VRFs resulted in only a modest effect on the laboratory measures of the endothelial cell damage/dysfunction and repair ability. The proposed beneficial effect of phosphodiesterase type 5 inhibition on vascular homeostasis requires further analysis. PMID:24407182

Pelliccione, Fiore; D'Angeli, Anatolia; D'Andrea, Settimio; Barbonetti, Arcangelo; Pezzella, Alfonso; Necozione, Stefano; Falone, Stefano; Amicarelli, Fernanda; Francavilla, Felice; Francavilla, Sandro

2014-01-01

256

Correction of Diabetic Erectile Dysfunction with Adipose Derived Stem Cells Modified with the Vascular Endothelial Growth Factor Gene in a Rodent Diabetic Model  

PubMed Central

The aim of this study was to determine whether adipose derived stem cells (ADSCs) expressing vascular endothelial growth factor (VEGF) gene can improve endothelial function, recover the impaired VEGF signaling pathway and enhance smooth muscle contents in a rat diabetic erectile dysfunction (DED) model. DED rats were induced via intraperitoneal injection of streptozotocin (40 mg/kg), and then screened by apomorphine (100 µg/kg). Five groups were used (n?=?12/group)–Group 1 (G1): intracavernous injection of lentivirus-VEGF; G2: ADSCs injection; G3: VEGF-expressing ADSCs injection; G4: Phosphate buffered saline injection; G1–G4 were DED rats; G5: normal rats. The mean arterial pressure (MAP) and intracavernosal pressure (ICP) were measured at days 7 and 28 after the injections. The components of the VEGF system, endothelial, smooth muscle, pericytes markers in cavernoursal tissue were assessed. On day 28 after injection, the group with intracavernosum injection of ADSCs expressing VEGF displayed more efficiently and significantly raised ICP and ICP/MAP (p<0.01) than those with ADSCs or lentivirus-VEGF injection. Western blot and immunofluorescent analysis demonstrated that improved erectile function by ADSCs-VEGF was associated with increased expression of endothelial markers (VEGF, VEGF R1, VEGF R2, eNOS, CD31 and vWF), smooth muscle markers (a-actin and smoothelin), and pericyte markers (CD146 and NG2). ADSCs expressing VEGF produced a therapeutic effect and restored erectile function in diabetic rats by enhancing VEGF-stimulated endothelial function and increasing the contents of smooth muscle and pericytes. PMID:24023647

Wu, Rongpei; Guan, Xuan; Ouyang, Bin; Huang, Yanping; Xiao, Haipeng; Luo, Daosheng; Atala, Anthony; Zhang, Yuanyuan; Deng, Chunhua

2013-01-01

257

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  

SciTech Connect

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{sub 30}, D{sub 45}, D{sub 60}, and D{sub 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{sub 30}, D{sub 45}, D{sub 60}, and D{sub 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.

Wernicke, A. Gabriella [Department of Radiation Oncology, Jefferson Medical College and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Valicenti, Richard [Department of Radiation Oncology, Jefferson Medical College and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania (United States)]. E-mail: richard.valicenti@mail.tju.edu; DiEva, Kelly [Department of Radiation Oncology, Jefferson Medical College and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Houser, Christopher [Department of Radiation Oncology, Jefferson Medical College and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Pequignot, Ed [Department of Medicine, Jefferson Medical College and Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA (United States)

2004-12-01

258

Bariatric Surgery Improves the Cavernosal Neuronal, Vasorelaxation, and Contraction Mechanisms for Erectile Dysfunction As Result of Amelioration of Glucose Homeostasis in a Diabetic Rat Model  

PubMed Central

Background Bariatric surgery is an effective treatment option for both obesity and obesity-related type 2 diabetes mellitus (T2DM). However, little is known regarding the effects of bariatric surgery on erectile dysfunction among patients with T2DM. Therefore, we investigated whether bariatric surgery would lead to structural and biochemical changes in the corpus cavernosum. Material and Method Twenty-five male Otsuka Long-Evans Tokushima Fatty rats were assigned to either a control group (sham operation, n?=?10) or a bariatric surgery group (gastric bypass surgery, n?=?15). Four weeks after the operation, each group of rats was evaluated with an oral glucose tolerance test (OGTT). The penile intracavernous pressure was measured for erectile functional analysis. Histologic evaluation of the tissue was performed with Masson's trichrome staining. Endothelial nitric oxide synthase (eNOS), neuronal nitric oxide synthase (nNOS), Rho kinase, and 8-hydroxy-2-deoxyguanosine (8-OHdG) levels in the corpus cavernosum were assayed by using western blot and ELISA. Results The mean body weight of the bariatric surgery group was lower than the control group (p?=?0.002). The postoperative OGTT result was lower in the bariatric surgery group than in the control group (p?=?0.014), and this was lower than the preoperative value (p?=?0.037). The intracavernous pressure/mean arterial pressure ratio was higher in the bariatric surgery group compared to the control group (p?=?0.021), and a higher cavernosum smooth muscle/collagen ratio was observed in the bariatric surgery group compared to the control group (p?=?0.025). Likewise, the expression of eNOS and nNOS was higher in bariatric surgery group than in the control group (p?=?0.027 and p?=?0.008, respectively). Decreased expression of Rho kinase and levels of 8-OHdG were observed in the bariatric surgery group (p?=?0.032). Conclusion In this animal model, bariatric surgery appears to ameliorate T2DM-related metabolic dysfunction leading to structural and biochemical changes in the corpus cavernosum, and thus, results in improvement of erectile dysfunction associated with T2DM. PMID:25137300

Choi, Yong Sun; Lee, Sang Kuon; Bae, Woong Jin; Kim, Su Jin; Cho, Hyuk Jin; Hong, Sung-Hoo; Lee, Ji Youl; Hwang, Tae-Kon; Kim, Sae Woong

2014-01-01

259

Management of Erectile Function by Penile Purinergic P2 Receptors in the Diabetic Rat  

E-print Network

improve erectile function in men with diabetes. Key Words: penis; erectile dysfunction; diabetes mellitus bovine serum albumin CCSM corpus cavernosum smooth muscle EC endothelial cell ED erectile dysfunction EFSManagement of Erectile Function by Penile Purinergic P2 Receptors in the Diabetic Rat Serap Gur

Burnstock, Geoffrey

260

Superoxide anion production by NADPH oxidase plays a major role in erectile dysfunction in middle-aged rats: prevention by antioxidant therapy.  

PubMed

INTRODUCTION.: Prevalence of erectile dysfunction (ED) increases progressively with aging, but the ED pathophysiology at its early stages is still poorly investigated. AIM.: This study aimed to evaluate the functional and molecular alterations of erectile function at middle age, focusing on the contribution of oxidative stress in erectile tissue for the ED. METHODS.: Young (3.5-month) and middle-aged (10-month) male Wistar rats were used. Rat corpus cavernosum (RCC) was dissected free and mounted in 10-mL organ baths containing Krebs solution. Intracavernosal pressure (ICP) in anesthetized rats was evaluated. MAIN OUTCOME MEASURES.: Concentration-response curves to endothelium-dependent and endothelium-independent agents, as well as to electrical field stimulation (EFS), were obtained in RCC strips. Measurement of cyclic guanosine monophosphate (cGMP) and expressions of neuronal nitric oxide synthase (nNOS) and endothelial NOS (eNOS), gp91(phox) and superoxide dismutase-1 (SOD-1) expressions in RCC were evaluated. RESULTS.: ICP was significantly reduced in middle-aged compared with young rats. RCC relaxations to acetylcholine (10(-8) to 10(-2) ?M), sodium nitroprusside (10(-8) to 10(-2) ?M), sildenafil (10(-9) to 10(-5) ?M), BAY 41-2272 (10(-9) to 10(-5) ?M), and EFS (4-32?Hz) were decreased in middle-aged group, which were nearly normalized by apocynin (NADPH oxidase inhibitor; 10(-4) ?M) or SOD (75?U/mL). Prolonged treatment with apocynin (85?mg/rat/day, 4 weeks) also restored the impaired relaxations in middle-aged rats. Relaxations to 8-bromoguanosine 3',5'-cyclic monophosphate sodium salt (8-Br-cGMP; 10(-8) to 3?×?10(-4) ?M) remained unchanged between groups. Basal and stimulated cGMP production were lower in middle-aged group, an effect fully restored by apocynin and SOD. Protein expression of nNOS and phosphorylated eNOS (p-eNOS) (Ser-1177) reduced, whereas gp(91phox) mRNA expression increased in RCC from middle-aged rats. CONCLUSIONS.: ED in middle-aged rats is associated with decreased NO bioavailability in erectile tissue due to upregulation of NADPH oxidase subunit gp91(phox) and downregulation of nNOS/p-eNOS. Antioxidant therapies may be a good pharmacological approach to prevent ED at its early stages. PMID:23347406

Silva, Fábio H; Mónica, Fabíola Z; Báu, Fernando R; Brugnerotto, Ana F; Priviero, Fernanda B M; Toque, Haroldo A; Antunes, Edson

2013-04-01

261

Systematic Review and Meta-Analysis of the Use of Phosphodiesterase Type 5 Inhibitors for Treatment of Erectile Dysfunction following Bilateral Nerve-Sparing Radical Prostatectomy  

PubMed Central

Prostate cancer is relatively common cancer occurring in males. Radical prostatectomy (RP) is the most effective treatment for a localized tumor but erectile dysfunction (ED) is common complication, even when bilateral nerve-sparing RP (BNSRP) is performed. Clinical trials have shown varied effectiveness of phosphodiesterase type-5 inhibitors (PDE5-Is) for treatment of post-BNSRP ED, but there remains controversy over the application of this treatment and no formal systematic review and meta-analysis for the use of PDE5-Is for this condition has been conducted. This review was to systematically assess the efficacy and safety of oral PDE5-Is for post-BNSRP ED. A database search was conducted to identify randomized controlled trials (RCTs). The comparative efficacy of treatments was analyzed by fixed or random effect modeling. Erectile function was measured using the International Index of Erectile Function (IIEF), Sexual Encounter Profile (SEP) question-2, 3 and the Global Assessment Question (GAQ). The rate and incidence of adverse events (AEs) were determined. The quality of included studies was appraised using the Cochrane Collaboration bias appraisal tool. Eight RCTs were included in the analyses. PDE5-Is were effective for treating post-BNSRP ED compared to placebo when erectile function was determined using the IIEF score [mean difference (MD) 5.63, 95% confidence interval (CI) (4.26–6.99)], SEP-2 [relative risk (RR) 1.63, 95% CI (1.18–2.25) ], SEP-3 [RR 2.00, 95% CI (1.27–3.15) ] and GAQ [RR 3.35, 95% CI (2.68–4.67) ]. The subgroup analysis could find a trend that longer treatment duration, higher dosage, on-demand dosing, sildenafil and mild ED are associated with more responsiveness to PDE5-Is. PDE5-Is were overall well tolerated with headache being the most commonly reported AE. Our data provides compelling evidence for the use of PDE5-Is as a primary treatment for post-BNSRP ED. However, further studies are required to optomize usage parameters (such as dosage and duration of treatment). PMID:24618671

Wang, Xiao; Wang, Xinghuan; Liu, Tao; He, Qianwen; Wang, Yipeng; Zhang, Xinhua

2014-01-01

262

ORAL BISPHENOL A (BPA) GIVEN TO RATS AT MODERATE DOSES IS ASSOCIATED WITH ERECTILE DYSFUNCTION, CAVERNOSAL LIPOFIBROSIS, AND ALTERATIONS OF GLOBAL GENE TRANSCRIPTION  

PubMed Central

Introduction Bisphenol A (BPA), a suspected reproductive biohazard and endocrine disruptor released from plastics is associated with erectile dysfunction (ED) in occupationally exposed workers. However, in rats, despite the induction of hypogonadism, apoptosis of the penile corporal smooth muscle, fat infiltration into the cavernosal tissue, and changes in global gene expression with the intraperitoneal administration of high dose BPA, ED was not observed. Aims We investigated whether BPA administered orally rather than intraperitoneally to rats for longer periods and lower doses will lead to ED. Main Outcomes Measures ED, histological, and biochemical markers in rat penile tissues. Methods 2.5-month old rats were given drinking water daily without and with BPA at 1 and 0.1 mg/kg/day. Two months later, erectile function was determined by cavernosometry (DIC) and electrical field stimulation (EFS) and serum levels of testosterone (T), estradiol (E2), and BPA were measured. Penile tissue sections were assayed by Masson (smooth muscle (SM)/collagen), Oil Red O (fat), TUNEL (apoptosis), immunohistochemistry for Oct 4 (stem cells), and ?-SM actin/ calponin (SM and myofibroblasts), applying quantitative image analysis. Other markers were assayed by western blots. DNA microarrays/microRNA assays defined transcription profiles. Results Orally administered BPA did not affect body weight, but: 1) decreased serum T and E2; 2) reduced the EFS response and increased the DIC drop rate; 3) increased within the corporal tissue the presence of fat, myofibroblasts and apoptosis; 4) lowered the contents of SM and stem cells, but not nerve terminals; and 5) caused alterations of the transcriptional profiles for both mRNA and microRNAs within the penile shaft. Conclusions Long-term exposure of rats to oral BPA,caused a moderate corporal veno-occlusive dysfunction (CVOD), possibly due to alterations within the corporal tissue that pose gene transcriptional changes related to inflammation, fibrosis and epithelial/ mesenchymal transition (EMT). PMID:24305612

Kovanecz, I; Gelfand, R; Masouminia, M; Gharib, S; Segura, D; Vernet, D; Rajfer, J; Li, DK; Kannan, K; Gonzalez-Cadavid, NF

2013-01-01

263

A randomized, double-blind, placebo-controlled, cross-over study to assess the efficacy of tadalafil (Cialis[reg]) in the treatment of erectile dysfunction following three-dimensional conformal external-beam radiotherapy for prostatic carcinoma  

SciTech Connect

Purpose: Erectile dysfunction after three-dimensional conformal external-beam radiotherapy (3DCRT) for prostatic carcinoma is reported in as many as 64% of those patients. The purpose of this study was to determine the efficacy of the oral drug tadalafil (Cialis (registered) ) in patients with erectile dysfunction after radiotherapy for prostatic carcinoma. Methods and Materials: Patients (N = 358) who completed radiotherapy at least 12 months before the study were approached by mail. All patients had been treated by 3DCRT; 60 patients were included and entered a double-blind, placebo-controlled, cross-over study lasting 12 weeks. They received 20 mg of tadalafil or placebo for 6 weeks. Drug or placebo was taken on demand at patient's discretion, with no restrictions regarding the consumption of alcohol or food, at least once a week and no more than once daily. At 6 weeks patients crossed over to the alternative treatment. Data were collected using the Sexual Encounter Profile (SEP) and the International Index of Erectile Function (IIEF) questionnaires. Side effects were also recorded. Results: Mean age at study entry was 69 years. All patients completed the study. For almost all questions of the IIEF questionnaire there was a significant increase in mean scores from baseline with tadalafil, but not with placebo. Sixty-seven percent of the patients reported an improvement of erectile function with tadalafil (placebo: 20%), and 48% reported successful intercourse with tadalafil (placebo: 9%) (p < 0.0001). Side effects were mild or moderate. Conclusions: Tadalafil is an effective treatment for erectile dysfunction after 3DCRT for prostatic carcinoma with successful intercourse reported in almost 50% of the patients, and it is well tolerated.

Incrocci, Luca [Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)]. E-mail: l.incrocci@erasmusmc.nl; Slagter, Cleo [Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Slob, A. Koos [Department of Endocrinology and Reproduction, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Hop, Wim C.J. [Department of Epidemiology and Biostatistics, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)

2006-10-01

264

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

SciTech Connect

Purpose: We evaluated the relationship between the onset of erectile dysfunction and dose to the penile bulb and neurovascular bundles (NVBs) after real-time ultrasound-guided prostate brachytherapy. Methods and Materials: One hundred forty-seven patients who underwent prostate brachytherapy met the following eligibility criteria: (1) treatment with {sup 125}I brachytherapy to a prescribed dose of 160 Gy with or without hormones without supplemental external beam radiation therapy, (2) identification as potent before the time of implantation based on a score of 2 or higher on the physician-assigned Mount Sinai Erectile Function Score and a score of 16 or higher on the abbreviated International Index of Erectile Function patient assessment, and (3) minimum follow-up of 12 months. Median follow-up was 25.7 months (range, 12-47 months). Results: The 3-year actuarial rate of impotence was 23% (34 of 147 patients). An additional 43% of potent patients (49 of 113 patients) were using a potency aid at last follow-up. The penile bulb volume receiving 100% of the prescription dose (V{sub 100}) ranged from 0-0.05 cc (median, 0 cc), with a dose to the hottest 5% (D{sub 5}) range of 12.5-97.9 Gy (median, 40.8 Gy). There was no correlation between penile bulb D{sub 5} or V{sub 100} and postimplantation impotency on actuarial analysis. For the combined right and left NVB structures, V{sub 100} range was 0.3-5.1 cc (median, 1.8 cc), and V{sub 150} range was 0-1.5 cc (median, 0.31 cc). There was no association between NVB V{sub 100} or V{sub 150} and postimplantation impotency on actuarial analysis. Conclusion: Penile bulb doses are low after real-time ultrasound-guided prostate brachytherapy. We found no correlation between dose to either the penile bulb or NVBs and the development of postimplantation impotency.

Solan, Amy N. [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY (United States)], E-mail: amy.solan@mountsinai.org; Cesaretti, Jamie A. [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY (United States); Stone, Nelson N. [Department of Urology, Mount Sinai School of Medicine, New York, NY (United States); Stock, Richard G. [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, NY (United States)

2009-04-01

265

Effect of tankyrase 1 on autophagy in the corpus cavernosum smooth muscle cells from ageing rats with erectile dysfunction and its potential mechanism  

PubMed Central

This study compared tankyrase 1 expression and autophagy quantity between erectile dysfunction (ED) and non-ED rats' corpus cavernosum smooth muscle cells (CSMCs). This study aslo explored the effect and possible mechanism of tankyrase 1 on autophagy and cell proliferation in ageing ED rats' CSMCs. The intracavernous pressure and mean systemic arterial pressure were measured to investigate erectile function so that eight 24-month-old ED and eight 8-month-old male Wistar rats were choosed respectively. The rat CSMCs were isolated and cultured by enzyme digestion, in which tankyrase 1 expression and autophagy quantity were compared. Tankyrase 1 overexpression was induced with plasmid transfection by Lipofectamine™. The effect of tankyrase 1 overexpression on proliferation, autophagy and mTOR pathway in 24-month-old ED rats' CSMCs was measured by the cell growth curve in MTT assay, cell cycle analysis in flow cytometry (FCM), key protein expression in Western blot, autophagy quantity in transmission electron microscopy, monodansylcadaverine staining and GFP-LC3 fluorescence. The primary CSMCs were confirmed by immunofluorescence, and the purity was 99.1% in FCM. Compared with that of 8-month-old rats, tankyrase 1 expression and autophagy quantity significantly decreased in 24-month-old ED rats' primary CSMCs (P < 0.01). Tankyrase 1 overexpression significantly increased the growth rate (P < 0.05) and increased the S phase of cell cycle (P < 0.01). The autophagosome quantity was remarkably increased (P < 0.01), LC3-I/II and Beclin 1 were upregulated (P < 0.01 and P < 0.05), and p-p70S6K (Thr389) was downregulated in 24-month-old ED rat CSMCs (P < 0.05). In conclusion, Tankyrase 1 and autophagy decrease in the CSMCs from aging rats with ED, and tankyrase 1 may have a positive effect on proliferation by enhancing autophagy and regulating the mTOR signalling pathway. PMID:20657601

Zhang, Jian; Wu, Xiao-Jun; Zhuo, De-Xiang; Liu, Tao; Li, Wei-Ren; Mao, Ze-Bin; Xin, Zhong-Cheng

2010-01-01

266

A Two-Stage Genome-Wide Association Study to Identify Single Nucleotide Polymorphisms Associated with Development of Erectile Dysfunction Following Radiotherapy for Prostate Cancer*  

PubMed Central

Purpose To identify single nucleotide polymorphisms (SNPs) associated with development of erectile dysfunction (ED) among prostate cancer patients treated with radiotherapy. Methods and Materials A two-stage genome-wide association study (GWAS) was performed. Patients were split randomly into a stage I discovery cohort (132 cases, 103 controls) and a stage II replication cohort (128 cases, 102 controls). The discovery cohort was genotyped using Affymetrix 6.0 genome-wide arrays. The 940 top ranking SNPs selected from the discovery cohort were genotyped in the replication cohort using Illumina iSelect custom SNP arrays. Results 12 SNPs identified in the discovery cohort and validated in the replication cohort were associated with development of ED following radiotherapy (Fisher combined p-values 2.1×10?5 to 6.2×10?4). Notably, these 12 SNPs lie in or near genes involved in erectile function or other normal cellular functions (adhesion and signaling) rather than DNA damage repair. In a multivariable model including non-genetic risk factors, the odds ratios for these SNPs ranged from 1.6 to 5.6 in the pooled cohort. There was a striking relationship between the cumulative number of SNP risk alleles an individual possessed and ED status (Sommers’ D p-value = 1.7×10?29). A one-allele increase in cumulative SNP score increased the odds for developing ED by a factor of 2.2 (p-value = 2.1×10?19). The cumulative SNP score model had a sensitivity of 84% and specificity of 75% for prediction of developing ED at the radiotherapy planning stage. Conclusions This GWAS identified a set of SNPs that are associated with development of ED following radiotherapy. These candidate genetic predictors warrant more definitive validation in an independent cohort. PMID:23021708

Kerns, Sarah L.; Stock, Richard; Stone, Nelson; Buckstein, Michael; Shao, Yongzhao; Campbell, Christopher; Rath, Lynda; DeRuysscher, Dirk; Lammering, Guido; Hixson, Rosetta; Cesaretti, Jamie; Terk, Mitchell; Ostrer, Harry; Rosenstein, Barry S.

2012-01-01

267

A 2-Stage Genome-Wide Association Study to Identify Single Nucleotide Polymorphisms Associated With Development of Erectile Dysfunction Following Radiation Therapy for Prostate Cancer  

SciTech Connect

Purpose: To identify single nucleotide polymorphisms (SNPs) associated with development of erectile dysfunction (ED) among prostate cancer patients treated with radiation therapy. Methods and Materials: A 2-stage genome-wide association study was performed. Patients were split randomly into a stage I discovery cohort (132 cases, 103 controls) and a stage II replication cohort (128 cases, 102 controls). The discovery cohort was genotyped using Affymetrix 6.0 genome-wide arrays. The 940 top ranking SNPs selected from the discovery cohort were genotyped in the replication cohort using Illumina iSelect custom SNP arrays. Results: Twelve SNPs identified in the discovery cohort and validated in the replication cohort were associated with development of ED following radiation therapy (Fisher combined P values 2.1 Multiplication-Sign 10{sup -5} to 6.2 Multiplication-Sign 10{sup -4}). Notably, these 12 SNPs lie in or near genes involved in erectile function or other normal cellular functions (adhesion and signaling) rather than DNA damage repair. In a multivariable model including nongenetic risk factors, the odds ratios for these SNPs ranged from 1.6 to 5.6 in the pooled cohort. There was a striking relationship between the cumulative number of SNP risk alleles an individual possessed and ED status (Sommers' D P value = 1.7 Multiplication-Sign 10{sup -29}). A 1-allele increase in cumulative SNP score increased the odds for developing ED by a factor of 2.2 (P value = 2.1 Multiplication-Sign 10{sup -19}). The cumulative SNP score model had a sensitivity of 84% and specificity of 75% for prediction of developing ED at the radiation therapy planning stage. Conclusions: This genome-wide association study identified a set of SNPs that are associated with development of ED following radiation therapy. These candidate genetic predictors warrant more definitive validation in an independent cohort.

Kerns, Sarah L. [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York (United States) [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York (United States); Departments of Pathology and Genetics, Albert Einstein College of Medicine, Bronx, New York (United States); Stock, Richard [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York (United States)] [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York (United States); Stone, Nelson [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York (United States) [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York (United States); Department of Urology, Mount Sinai School of Medicine, New York, New York (United States); Buckstein, Michael [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York (United States)] [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York (United States); Shao, Yongzhao [Division of Biostatistics, New York University School of Medicine, New York, New York (United States)] [Division of Biostatistics, New York University School of Medicine, New York, New York (United States); Campbell, Christopher [Departments of Pathology and Genetics, Albert Einstein College of Medicine, Bronx, New York (United States)] [Departments of Pathology and Genetics, Albert Einstein College of Medicine, Bronx, New York (United States); Rath, Lynda [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York (United States)] [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York (United States); De Ruysscher, Dirk; Lammering, Guido [Department of Radiation Oncology, Maastricht University Medical Center, Maastricht (Netherlands)] [Department of Radiation Oncology, Maastricht University Medical Center, Maastricht (Netherlands); Hixson, Rosetta; Cesaretti, Jamie; Terk, Mitchell [Florida Radiation Oncology Group, Jacksonville, Florida (United States)] [Florida Radiation Oncology Group, Jacksonville, Florida (United States); Ostrer, Harry [Departments of Pathology and Genetics, Albert Einstein College of Medicine, Bronx, New York (United States)] [Departments of Pathology and Genetics, Albert Einstein College of Medicine, Bronx, New York (United States); Rosenstein, Barry S., E-mail: barry.rosenstein@mssm.edu [Department of Radiation Oncology, Mount Sinai School of Medicine, New York, New York (United States); Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States); Departments of Dermatology and Preventive Medicine, Mount Sinai School of Medicine, New York, New York (United States)

2013-01-01

268

Sustained efficacy and tolerability of vardenafil, a highly potent selective phosphodiesterase type 5 inhibitor, in men with erectile dysfunction: results of a randomized, double-blind, 26-week placebo-controlled pivotal trial  

Microsoft Academic Search

The durability of key efficacy response parameters and safety of vardenafil was evaluated in a pivotal trial conducted in a broad population of men with erectile dysfunction (ED) in North America. In this randomized, double-blind, placebo-controlled, multicenter, fixed-dose, parallel-group, 6-month comparison study, men >18 years of age with ED for >6 months received 5-mg, 10-mg, and 20-mg doses of vardenafil

Wayne J. G. Hellstrom; Marc Gittelman; Gary Karlin; Thomas Segerson; Marc Thibonnier; Terry Taylor; Harin Padma-Nathan

2003-01-01

269

Serum from patients with erectile dysfunction inhibits circulating angiogenic cells from healthy men: relationship with cardiovascular risk, endothelial damage and circulating angiogenic modulators.  

PubMed

Erectile dysfunction (ED) is an early manifestation of arteriosclerosis associated with endothelial damage/dysfunction and to a blunted ability of cultured mononuclear circulating cells (MNCs) to differentiate circulating angiogenic cells (CACs), putatively involved in endothelial damage repair. Here we explored effects of human serum (HS) from patients with ED and cardiovascular risk factors (VRFs) but no clinical atherosclerosis, on cultured MNCs of healthy men to differentiate CACs and to form colonies. Effect of HS on number of CACS and of colony forming units (CFUs) was correlated with circulating markers of endothelial damage and with angiogenic modulators. MNCs from healthy men were cultured in standard conditions or with 20% HS from 35 patients with ED and from 10 healthy men. CACs were identified after 7 days of culture by uptake of acetylated low-density lipoprotein with concomitant binding of Ulex europaeus agglutinin I. CFUs were counted after 5 days of culture. Enzyme-linked immunosorbent assays assessed plasmatic soluble (s) form of E-selectin, Endothelin (ET)-1, tissue type plasminogen activator (tPA), vascular endothelial growth factor (VEGF)(165) and sVEGF receptor (R)-1. The number of CACs and of CFUs from healthy men was reduced after culturing MNCs with HS compared to standard medium. The inhibitory effect was significantly higher with HS from ED patients with higher or lower VRF exposure compared to healthy men. Inhibition was positively correlated with VRFs exposure, with ED severity, with common carotid artery intima media thickness measured using B-mode ultrasound, and to a lesser extent with plasmatic sE-Selectin, sET-1 and sVEGFR-1. Dysfunction of cells involved in vascular homoeostasis is induced by soluble factors still unknown and already present in a very initial systemic vascular disease in men with ED and VRFs. PMID:22394130

Pelliccione, F; D'Angeli, A; Filipponi, S; Falone, S; Necozione, S; Barbonetti, A; Francavilla, F; Francavilla, S

2012-10-01

270

ORIGINAL ARTICLE Association between cigarette smoking and erectile tumescence  

E-print Network

smoking is an independent risk factor for erectile dysfunction (ED), and results of large cross-sectional1ORIGINAL ARTICLE Association between cigarette smoking and erectile tumescence: the mediating role of heart rate variability CB Harte1,2 and CM Meston3 Cigarette smoking deleteriously affects erectile

Meston, Cindy

271

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

PubMed Central

Introduction The high effectiveness of phosphodiesterase type 5 inhibitors (PDE5-i) in the treatment of erectile dysfunction (ED) has been demonstrated. However, previous research shows that PDE5-i treatments have high discontinuation rates. Aim The main goals of this study were to (i) characterize the way men use PDE5-i and (ii) analyze the adherence to treatment, identifying the factors that influence PDE5-i use. Methods A total of 148 men with clinical diagnosis for ED who maintained the treatment with PDE5-i for over 3 years were interviewed. Interviews concerning their ongoing treatment were carried out using a standardized questionnaire with quantitative and qualitative items. Main Outcome Measures Physiological measures included the intracavernous alprostadil injection test, associated with penile rigidometry and penile Doppler ultrasound. The qualitative measure included two questions: “Do you use the drug in every sexual intercourse?” and “How do you use the inhibitor?” Results ED causes were classified as venogenic (31%), arteriogenic (23%), psychogenic (18%), iatrogenic (13%), neurogenic (8%), and diabetic (7%). Participation rate was 71.8%. Of the 148 patients studied, 75% claimed not to use PDE5-i in every intercourse. Most used tadalafil (66%), followed by sildenafil (20%), vardenafil (10%), and 4% alternated the type of medicine. Four main categories emerged concerning the factors that determine the intake of PDE5-i in some intercourse situations and not in others: (i) psychological factors; (ii) medication-related factors; (iii) circumstantial factors; and (iv) relational factors. 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. PMID:25356304

Carvalheira, Ana; Forjaz, Vera; Pereira, Nuno Monteiro

2014-01-01

272

JAMA Patient Page: Male Sexual Dysfunction  

MedlinePLUS

... call 718/946-7424. • Low libido (sexual interest) • Erectile dysfunction (ED, difficulty achieving or maintaining an erection) • Premature ... or discontinue the medication. • Prescription medications that treat erectile dysfunction may help a man achieve and maintain erections. • ...

273

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

PubMed Central

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

Moyad, Mark A; Park, Kwangsung

2012-01-01

274

Simultaneous determination of 38 phosphodiestrase-5 inhibitors in illicit erectile dysfunction products by liquid chromatography-electrospray ionization-tandem mass spectrometry.  

PubMed

This paper describes the development and validation of simultaneous analytical method for 38 compounds, sildenafil, tadalafil, vardenafil and their analogues in illicit erectile dysfunction (ED) products by the liquid chromatography-electrospray ionization-tandem mass method (LC-ESI-MS/MS). Chromatographic separation was performed on a C18 reversed-phase column using a gradient of solvent A: aqueous 2 mM ammonium formate solution and solvent B: acetonitrile (ACN). All components were monitored under time-scheduled multiple reaction monitoring (MRM) mode. The limits of detection (LOD) ranged from 0.004 ng/ml to 0.455 ng/ml and the limits of quantification (LOQ) ranged from 0.012 ng/ml to 1.5 ng/ml. Calibration curves were linear with correlation coefficients over 0.9991. Mean recoveries ranged from 73.6% to 111.3%, and relative standard deviation (RSD) was less than 10%. The intra- and inter-day precision ranged from 0.2% to 16.3% and from 0.2% to 17.0%, respectively. The proposed method was applied to investigate the 52 illicit ED products. PMID:23747491

Lee, Eung-Sun; Lee, Ji Hyun; Han, Kyoung Moon; Kim, Ji Won; Hwang, In Sun; Cho, Sooyeul; Han, Soon Young; Kim, Jinho

2013-09-01

275

The SIAMS-ED Trial: A National, Independent, Multicentre Study on Cardiometabolic and Hormonal Impairment of Men with Erectile Dysfunction Treated with Vardenafil.  

PubMed

Increased cardiovascular risk has been associated with reduced response to proerectile drugs. The Italian Society of Andrology and Sexual Medicine (SIAMS) promoted an independent, multicenter study performed in 604 men (55 ± 12?yrs) suffering from erectile dysfunction (ED) to assess multiple health outcomes and response to 6-month vardenafil challenge in a real-life setting. Overall, 30.8% men had metabolic syndrome. Cardiovascular risk stratification revealed a greater number of ED subjects with moderate risk of a major adverse cardiovascular event than the general population (P < 0.01). Age-adjusted pulse pressure was positively correlated with ED severity and negatively with androgens and waist circumference (P < 0.01). A decline in total testosterone was observed with increasing arterial pulse pressure (P < 0.05), which was not accompanied by compensatory LH rise. Follow-up on 185 men treated with vardenafil in an nonrandomized, open, single-arm trial documented a significant rise in IIEF-5 (delta = 6.1 ± 4.8) that was maintained in men with high cardiovascular risk. Mild adverse events occurred in <5%, with no differences between cardiovascular risk classes. In summary, ED is a frequent symptom in patients with an elevated, but often unknown, risk of future cardiovascular events. Androgens predict vascular resistance in ED patients. Vardenafil's response and safety profile were preserved in subjects with higher cardiovascular risk. PMID:24976827

Isidori, Andrea M; Corona, Giovanni; Aversa, Antonio; Gianfrilli, Daniele; Jannini, Emmanuele A; Foresta, Carlo; Maggi, Mario; Lenzi, Andrea

2014-01-01

276

The SIAMS-ED Trial: A National, Independent, Multicentre Study on Cardiometabolic and Hormonal Impairment of Men with Erectile Dysfunction Treated with Vardenafil  

PubMed Central

Increased cardiovascular risk has been associated with reduced response to proerectile drugs. The Italian Society of Andrology and Sexual Medicine (SIAMS) promoted an independent, multicenter study performed in 604 men (55 ± 12?yrs) suffering from erectile dysfunction (ED) to assess multiple health outcomes and response to 6-month vardenafil challenge in a real-life setting. Overall, 30.8% men had metabolic syndrome. Cardiovascular risk stratification revealed a greater number of ED subjects with moderate risk of a major adverse cardiovascular event than the general population (P < 0.01). Age-adjusted pulse pressure was positively correlated with ED severity and negatively with androgens and waist circumference (P < 0.01). A decline in total testosterone was observed with increasing arterial pulse pressure (P < 0.05), which was not accompanied by compensatory LH rise. Follow-up on 185 men treated with vardenafil in an nonrandomized, open, single-arm trial documented a significant rise in IIEF-5 (delta = 6.1 ± 4.8) that was maintained in men with high cardiovascular risk. Mild adverse events occurred in <5%, with no differences between cardiovascular risk classes. In summary, ED is a frequent symptom in patients with an elevated, but often unknown, risk of future cardiovascular events. Androgens predict vascular resistance in ED patients. Vardenafil's response and safety profile were preserved in subjects with higher cardiovascular risk. PMID:24976827

Isidori, Andrea M.; Corona, Giovanni; Gianfrilli, Daniele; Jannini, Emmanuele A.; Foresta, Carlo; Lenzi, Andrea; Andò, Sebastiano; Angelletti, Gabriella; Matteo, Baldi; Balercia, Giancarlo; Giuseppe, Bellastella; Calogero, Aldo E.; Canale, Domenico; Caprio, Massimiliano; Caretta, Nicola; Erennio, Ciotoli; Colpi, Giovanni Maria; Fabbri, Andrea; Fornengo, Riccardo; Francavilla, Sandro; Gavioli, Silvia; Angelo, Giagulli Vito; Giannetta, Elisa; Goglia, Umberto; Nicola, Ilacqua; La Vignera, Sandro; Lemma, Andrea; Mancini, Mario; Manieri, Chiara; Mansani, Riccardo; Tommaso, Ministrini; Minuto, Francesco; Alessandro, Oppo; Paggi, Francesca; Rosario, Pivonello; Fiore, Pelliccione; Anna, Perri; Perrini, Sebastio; Riccardo, Pofi; Sbardella, Emilia; Stefano, Serra; Sinisi, Antonio

2014-01-01

277

Update on drug interactions with phosphodiesterase-5 inhibitors prescribed as first-line therapy for patients with erectile dysfunction or pulmonary hypertension.  

PubMed

Phosphodiesterase-5 inhibitors (PDE5i, sildenafil, vardenafil, tadalafil and avanafil) are a first-line medical therapy for erectile dysfunction (ED). In all likelihood, PDE5i usage will increase because sildenafil (Viagra® and Revatio®) and tadalafil (Cialis® and Adcirca®) have recently been recommended as first-line therapy for patients with pulmonary hypertension (PH). PDE5i exhibit higher plasma concentrations when co-administered with cytochrome P (CYP) 3A inhibitors, which influences their side-effect profile. The higher PDE5i plasma concentrations, caused by CYP3A inhibitors, influence the severity and timing of PDE5i drug interactions and require dose adjustment. PDE5i are safe when used with most antihypertensive agents, but co-administration with nitrates or ?-blockers can cause severe hypotension and syncope. Dose adjustment is also necessary when PDE5i are co-administered with CYP3A inducers. The combination of oral tadalafil and bosentan (endothelin receptor antagonist) reduces tadalafil levels and requires dose adjustment. Current literature reports a number of interactions between PDE5i and other agents and further studies are needed to expand our knowledge base of these interactions. This review discusses relevant PDE5i drug interactions, including those with CYP 450 inhibitors and inducers which are frequently used during the treatment of ED and PH. PMID:23140258

Gur, Serap; Kadowitz, Philip J; Gokce, Ahmet; Sikka, Suresh C; Lokman, Utku; Hellstrom, Wayne J G

2013-02-01

278

Prevalence and Severity of Erectile Dysfunction as Assessed by IIEF-5 in North Indian Type 2 Diabetic Males and Its Correlation with Variables  

PubMed Central

Introduction: The aim of this study was to assess the severity of the erectile (ED) dysfunction among type 2 diabetic men. For subjective information patients were asked to fill up the IIEF questionnaire. This study was also done to correlate ED with other variables like age, obesity, duration of diabetes, degree of diabetic control and complications of diabetes. Neuropathy was assessed objectively by using the Vibration Perception Threshold (VPT). Material and Methods: This study was conducted on 348 patients. Age range of these subjects was 25 years to 75 years. All patients underwent routine clinical examinations which included recording of duration of diabetes, type of diabetes, Body Mass Index, previous HbA1c tests and VPT measurement. Results and Conclusion: In the present study, it was observed that there was a significant association of ED with age, duration of diabetes, glycemic control and BMI. In fact, VPT emerged as a strong predictor of ED. We conclude that adding objectivity of VPT measurement improves the subjective predictive value of IIEF-5. PMID:24551679

Goyal, Arvind; Singh, Parminder; Ahuja, Ashish

2013-01-01

279

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

PubMed

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

Moyad, Mark A; Park, Kwangsung

2012-11-01

280

Serum High-Sensitivity C-Reactive Protein Levels and Response to 5 mg Tadalafil Once Daily in Patients With Erectile Dysfunction and Diabetes  

PubMed Central

Purpose We studied the relative importance of high-sensitivity C-reactive protein (hs-CRP) concentrations in patients with erectile dysfunction (ED) and diabetes and determined whether the hs-CRP level predicts the response to treatment with 5 mg tadalafil once daily. Materials and Methods We enrolled 102 men (aged 40-60 years) with diabetes and ED. All patients completed the International Index of Erectile Function (IIEF) questionnaire and were given 5 mg tadalafil daily. The IIEF and serum hs-CRP levels in patients and healthy controls and in patient responders and nonresponders to 5 mg tadalafil once daily were compared. Results Median age was 53.2 years (range, 45 to 62 years) in patients and 55.6 years (range, 47 to 64 years) in healthy controls (p=0.158). The median duration of diabetes was 54.3 months (range, 34 to 70 months). The median IIEF and hs-CRP level were 12.1 (range, 5 to 20) and 0.21 mg/dL (range, 0.05 to 0.6 mg/dL) in patients and 28.2 (range, 13 to 31) and 0.09 mg/dL (range, 0.04 to 0.2 mg/dL) in the controls, respectively (pIIEF=0.000, pCRP=0.031). After tadalafil treatment, 71 patients (69.6%) achieved an erection sufficient for sexual intercourse, whereas 31 (30.4%) did not. The median age of the tadalafil nonresponders was 56.2 years (range, 45 to 64 years) and that of the responders was 51.3 years (range, 42 to 62 years; p=0.065). Median hs-CRP levels were 0.31 mg/dL (range, 0.18 to 0.62 mg/dL) in nonresponders and 0.14 mg/dL (range, 0.09 to 0.4 mg/dL) in responders, respectively (p=0.028). Conclusions Serum hs-CRP was significantly higher in patients with ED and diabetes mellitus than in patients without ED. A significant correlation was observed between serum hs-CRP levels, the degree of ED, and responsiveness to tadalafil. PMID:24363868

Lee, Jung Woo; Park, Nam Cheol

2013-01-01

281

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  

SciTech Connect

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.

Wielen, Gerard J. van der [Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)], E-mail: g.vanderwielen@erasmusmc.nl; Hoogeman, Mischa S. [Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Dohle, Gert R. [Department of Urology, Erasmus MC, Rotterdam (Netherlands); Putten, Wim L.J. van [Department of Biostatistics, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam (Netherlands); Incrocci, Luca [Department of Radiation Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam (Netherlands)

2008-07-01

282

Oral Bisphenol A (BPA) given to rats at moderate doses is associated with erectile dysfunction, cavernosal lipofibrosis and alterations of global gene transcription.  

PubMed

Bisphenol A (BPA), a suspected reproductive biohazard and endocrine disruptor, released from plastics is associated with ED in occupationally exposed workers. However, in rats, despite the induction of hypogonadism, apoptosis of the penile corporal smooth muscle (SM), fat infiltration into the cavernosal tissue and changes in global gene expression with the intraperitoneal administration of high dose BPA, ED was not observed. We investigated whether BPA administered orally rather than intraperitoneally to rats for longer periods and lower doses will lead to ED. Main outcome measures are ED, histological, and biochemical markers in rat penile tissues. In all, 2.5-month-old rats were given drinking water daily without and with BPA at 1 and 0.1 mg kg(-1) per day. Two months later, erectile function was determined by cavernosometry and electrical field stimulation (EFS) and serum levels of testosterone (T), estradiol (E2) and BPA were measured. Penile tissue sections were assayed by Masson (SM/collagen), Oil Red O (fat), terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) (apoptosis), immunohistochemistry for Oct4 (stem cells), and ?-SM actin/calponin (SM and myofibroblasts), applying quantitative image analysis. Other markers were assayed by western blotting. DNA microarrays/microRNA (miR) assays defined transcription profiles. Orally administered BPA did not affect body weight, but (1) decreased serum T and E2; (2) reduced the EFS response and increased the drop rate; (3) increased within the corporal tissue the presence of fat, myofibroblasts and apoptosis; (4) lowered the contents of SM and stem cells, but not nerve terminals; and (5) caused alterations in the transcriptional profiles for both mRNA and miRs within the penile shaft. Long-term exposure of rats to oral BPA caused a moderate corporal veno-occlusive dysfunction (CVOD), possibly due to alterations within the corporal tissue that pose gene transcriptional changes related to inflammation, fibrosis and epithelial/mesenchymal transition (EMT). PMID:24305612

Kovanecz, I; Gelfand, R; Masouminia, M; Gharib, S; Segura, D; Vernet, D; Rajfer, J; Li, D K; Kannan, K; Gonzalez-Cadavid, N F

2014-01-01

283

A rapid, quantitative liquid chromatography-mass spectrometry screening method for 71 active and 11 natural erectile dysfunction ingredients present in potentially adulterated or counterfeit products.  

PubMed

A rapid LC-MS/MS method has been developed to simultaneously separate 71 erectile dysfunction (ED) drugs and 11 natural ingredients that are sometimes found alongside ED drugs, present in suspected adulterated or counterfeit samples. The separation was achieved in 10min using 2.6?m fused-core C18 particles in a 100×2.1mm column coupled to an LTQ Orbitrap XL mass spectrometer operated in positive electrospray mode. Using a straightforward methanolic extraction procedure, recovery from real samples (tablets, capsules, oral liquids and herbal products) was 92-111% and the lower and upper limits of detection and quantification were in the sub ng/mL and the sub ?g/mL ranges, respectively. The intra- and inter-assay precision were ?3.2% and 10.4% respectively across three concentrations of standards (50, 250 and 1000ng/mL) measured for 4 representative drugs spiked into a tablet-based matrix. This behavior was consistently observed for all the other compounds. The mass accuracy was less than 3ppm. Moreover, an advantage of this method is that the full scan event in the acquisition method associated with the high resolution of the Orbitrap XL allows post-analysis identification, in an untargeted approach, of additional species in the complex matrices. Our LC-MS/MS method for ED drugs was successfully applied to 32 samples and the drug identifications were in 100% agreement with those obtained by the conventional methods HPLC-UV and GC-MS. Following the complete validation of the ED method, it has been introduced in the current counterfeit identification procedures at Health Canada. PMID:24767800

Lebel, Philippe; Gagnon, Jacques; Furtos, Alexandra; Waldron, Karen C

2014-05-23

284

Vasculogenic mimicry formation in hepatocellular carcinoma  

Microsoft Academic Search

Objective  To explore possibility of vasculogenic mimicry (VM) in hepatocellular carcinoma (HCC) by constructing tumor cell three-dimensional\\u000a culture system and liver cancer tissues.\\u000a \\u000a \\u000a \\u000a Methods  Based on three-dimensional cell culture system developed by matrigel, liver cancer cell lines HepG2 were tested for evidence\\u000a of VM. Fifteen HCC simples were collected. Potential formation of tumor channels and their characterization of network were\\u000a observed by

Jing Zhao; Chenyu Wang; Aijun Yang; Wei Liu; Min Li

2008-01-01

285

Slug promoted vasculogenic mimicry in hepatocellular carcinoma  

PubMed Central

Vasculogenic mimicry (VM) refers to the unique capability of aggressive tumour cells to mimic the pattern of embryonic vasculogenic networks. Epithelial–mesenchymal transition (EMT) regulator slug have been implicated in the tumour invasion and metastasis of human hepatocellular carcinoma (HCC). However, the relationship between slug and VM formation is not clear. In the study, we demonstrated that slug expression was associated with EMT and cancer stem cell (CSCs) phenotype in HCC patients. Importantly, slug showed statistically correlation with VM formation. We consistently demonstrated that an overexpression of slug in HCC cells significantly increased CSCs subpopulation that was obvious by the increased clone forming efficiency in soft agar and by flowcytometry analysis. Meantime, the VM formation and VM mediator overexpression were also induced by slug induction. Finally, slug overexpression lead to the maintenance of CSCs phenotype and VM formation was demonstrated in vivo. Therefore, the results of this study indicate that slug induced the increase and maintenance of CSCs subpopulation and contributed to VM formation eventually. The related molecular pathways may be used as novel therapeutic targets for the inhibition of HCC angiogenesis and metastasis. PMID:23815612

Sun, Dan; Sun, Baocun; Liu, Tieju; Zhao, Xiulan; Che, Na; Gu, Qiang; Dong, Xueyi; Yao, Zhi; Li, Rui; Li, Jing; Chi, Jiadong; Sun, Ran

2013-01-01

286

Slug promoted vasculogenic mimicry in hepatocellular carcinoma.  

PubMed

Vasculogenic mimicry (VM) refers to the unique capability of aggressive tumour cells to mimic the pattern of embryonic vasculogenic networks. Epithelial-mesenchymal transition (EMT) regulator slug have been implicated in the tumour invasion and metastasis of human hepatocellular carcinoma (HCC). However, the relationship between slug and VM formation is not clear. In the study, we demonstrated that slug expression was associated with EMT and cancer stem cell (CSCs) phenotype in HCC patients. Importantly, slug showed statistically correlation with VM formation. We consistently demonstrated that an overexpression of slug in HCC cells significantly increased CSCs subpopulation that was obvious by the increased clone forming efficiency in soft agar and by flowcytometry analysis. Meantime, the VM formation and VM mediator overexpression were also induced by slug induction. Finally, slug overexpression lead to the maintenance of CSCs phenotype and VM formation was demonstrated in vivo. Therefore, the results of this study indicate that slug induced the increase and maintenance of CSCs subpopulation and contributed to VM formation eventually. The related molecular pathways may be used as novel therapeutic targets for the inhibition of HCC angiogenesis and metastasis. PMID:23815612

Sun, Dan; Sun, Baocun; Liu, Tieju; Zhao, Xiulan; Che, Na; Gu, Qiang; Dong, Xueyi; Yao, Zhi; Li, Rui; Li, Jing; Chi, Jiadong; Sun, Ran

2013-08-01

287

Cardiovascular Implications of Erectile Dysfunction  

MedlinePLUS

... pills. The PDE5-Is are not safe with nitrate medications like nitroglycerin, Nitrostat, Nitro Paste, Imdur, isosorbide ... and Isordil. Mixing a PDE5-I with a nitrate medication could result in severely low blood pressure ...

288

Erectile Dysfunction (ED): Surgical Management  

MedlinePLUS

... or impulses in the brain (chemicals such as dopamine , acetylcholine and nitric oxide ) to tell the muscles ... levels that can cause bladder and kidney problems. dopamine: A chemical compound, found in the brain, that ...

289

Erectile preservation following radical prostatectomy  

PubMed Central

Prostate cancer is the most common cancer among men, representing approximately 25% of all new cancer diagnoses in the USA. For clinically localized prostate cancer, the gold standard for therapy remains radical prostatectomy. One of the main adverse effects of this procedure is erectile dysfunction, which can have a significant impact on the patient’s quality of life. There are several mechanisms of erectile dysfunction postprostatectomy, including arteriogenic, venogenic and neurogenic types, as well as the potentially heightened risk of postprostatectomy patients to develop Peyronie’s disease. The purpose of this review is to explain the various treatment options available, including phosphodiesterase type 5 inhibitors, intracavernosal injections, intraurethral alprostadil suppositories, vacuum erection devices, and penile prostheses. The role of these therapies in an erectile-dysfunction-treatment function, as well as in penile rehabilitation, will be discussed. Finally, a review of research on novel therapies will also be presented. A comprehensive literature review was performed using the PubMed database. Articles were chosen based on topical relevance and assessed for methodology and major findings. There are data to support the use of each of the therapeutic options in both treatment and rehabilitative roles. More study is needed, however, specifically in regard to penile rehabilitation, to confirm its benefits, as well as to determine optimal rehabilitation protocols. PMID:21789097

Segal, Robert; Burnett, Arthur L.

2011-01-01

290

Genetic and Clinical Predictors of Sexual Dysfunction in Citalopram-Treated Depressed Patients  

E-print Network

, for association with erectile dysfunction, anorgasmia, and decreased libido during citalopram treatment. Clinical-reports of erectile dysfunction, decreased libido, or difficulty achieving orgasm based on the Patient-Rated Inventory (37%) reported erectile dysfunction. Using a set-based test for association, single nucleotide

Baker, Chris I.

291

Effect of Nightly versus On-Demand Vardenafil on Recovery of Erectile Function in Men Following Bilateral Nerve-Sparing Radical Prostatectomy  

Microsoft Academic Search

BackgroundTo date, no data have been available from large, well-designed trials comparing on demand and nightly dosing of phosphodiesterase type 5 (PDE5) inhibitors on recovery of erectile function in postprostatectomy patients with erectile dysfunction (ED).

Francesco Montorsi; Gerald Brock; Jay Lee; JoAnn Shapiro; Hendrik Van Poppel; Markus Graefen; Christian Stief

2008-01-01

292

Are the Inhibitory Effects of Nicotine on Erectile Response in Nonsmokers Generalizable to Long-Term Smokers? A Reply  

E-print Network

, Perez JB, Heatley GJ. Cessation of smoking rapidly decreases erectile dysfunction. Endocr Pract 1998Are the Inhibitory Effects of Nicotine on Erectile Response in Nonsmokers Generalizable to Long examining the effects of smoking cessation on erectile functioning in men. Guay and col- leagues [1] found

Meston, Cindy

293

Guided vasculogenic sprouting induced by the immobilized fusion construct CaM-VEGF120.  

E-print Network

??This project is intended to utilize an immobilized bio-active first generation fusion constructed cytokine inducing in receptive cell lines guided vasculogenic development. This research through… (more)

Robb, Malcolm

2012-01-01

294

Psychosocial outcomes after initial treatment of erectile dysfunction with tadalafil once daily, tadalafil on demand or sildenafil citrate on demand: results from a randomized, open-label study.  

PubMed

Initiation of ED treatment with a particular PDE5I may influence treatment-adherence and other outcomes. In this multicenter, open-label study, men with ED, naïve to PDE5I, were randomized to tadalafil 5?mg once-a-day (OaD; N=257), 10?mg on demand (PRN; N=252) or sildenafil-citrate (sildenafil) 50?mg PRN (N=261) for 8 weeks (dose adjustments allowed), followed by 16 weeks of pragmatic treatment (switching between PDE5I allowed). Primary outcomes (treatment-adherence) were reported previously. Here, we report effects on: Psychological and Interpersonal Relationship Scales, Self-Esteem and Relationship (SEAR) questionnaire, ED Inventory of Treatment Satisfaction (EDITS), International Index of Erectile Function (IIEF), Sexual Encounter Profile (SEP) and Global Assessment Questions (GAQ). Mixed-model for repeated measures and analysis of covariance were used to analyze changes from baseline; GAQ-responses were evaluated by logistic regression. Analyses were adjusted for treatment, country, ED-severity, baseline and baseline-by-treatment interaction. Patients randomized to tadalafil OaD or PRN reported greater improvement (least-square mean (s.e.) change) in Sexual Self-Confidence (OaD +0.90 (0.048), PRN +0.93 (0.050), vs +0.73 (0.049); P=0.006 and P=0.001) and Spontaneity (OaD +0.11 (0.035), PRN +0.13 (0.035), vs +0.02 (0.035); P=0.044 and P=0.010) compared with sildenafil. Improvements in GAQ and SEP responses, IIEF-EF, orgasmic function, sexual desire, overall satisfaction domains, SEAR and EDITS scores did not differ significantly between treatment groups. PMID:24784894

Hatzimouratidis, K; Buvat, J; Büttner, H; Vendeira, P A S; Moncada, I; Boehmer, M; Henneges, C; Boess, F G

2014-11-01

295

Stress Affects a Gastrin-Releasing Peptide System in the Spinal Cord That Mediates Sexual Function: Implications for Psychogenic Erectile Dysfunction  

Microsoft Academic Search

BackgroundMany men suffering from stress, including post-traumatic stress disorder (PTSD), report sexual dysfunction, which is traditionally treated via psychological counseling. Recently, we identified a gastrin-releasing peptide (GRP) system in the lumbar spinal cord that is a primary mediator for male reproductive functions.Methodology\\/Principal FindingsTo ask whether an acute severe stress could alter the male specific GRP system, we used a single-prolonged

Hirotaka Sakamoto; Ken-Ichi Matsuda; Damian G. Zuloaga; Nobuko Nishiura; Keiko Takanami; Cynthia L. Jordan; S. Marc Breedlove; Mitsuhiro Kawata; Henry Waldvogel

2009-01-01

296

18 National Kidney and Urologic Diseases Information Clearinghouse How can I prevent erectile  

E-print Network

18 National Kidney and Urologic Diseases Information Clearinghouse How can I prevent erectile dysfunction? You can prevent many of the causes of ED by making healthy lifestyle choices. Following a healthy

Baker, Chris I.

297

The Effect of Endovascular Revascularization of Common Iliac Artery Occlusions on Erectile Function  

SciTech Connect

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.

Gur, Serkan, E-mail: mserkangur@yahoo.com [Sifa Hospital, Department of Radiology (Turkey)] [Sifa Hospital, Department of Radiology (Turkey); Ozkan, Ugur [Baskent University, Department of Radiology, Faculty of Medicine (Turkey)] [Baskent University, Department of Radiology, Faculty of Medicine (Turkey); Onder, Hakan; Tekbas, Gueven [Dicle University, Department of Radiology, Faculty of Medicine (Turkey)] [Dicle University, Department of Radiology, Faculty of Medicine (Turkey); Oguzkurt, Levent [Baskent University, Department of Radiology, Faculty of Medicine (Turkey)] [Baskent University, Department of Radiology, Faculty of Medicine (Turkey)

2013-02-15

298

Recovery of erectile function by the oral administration of apomorphine  

Microsoft Academic Search

Objectives. Apomorphine has been reported to be effective in causing erections in animals and man when administered parenterally. The side effects, notably nausea, have seriously limited its clinical usefulness. We formulated apomorphine for controlled sublingual absorption and herein report on four preliminary studies evaluating efficacy and side effects in men with no documentable organic cause of erectile dysfunction.Methods. Patients complaining

Jeremy P. W. Heaton; Alvaro Morales; Michael A. Adams; Brenda Johnston; Ragab El-Rashidy

1995-01-01

299

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

Microsoft Academic Search

Saffron (Crocus sativus Linn.) have been perceived by the public as a strong aphrodisiac herbal product. However, studies addressing the potential beneficial effects of saffron on erectile function (EF) in men with ED are lacking. Our aim was to evaluate the efficacy and safety of saffron administration on EF in men with ED. After a 4-week baseline assessment, 346 men

M R Safarinejad; N Shafiei; S Safarinejad; Safarinejad

2010-01-01

300

On life satisfaction in male erectile dysfunction  

Microsoft Academic Search

A consecutive series of 413 impotent men and 109 References rated their satisfaction with life as a whole and with seven different domains of life along a six graded scale ranging from very satisfied to very dissatisfied. In a subsample of impotent men treated with PGE1 these self-ratings were repeated applying the concept that dissatisfaction reflects an aspirations\\/achievement gap and

AR Fugl-Meyer; G Lodnert; I-B Bränholm; KS Fugl-Meyer

1997-01-01

301

Cell phone usage and erectile function  

PubMed Central

Introduction The objective of this pilot study was to report our experience concerning the effects of cell phone usage on erectile function (EF) in men. Material and Methods We recruited 20 consecutive men complaining of erectile dysfunction (ED) for at least six months (Group A), and another group of 10 healthy men with no complaints of ED (Group B). Anamnesis, basic laboratory investigations, and clinical examinations were performed. All men completed the German version of the Sexual Health Inventory for Men (SHIM) for evaluation of the International Index of Erectile Function (IIEF), as well as another questionnaire designed by our clinicians that assessed cell phone usage habits. Results There was no significant difference between both groups regarding age, weight, height, and total testosterone (Table 1). The SHIM scores of Group A were significantly lower than that of Group B, 11.2 ±5 and 24.2 ±2.3, respectively. Total time spent talking on the cell phone per week was not significantly higher in Group A over B, 17.6 ±11.1 vs. 12.5 ±7 hours. Men with ED were found to carry their ‘switched on’ cell phones for a significantly longer time than those without ED, 4.4 ±3.6 vs. 1.8 ±1 hours per day. Conclusions We found a potential correlation with cell phone usage and a negative impact on EF. Further large–scale studies confirming our initial data and exploring the mechanisms involved in this phenomenon are recommended. PMID:24578997

Patzak, Johanna; Fischereder, Katja; Pummer, Karl; Shamloul, Rany

2013-01-01

302

Vasculogenic mimicry: a novel target for glioma therapy.  

PubMed

Anti-angiogenic therapy has shown promising but insufficient efficacy on gliomas. Recent studies suggest that vasculogenic mimicry (VM), or the formation of non-endothelial, tumor-cell-lined microvascular channels, occurs in aggressive tumors, including gliomas. There is also evidence of a physiological connection between the endothelial-lined vasculature and VM channels. Tumor cells, by virtue of their high plasticity, can form vessel-like structures themselves, which may function as blood supply networks. Our previous study on gliomas showed that microvessel density was comparably less in VM-positive tumors than in VM-negative tumors. Thus, VM may act as a complement to ensure tumor blood supply, especially in regions with less microvessel density. Patients with VM-positive gliomas survived a shorter period of time than did patients with VM-negative gliomas. Although the detailed molecular mechanisms for VM are not fully understood, glioma stem cells might play a key role, since they are involved in tumor tissue remodeling and contribute to neovascularization via transdifferentiation. In the future, successful treatment of gliomas should involve targeting both VM and angiogenesis. In this review, we summarize the progress and challenges of VM in gliomas. PMID:23816560

Chen, Yin-Sheng; Chen, Zhong-Ping

2014-02-01

303

Molecular regulation of vasculogenic mimicry in tumors and potential tumor-target therapy  

PubMed Central

Vasculogenic mimicry (VM)”, is a term that describes the unique ability of highly aggressive tumor cells to express a multipotent, stem cell-like phenotype, and form a pattern of vasculogenic-like networks in three-dimensional culture. As an angiogenesis-independent pathway, VM and/or periodic acid-schiff-positive patterns are associated with poor prognosis in tumor patients. Moreover, VM is resistant to angiogenesis inhibitors. Here, we will review the advances in research on biochemical and molecular signaling pathways of VM in tumors and on potential anti-VM therapy strategy. PMID:21160860

Fan, Yue-Zu; Sun, Wei

2010-01-01

304

ORIGINAL RESEARCH--PHYSIOLOGY The Inhibitory Effects of Nicotine on Physiological Sexual  

E-print Network

as nonsmokers to report erectile dysfunction [12­19]. However, limited research has investigated this link that long-term cigarette smoking is an independent risk factor for the introduction of sexual dysfunction indicates that cigarette smok- ing is an independent risk factor for introducing vasculogenic erectile

Meston, Cindy

305

Vasculogenic mimicry: a new prognostic sign of human osteosarcoma.  

PubMed

Vasculogenic mimicry (VM), a formation of nonendothelial microvascular channels, has been generally recognized as a new pattern of neovascularization in aggressive malignancies. However, whether VM is present and clinically significant in osteosarcoma remains unknown. We identified VM by CD34/periodic acid-Schiff double staining of osteosarcoma specimens before chemotherapy and investigated its prognostic implications. Tumors were also immunohistochemically stained for focal adhesion kinase (FAK) and migration inducing gene 7 (Mig-7) to determine whether these markers are associated with the occurrence of VM. VM was found in 15 of 66 osteoblastic-type osteosarcoma samples (22.7%), and the incidence of VM did not differ with respect to patient sex, age, tumor size, tumor site, surgical type, or histologic response to preoperative chemotherapy. However, Kaplan-Meier survival analysis determined that the presence of VM and the tumor necrosis rate after preoperative chemotherapy are associated with both the overall survival (P = .011 and P = .040, respectively) and metastasis-free survival (P = .002 and P = .045, respectively). Furthermore, Cox proportional hazards analysis showed that the presence of VM and the histologic response to preoperative chemotherapy were independent indicators for both poor overall survival (P = .007 and P = .024, respectively) and poor metastasis-free survival (P = .002 and P = .027, respectively). The expression level of FAK and Mig-7 were higher in the VM group than the non-VM group (P = .017 and P = .021, respectively). These results demonstrate the presence of VM in osteoblastic osteosarcoma and suggest that VM is an unfavorable prognostic factor with FAK and Mig-7 expressions as a potential mechanism of VM formation in osteosarcoma. PMID:25123071

Ren, Ke; Yao, Nan; Wang, Guangye; Tian, Lei; Ma, Jie; Shi, Xin; Zhang, Lei; Zhang, Jian; Zhou, Xing; Zhou, Guangxin; Wu, Sujia; Sun, Xiaoliang

2014-10-01

306

Epidemiology and pathophysiology of male sexual dysfunction  

Microsoft Academic Search

Male sexual dysfunction (MSD) is a common disorder associated with a wide range of physical and psychological conditions. Erectile dysfunction, the most commonly studied aspect of MSD, is common and increases with age and with certain comorbid conditions. The pathophysiology of ED and other forms of MSD can be traced to a variety of etiologies, including vascular, hormonal, psychiatric, iatrogenic

J Kaminetsky

2008-01-01

307

Selective serotonin reuptake inhibitors for premature ejaculation: review of erectile and ejaculatory side effects.  

PubMed

Premature ejaculation is one of the most prevalent sexual disorders affecting men today. The lack of approved therapies has resulted in the prescription of many 'off-label' treatments to manage the condition. Selective serotonin reuptake inhibitors have an interesting side effect of prolonging ejaculatory latency. Consequently, these agents are often considered a first line treatment for patients suffering from premature ejaculation. Erectile dysfunction is another common side effect reported by men treated with selective serotonin reuptake inhibitors. Nitric oxide is the primary mediator of erectile function. Preclinical studies have provided evidence that selective serotonin reuptake inhibitors decrease nitric oxide bioavailability. This invited mini-review aims to examine the physiology of the erectile and ejaculatory responses, discuss the indicated and 'off-label' clinical utility of selective serotonin reuptake inhibitors, and to summarize evidence from basic science and clinical studies pertaining to mechanisms of how selective serotonin reuptake inhibitor therapy modifies ejaculatory and erectile function. PMID:24446888

Lasker, George F; Halis, Fikret; Gokce, Ahmet

2014-01-01

308

Evaluation of Male Sexual Dysfunction  

Microsoft Academic Search

\\u000a The management of male sexual dysfunction and specifically erectile dysfunction (ED) has seen major changes in each decade\\u000a since the 1970s thanks to the discovery that a papaverine injection could produce erection, the NIH Consensus Statement which\\u000a defined ED in 1992, advances in minimally invasive diagnostics, and the development of orally effective erectogenic class\\u000a of drugs, the phosphodiesterase type-5 inhibitors

Gregory A. Broderick

309

10.1177/0897190003253959 ARTICLEHEATHER B. MILLER and JACQUELYN S. HUNTFEMALE SEXUAL DYSFUNCTION Female Sexual Dysfunction: Review of the  

E-print Network

for treatment of male erectile dysfunction has set the stage for more open discussion of female sexual10.1177/0897190003253959 ARTICLEHEATHER B. MILLER and JACQUELYN S. HUNTFEMALE SEXUAL DYSFUNCTION Female Sexual Dysfunction: Review of the Disorder and Evidence for Available Treatment Alternatives

Dever, Jennifer A.

310

Hydroxyurea therapy for priapism prevention and erectile function recovery in sickle cell disease: a case report and review of the literature.  

PubMed

Prolonged ischemic priapism in patients with sickling hemoglobinopathies is a urologic emergency requiring immediate intervention to avoid irreversible anoxic penile injury, corporal fibrosis, and erectile dysfunction. Therapeutic options, however, are limited and often ineffective. Here, we report recovery of erectile function with hydroxyurea therapy in an adolescent with hemoglobin SS following a prolonged episode of priapism and subsequent severe erectile dysfunction. This case suggests a potential role of hydroxyurea in reversing end organ damage in patients with hemoglobin SS and also supports basic science work indicating involvement of the NO-dependent pathway in the pathogenesis of sickle cell disease-associated priapism. PMID:24824148

Anele, Uzoma A; Kyle Mack, A; Resar, Linda M S; Burnett, Arthur L

2014-09-01

311

Visual Stimulation Facilitates Penile Responses to Vibration in Men with and without Erectile Disorder.  

ERIC Educational Resources Information Center

Compared reflexogenic and psychogenic penile responses in men with and without erectile disorder. Hypothesized that men with psychogenic dysfunction respond minimally to vibrotactile stimulation. As predicted, responses were different in the vibration condition. Interpretations are provided in terms of attention and appraisal. (BF)

Janssen, Erick; And Others

1994-01-01

312

Emerging concepts in erectile preservation following radical prostatectomy: a guide for clinicians  

Microsoft Academic Search

Radical prostatectomy (RP) is a commonly performed procedure for the management of prostate cancer. While documented oncologic outcome for early stage disease is excellent, functional impairments such as incontinence and erectile dysfunction (ED) are common after the procedure. Recent evidence has implicated cavernous nerve damage and subsequent corporal oxygen deprivation, as well as corporal inflammation, in the pathogenesis of post-RP

D J Moskovic; B J Miles; L I Lipshultz; M Khera

2011-01-01

313

Prognostic significance and mechanisms of patterned matrix vasculogenic mimicry in hepatocellular carcinoma  

Microsoft Academic Search

Vasculogenic mimicry (VM), including tubular VM and patterned matrix VM, has been generally recognized as a new pattern of\\u000a tumor neovascularization. Pilot studies of tubular VM showed that it was present in hepatocellular carcinoma (HCC) and associated\\u000a with poor clinical prognosis. However, whether patterned matrix VM is clinically significant in HCC is unknown. To elucidate\\u000a the effects of patterned matrix

Wen-bin Liu; Ge-liang Xu; Wei-dong Jia; Jian-sheng Li; Jin-liang Ma; Ke Chen; Zhi-hua Wang; Yong-sheng Ge; Wei-hua Ren; Ji-hai Yu; Wei Wang; Xiu-jun Wang

314

Ejaculatory dysfunction as a cause of infertility  

Microsoft Academic Search

Ejaculatory dysfunction (EjD), the most prevalent male sexual disorder, is clearly different from erectile dysfunction (ED).\\u000a EjD is divided into 4 categories: premature ejaculation, delayed ejaculation, retrograde ejaculation and anejaculation. EjD-related\\u000a infertility is one of the most serious problems in young patients. If sexual intercourse is achieved successfully without\\u000a any ejaculate sexual partners\\/wives will not be able to conceive. Therefore,

Nobuyuki Kondoh

315

Pharmacotherapy of Sexual Dysfunctions : Current Status  

PubMed Central

The sexual dysfunctions are one of the most prevalent conditions. Sexual dysfunctions can have profound effect on the psychological well-being of an individual and the psychosexual relationship of a couple. Management of the sexual dysfunction should be preceded by an accurate diagnosis reached after a complete medical and sexual history and physical examination. Current focus of researchers has been on understanding the pathophysiology of erectile dysfunction, premature ejaculation and other sexual dysfunctions that can help in developing newer pharmacological cures for these conditions. Recently, a number of clinical trials have studied the potential effectiveness of the phosphodiesterase (PDE)-5 inhibitor sildenafil in the treatment of Erectile Dysfunction (ED) and Premature Ejaculation (PME). The introduction of PDE-5 inhibitors like sildenafil, vardenafil and tadalafil has revolutionized the treatment of sexual dysfunctions. This review focuses on the recent pharmacological advances in the treatment of common sexual dysfunctions like ED and PME with special focus on the role of PDE-5 inhibitors. Also discussed is the pharmacological treatment of other less prevalent and recognized disorders like female sexual dysfunction, drug induced sexual dysfunction etc. PMID:21224902

Avasthi, Ajith; Biswas, Parthasarathy

2004-01-01

316

MiR-124 represses vasculogenic mimicry and cell motility by targeting amotL1 in cervical cancer cells.  

PubMed

miRNAs have extensive functions in differentiation, metabolism, programmed cell death, and tumor metastasis by post-transcriptional regulation. Vasculogenic mimicry is an important pathway in tumor metastasis. Many factors can regulate vasculogenic mimicry, including miRNAs. In previous studies, miR-124 was found to repress proliferation and metastasis in different types of cancers, but whether it functions in cervical cancer remained unknown. Here, we demonstrate that miR-124 can repress vasculogenic mimicry, migration and invasion in HeLa and C33A cells in vitro. Furthermore, we reveal that the effect of miR-124 on vasculogenic mimicry, migration and invasion results from its interaction with AmotL1. MiR-124 regulates AmotL1 negatively by targeting its 3'untranslated region (3'UTR). We found that miR-124 can repress the EMT process. Together, these results improve our understanding of the function of miR-124 in tumor metastasis and will help to provide new potential target sites for cervical cancer treatment. PMID:25218344

Wan, Hai-Ying; Li, Qin-Qin; Zhang, Yan; Tian, Wei; Li, Ya-Nan; Liu, Min; Li, Xin; Tang, Hua

2014-12-01

317

Rapamycin suppresses self-renewal and vasculogenic potential of stem cells isolated from infantile hemangioma.  

PubMed

Infantile hemangioma (IH) is a common childhood vascular tumor. Although benign, some hemangiomas cause deformation and destruction of features or endanger life. The current treatments, corticosteroid or propranolol, are administered for several months and can have adverse effects on the infant. We designed a high-throughput screen to identify the Food and Drug Administration-approved drugs that could be used to treat this tumor. Rapamycin, an mTOR (mammalian target of Rapamycin) inhibitor, was identified, based on its ability to inhibit proliferation of a hemangioma-derived stem cell population, human vasculogenic cells, which we had previously discovered. In vitro and in vivo studies show that Rapamycin reduces the self-renewal capacity of the hemangioma stem cells, diminishes differentiation potential, and inhibits the vasculogenic activity of these cells in vivo. Longitudinal in vivo imaging of blood flow through vessels formed with hemangioma stem cells shows that Rapamycin also leads to regression of hemangioma blood vessels, consistent with its known anti-angiogenic activity. Finally, we demonstrate that Rapamycin-induced loss of stemness can work in concert with corticosteroid, the current standard therapy for problematic hemangioma, to block hemangioma formation in vivo. Our studies reveal that Rapamycin targets the self-renewal and vascular differentiation potential in patient-derived hemangioma stem cells, and suggests a novel therapeutic strategy to prevent formation of this disfiguring and endangering childhood tumor. PMID:21938011

Greenberger, Shoshana; Yuan, Siming; Walsh, Logan A; Boscolo, Elisa; Kang, Kyu-Tae; Matthews, Benjamin; Mulliken, John B; Bischoff, Joyce

2011-12-01

318

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

PubMed Central

The seriousness of metabolic syndrome is not due to the disease itself but its promotion of other diseases, such as erectile dysfunction and cardiovascular and cerebrovascular diseases. We investigated the effects of Korean red ginseng (KRG, Panax ginseng) extract on erectile function in a rat model of metabolic syndrome. We divided the rats into three groups: control, metabolic syndrome+normal saline (N/S) and metabolic syndrome+KRG. To determine the occurrence of metabolic syndrome in all groups, body weight and various biochemical parameters (e.g., blood glucose, insulin, cholesterol) were measured, and the intra-abdominal glucose tolerance test was performed. To investigate penile erection, the peak intracavernosal pressure (ICP), mean arterial pressure (MAP) and Masson's trichrome stain were evaluated. Erectile function was also investigated by measuring the cyclic guanosine monophosphate (cGMP) levels of the corpus cavernosum. We found that the various biochemical parameters and body weight were similar in the metabolic syndrome+KRG group and the control group, although the values were slightly higher. The peak ICP/MAP ratio of the metabolic syndrome+N/S group was markedly decreased compared to the other groups. The cGMP level of the corpus cavernosum in the metabolic syndrome+N/S group was significantly lower than that of the other groups. As demonstrated in this model of metabolic syndrome with erectile dysfunction, KRG may improve erectile function. PMID:23377529

Kim, Sung-Dae; Kim, Young-Joo; Huh, Jung-Sik; Kim, Sae-Woong; Sohn, Dong-Wan

2013-01-01

319

Chronic Oral Administration of the Arginase Inhibitor 2(S)-amino-6-boronohexanoic Acid (ABH) Improves Erectile Function in Aged Rats  

PubMed Central

Arginase expression and activity have been noted to be heightened in conditions associated with erectile dysfunction, including aging. Previously, arginase inhibition by chronic administration of the arginase inhibitor 2-(S)-amino-6-boronohexanoic acid (ABH) has been shown to improve endothelial dysfunction in aged rats. The objective of this study was to assess whether chronic oral ABH administration affects cavernosal erectile function. Rats were divided into 4 groups: young control, young treated with arginase inhibitor, aged control, and aged treated with arginase inhibitor. Arginase activity was measured and presented as a proportion of young untreated rats. In vivo erectile responses to cavernous nerve stimulation were measured in all cohorts. The cavernous nerve was stimulated with a graded electrical stimulus, and the intracavernosal/ mean arterial pressure ratios and total intracavernosal pressure were recorded. Arginase activity was elevated in the aged rats compared with young controls; however, arginase activity was significantly decreased in aged rats treated with ABH. With the addition of ABH, erectile responses improved in the aged rats (P < .05). Oral inhibition of arginase with ABH results in improved erectile function in aged rats, resulting in erectile hemodynamics similar to young rats. This represents the first documentation of systemic arginase inhibition positively affecting corporal cavernosal function. PMID:22492840

Segal, Robert; Hannan, Johanna L.; Liu, Xiaopu; Kutlu, Omer; Burnett, Arthur L.; Champion, Hunter C.; Kim, Jae Hyung; Steppan, Jochen; Berkowitz, Dan E.; Bivalacqua, Trinity J.

2014-01-01

320

Thyroid hormone: the modulator of erectile function in the rabbit.  

PubMed

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 erection monitored as contractile force of the erectile tissue, sperm count and motility; in parallel with the haematocrit, red cell count or rheology, Heart Rate (HR), Mean Arterial Pressure (MAP), Thyroid Stimulating Hormones (TSH) and Thyroxine levels. Hypothyroidism or thyroidectomy was found to cause depletion of Endothelium Derived Relaxant Factor (EDRF) thereby causing very feeble contraction of the cavernosum muscle, in both prostaglandin E1 (PGE1) and sildenafil, oligospermia and less than 45 % motile sperms. Thyroxine treatment produced contraction proportionate to the concentrations of PGE1 and Sildenafil; providing evidence that the erectogenic actions of both PGE1 and Sildenafil are possible only in the presence of adequate thyroid hormone level. PMID:17242734

Amadi, K; Sabo, M A; Sagay, A S

2006-01-01

321

Internet-Based Brief Sex Therapy for Heterosexual Men with Sexual Dysfunctions: A Randomized Controlled Pilot Trial  

Microsoft Academic Search

Introduction. Internet-based sex therapy for men with erectile dysfunction has been advocated as an easily accessible and cost-effective treatment. Aim. To test whether Internet-based sex therapy is superior to waiting list. Methods. Internet-based therapy was administered to heterosexual men with erectile dysfunction or premature ejaculation, without face-to-face contact, in a waiting-list controlled design, with pre-, post-, and follow-up mea- surements

Peter Leusink; Selma van Diest; Luk Gijs; A. Koos Slob

2009-01-01

322

Stem cells: novel players in the treatment of erectile dysfunction  

Microsoft Academic Search

Stem cells are defined by their capacity for both self-renewal and directed differentiation; thus, they represent great promise for regenerative medicine. Historically, stem cells have been categorized as either embryonic stem cells (ESCs) or adult stem cells (ASCs). It was previously believed that only ESCs hold the ability to differentiate into any cell type, whereas ASCs have the capacity to

Haiyang Zhang; Maarten Albersen; Xunbo Jin; Guiting Lin

2012-01-01

323

The Clinical Pharmacokinetics of Phosphodiesterase5 Inhibitors for Erectile Dysfunction  

Microsoft Academic Search

Differences in the clinical pharmacology of the 3 currently available oral phosphodiesterase-5 (PDE5) inhibitors, sildenafil, vardenafil, and tadalafil, are largely determined by their clinical pharmacokinetics as well as their PDE inhibitory activity profile. This review comparatively discusses the major characteristics of the pharmacokinetic profile of all 3 PDE5 inhibitors, including bioavailability and rate of absorption, Biopharmaceutical Classification System categorization, elimination

Manish Gupta; Andreas Kovar; Bernd Meibohm

2005-01-01

324

Urinary Dysfunction  

MedlinePLUS

... PCF Spotlight Glossary African American Men Living with Prostate Cancer Urinary Dysfunction Side Effects Urinary Dysfunction Bowel Dysfunction ... dysfunction is normal following initial therapy for localized prostate cancer. But it’s important to realize that not all ...

325

NS11021, a novel opener of large-conductance Ca2+-activated K+ channels, enhances erectile responses in rats  

PubMed Central

Background and purpose: Large-conductance Ca2+-activated K+ channels (BKCa), located on the arterial and corporal smooth muscle, are potential targets for treatment of erectile dysfunction (ED). This study investigated whether NS11021 (1-(3,5-Bis-trifluoromethyl-phenyl)-3-[4-bromo-2-(1H-tetrazol-5-yl)-phenyl]-thiourea), a novel opener of BKCa channels, relaxes erectile tissue in vitro and enhances erectile responses in intact rats. The effects were compared with sildenafil, an inhibitor of phosphodiesterase type 5. Experimental approach: Patch clamp was used to record whole cell current in rat isolated corpus cavernosum smooth muscle cells (SMCs) and human umbilical vein endothelial cells (HUVECs). Isometric tension was measured in intracavernous arterial rings and corpus cavernosum strips isolated from rats and men, and simultaneous measurements of intracellular Ca2+ concentration ([Ca2+]i) and tension were performed in intracavernous arteries. Erectile response was measured in anaesthetized rats. Key results: In patch clamp recordings, NS11021 increased currents sensitive to the selective BKCa channel blocker, iberiotoxin (IbTX) in SMCs, but did not modulate K+ current in HUVECs. NS11021 reduced [Ca2+]i and tension in penile arteries. IbTX inhibited the vasorelaxation induced by NS11021 and sildenafil in human erectile tissue. NS11021 and sildenafil but not vehicle increased erectile responses in anaesthetized rats, an effect which was abolished after pretreatment with tetraethylammonium. Conclusions and implications: NS11021 leads to relaxation of both intracavernous arteries and corpus cavernosum strips primarily through opening of BKCa channels. It is also effective in facilitating erectile responses in anaesthetized rats. These results suggest a potential for use of BKCa openers in the treatment of ED. PMID:19845682

Kun, A; Matchkov, VV; Stankevicius, E; Nardi, A; Hughes, AD; Kirkeby, HJ; Demnitz, J; Simonsen, U

2009-01-01

326

Sexual Dysfunction after Radical Prostatectomy  

PubMed Central

Sexual dysfunction associated with radical retropubic prostatectomy (RRP) may start before the surgery. Men undergoing RRP frequently have some degree of sexual dysfunction. In addition to the psychological stress of the diagnosis, the biopsy may itself have a detrimental effect. After surgery, all men will experience loss of ejaculate, because the organ responsible for ejaculate has been removed. Orgasm quality is adversely affected in many men. Erectile dysfunction is immediate and recovery from it is slow. Initially, phosphodiesterase (PDE)-5 inhibitors do not work, and they take up to 18 months for their effect to be maximized. Younger men who have had bilateral nerve-sparing procedures respond the best. Combination treatment with prostaglandin E1 or high-dose PDE-5 inhibitors may provide salvage therapy when initial PDE-5 inhibitor therapy has failed. PMID:16985895

McCullough, Andrew R

2005-01-01

327

Androgens Modulate Endothelial Function and Endothelial Progenitor Cells in Erectile Physiology  

PubMed Central

The incidence of erectile dysfunction (ED) increases with age and cardiovascular disease risk factors, such as hypertension, hyperlipidemia, insulin resistance, obesity, and diabetes. These risk factors are thought to contribute to endothelial dysfunction and atherosclerosis, thus contributing to the pathophysiology of ED. The role of the endothelium in regulating erectile physiology is well established. However, the role of androgens in modulating endothelial function and endothelial repair mechanisms subsequent to vascular injury in erectile tissue remains a subject of intensive research. The clinical and preclinical evidence discussed in this review suggests that androgens regulate endothelial function and also play an important role in the development and maturation of endothelial progenitor cells (EPCs), which are thought to play a critical role in repair of endothelial injury in vascular beds. In this review, we discuss the data available on the effects of androgens on endothelial function and EPCs in the repair of vascular injury. Indeed, more research is needed to fully understand the molecular and cellular basis of androgen action in regulating the development, differentiation, maturation, migration, and homing of EPCs to the site of injury. A better understanding of these processes will be critical to the development of new therapeutic approaches to the treatment of vascular ED. PMID:24255752

Galoosian, Artin

2013-01-01

328

Sildenafil in the Treatment of Sexual Dysfunction in Spinal Cord–Injured Male Patients  

Microsoft Academic Search

Objectives: The aim of this study was to evaluate the efficacy and safety of sildenafil in the treatment of erectile dysfunction (ED) in spinal cord–injury (SCI) patients. Moreover, we looked for neurological conditions permitting therapeutic success and for the ideal dose needed to achieve sufficient erections.Methods: 41 SCI patients were prospectively examined. Sexual dysfunction was assessed by means of anamnesis,

Daniel Max Schmid; Brigitte Schurch; Dieter Hauri

2000-01-01

329

Erectile Function Outcomes in the Current Era of Anatomic Nerve-Sparing Radical Prostatectomy  

PubMed Central

The contemporary use of anatomic nerve-sparing radical prostatectomy, which entails preserving the autonomic nerve supply to the penis required for penile erection, has led to improved erectile function outcomes compared with what has been seen historically. However, delay of postoperative recovery of erection for as long as 2 years is common, such that dysfunctional erection status lingers as a major postoperative problem. Several possible strategies to improve overall recovery rates and to hasten postoperative recovery of erectile function are currently being advanced. These include pharmacologic rehabilitation therapy and neuromodulatory therapy. Rigorous basic scientific investigation and clinical assessment of these new strategic approaches are critically important to establish their actual therapeutic benefits. PMID:17021626

Burnett, Arthur L

2006-01-01

330

OCT4 Expression and Vasculogenic Mimicry Formation Positively Correlate with Poor Prognosis in Human Breast Cancer.  

PubMed

To evaluate the prognostic value of OCT4 expression and vasculogenic mimicry (VM) in human breast cancer, we examined OCT4 expression and VM formation using immunohistochemistry and CD31/PAS (periodic acid-schiff) double staining on 90 breast cancer specimens. All patients were followed up for five-149 months following surgery. Survival curves were generated using Kaplan-Meier method. Multivariate analysis was performed using Cox regression model to assess the prognostic values. Results showed positive correlation between OCT4 expression and VM formation (p < 0.05). Both OCT4 expression and VM were also positively correlated with lymph node metastasis, higher histological grade, and Nottingham prognostic index (p < 0.05). Patients with OCT4 expression or VM formation exhibited poorer overall survival (OS) and disease-free survival (DFS) than OCT4-negative or VM-negative patients (p < 0.05). OCT4-positive/VM-positive patients also had the worst OS and DFS (p < 0.05). In multivariate survival analysis, VM, Nottingham prognostic index (NPI), and Her2 were independent prognostic factors related to OS and OCT4-positive/VM-positive patients, whereas NPI and Her2 were independent predictors of DFS. These results suggest that a combined OCT4 expression/VM could improve the prognostic judgment for breast cancer patients. PMID:25353179

Liu, Tieju; Sun, Baocun; Zhao, Xiulan; Li, Yanlei; Gu, Qiang; Dong, Xueyi; Liu, Fang

2014-01-01

331

Merkel cell carcinoma expresses vasculogenic mimicry: demonstration in patients and experimental manipulation in xenografts.  

PubMed

Merkel cell carcinoma (MCC) is a highly virulent cutaneous neoplasm that, like melanoma, is a frequent cause of patient morbidity and mortality. The cellular mechanisms responsible for the aggressive behavior of MCC remain unknown. Vasculogenic mimicry (VM) is a phenomenon associated with cancer virulence, including in melanoma, whereby anastomosing laminin networks form in association with tumor cells that express certain endothelial genes. To determine whether VM is a factor in MCC, we employed a relevant xenograft model using two independent human MCC lines. Experimentally induced tumors were remarkably similar histologically to patient MCC, and both contained laminin networks associated with vascular endothelial-cadherin (CD144) and vascular endothelial growth factor receptor 1, as well as Nodal expression typical of VM in melanoma. Moreover, two established chemotherapeutic agents utilized for human MCC, etoposide and carboplatin, induced necrosis in xenografts on systemic administration while enriching for laminin networks in apparently resistant viable tumor regions that persisted. These findings for the first time establish VM-like laminin networks as a biomarker in MCC, demonstrate the experimental utility of the MCC xenograft model, and suggest that VM-rich regions of MCC may be refractory to conventional chemotherapeutic agents. PMID:25111691

Lezcano, Cecilia; Kleffel, Sonja; Lee, Nayoung; Larson, Allison R; Zhan, Qian; DoRosario, Andrew; Wang, Linda C; Schatton, Tobias; Murphy, George F

2014-10-01

332

The Gay Men Sex Studies: prevalence of sexual dysfunctions in Belgian HIV(+) gay men.  

PubMed

The aim of this Internet-based survey was to investigate the prevalence and associated predictors of sexual dysfunctions in Belgian self-reported HIV-positive men who have sex with other men. Of the 72 participants, 56% had a mild-to-severe erectile dysfunction, and 15% reported a hypoactive sexual desire disorder. The prevalence of premature ejaculation and anodyspareunia was 18% for both. Independent predictors for erectile dysfunction were frequency of masturbation, frequency of sex with partner, use of erectile enhancement drugs, having a passive sex role, and not having a steady relationship. Independent predictors for hypoactive sexual desire disorder were frequency of masturbation and having a lower lifetime number of sexual partners. Independent predictors for premature ejaculation were not having a steady relationship, having a lower lifetime number of sexual partners, and a lower level of education. The only independent predictor for anodyspareunia was having an active sex role. PMID:23671398

Vansintejan, Johan; Janssen, Joris; Van De Vijver, Erwin; Vandevoorde, Jan; Devroey, Dirk

2013-01-01

333

[Structural and functional cardiac changes and sex hormone levels in men with sexual dysfunctions].  

PubMed

44 men with chronic prostatitis were examined for structural-functional heart alterations with reference to severity of erectile dysfunction (ED). Sex hormones were also estimated. Control group consisted of 20 healthy men. Doppler echocardiography, 24-h monitoring of arterial pressure (AP) and ECG, finger and ultrasound investigation of the prostatic gland and microscopy of its secretion were made. Blood plasm testosteron, prolactin and dehydroepiandrosterone-sulphate were estimated by enzyme immunoassay. Erectile function was assessed by the questionnaire "International index of erectile function". Thus, sexual hormone changes associated with sexual dysfunction in men promote left ventricular diastolic dysfunction. The type of intracardiac hemodynamics in this case is, as a rule, restrictive. PMID:15164508

Iskenderov, B G; Vakina, T N; Shutov, A M

2004-01-01

334

Expression Profiling of Galectin-3-Depleted Melanoma Cells Reveals its Major Role in Melanoma Cell Plasticity and Vasculogenic Mimicry  

PubMed Central

Galectin-3 (Gal-3) is a ?-galactoside-binding protein that is involved in cancer progression and metastasis. Using a progressive human melanoma tissue microarray, we previously demonstrated that melanocytes accumulate Gal-3 during the progression from benign to dysplastic nevi to melanoma and further to metastatic melanoma. Herein, we show that silencing of Gal-3 expression with small hairpin RNA results in a loss of tumorigenic and metastatic potential of melanoma cells. In vitro, Gal-3 silencing resulted in loss of tumor cell invasiveness and capacity to form tube-like structures on collagen (“vasculogenic mimicry”). cDNA microarray analysis after Gal-3 silencing revealed that Gal-3 regulates the expression of multiple genes, including endothelial cell markers that appear to be aberrantly expressed in highly aggressive melanoma cells, causing melanoma cell plasticity. These genes included vascular endothelial-cadherin, which plays a pivotal role in vasculogenic mimicry, as well as interleukin-8, fibronectin-1, endothelial differentiation sphingolipid G-protein receptor-1, and matrix metalloproteinase-2. Chromatin immunoprecipitation assays and promoter analyses revealed that Gal-3 silencing resulted in a decrease of vascular endothelial-cadherin and interleukin-8 promoter activities due to enhanced recruitment of transcription factor early growth response-1. Moreover, transient overexpression of early growth response-1 in C8161-c9 cells resulted in a loss of vascular endothelial-cadherin and interleukin-8 promoter activities and protein expression. Thus, Gal-3 plays an essential role during the acquisition of vasculogenic mimicry and angiogenic properties associated with melanoma progression. PMID:18988806

Mourad-Zeidan, Alexandra A.; Melnikova, Vladislava O.; Wang, Hua; Raz, Avraham; Bar-Eli, Menashe

2008-01-01

335

[Questionnaires on male sexual dysfunction and their clinical application].  

PubMed

With the increasing incidence and prevalence of male sexual dysfunction, andrologists are more and more in need of accurate and efficient tools to assess therapeutic efficacy and patients' satisfaction and to help patients achieve satisfactory treatment results. This article summarizes some of the most commonly used questionnaires for the diagnosis and assessment of the treatment of male sexual dysfunction, including International Index of Erectile Function (IIEF), Erection Hardness Score (EHS), Quality of Erection Questionnaire (QEQ), Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), Treatment Satisfaction Scale (TSS), Self-Esteem and Relationship (SEAR), Premature Ejaculation Profile (PEP), Premature Ejaculation Diagnostic Tool (PEDT), Index of Premature Ejaculation (IPE), Arabic Index of Premature Ejaculation (AIPE), Aging Male Symptoms Scale (AMS), Androgen Deficiency in the Aging Male (ADAM), and Symptomatic Inventory for Screening Late-Onset Hypogonadism in Males (SILOH), and presents an overview on their clinical application. PMID:25306815

Cai, Yang; Wang, Tao; Liu, Ji-Hong

2014-09-01

336

Bladder, Bowel, and Sexual Dysfunction in Parkinson's Disease  

PubMed Central

Bladder dysfunction (urinary urgency/frequency), bowel dysfunction (constipation), and sexual dysfunction (erectile dysfunction) (also called “pelvic organ” dysfunctions) are common nonmotor disorders in Parkinson's disease (PD). In contrast to motor disorders, pelvic organ autonomic dysfunctions are often nonresponsive to levodopa treatment. The brain pathology causing the bladder dysfunction (appearance of overactivity) involves an altered dopamine-basal ganglia circuit, which normally suppresses the micturition reflex. By contrast, peripheral myenteric pathology causing slowed colonic transit (loss of rectal contractions) and central pathology causing weak strain and paradoxical anal sphincter contraction on defecation (PSD, also called as anismus) are responsible for the bowel dysfunction. In addition, hypothalamic dysfunction is mostly responsible for the sexual dysfunction (decrease in libido and erection) in PD, via altered dopamine-oxytocin pathways, which normally promote libido and erection. The pathophysiology of the pelvic organ dysfunction in PD differs from that in multiple system atrophy; therefore, it might aid in differential diagnosis. Anticholinergic agents are used to treat bladder dysfunction in PD, although these drugs should be used with caution particularly in elderly patients who have cognitive decline. Dietary fibers, laxatives, and “prokinetic” drugs such as serotonergic agonists are used to treat bowel dysfunction in PD. Phosphodiesterase inhibitors are used to treat sexual dysfunction in PD. These treatments might be beneficial in maximizing the patients' quality of life. PMID:21918729

Sakakibara, Ryuji; Kishi, Masahiko; Ogawa, Emina; Tateno, Fuyuki; Uchiyama, Tomoyuki; Yamamoto, Tatsuya; Yamanishi, Tomonori

2011-01-01

337

Gene transfer of endothelial nitric oxide synthase to the penis augments erectile responses in the aged rat  

PubMed Central

Nitric oxide (NO), a mediator involved in penile erection, is synthesized by the nitric oxide synthase (NOS) family of enzymes. It has been shown that NOS activity decreases with age. To determine whether adenoviral-mediated overexpression of endothelial NOS (eNOS) could enhance erectile responses, we administered a recombinant adenovirus containing the eNOS gene (AdCMVeNOS) into the corpora cavernosum of the aged rat. Adenoviral expression of the ?-galactosidase reporter gene was observed in cavernosal tissue 1 day after intracavernosal administration of AdCMV?gal; 1 day after administration of AdCMVeNOS, transgene expression was confirmed by immunoblot staining of eNOS protein, and cGMP levels were increased. The increase in cavernosal pressure in response to cavernosal nerve stimulation was enhanced in animals transfected with eNOS, and erectile responses to acetylcholine and zaprinast were enhanced at a time when the erectile response to the NO donor sodium 1-(N,N-diethylamino)diazen-1-ium-1,2-diolate was not altered. These results suggest that in vivo gene transfer of eNOS, alone or in combination with a type V phosphodiesterase inhibitor, may constitute a new therapeutic intervention for the treatment of erectile dysfunction. PMID:10500231

Champion, H. C.; Bivalacqua, T. J.; Hyman, A. L.; Ignarro, L. J.; Hellstrom, W. J. G.; Kadowitz, P. J.

1999-01-01

338

Nicotinamide Inhibits Vasculogenic Mimicry, an Alternative Vascularization Pathway Observed in Highly Aggressive Melanoma  

PubMed Central

Vasculogenic mimicry (VM) describes functional vascular channels composed only of tumor cells and its presence predicts poor prognosis in melanoma patients. Inhibition of this alternative vascularization pathway might be of clinical importance, especially as several anti-angiogenic therapies targeting endothelial cells are largely ineffective in melanoma. We show the presence of VM structures histologically in a series of human melanoma lesions and demonstrate that cell cultures derived from these lesions form tubes in 3D cultures ex vivo. We tested the ability of nicotinamide, the amide form of vitamin B3 (niacin), which acts as an epigenetic gene regulator through unique cellular pathways, to modify VM. Nicotinamide effectively inhibited the formation of VM structures and destroyed already formed ones, in a dose-dependent manner. Remarkably, VM formation capacity remained suppressed even one month after the complete withdrawal of Nicotimamid. The inhibitory effect of nicotinamide on VM formation could be at least partially explained by a nicotinamide-driven downregulation of vascular endothelial cadherin (VE-Cadherin), which is known to have a central role in VM. Further major changes in the expression profile of hundreds of genes, most of them clustered in biologically-relevant clusters, were observed. In addition, nicotinamide significantly inhibited melanoma cell proliferation, but had an opposite effect on their invasion capacity. Cell cycle analysis indicated moderate changes in apoptotic indices. Therefore, nicotinamide could be further used to unravel new biological mechanisms that drive VM and tumor progression. Targeting VM, especially in combination with anti-angiogenic strategies, is expected to be synergistic and might yield substantial anti neoplastic effects in a variety of malignancies. PMID:23451174

Shalmon, Bruria; Kubi, Adva; Treves, Avraham J.; Shapira-Frommer, Ronnie; Avivi, Camilla; Ortenberg, Rona; Ben-Ami, Eytan; Schachter, Jacob; Besser, Michal J.; Markel, Gal

2013-01-01

339

Osteopontin as a key mediator for vasculogenic mimicry in hepatocellular carcinoma.  

PubMed

Osteopontin (OPN) is overexpressed in a variety of cancers including hepatocellular carcinoma (HCC), and is likely involved in the process of vasculogenic mimicry (VM) in some tumor cells. In this study, we explored whether OPN plays a role for VM in HCC. Metastatic MHCC97-H human HCC cells and non-metastatic Hep3B human HCC cells were compared for their abilities to establish VM. Three dimensional-culture assays showed that MHCC97-H cells but not Hep3B cells were able to form the chord-like structure that represents VM. Real-time RT-PCR arrays were used to detect gene expression profiles of the two HCC cell lines in three-dimensional culture. PCR array analyses revealed the increased expression of OPN in MHCC97-H cells forming VM compared with Hep3B cells. Small interfering RNA was employed to investigate whether OPN knockdown could influence VM, and the expression of matrix metalloproteinase (MMP)-2, MMP-9 and urokinase-type plasminogen activator (uPA) in MHCC97-H cells. OPN knockdown resulted in a significant decrease in the ability of MHCC97-H cells to form VM, which was accompanied by the down-regulation of MMP-2 and uPA expression. Furthermore, human HCC tissue samples were studied by immunohistochemistry to analyze the correlations between VM and the expression of OPN, MMP-2 and uPA. There existed significant positive correlations between VM and the expression of OPN, MMP-2 and uPA in HCC tissue samples. In conclusion, OPN is required for VM in HCC cells, and its action may be associated with activation of MMP-2 and uPA. OPN-targeted therapeutics may be useful for patients with advanced HCC. PMID:21512310

Liu, Wenbin; Xu, Geliang; Ma, Jinliang; Jia, Weidong; Li, Jiansheng; Chen, Ke; Wang, Wei; Hao, Chen; Wang, Yongcang; Wang, Xiujun

2011-01-01

340

Association of Notch1 with vasculogenic mimicry in human hepatocellular carcinoma cell lines  

PubMed Central

Background and aims: According to recent findings, some tumor cells function as endothelial progenitor cells to initiate tumor vasculogenesis, known as “vasculogenic mimicry” (VM). Notch1, the key regulator of vasculogenesis and embryonic differentiation, has shown a correlation with a poor prognosis in hepatocellular carcinoma (HCC). We attempted to elucidate the relationship between Notch1 and the vascularization of HCC. Materials and methods: HCC cell lines were assayed for tube formation and low-density lipoprotein (LDL) absorption. The translation level of targets of interest was verified using western blot. Notch1 was silenced in HepG2, BEL-7402 and HCCLM6 using lentivirus shRNA. A hypoxic culture was conducted in an anaerobic culture chamber to induce VM in HepG2. Samples from 53 patients with HCC, i.e., 5 with metastasis and 48 without were tested for Notch1+ cells and CD34 negative plus Periodic Acid-Schiff (PAS) positive structures, respectively. Results: BEL-7402 and HCCLM6 were capable of tube formation and LDL absorption in vitro, while HepG2 was negative for both. Notch1 down-regulation suppressed endothelial marker expression and greatly impaired tube formation. After hypoxic culture, the tube formation capacity of HepG2 was significantly enhanced, along with an increase in Notch1 expression. Notch1 was strongly and profusely expressed in all 5 cases of distant metastasis, while 19 of the 48 cases without metastasis were sparsely positive (P < 0.05). Notch1 positivity was mainly seen in the cytoplasm and nuclei. VM structures were only found in 2 cases from the metastasis group (P < 0.05). Conclusions: HCC is capable of VM. Notch1 might serve as a potential target for VM development in HCC. PMID:25337219

Zhu, Man-Sheng; Xu, Lei-Bo; Zeng, Hong; Shi, Xiang-De; Wu, Wen-Rui; Liu, Chao

2014-01-01

341

Molecular Regulation of Tumor Cell Vasculogenic Mimicry by Tyrosine Phosphorylation: Role of Epithelial Cell Kinase (Eck\\/EphA2)1  

Microsoft Academic Search

During embryogenesis, blood vessels are formed initially by the process of vasculogenesis, the in situ differentiation of mesenchymal cells into endothelial cells, which form a primitive, patterned vasculogenic network. This is followed by angiogenesis, the sprouting of new vessels from pre- existing vasculature, to yield a more refined microcirculation. However, we and our collaborators have recently described a process termed

Angela R. Hess; Elisabeth A. Seftor; Lynn M. G. Gardner; Kelly Carles-Kinch; Galen B. Schneider; Richard E. B. Seftor; Michael S. Kinch; Mary J. C. Hendrix

342

[Psychological theories and treatments of erectile impotence].  

PubMed

The conceptual inaccuracies and the diagnostic difficulties encountered in the study of erectile impotence are underlined by the author. After a review and critique of the psychoanalytical and behavioral trends, of the "new sex therapy" and of cognitivism, the therapeutic methods which derive from these concepts are compared with each other. A particular attention is devoted to anxiety since its definition and prevalence varies considerably in the literature despite a misleading superficial similarity. PMID:3893044

Mormont, C

1985-01-01

343

Current Concepts in Ejaculatory Dysfunction  

PubMed Central

Although erectile dysfunction has recently become the most well-known aspect of male sexual dysfunction, the most prevalent male sexual disorders are ejaculatory dysfunctions. Ejaculatory disorders are divided into 4 categories: premature ejaculation (PE), delayed ejaculation, retrograde ejaculation, and anejaculation/anorgasmia. Pharmacologic treatment for certain ejaculatory disorders exists, for example the off-label use of selective serotonin reuptake inhibitors for PE. Unfortunately, the other ejaculatory disorders are less studied and not as well understood. This review revisits the physiology of the normal ejaculatory response, specifically explores the mechanisms of anejaculation, and presents emerging data. The neurophysiology of the ejaculatory reflex is complex, making classification of the role of individual neurotransmitters extremely difficult. However, recent research has elucidated more about the role of serotonin and dopamine at the central level in the physiology of both arousal and orgasm. Other recent studies that look at differing pharmacokinetic profiles and binding affinities of the ?1-antagonists serve as an indication of the centrally mediated role of ejaculation and orgasm. As our understanding of the interaction between central and peripheral modulations and regulation of the process of ejaculation increases, the probability of developing centrally acting pharmaceutical agents for the treatment of sexual dysfunction approaches reality. PMID:17215997

Wolters, Jeffrey P; Hellstrom, Wayne J. G

2006-01-01

344

Acetylsalicylic acid protects erectile function in diabetic rats.  

PubMed

We aimed to evaluate the effect of acetylsalicylic acid (ASA) treatment on diabetes-induced erectile dysfunction. Adult male Sprague-Dawley rats were divided into four groups as follows: (i) control (C), (ii) diabetic (D), (iii) ASA-treated control (C+ASA) and (iv) ASA-treated diabetic (D+ASA) groups. In groups 2 and 4, diabetes was induced by injection of 35 mg kg(-1) streptozotocin. ASA (100 mg kg(-1) day(-1) , orally) was administrated to rats in groups 3 and 4 for 8 weeks. Both intracavernosal pressure (ICP) and mean arterial blood pressure (MAP) were measured in in vivo studies. In organ bath, the relaxation responses to acetylcholine (ACh), electrical field stimulation (EFS) and sodium nitroprusside were tested in corpus cavernosum (CC) strips. The mRNA expression for neuronal nitric oxide synthase (nNOS) was calculated using reverse transcription polymerase chain reaction technique. In in vivo experiments, diabetic rats displayed reduced ICP/MAP values, which were normalised with ASA treatment. The relaxant response to high-dose ACh and EFS at low frequencies (1-8 Hz) in CC strips from the D+ASA group were significantly higher when compared to the D group. Treatment with ASA normalised the raised mRNA expressions of nNOS in diabetic penile tissues. ASA may be involved in mRNA of protein synthesis of NO released from nonadrenergic and noncholinergic cavernosal nerve in diabetes. PMID:24428436

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

2014-11-01

345

BNIP3 supports melanoma cell migration and vasculogenic mimicry by orchestrating the actin cytoskeleton  

PubMed Central

BNIP3 is an atypical BH3-only member of the BCL-2 family of proteins with reported pro-death as well as pro-autophagic and cytoprotective functions, depending on the type of stress and cellular context. In line with this, the role of BNIP3 in cancer is highly controversial and increased BNIP3 levels in cancer patients have been linked with both good as well as poor prognosis. In this study, using small hairpin RNA (shRNA) lentiviral transduction to stably knockdown BNIP3 (BNIP3-shRNA) expression levels in melanoma cells, we show that BNIP3 supports cancer cell survival and long-term clonogenic growth. Although BNIP3-shRNA increased mitochondrial mass and baseline levels of reactive oxygen species production, which are features associated with aggressive cancer cell behavior, it also prevented cell migration and completely abolished the ability to form a tubular-like network on matrigel, a hallmark of vasculogenic mimicry (VM). We found that this attenuated aggressive behavior of these melanoma cells was underscored by severe changes in cell morphology and remodeling of the actin cytoskeleton associated with loss of BNIP3. Indeed, BNIP3-silenced melanoma cells displayed enhanced formation of actin stress fibers and membrane ruffles, while lamellopodial protrusions and filopodia, tight junctions and adherens junctions were reduced. Moreover, loss of BNIP3 resulted in re-organization of focal adhesion sites associated with increased levels of phosphorylated focal adhesion kinase. Remarkably, BNIP3 silencing led to a drop of the protein levels of the integrin-associated protein CD47 and its downstream signaling effectors Rac1 and Cdc42. These observations underscore that BNIP3 is required to maintain steady-state levels of intracellular complexes orchestrating the plasticity of the actin cytoskeleton, which is integral to cell migration and other vital processes stimulating cancer progression. All together these results unveil an unprecedented pro-tumorigenic role of BNIP3 driving melanoma cell's aggressive features, like migration and VM. PMID:24625986

Maes, H; Van Eygen, S; Krysko, D V; Vandenabeele, P; Nys, K; Rillaerts, K; Garg, A D; Verfaillie, T; Agostinis, P

2014-01-01

346

Prognostic significance and mechanisms of patterned matrix vasculogenic mimicry in hepatocellular carcinoma.  

PubMed

Vasculogenic mimicry (VM), including tubular VM and patterned matrix VM, has been generally recognized as a new pattern of tumor neovascularization. Pilot studies of tubular VM showed that it was present in hepatocellular carcinoma (HCC) and associated with poor clinical prognosis. However, whether patterned matrix VM is clinically significant in HCC is unknown. To elucidate the effects of patterned matrix VM on prognosis of HCC and the mechanisms involved in VM formation, we examined 151 cases of surgically resected human HCC by immunohistochemistry and transmission electron microscopy and conducted hypoxic experiments on human HCC cell line MHCC97-H. We observed 31 of 151 (20.5%) cases exhibited evidence of patterned matrix VM. The expression of patterned matrix VM was associated with larger tumors (P = 0.042), vascular invasion (P = 0.016), high-grade HCC (P = 0.022), and late-stage HCC (P = 0.013). Kaplan-Meier survival analysis revealed that cases of the VM group had lower overall survival (OS) rate (P < 0.001) and disease-free survival (DFS) rate (P = 0.002) than that of the non-VM group. Univariate and multivariate analysis indicated that the presence of patterned matrix VM was independent adverse prognostic factor for both OS (P = 0.004) and DFS (P = 0.011). Expression of hypoxia-inducible factor 1 alpha (HIF-1alpha), matrix metalloproteinase (MMP)-2, and MMP-9 were higher in the VM group than in the non-VM group (P = 0.001, P = 0.030, P = 0.007, respectively). After VM formation was induced by hypoxia, up-regulated expression of HIF-1?, MMP-2, and MMP-9 was also detected in cells cultured under hypoxia condition. Our results indicate that patterned matrix VM exists in HCC, and it might serve as an unfavorable prognostic factor for HCC patients. It is possible that hypoxia via induction of expression of HIF-1alpha, MMP-2, and MMP-9 may enhance VM formation in HCC. PMID:20957524

Liu, Wen-bin; Xu, Ge-liang; Jia, Wei-dong; Li, Jian-sheng; Ma, Jin-liang; Chen, Ke; Wang, Zhi-hua; Ge, Yong-sheng; Ren, Wei-hua; Yu, Ji-hai; Wang, Wei; Wang, Xiu-Jun

2011-12-01

347

Sexual dysfunction in males with chronic hepatitis C and antiviral therapy: interferon-induced functional androgen deficiency or depression?  

Microsoft Academic Search

Decrease of libido and erectile dysfunction are reported by male patients during antiviral therapy of chronic hepatitis C, but therapy-associated underlying factors for sexual dysfunction are not well defined. To assess putative contributions of interferon-induced sex hormone changes to sexual dysfunction, we prospectively investigated changes in free testosterone, total testosterone, dehydro- epiandrosterone sulfate, prolactin, sex hormone-binding globulin, FSH and LH

M R Kraus; A Schäfer; T Bentink; M Scheurlen; B Weissbrich; O Al-Taie; J Seufert

2005-01-01

348

Sexual and gonadal dysfunction in chronic kidney disease: Pathophysiology  

PubMed Central

Sexual and gonadal dysfunction/infertility are quite common in patients with chronic kidney disease. Forty percent of male and 55% of female dialysis patients do not achieve orgasm. The pathophysiology of gonadal dysfunction is multifactorial. It is usually a combination of psychological, physiological, and other comorbid factors. Erectile dysfunction in males is mainly due to arterial factors, venous leakage, psychological factors, neurogenic factors, endocrine factors, and drugs. Sexual dysfunction in females is mainly due to hormonal factors and manifests mainly as menstrual irregularities, amenorrhea, lack of vaginal lubrication, and failure to conceive. Treatment of gonadal dysfunction in chronic kidney disease is multipronged and an exact understanding of underlying pathology is essential in proper management of these patients. PMID:22470857

Rathi, Manish; Ramachandran, Raja

2012-01-01

349

Drugs For Male Sexual Dysfunction Show Promise In The Lab For Treating Female Sexual Disorders  

NSDL National Science Digital Library

This is an APS press release on a study that found that female sexual dysfunction may be, in part, the result of inadequate supply of blood to the female genitals and may be addressed with erectile dysfunction drugs. Originally developed as therapy for hypertension, these drugs work by dilating blood vessels sufficiently to produce erections in males. These drugs have not been fully explored in females.

APS Communications Office (American Physiological Society Communications Office)

2006-04-17

350

Lack of Central Nitric Oxide Triggers Erectile Dysfuntion in Diabetes  

NSDL National Science Digital Library

Journal article "Lack of central nitric oxide triggers erectile dysfuntion in diabetes", by Kaushik P. Patel, Keshore R. Bidasee, William G. Mayhan, and Zeng Hong, found in the APS journal of Regulatory, Integrative, and Comparative Physiology.

PhD Kaushik P. Patel (University of Nebraska Cellular and Integrative Physiology); Keshore R. Bidasee (University of Nebraska Pharmacology); Hong Zeng (University of Nebraska Cellular and Integrative Physiology); PhD William G. Mayhan (University of Nebraska Cellular and Integrative Physiology)

2007-03-01

351

Sexual dysfunction in African males in Nairobi, Kenya.  

PubMed

Out of a total of 295 subjects referred to the Pangani Clinic for psychiatric assessment, between January 1990 and December 1993, 49 were studied. All were males and aged between 16 and 55 years. Using a cross-sectional design study, they were consecutively assessed for sexual dysfunction. Each subject was studied using, the Self Rating Questionnaire, the Standardized Psychiatric Interview and WHO Audit Instrument for Alcohol abuse. The final diagnoses of sexual dysfunction were made according to DSM-R categories. A matched analysis using Chi-squared (X2) test were carried out. The finding was that erectile disorder was the major disorder seen in 57.1% of the subjects. The peak age for sexual dysfunction was between 26 and 36 years. In an African setting, questions pertinent to bewitchment and age (husband versus wife) are very important with regard to sexual dysfunction. PMID:8904041

Sebit, M B

1995-10-01

352

Sexual dysfunction after cystectomy and urinary diversion.  

PubMed

Erectile dysfunction (ED) in men and sexual dysfunction in men and women are common after cystectomy and urinary diversion. Research has focused on both qualifying the prevalence of ED following cystectomy and identifying surgical approaches to limit sexual dysfunction after surgery, but most studies have been limited by small patient populations, an absence of control groups, and a lack of adjustment for confounding factors. Similarly, quality of life (QoL) research studies have also emerged in the context of bladder cancer and cystectomy, and increase our understanding of sexual outcomes associated with cystectomy. A number of instruments for collection of patient-reported outcomes among patients with bladder cancer treated with cystectomy are available for the assessment of condition-specific and procedure-specific QoL. However, other factors that negatively affect sexual function after removal of the bladder, such as psychological issues, age, and health-related competing risks for ED, body image, partner response, and change in life course and sexual priorities, have received less attention. Nevertheless, ED and sexual dysfunction are important complications of cystectomy and urinary diversion. Although changes in the approach to surgery, such as nerve-sparing cystectomy, might improve outcomes, evaluation and management of the source factors of ED and sexual dysfunction are necessary to optimize recovery of function. PMID:24980191

Modh, Rishi A; Mulhall, John P; Gilbert, Scott M

2014-08-01

353

Self-efficacy as a relevant construct in understanding sexual response and dysfunction.  

PubMed

While self-efficacy has been widely used to explain and treat various biobehavioral responses, few investigations have examined this concept in the context of sexual response and dysfunction. In this study, the authors constructed a measure of sexual self-efficacy, investigated whether it differentiated men with and without sexual dysfunction, and determined the utility of this construct by exploring its relation to other variables known to be related to erectile dysfunction in a sample of 60 men with erectile dysfunction and 14 functional men visiting a urology clinic. The sexual self-efficacy index differentiated men with and without erectile dysfunction, and general linear modeling showed that the index did indeed relate to other variables known to affect sexual and emotional response during a partnered sexual experience. These findings suggest that, as a unifying construct that predicts cognitive, affective, motivational, and behavioral responses, sexual self-efficacy has the potential to play an important role in the assessment of effective treatments for sexual problems. PMID:24328698

Rowland, David L; Adamski, Beth A; Neal, Cody J; Myers, Amy L; Burnett, Arthur L

2015-01-01

354

Human white adipose tissue vasculature contains endothelial colony-forming cells with robust in vivo vasculogenic potential  

PubMed Central

Blood-derived endothelial colony-forming cells (ECFCs) have robust vasculogenic potential that can be exploited to bioengineer long-lasting human vascular networks in vivo. However, circulating ECFCs are exceedingly rare in adult peripheral blood. Because the mechanism by which ECFCs are mobilized into circulation is currently unknown, the reliability of peripheral blood as a clinical source of ECFCs remains a concern. Thus, there is a need to find alternative sources of autologous ECFCs. Here we aimed to determine whether ECFCs reside in the vasculature of human white adipose tissue (WAT) and to evaluate if WAT-derived ECFCs (watECFCs) have equal clinical potential to blood-derived ECFCs. We isolated the complete endothelial cell (EC) population from intact biopsies of normal human subcutaneous WAT by enzymatic digestion and selection of CD31+ cells. Subsequently, we extensively compared WAT-derived EC phenotype and functionality to bonafide ECFCs derived from both umbilical cord blood and adult peripheral blood. We demonstrated that human WAT is indeed a dependable source of ECFCs with indistinguishable properties to adult peripheral blood ECFCs, including hierarchical clonogenic ability, large expansion potential, stable endothelial phenotype, and robust in vivo blood vessel-forming capacity. Considering the unreliability and low rate of occurrence of ECFCs in adult blood and that biopsies of WAT can be obtained with minimal intervention in an ambulatory setting, our results indicate WAT as a more practical alternative to obtain large amounts of readily available autologous ECFCs for future vascular cell therapies. PMID:23636611

Lin, Ruei-Zeng; Moreno-Luna, Rafael; Munoz-Hernandez, Rocio; Li, Dan; Jaminet, Shou-Ching S.; Greene, Arin K.; Melero-Martin, Juan M.

2013-01-01

355

Female Sexual Dysfunction: Therapeutic Options and Experimental Challenges  

PubMed Central

Female sexual dysfunction (FSD) is a prevalent problem, afflicting approximately 40% of women and there are few treatment options. FSD is more typical as women age and is a progressive and widespread condition. Common symptoms associated with FSD include diminished vaginal lubrication, pain and discomfort upon intercourse, decreased sense of arousal and difficulty in achieving orgasm. Only a small percentage of women seek medical attention. In comparison to the overwhelming research and treatment for erectile dysfunction in males, specifically with the development of phosphodiesterase type 5 inhibitors, significantly less has been explored regarding FSD and treatment is primarily limited to psychological therapy. Several cardiovascular diseases have been linked with FSD including atherosclerosis, peripheral arterial disease and hypertension, all of which are also pathological conditions associated with aging and erectile dysfunction in men. Using animal models, we have expanded our understanding of FSD, however a tremendous amount is still to be learned in order to properly treat women suffering from FSD. The aim of this review is to provide the most current knowledge on FSD, advances in basic science addressing this dysfunction, and explore developing therapeutic options. PMID:19538161

Allahdadi, Kyan J.; Tostes, Rita C.A.; Webb, R. Clinton

2010-01-01

356

Gustatory dysfunction.  

PubMed

Tastes in humans provide a vital tool for screening soluble chemicals for food evaluation, selection, and avoidance of potentially toxic substances. Taste or gustatory dysfunctions are implicated in loss of appetite, unintended weight loss, malnutrition, and reduced quality of life. Dental practitioners are often the first clinicians to be presented with complaints about taste dysfunction. This brief review provides a summary of the common causes of taste disorders, problems associated with assessing taste function in a clinical setting and management options available to the dental practitioner. PMID:25210380

Maheswaran, T; Abikshyeet, P; Sitra, G; Gokulanathan, S; Vaithiyanadane, V; Jeelani, S

2014-07-01

357

Comparing Vasculogenic Mimicry with Endothelial Cell Lined Vessels: Techniques for 3D Reconstruction and Quantitative Analysis of Tissue Components from Archival Paraffin Blocks  

PubMed Central

We previously described techniques to generate 3D reconstructions of the tumor microcirculation using immunofluorescence histochemistry and laser scanning confocal microscopy on serial sections from archival formalin-fixed, paraffin embedded tissues. By aligning sequential z-stacks in an immersive visualization environment (ImmersaDesk), the need to insert fiduciary markers into tissue was eliminated. In this study, we developed methods to stitch overlapping confocal z-series together to extend the surface area of interest well beyond that captured by the confocal microscope objective and developed methods to quantify the distribution of markers of interest in three dimensions. These techniques were applied to the problem of comparing the surface area of non-endothelial cell lined, laminin-rich looping vasculogenic mimicry (VM) patterns, that are known to transmit fluid, with the surface area of endothelial cell lined vessels in metastatic uveal melanoma to the liver in three dimensions. After labeling sections with antibodies to CD34 and laminin, the surface area of VM patterns to vessels was calculated by segmenting out structures that labeled with laminin but not with CD34 from those structures labeling with CD34, or CD34 and laminin. In metastatic uveal melanoma tissues featuring co-localization of high microvascular density [66.4 microvessels adjusted for 0.313 mm2 area (range 56.7-72.7)] and vasculogenic mimicry patterning, the surface area of vasculogenic mimicry patterns was 11.6 fold greater (range 10.8-14.1) than the surface provided by CD34-positive vessels. These methods may be extended to visualize and quantify molecular markers in three dimensions in a variety of pathological entities from archival paraffin embedded tissues. PMID:17536318

Lin, Amy Y.; Ai, Zhuming; Lee, Sang-Chul; Bajcsy, Peter; Pe'er, Jacob; Leach, Lu; Maniotis, Andrew J.; Folberg, Robert

2006-01-01

358

Sexual Dysfunction Improved in Heroin-Dependent Men after Methadone Maintenance Treatment in Tianjin, China  

PubMed Central

Objective To investigate whether methadone maintenance treatment (MMT) is correlated with sexual dysfunction in heroin-dependent men and to determine the prevalence and risk factors of sexual dysfunction among men on MMT. Methods The study included a retrospective survey and a cross-sectional survey which contained interviews of 293 men who are currently engaged in MMT. The results of the two surveys were compared. For a subset of 43 participants, radioimmunoassay was additionally conducted using retrospective and prospective blood samples to test the levels of plasma testosterone and luteinizing hormone. Other study evaluations were the International Index of Erectile Function (IIEF-15), and Self-rating Depression Scale. Results Sexual dysfunction in all five IIEF-15 domains (erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction) was strongly associated with long-term use of heroin. A decrease in the severity of sexual dysfunction was associated with MMT initiation. Erectile dysfunction, lack of sexual desire, inability to orgasm, and lack of intercourse satisfaction were significantly correlated with increasing age of the participants. Methadone dose and duration of methadone treatment were not found to be associated with sexual dysfunction. The level of plasma testosterone significantly declined during methadone treatment, but results from multivariate analysis indicated low levels of testosterone were not the main cause of sexual dysfunction. No correlation between reported depression status and sexual function was found. Conclusions While high levels of sexual dysfunction were reported by heroin-dependent men in our study before and after MMT initiation, MMT appears to be correlated with improved sexual function in the population of the study. PMID:24520361

Zhang, Minying; Zhang, Huifang; Shi, Cynthia X.; McGoogan, Jennifer M.; Zhang, Baohua; Zhao, Linglong; Zhang, Mianzhi; Rou, Keming; Wu, Zunyou

2014-01-01

359

Prevalence of Erectile and Ejaculatory Difficulties among Men in Croatia  

PubMed Central

Aim To determine the prevalence and risk factors of erectile difficulties and rapid ejaculation in men in Croatia. Method We surveyed 615 of 888 contacted men aged 35-84 years. The mean age of participants was 54?±?12 years. College-educated respondents and the respondents from large cities were slightly overrepresented in the sample. Structured face-to-face interviews were conducted in June and July 2004 by 63 trained interviewers. The questionnaire used in interviews was created for commercial purposes and had not been validated before. Results Out of 615 men who were sexually active in the preceding month and gave the valid answers to the questions on erectile difficulties and rapid ejaculation, 130 suffered from erectile or ejaculatory difficulties. Men who had been sexually active the month before the interview and gave the valid answers to the questions on sexual difficulties reported having erectile difficulties more often (77 out of 615) than rapid ejaculation (57 out of 601). Additional 26.8% (165 out of 615) and 26.3% (158 out of 601) men were classified as being at risk for erectile difficulties and rapid ejaculation, respectively. The prevalence of erectile difficulties varied from 5.8% in the 35-39 age group to 30% in the 70-79 age group. The association between age and rapid ejaculation was curvilinear, ie, U-shaped. Rates of rapid ejaculation were highest in the youngest (15.7%) and the oldest (12.5%) age groups. Older age (odds ratios [OR], 6.2-10.3), overweight (OR, 3.3-4.2), alcohol (OR, 0.3-0.4), intense physical activity (OR, 0.3), traditional attitudes about sexuality (OR, 2.8), and discussing sex with one’s partner (OR, 0.1-0.3) were associated with erectile difficulties. Education (OR, 0.1-0.3), being overweight (OR, 22.0) or obese (OR, 20.1), alcohol consumption (OR, 0.2-0.3), stress and anxiety (OR, 10.8-12.5), holding traditional attitudes (OR, 2.8) and moderate physical activity (OR, 0.1) were factors associated with rapid ejaculation. Conclusion The prevalence of erectile difficulties was higher than the prevalence of rapid ejaculation in men in Croatia. The odds of having these sexual difficulties increased with older age, overweight, traditional attitudes toward sex, and higher level of stress and anxiety. PMID:16489704

Stulhofer, Aleksandar; Bajic, Zarko

2006-01-01

360

Pericyte recruitment during vasculogenic tube assembly stimulates endothelial basement membrane matrix formation  

PubMed Central

We show that endothelial cell (EC)–generated vascular guidance tunnels (ie, matrix spaces created during tube formation) serve as conduits for the recruitment and motility of pericytes along EC ablumenal surfaces to facilitate vessel maturation events, including vascular basement membrane matrix assembly and restriction of EC tube diameter. During quail development, pericyte recruitment along microvascular tubes directly correlates with vascular basement membrane matrix deposition. Pericyte recruitment to EC tubes leads to specific induction of fibronectin and nidogen-1 (ie, matrix-bridging proteins that link together basement membrane components) as well as perlecan and laminin isoforms. Coincident with these events, up-regulation of integrins, ?5?1, ?3?1, ?6?1, and ?1?1, which bind fibronectin, nidogens, laminin isoforms, and collagen type IV, occurs in EC-pericyte cocultures, but not EC-only cultures. Integrin-blocking antibodies to these receptors, disruption of fibronectin matrix assembly, and small interfering RNA suppression of pericyte tissue inhibitor of metalloproteinase (TIMP)-3 (a known regulator of vascular tube stabilization) all lead to decreased EC basement membrane, resulting in increased vessel lumen diameter, a key indicator of dysfunctional EC-pericyte interactions. Thus, pericyte recruitment to EC-lined tubes during vasculogenesis is a stimulatory event controlling vascular basement membrane matrix assembly, a fundamental maturation step regulating the transition from vascular morphogenesis to stabilization. PMID:19822899

Stratman, Amber N.; Malotte, Kristine M.; Mahan, Rachel D.; Davis, Michael J.

2009-01-01

361

Demographic and clinical correlates of sexual dysfunction among Nigerian male outpatients on conventional antipsychotic medications  

PubMed Central

Background In psychotic disorders, early intervention with antipsychotic medications increases the likelihood of favourable long-term course. However, the pharmacologic management especially with conventional antipsychotic medications is complicated by a high rate of adverse effects including sexual dysfunction. This study aims to determine the demographic and clinical factors associated with sexual dysfunction among male psychiatric outpatients on conventional antipsychotic medications in South-western Nigeria. Methods Two hundred and seventy five consecutive male outpatients with psychotic disorders on conventional antipsychotic medications were interviewed. Data was collected on demographic characteristics, illness-related and medication-related variables. Illness severity was assessed with the Brief psychiatric rating scale. The International Index of Erectile Function questionnaire was used to assess for sexual dysfunctions. Results A total of 111 (40.4%) respondents had one or more forms of sexual dysfunction. Sexual desire dysfunction was present in 47 (17.1%) of respondents, erectile dysfunction in 95 (34.5%), orgasmic dysfunctions in 51 (18.5%), intercourse dissatisfaction in 72 (26.2%) and overall dissatisfaction in 64 (23.3%). Sexual dysfunction was significantly associated with employment status, age, marital status, haloperidol use, medication dosage, and presence of psychopathology. Unemployment was the only significant independent correlate of sexual dysfunction, with unemployed respondents twice more likely to have sexual dysfunction compared with those employed (Wald?=?3.865, Odds Ratio?=?2.033, 95% confidence interval?=?1.002 - 4.124, p?=?0.049). Conclusions The high prevalence of sexual dysfunction found in this study suggests a need among clinicians for increased awareness and recognition of the sexual side effects in patients taking conventional antipsychotic medications. This knowledge should guide conventional antipsychotic medication prescription in the at-risk population to improve treatment adherence. PMID:22676295

2012-01-01

362

The Effects of Chlormadinone Acetate on Lower Urinary Tract Symptoms and Erectile Functions of Patients with Benign Prostatic Hyperplasia: A Prospective Multicenter Clinical Study  

PubMed Central

Purpose. To evaluate the effects of chlormadinone acetate (CMA), progesterone-derived antiandrogen, on lower urinary tract symptoms (LUTS) and erectile functions of benign prostatic hyperplasia (BPH). Methods. A multicenter, single-cohort prospective study was conducted. A total of 114 patients received CMA for 16 weeks. The endpoints were changes in International Prostate Symptom Scores (IPSS), IPSS-QOL, International Index of Erectile Function-5, Qmax prostate volume, and residual urine volume. Results. Significant improvements were observed in IPSS from week 8 to week 48 (32 weeks after treatment). IPSS-QOL improvements were also significant from week 8 to week 48. Qmax increased to a maximum at Week 16 and remained elevated throughout the study. Moreover, a decrease of 25% in prostate volume was observed at Week 16. IPSS, QOL, and Qmax changes during the study were not different between the previously treated and untreated patients. IPSS storage subscore changes differed between the age groups. Few severe adverse reactions were observed, except for erectile dysfunction. Conclusions. CMA rapidly and significantly reduced prostate volume and improved voiding and storage symptoms and QOL. Our results suggest that CMA is safe and beneficial, especially for elderly patients with LUTS associated with BPH. PMID:23762042

Fujimoto, Kiyohide; Hirao, Yoshihiko; Ohashi, Yasuo; Fuji, Kohzo; Tsuji, Hidenori; Miyazawa, Katsuhito; Ohtani, Mikinobu; Furuya, Ryoji; Boku, Eitetsu

2013-01-01

363

Sexual Dysfunction before and after Cardiac Rehabilitation  

PubMed Central

Background. The aim of this study was to assess sexual function before and after cardiac rehabilitation in relation to medical variables. Methods. Analysis of patients participating in a 12-week exercise-based outpatient cardiac rehabilitation program (OCR) between April 1999 and December 2007. Exercise capacity (ExC) and quality of life including sexual function were assessed before and after OCR. Results. Complete data were available in 896 male patients. No sexual activity at all was indicated by 23.1% at baseline and 21.8% after OCR, no problems with sexual activity by 40.8% at baseline and 38.6% after OCR. Patients showed an increase in specific problems (erectile dysfunction and lack of orgasm) from 18% to 23% (P < .0001) during OCR. We found the following independent positive and negative predictors of sexual problems after OCR: hyperlipidemia, age, CABG, baseline ExC and improvement of ExC, subjective physical and mental capacity, and sense of affiliation. Conclusions. Sexual dysfunction is present in over half of the patients undergoing OCR with no overall improvement during OCR. Age, CABG, low exercise capacity are independent predictors of sexual dysfunction after OCR. PMID:22110969

Schumann, Jörg; Zellweger, Michael J.; Di Valentino, Marcello; Piazzalonga, Simone; Hoffmann, Andreas

2010-01-01

364

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

PubMed

Abstract Many studies are aimed towards a solution for erectile dysfunction which is a worldwide health problem. Medicinal and natural herbal medications have been prescribed but their long-term effects are not well known. This study aimed to investigate the impact of the chronic administration of F. hermonis root extract on the structure of the male mice reproductive organs and their fertility and to study the possible protective role of vitamin C. Sixty male albino mice were divided into 3 groups: the control, the experimental group that received F. hermonis root extract orally (6?mg/kg) for six weeks, and the treated group that received F. hermonis plus vitamin C for six weeks. Serum testosterone level and mice fertility were assessed. At the end of the experiment mice were sacrificed; testis, epididymis, and seminal vesicle were dissected and processed for routine histopathological and immunohistochemical examination. The chronic administration of F. hermonis extract significantly decreased the level of testosterone and partially impaired fertility. Histopathological degenerative changes and a significant reduction in estrogen receptor (ER)? expression were observed in testes, epididymis, and seminal vesicle. Vitamin C administration did not completely protect the testis from these harmful effects. Although F. hermonis roots are recommended to improve erectile and fertility problems, it should be used for short periods and with extreme caution. Further clinical studies to assess safety and efficacy are needed. PMID:24871072

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

2014-10-01

365

Erectile function and late-onset hypogonadism symptoms related to lower urinary tract symptom severity in elderly men  

PubMed Central

The aim of this study was to evaluate the relationship between lower urinary tract symptoms (LUTSs), erectile dysfunction (ED) and symptomatic late-onset hypogonadism (SLOH) in ageing men in the Aegean region of Turkey. Five hundred consecutive patients >40 years old who had been in a steady sexual relationship for the past 6 months and were admitted to one of six urology clinics were included in the study. Serum prostate-specific antigen and testosterone levels and urinary flow rates were measured. All patients filled out the International Prostate Symptom Score and Quality of Life (IPSS–QoL), International Index of Erectile Function (IIEF) and Aging Males' Symptoms (AMS) scale forms. Of the patients, 23.9% had mild LUTSs, 53.3% had moderate LUTSs and 22.8% had severe LUTSs. The total testosterone level did not differ between groups. Additionally, 69.6% had ED. The presence of impotence increased with increasing LUTS severity. Symptomatic late-onset hypogonadism (AMS >27) was observed in 71.2% of the patients. The prevalence of severe hypogonadism symptoms increased with the IPSS scores. A correlation analysis revealed that all three questionnaire scores were significantly correlated. In conclusion, LUTS severity is an age-independent risk factor for ED and SLOH. LUTS severity and SLOH symptoms appear to have a strong link that requires etiological and biological clarification in future studies. PMID:23817501

Bozkurt, Ozan; Bolat, Deniz; Demir, Omer; Ucer, Oktay; Sahin, Ali; Ozcift, Burak; Pektas, Abdulkadir; Turan, Tahir; Gumus, Bilal H; Can, Ertan; Bolukbasi, Ahmet; Erol, Haluk; Esen, Adil

2013-01-01

366

Erectile function and late-onset hypogonadism symptoms related to lower urinary tract symptom severity in elderly men.  

PubMed

The aim of this study was to evaluate the relationship between lower urinary tract symptoms (LUTSs), erectile dysfunction (ED) and symptomatic late-onset hypogonadism (SLOH) in ageing men in the Aegean region of Turkey. Five hundred consecutive patients >40 years old who had been in a steady sexual relationship for the past 6 months and were admitted to one of six urology clinics were included in the study. Serum prostate-specific antigen and testosterone levels and urinary flow rates were measured. All patients filled out the International Prostate Symptom Score and Quality of Life (IPSS-QoL), International Index of Erectile Function (IIEF) and Aging Males' Symptoms (AMS) scale forms. Of the patients, 23.9% had mild LUTSs, 53.3% had moderate LUTSs and 22.8% had severe LUTSs. The total testosterone level did not differ between groups. Additionally, 69.6% had ED. The presence of impotence increased with increasing LUTS severity. Symptomatic late-onset hypogonadism (AMS >27) was observed in 71.2% of the patients. The prevalence of severe hypogonadism symptoms increased with the IPSS scores. A correlation analysis revealed that all three questionnaire scores were significantly correlated. In conclusion, LUTS severity is an age-independent risk factor for ED and SLOH. LUTS severity and SLOH symptoms appear to have a strong link that requires etiological and biological clarification in future studies. PMID:23817501

Bozkurt, Ozan; Bolat, Deniz; Demir, Omer; Ucer, Oktay; Sahin, Ali; Ozcift, Burak; Pekta?, Abdulkadir; Turan, Tahir; Gümü?, Bilal H; Can, Ertan; Bolukbasi, Ahmet; Erol, Haluk; Esen, Adil

2013-11-01

367

Efficacy of ellagic acid and sildenafil in diabetes-induced sexual dysfunction  

PubMed Central

Background: Diabetes induced sexual dysfunction is a leading cause of male sexual disorder and an early indicator of cardiovascular complication. Reactive oxygen species generated in body during diabetes is a main causative factor for erectile dysfunction, a sexual dysfunction. Adjuvant antioxidant therapy along with phosphodiesterases type 5 enzyme inhibitor (PDE5i) is more effective than PDE5i alone. Objective: The aim of the study was to investigate efficacy of ellagic acid a known antioxidant and sildenafil in diabetes induced erectile dysfunction. Materials and Methods: Type 1 diabetes was induced in male rats and rats were treated with ellagic acid (50 mg/kg, p.o.) and a combination of ellagic acid (50 mg/kg, p.o.) and sildenafil (5 mg/kg, p.o.), a PDE5i for 28 days. Sexual function was observed in diabetic rat and compared with those of treatment group and normal rats. Effect of ellagic acid was studied on advanced glycation end products (AGE) and isolated rat corpus cavernosum in vitro. Results: Sexual function of diabetic rats was found to be reduced and ellegic acid treatment could preserve sexual function of diabetic rats to some extent. Ellagic acid + sildenafil treatment was more efficient in management of diabetes induced sexual dysfunction. Ellagic acid inhibited (AGE) in vitro implying its role in reducing oxidative stress in diabetes. The polyphenol could not increase sexual function in normal rats and relax isolated rat corpus cavernosum smooth muscle significantly. Conclusion: The study proves usefulness of adjuvant antioxidant therapy in the management of erectile dysfunction in diabetes. PMID:25298678

Goswami, Sumanta Kumar; Vishwanath, Manikanta; Gangadarappa, Suma Kallahalli; Razdan, Rema; Inamdar, Mohammed Naseeruddin

2014-01-01

368

Epidemiology of sexual dysfunction in the male population.  

PubMed

Sexual dysfunctions have found an increasing attention in recent epidemiological studies of the ageing male. The purpose of this paper is to review the prevalence of sexual dysfunctions and risk factors based on community samples. Studies have not only demonstrated a strong age-related incline of erectile dysfunction (ED), but also of ejaculatory and orgasmic disorders (particularly a reduced or absent ejaculation). Despite a declining sexual desire, sexual interest remains present in old age. Lower urinary tract symptoms have been identified as strong risk factors for ED along with cardiovascular, metabolic, psychiatric disorders and lifestyle factors. The wide range of prevalence rate estimates is likely because of different definitions and criteria of sexual dysfunctions. More research is needed on other dysfunctions besides ED and on the partner relationship as a major determinant of sexual activity and satisfaction. The interrelationship between risk factors calls for interdisciplinary prevention and treatment approaches. As disability-free life expectancy keeps increasing, the need to identify, adequately assess and treat male sexual dysfunction as an important impediment to quality of life most likely will become even more pressing. PMID:16872462

Beutel, M E; Weidner, W; Brähler, E

2006-08-01

369

Combined effect of osteopontin and BMP-2 derived peptides grafted to an adhesive hydrogel on osteogenic and vasculogenic differentiation of marrow stromal cells.  

PubMed

The objective of this work was to investigate the combined effect of grafting the peptide corresponding to amino acid residues 162-168 of osteopontin (OPD peptide) and the peptide corresponding to amino acid residues 73-92 of bone morphogenetic protein-2 (BMP peptide) to an RGD-conjugated inert hydrogel on osteogenic and vasculogenic differentiation of bone marrow stromal (BMS) cells. RGD-conjugated three-dimensional (3D) porous hydrogel scaffolds with well-defined cylindrical pore geometry were produced from sacrificial wax molds fabricated by fused deposition modeling rapid prototyping system. Propargyl acrylate and 4-pentenal were conjugated to the hydrogel for orthogonal grafting of BMP and OPD peptides by click reaction and oxime ligation, respectively. The OPD peptide was grafted by the reaction between aminooxy moiety of aminooxy-mPEG-OPD (mPEG = mini-poly(ethylene glycol)) and the aldehyde moiety in the hydrogel. The BMP peptide was grafted by the reaction between the azide moiety of Az-mPEG-BMP and the propargyl moiety in the hydrogel. The hydrogels seeded with BMS cells were characterized by biochemical, immunocytochemical, and mRNA analyses. Groups included RGD control hydrogel (RGD), RGD and BMP peptides without OPD (RGD+BMP), RGD and BMP peptides with mutant OPD (RGD+BMP+mOPD), and RGD and BMP peptides with OPD (RGD+BMP+OPD) grafted hydrogels. The extent of mineralization of RGD, RGD+BMP, RGD+BMP+mOPD, and RGD+BMP+OPD groups after 28 days was 650 ± 70, 990 ± 30, 850 ± 30, and 1150 ± 40 mg/(mg of DNA), respectively, indicating that the BMP and OPD peptides enhanced osteogenic differentiation of the BMS cells. The BMS cells seeded on RGD+BMP+OPD grafted hydrogels stained positive for vasculogenic markers ?-SMA, PECAM-1, and VE-cadherin while the groups without OPD peptide (RGD+BMP and RGD+BMP+mOPD) stained only for ?-SMA but not PECAM-1 or VE-cadherin. These results were consistent with the significantly higher PECAM-1 mRNA expression for RGD+BMP+OPD group after 21 and 28 days, compared to the groups without OPD. These findings suggest that the RGD+BMP+OPD peptides provide a favorable microenvironment for concurrent osteogenic and vasculogenic differentiation of progenitor marrow-derived cells. PMID:22372823

He, Xuezhong; Yang, Xiaoming; Jabbari, Esmaiel

2012-03-27

370

Sildenafil for Male Erectile Dysfunction: A Systematic Review and Meta-analysis  

Microsoft Academic Search

ence, 33.7; 95% confidence interval (CI), 29.2-38.2; 2283 men) and a greater percentage of men experiencing at least 1 intercourse success during treatment (83% vs 45%; relative benefit increase, 1.8; 95% CI, 1.7-1.9; 2205 men). In data pooled from 6 parallel-group, fixed-dose trials, efficacy appeared slightly greater at higher doses. Treat- ment response appeared to vary between patient sub- groups,

Howard A. Fink; Roderick Mac Donald; Indulis R. Rutks; David B. Nelson; Timothy J. Wilt

2002-01-01

371

PENILE TRAUMA: AN ETIOLOGIC FACTOR IN PEYRONIE'S DISEASE AND ERECTILE DYSFUNCTION  

Microsoft Academic Search

PurposeIt has been postulated that trauma to either the partially or fully erect penis is a potential cause of Peyronie's disease. In addition, it has been proposed that engaging in sexual relations with a partial erection due to mild impotence is a risk factor for the development of Peyronie's disease. This study was performed to determine whether patients with either

Jonathan P. Jarow; Franklin C. Lowe

1997-01-01

372

The dual control model of male sexual response: a theoretical approach to centrally mediated erectile dysfunction  

Microsoft Academic Search

A theoretical model of dual control of male sexual response is considered, based on the balancing of central excitation and inhibition, with individuals varying in their propensity for both sexual excitation and inhibition of sexual response. A questionnaire method for measuring propensities for sexual excitation and inhibition has been developed (SIS\\/SES questionnaire), resulting in one excitation factor (SES) and two

John Bancroft; Erick Janssen

2000-01-01

373

Health-related quality of life in men with erectile dysfunction  

Microsoft Academic Search

OBJECTIVE: To assess health-related quality of life (HRQOL)\\u000a \\u000a \\u000a DESIGN: Descriptive survey with general and disease-specific measures. The instrument contained three established, validated HRQOL\\u000a measures, a validated comorbidity checklist,] and sociodemographics. The RAND 36-Item Health Survey 1.0 (SF-36) was used to\\u000a assess general HRQOL. Sexual function and sexual bother were assessed using the UCLA Prostate Cancer Index. The marital interaction\\u000a scale

Mark S. Litwin; Robert J. Nied; Nasreen Dhanani

1998-01-01

374

What I need to know about Erectile Dysfunction 19 Points to Remember  

E-print Network

. For many men, the answer is as simple as taking a pill. Other men have to try two or three options before lifestyle choices. Following a healthy diet may help prevent ED. Quitting smoking and getting physical

Baker, Chris I.

375

What I need to know about Erectile Dysfunction 21 Hope through Research  

E-print Network

. One team of researchers is exploring the effect of weight loss on ED in men who are obese and sexual in Sexual Function Following Bariatric Surgery study, funded under National Institutes of Health (NIH. Other investigators are studying how better control of blood sugar and blood pressure in diabetes could

Baker, Chris I.

376

Prevalence and cardiovascular disease risk differences for erectile dysfunction patients by three metabolic syndrome definitions  

Microsoft Academic Search

There is growing evidence of a link between ED, metabolic syndrome (MS) and cardiovascular disease (CVD). The study was to explore the prevalence of MS using three different definitions (World Health Organization (WHO), International Diabetes Foundation (IDF) and Adult Treatment Panel III (ATP III)), and to compare the association of CVD in ED outpatients using these definitions. This study enrolled

S-T Chang; C-M Chu; K-L Pan; Y-S Lin; P-C Wang; J-J Shee; C-S Chen

2011-01-01

377

A case of late-onset allgrove syndrome presenting with predominant autonomic dysfunction  

PubMed Central

Allgrove Syndrome or triple A syndrome is a rare familial multisystem disorder characterized by achalasia, alacrima and adrenal insufficiency. The objective was to describe a case of 4A syndrome where autonomic dysfunction was the presenting feature. A 22-year-old male presented with erectile dysfunction and loss of spontaneous morning erections for six months. He was having nocturnal diarrhea and recurrent postural dizziness for three months. He was found to have hyperpigmentation at pressure points, postural hypotension and other features of autonomic dysfunction. Laboratory investigations and imaging studies revealed hypoadrenalism, achalasia, alacrima and peripheral neuropathy. Autonomic neuropathy-related features persisted even after correction of hypoadrenalism. Based on clinical features and investigation he was diagnosed as a case of 4A syndrome presenting with autonomic dysfunction. Allgrove or 4A syndrome should be considered as a rare differential diagnosis of someone presenting with features of autonomic neuropathy. PMID:23956580

Sanyal, Debmalya; Bhattacharjee, Shakya

2013-01-01

378

A Comparative Study of Sexual Dysfunction due to Typical and Atypical Antipsychotics in Remitted Bipolar-I Disorder  

PubMed Central

In the remitted phase of bipolar I disorder, sexual dysfunction is commonly due to drugs used in the treatment rather than the disease itself. There are very few studies, especially in the Indian population, addressing the frequency of sexual dysfunction due to antipsychotics in bipolar I disorder. Hence this study was done to determine the sexual dysfunction due to antipsychotics and to compare the same among typical and atypical antipsychotics. A cross sectional study with 108 male patients of remitted bipolar I disorder (DSM-IV), chosen by purposive sampling technique was done. Psychopathology was assessed using the Brief Psychiatric Rating Scale, Structured Interview Guide for the Hamilton Depression Rating Scale and Young Mania Rating Scale. Sexual side effects due to antipsychotics were assessed using the Udvalg for Kliniske ndersogelser (UKU) side effect rating scale. The total sample size was divided into two groups of those on typical antipsychotics (n = 53) and atypical antipsychotics (n = 55). The two groups were compared for sexual dysfunction using Chi-square test. Results showed dysfunction in at least one phase of the sexual response cycle, comprising of desire, arousal and orgasm, was present in 66% of the sample population. Erectile dysfunction was present in 42% of the sample population and it was the most common type of sexual dysfunction reported. It was also significantly different across the two groups (p = 0.025). There was no significant difference in other aspects of sexual dysfunction across the two groups. In conclusion patients of Bipolar I disorder experience sexual side effects of antipsychotics frequently. Erectile dysfunction is the most common sexual dysfunction among men and this is significantly higher with typical than atypical antipsychotics. PMID:21224908

Nagaraj, Anil Kumar M.; Nizamie, Haque S.; Akhtar, Sayeed; Sinha, Baxi Neeraj P.; Goyal, Nishant

2004-01-01

379

Sexual Dysfunction, HIV, and AIDS in Men Who Have Sex with Men  

PubMed Central

Abstract HIV infection is associated with sexual dysfunction. Using validated instruments, we investigated the relationship between HIV/AIDS and sexual function in a contemporary cohort of men who have sex with men (MSM). An anonymous Internet-based survey was disseminated to MSM via organizations and social networking sites that cater to this population. Information on ethnodemographic variables, health status (including HIV status, disease stage, and other health conditions), and sexual behavior was collected. Men were categorized as HIV-negative, HIV-positive/AIDS-negative, or HIV-positive /AIDS-positive. A modified validated version of the International Index of Erectile Function (IIEF) for use in MSM and the Premature Ejaculation Diagnostic Tool (PEDT) were used to stratify risk of sexual dysfunction. The study cohort included 1361 men (236 of whom were HIV-positive) who provided complete data on HIV status, IIEF, and PEDT. There was a significant trend toward greater prevalence of erectile dysfunction (ED) in men with progressive HIV infection 40–59 years of age relative to age matched HIV-negative men (p=0.02). In a logistic regression model controlling for other variables, HIV infection without AIDS was not associated with greater odds of ED; however, HIV infection with AIDS was associated with greater odds of ED (p=0.006). In a separate logistic regression model, HIV infection with or without AIDS was not significantly associated with greater odds of premature ejaculation (p>0.05). Use of phosphodiesterase 5 (PDE5) inhibitor drugs was much more common in HIV-infected men. HIV infection is a risk factor for poorer sexual function primarily due to higher risk of erectile dysfunction in men with AIDS. PMID:21501095

Shindel, Alan W.; Horberg, Michael A.; Smith, James F.

2011-01-01

380

Sexual dysfunction in men and women with endocrine disorders.  

PubMed

Endocrine disease frequently interrupts sexual function, and sexual dysfunction may signal serious endocrine disease. Diabetic autonomic neuropathy and endothelial dysfunction impair erectile function, and phosphodiesterase inhibition produces only moderate benefit. The effect of diabetes on women's sexual function is complex: the most consistent finding is a correlation between sexual dysfunction and depression. Reductions in testosterone level in men are associated with low sexual desire and reduced nocturnal erections and ejaculate volume, all of which improve with testosterone supplementation. The age-dependent decline in testosterone production in men is not associated with precise sexual symptoms, and supplementation has not been shown to produce sexual benefit. In women, sexual dysfunction has not been associated with serum testosterone, but this may be confounded by limitations of assays at low concentrations and by the greater importance of intracellular production of testosterone in women than in men. Testosterone supplementation after menopause does improve some aspects of sexual function in women, but long-term outcome data are needed. More research on the sexual effects of abnormal adrenal and thyroid function, hyperprolactinaemia, and metabolic syndrome should also be prioritised. We have good data on local management of the genital consequences of oestrogen lack, but need to better understand the potential role of systemic oestrogen supplementation from menopause onwards in sexually symptomatic women. PMID:17307107

Bhasin, Shalender; Enzlin, Paul; Coviello, Andrea; Basson, Rosemary

2007-02-17

381

Impact of penile rehabilitation with low-dose vardenafil on recovery of erectile function in Japanese men following nerve-sparing radical prostatectomy.  

PubMed

Erectile dysfunction (ED) is a major complication after radical prostatectomy (RP); however, debate continues regarding the efficacy of penile rehabilitation in the recovery of the postoperative erectile function (EF). This study included a total of 103 consecutive sexually active Japanese men with localized prostate cancer undergoing nerve-sparing RP, and analyzed the postoperative EF, focusing on the significance of penile rehabilitation. In this series, 24 and 79 patients underwent bilateral and unilateral nerve-sparing RPs, respectively, and 10 or 20 mg of vardenafil was administered to 35 patients at least once weekly, who agreed to undergo penile rehabilitation. Twelve months after RP, 48 (46.6%) of the 103 patients were judged to have recovered EF sufficient for sexual intercourse without any assistance. The proportion of patients who recovered EF in those undergoing penile rehabilitation (60.0%) was significantly greater than that in those without penile rehabilitation (38.2%). Of several parameters examined, the preoperative International Index of Erectile Function-5 (IIEF-5) score and nerve-sparing procedure were significantly associated with the postoperative EF recovery rates in patients with and without management by penile rehabilitation, respectively. Furthermore, univariate analysis identified the preoperative IIEF-5 score, nerve-sparing procedure and penile rehabilitation as significant predictors of EF recovery, among which the preoperative IIEF-5 score and nerve-sparing procedure appeared to be independently associated with EF recovery. Considering these findings, despite the lack of independent significance, penile rehabilitation with low-dose vardenafil could exert a beneficial effect on EF recovery in Japanese men following nerve-sparing RP. PMID:24994781

Nakano, Yuzo; Miyake, Hideaki; Chiba, Koji; Fujisawa, Masato

2014-01-01

382

Impact of penile rehabilitation with low-dose vardenafil on recovery of erectile function in Japanese men following nerve-sparing radical prostatectomy  

PubMed Central

Erectile dysfunction (ED) is a major complication after radical prostatectomy (RP); however, debate continues regarding the efficacy of penile rehabilitation in the recovery of the postoperative erectile function (EF). This study included a total of 103 consecutive sexually active Japanese men with localized prostate cancer undergoing nerve-sparing RP, and analyzed the postoperative EF, focusing on the significance of penile rehabilitation. In this series, 24 and 79 patients underwent bilateral and unilateral nerve-sparing RPs, respectively, and 10 or 20 mg of vardenafil was administered to 35 patients at least once weekly, who agreed to undergo penile rehabilitation. Twelve months after RP, 48 (46.6%) of the 103 patients were judged to have recovered EF sufficient for sexual intercourse without any assistance. The proportion of patients who recovered EF in those undergoing penile rehabilitation (60.0%) was significantly greater than that in those without penile rehabilitation (38.2%). Of several parameters examined, the preoperative International Index of Erectile Function-5 (IIEF-5) score and nerve-sparing procedure were significantly associated with the postoperative EF recovery rates in patients with and without management by penile rehabilitation, respectively. Furthermore, univariate analysis identified the preoperative IIEF-5 score, nerve-sparing procedure and penile rehabilitation as significant predictors of EF recovery, among which the preoperative IIEF-5 score and nerve-sparing procedure appeared to be independently associated with EF recovery. Considering these findings, despite the lack of independent significance, penile rehabilitation with low-dose vardenafil could exert a beneficial effect on EF recovery in Japanese men following nerve-sparing RP. PMID:24994781

Nakano, Yuzo; Miyake, Hideaki; Chiba, Koji; Fujisawa, Masato

2014-01-01

383

Epithelial-Mesenchymal Transition Regulated by EphA2 Contributes to Vasculogenic Mimicry Formation of Head and Neck Squamous Cell Carcinoma  

PubMed Central

Purpose. Vasculogenic mimicry (VM) was related to invasion and metastasis of head and neck squamous cell carcinoma (HNSCC) patients. This study was designed to investigate the role of EphA2 in VM formation of HNSCC. Methods. The SiRNA technique was used to knock down the expression of EphA2 in vitro. The ability of cell migration and invasion were measured by transwell and wound healing assays; three-dimensional culture was used to detect the ability of channel-like structure formation; Western blot was used to detect the expression of epithelial-mesenchymal transition- (EMT-) related molecules in vitro. Further semiquantitative real-time RT-PCR assays and immunohistochemistry were used to demonstrate expression of EphA2 and EMT-related molecules according to VM presence or not in human tissue. Results. Knocking down EphA2 in vitro leads to disabled channel-like structure formation, reduction of invasion and migration ability, and reverse of EMT-related markers. Both semiquantitative real-time RT-PCR and immunohistochemistry showed that expressions of EphA2, Twist, and Vimentin were higher in the VM-positive group than in the VM-negative group significantly, while expressions of E-cadherin, claudin4, and DSG-3 were reverse. Conclusions. EphA2 played a key role in VM formation of HNSCC through regulation of EMT. PMID:24864260

Wang, Wei; Lin, Peng; Sun, Baocun; Zhang, Shiwu; Cai, Wenjuan; Han, Chunrong; Li, Li; Lu, Honghua; Zhao, Xiulan

2014-01-01

384

Centrally acting mechanisms for the treatment of male sexual dysfunction.  

PubMed

The development of pharmacologic therapy for erectile dysfunction (ED) has been possible because of incremental growth in our understanding of the physiology of normal erections and the complex pathophysiology of ED. Although the oral phosphodiesterase type 5 (PDE5) inhibitors have provided safe, effective treatment of ED for some men, a large proportion of men who have ED do not respond to PDE5 inhibitors or become less responsive or less satisfied as the duration of therapy increases. Also, men who are receiving organic nitrates and nitrates, such as amyl nitrate, cannot take PDE5 inhibitors because of nitrate interactions. The current options for treatment beyond PDE5 inhibitors are invasive, unappealing to some patients, and sometimes ineffective. The search for other options by which ED can be treated has branched out and now encompasses centrally acting mechanisms that control erectile function. Drugs available in Europe include apomorphine. This article focuses on the mechanism of centrally acting agents and reviews clinical data on potential new centrally acting drugs for men who have ED. PMID:17983889

Miner, Martin M; Seftel, Allen D

2007-11-01

385

Effect of an Adipose-Derived Stem Cell and Nerve Growth Factor-Incorporated Hydrogel on Recovery of Erectile Function in a Rat Model of Cavernous Nerve Injury  

PubMed Central

Postprostatectomy erectile dysfunction (ED) is the major problem for patients with clinically localized prostate cancer. Recently, gene and stem cell-based therapy of the corpus cavernosum has been attempted for postprostatectomy ED, but those therapies are limited by rapid blood flow and disruption of the normal architecture of the corpus cavernosum. In this study, we attempted to regenerate the damaged cavernous nerve (CN), which is the main cause of ED. We investigated the effectiveness of human adipose-derived stem cell (hADSC) and nerve growth factor-incorporated hyaluronic acid-based hydrogel (NGF-hydrogel) application on the CN in a rat model of bilateral cavernous nerve crush injury. Four weeks after the operation, erectile function was assessed by detecting the intracavernous pressure (ICP)/arterial pressure level by CN electrostimulation. The ICP was significantly increased by application of hADSC with NGF-hydrogel compared to the other experimental groups. CN and penile tissue were collected for histological examination. PKH-26 labeled hADSC colocalized with beta III tubulin were shown in CN tissue sections. hADSC/NGF-hydrogel treatment prevented smooth muscle atrophy in the corpus cavernosum. In addition, the hADSC/NGF-hydrogel group showed increased endothelial nitric oxide synthase protein expression. This study suggests that application of hADSCs with NGF-hydrogel on the CN might be a promising treatment for postprostatectomy ED. PMID:22834730

Kim, In Gul; Piao, Shuyu; Lee, Ji Young; Hong, Sung Hoo; Hwang, Tae-Kon; Kim, Sae Woong; Kim, Choung Soo; Ra, Jeong Chan; Noh, Insup

2013-01-01

386

PA03.23. To Evaluate the efficacy of "Vajikar Kalp" in Male sexual dysfunction  

PubMed Central

Purpose: To evaluate the efficacy of an aphrodisiac preparation in male sexual dysfunction. Method: The Vajikar Kalp was administered in 30 patients at the dosage of 2 gms twice a day with luke warm cow's milk. The combination was made of 1.Asparagus Racemosa - 500 mg, 2.Tribulus Terrestris - 500 mg, 3. Mucuna Pruriens - 500 mg, 4. Withania Somnifera - 500 mg. Patients were observed on days 0, 15, 30, 60 and 90. International Index of Erectile Function was used to assess the improvement. Other subjective parameters were also checked before and after the treatment. Result: The Clinical Study was conducted for making the data more reliable and authentic. In a 90 day Study Kalp offered significant improvement in Erectile Dysfunction, Libido, and Ejaculation & Orgasm. Kalp offered statistically significant increase in Testosterone level. Vajikar Kalp offered significant increase in sexual desire, intercourse frequency, intercourse satisfaction and orgasmic function. Conclusion: The study demonstrated that the Vaijkar Kalp made of herbs was effective in improving male sexual dysfunction.

Khedkar, Amol

2013-01-01

387

[Therapy for male patients with sexual dysfunction].  

PubMed

Phosphodiasterase type 5 inhibitors (sildenafil, vardenafil, tadalafil) are the first line symptomatic therapy for patients with erectile dysfunction. The patient should receive a meticolous information on the use of these drugs and their possible side effects. These drugs are safe and can be used even in patients with stable cardiovascular disease. Patients not responding to oral drugs may be offered intraurethral or intracavernous alprostadil. Vacuum constriction devices are a second line option more acceptable to older patients. Penile prosthesis are very seldom used in Switzerland and vascular surgery is a vanishing option. Testosterone substitution is seldom needed in this setting. Treatment of premature ejaculation subdivides into behavioural therapy ("stop-start" or "squeeze" technique) and drug therapy as well. Topical therapy with lidocaine/prilocaine-containing medications to be applied before sexual intercourse and a oral daily off label use therapy with selective serotonin re-uptake inhibitors (paroxetine, fluoxetine, sertraline) can be offered. Dapoxetine, a potent selective serotonin reuptake inhibitor with short half life time, is the first officially approved medication for the treatment of premature ejaculation and should be available soon in Switzerland. PMID:20235039

Casella, Roberto

2010-03-01

388

Evaluating the effects of an alpha-2 adrenoceptor antagonist on erectile function in the human male  

Microsoft Academic Search

The effects of a new alpha-2 adrenoceptor antagonist on erectile function was assessed in 12 normal volunteers (mean age 28.7, range 20–42), using a double blind, placebo controlled design with two doses of drug and three testing sessions. The drug was administered by intravenous infusion and erectile responses to erotic fantasy and films were monitored by a Rigiscan device. Four

Miguel Munoz; John Bancroft; Martin Turner

1994-01-01

389

Intracavernosal administration of sodium nitrite as an erectile pharmacotherapy.  

PubMed

It has been reported that sodium nitrite (NaNO2) can act as a storage form of nitric oxide (NO) that can have beneficial pharmacologic actions. The present study was undertaken to investigate the effects of NaNO2 on erectile function in the rat. The intracavernosal (i.c.) injection of NaNO2 produced dose-related increases in i.c. pressure and decreases in systemic arterial pressure. NaNO2 was 1000-fold less potent than sodium nitroprusside in increasing i.c. pressure. Increases in i.c. pressure in response to NaNO2 were attenuated by the nitric oxide synthase (NOS) inhibitor N-nitro-L-arginine methyl ester (L-NAME). The increases in i.c. pressure in response to NaNO2 were not altered by the xanthine oxidoreductase inhibitor allopurinol. The decreases in systemic arterial pressure in response to i.c. injections of NaNO2 were attenuated by allopurinol and were either unchanged or increased by L-NAME. These data suggest that NaNO2 is converted to vasoactive NO in the corpora cavernosum and systemic vascular bed of the rat by different mechanisms. The present data suggest that the conversion of NaNO2 to vasoactive NO is mediated by NOS in the corpora cavernosum and by xanthine oxidoreductase in the systemic vascular bed of the rat. These data show NaNO2 can serve as a NO donor that increases erectile activity in the rat. PMID:20651825

Lasker, George F; Matt, Christopher J; Badejo, Adeleke M; Casey, David B; Dhaliwal, Jasdeep S; Murthy, Subramanyam N; Kadowitz, Philip J

2010-07-01

390

Sexual dysfunctions in patients with diabetes: a study from Iran  

PubMed Central

Background Diabetes mellitus is a chronic disease that causes short and long-term complications. This study aimed to investigate the prevalence of sexual dysfunctions (SD) among diabetic patients in Iran and to examine whether glycemic control has a role in SD. Methods A consecutive sample of diabetic women and men who were registered in the Isfahan Endocrine and Metabolism Center, Iran were studied. Sexual dysfunction was evaluated using the Female Sexual Function Index (FSFI) in women and the International Index of Erectile Function (IIEF) in men. In addition the level of glycosylated hemoglobin was assessed to classify the diabetes status in patients. Results In all 200 patients (100 male and 100 female) were entered into the study. The mean age of patients was 48.6 (SD = 7.3) years and most had type 2 diabetes (91.0%). The results showed that sexual dysfunctions were widespread in both gender and 165 (82.5%) patients reported that experienced at least one sexual dysfunction. There were significant associations between sexual dysfunctions and gender and type of diabetes (P = 0.04). Women and patients with type 1 diabetes had higher rates of SD. No major differences were found between SD and age, diabetes status, duration of diabetes and hypertension. In addition, glycemic control did not show a significant association with SD in both genders. Conclusion The findings of this study showed that SD prevalence was high in diabetic patients of both genders and the glycemic control did not correlate with the frequency of SD in the study population. It is recommended that SD should be addressed more precisely in health care practice in Iran. PMID:20482781

2010-01-01

391

Suberoylanilide hydroxamic acid, an inhibitor of histone deacetylase, suppresses vasculogenic mimicry and proliferation of highly aggressive pancreatic cancer PaTu8988 cells  

PubMed Central

Background Pancreatic cancer is one of the most aggressive human malignancies with a extremely low 5-year survival rate. Hence, the search for more effective anti-pancreatic cancer agents is urgent. Methods PaTu8988 pancreatic cancer cells were treated with different concentrations of suberoylanilide hydroxamic acid (SAHA), cell survival, proliferation, migration and vasculogenic mimicry (VM) were analyzed. Associated signaling changes were also analyzed by RT-PCR and Western blots. Results Here, we reported that SAHA, a histone deacetylase inhibitor (HDACi), exerted significant inhibitory efficiency against pancreatic cancer cell survival, proliferation, migration and VM. SAHA dose-dependently inhibited PaTu8988 pancreatic cancer cell growth with the IC-50 of 3.4?±?0. 7 ?M. Meanwhile, SAHA suppressed PaTu8988 cell cycle progression through inducing G2/M arrest, which was associated with cyclin-dependent kinase 1 (CDK-1)/cyclin-B1 degradation and p21/p27 upregulation. Further, SAHA induced both apoptotic and non-apoptotic death of PaTu8988 cells. Significantly, SAHA suppressed PaTu8988 cell in vitro migration and cell-dominant tube formation or VM, which was accompanied by semaphorin-4D (Sema-4D) and integrin-?5 down-regulation. Our evidences showed that Akt activation might be important for Sema-4D expression in PaTu8988 cells, and SAHA-induced Sema-4D down-regulation might be associated with Akt inhibition. Conclusions This study is among the first to report the VM formation in cultured human pancreatic cancer cells. And we provided strong evidence to suggest that SAHA executes significant anti-VM efficiency in the progressive pancreatic cancer cells. Thus, SAHA could be further investigated as a promising anti-pancreatic cancer agent. PMID:24886166

2014-01-01

392

Liposomes, modified with PTD(HIV-1) peptide, containing epirubicin and celecoxib, to target vasculogenic mimicry channels in invasive breast cancer.  

PubMed

Refractoriness of invasive breast cancer is closely related with the vasculogenic mimicry (VM) channels, which exhibit highly drug resistance to conventional chemotherapies. In the present study, the nanostructured targeting epirubicin plus celecoxib liposomes were developed by modifying a human immunodeficiency virus peptide lipid-derivative conjugate (DSPE-PEG2000-PTDHIV-1) for elimination of invasive breast cancer cells along with their VM channels. The studies were undertaken on invasive human breast cancer MDA-MB-435S cells and MDA-MB-435S xenografts in nude mice. The constructed targeting epirubicin plus celecoxib liposomes were approximately 100 nm in size. In vitro results showed that the targeting liposomes exhibited strong transport ability across cell and nuclei membranes of invasive breast cancer, were able to penetrate and destruct the invasive breast cancer spheroids, initiated apoptosis via activating apoptotic enzymes (caspase 8, 3), and destroyed the VM channels via down-regulating the protein indicators (MMP-9, VE-Cad, FAK, EphA2 and HIF-1?) in invasive breast cancer cells. In vivo results demonstrated that the targeting liposomes displayed a prolonged circulation time in blood system, accumulated more in tumor location, were able to eliminate the VM channels and angiogenesis in tumor tissues, and resulted in a robust overall anticancer efficacy in invasive breast cancer MDA-MB-435S xenografts in nude mice. In conclusion, the nanostructured targeting epirubicin plus celecoxib liposomes could eliminate invasive breast cancer along with the VM channels, hence providing a promising strategy for treatment of invasive breast cancer. PMID:24912818

Ju, Rui-Jun; Li, Xue-Tao; Shi, Ji-Feng; Li, Xiu-Ying; Sun, Meng-Ge; Zeng, Fan; Zhou, Jia; Liu, Lei; Zhang, Cheng-Xiang; Zhao, Wei-Yu; Lu, Wan-Liang

2014-08-01

393

Loneliness and Sexual Dysfunctions.  

ERIC Educational Resources Information Center

Argues that sexual dysfunctions result from early childhood experiences which were originally nonsexual in nature. Contends that psychological difficulties centered around problems of loneliness tend to generate certain sexual dysfunctions. Extends and explores suggestion that genesis of sexual conflicts is in nonsexual infant separation anxiety…

Mijuskovic, Ben

1987-01-01

394

Animal models in urological disease and sexual dysfunction  

PubMed Central

There are several conditions associated with dysfunction of the lower urinary tract or which result in a reduction in the ability to engage in satisfactory sexual function and result in significant bother to sufferers, partners and/or carers. This review describes some of the animal models that may be used to discover safe and effective medicines with which to treat them. While alpha adrenoceptor antagonists and 5-alpha-reductase inhibitors deliver improvement in symptom relief in benign prostatic hyperplasia sufferers, the availability of efficacious and well-tolerated medicines to treat incontinence is less well served. Stress urinary incontinence (SUI) has no approved medical therapy in the United States and overactive bladder (OAB) therapy is limited to treatment with muscarinic antagonists (anti-muscarinics). SUI and OAB are characterised by high prevalence, a growing ageing population and a strong desire from sufferers and physicians for more effective treatment options. High patient numbers with low presentation rates characterizes sexual dysfunction in men and women. The introduction of Viagra™ in 1998 for treating male erectile dysfunction and the success of the phosphodiesterase type 5 inhibitor class (PDE5 inhibitor) have indicated the willingness of sufferers to seek treatment when an effective alternative to injections and devices is available. The main value of preclinical models in discovering new medicines is to predict clinical outcomes. This translation can be established relatively easily in areas of medicine where there are a large number of drugs with different underlying pharmacological mechanisms in clinical usage. However, apart from, for example, the use of PDE5 inhibitors to treat male erectile dysfunction and the use of anti-muscarinics to treat OAB, this clinical information is limited. Therefore, current confidence in existing preclinical models is based on our understanding of the biochemical, physiological, pathophysiological and psychological mechanisms underlying the conditions in humans and how they are reflected in preclinical models. Confidence in both the models used and the pharmacological data generated is reinforced if different models of related aspects of the same disorder generate confirmatory data. However, these models will only be fully validated in retrospect once the pharmacological agents they have helped identify are tested in humans. PMID:16465185

McMurray, Gordon; Casey, James H; Naylor, Alasdair M

2006-01-01

395

Olfactory dysfunction in dementia.  

PubMed

The natural aging process brings about some inevitable consequences, such as olfactory dysfunction, which is also frequently linked to numerous neurodegenerative disorders. Many age-related dementia, such as Alzheimer's disease, Vascular dementia, Parkinson's disease, and Frontotemporal Dementia often display olfactory dysfunction. Despite the overwhelming evidence of above mentioned facts, the symptomatic relevance and potential clinical and pre-clinical value of olfactory dysfunction remains overlooked by many clinicians and public alike. Olfactory dysfunction has strong practical implications on daily activities and, although not as prominent as in other mammals, olfaction is still an evolutionarily relevant sense involved in human survival (e.g., smelling gas; bad food). In this work, we provide a brief review of current research related to the olfactory dysfunction profiles in different types of dementia. Additionally, we present a compilation of accessible, easy to use olfaction assessment tools; and highlight future directions in terms of improving clinical diagnosis in patient care and research. PMID:25405189

Alves, Jorge; Petrosyan, Agavni; Magalhães, Rosana

2014-11-16

396

Olfactory dysfunction in dementia  

PubMed Central

The natural aging process brings about some inevitable consequences, such as olfactory dysfunction, which is also frequently linked to numerous neurodegenerative disorders. Many age-related dementia, such as Alzheimer’s disease, Vascular dementia, Parkinson’s disease, and Frontotemporal Dementia often display olfactory dysfunction. Despite the overwhelming evidence of above mentioned facts, the symptomatic relevance and potential clinical and pre-clinical value of olfactory dysfunction remains overlooked by many clinicians and public alike. Olfactory dysfunction has strong practical implications on daily activities and, although not as prominent as in other mammals, olfaction is still an evolutionarily relevant sense involved in human survival (e.g., smelling gas; bad food). In this work, we provide a brief review of current research related to the olfactory dysfunction profiles in different types of dementia. Additionally, we present a compilation of accessible, easy to use olfaction assessment tools; and highlight future directions in terms of improving clinical diagnosis in patient care and research.

Alves, Jorge; Petrosyan, Agavni; Magalhaes, Rosana

2014-01-01

397

The correlation between emotional distress and aging males' symptoms at a psychiatric outpatient clinic: sexual dysfunction as a distinguishing characteristic between andropause and anxiety/depression in aging men  

PubMed Central

Background Andropause and psychiatric disorders are associated with various symptoms in aging males and are part of the differential diagnosis of depression and anxiety. This study was designed to investigate the relationship between symptoms of aging, anxiety, and depression, and to determine if sexual dysfunction could be a differentiating characteristic in the psychiatric outpatient clinic. Methods One hundred seventy-six male psychiatric outpatients participated in the study and completed self-reported measures assessing symptoms of aging, depression, and anxiety. Symptoms of aging were assessed by the Aging Males’ Symptoms scale. Anxiety and depression were measured by the Hospital Anxiety and Depression Scale. Erectile dysfunction was considered if a response to item 15 on the Aging Males’ Symptoms scale (impaired sexual potency) was rated with 4 or 5 points. Affective disturbance was assessed by the total scores of the Hospital Anxiety and Depression Scale. Results Age was correlated with less anxiety and more sexual symptoms. Anxiety and depression were associated with more severe symptoms of aging, and depression was associated with more sexual symptoms than was anxiety. Impaired sexual potency was the only sexual symptom not significantly associated with depression and anxiety. Depression was associated with an interspousal age gap of ?6 years. The point prevalence of erectile dysfunction was 28.4%, and age and affective disturbance were associated with the risk of erectile dysfunction. Conclusion Impaired sexual potency should raise the suspicion of androgen deficiency rather than depression and anxiety among middle-aged or older male psychiatric outpatients. PMID:23766639

Chen, Ching-Yen; Lee, Chin-Pang; Chen, Yu; Jiang, Jun-Ran; Chu, Chun-Lin; Chen, Chun-Liang

2013-01-01

398

Effectiveness of Saikokaryukotsuboreito (Herbal Medicine) for Antipsychotic-Induced Sexual Dysfunction in Male Patients with Schizophrenia: A Description of Two Cases  

PubMed Central

Antipsychotics sometimes cause sexual dysfunction in people with schizophrenia. The authors report the effectiveness of Saikokaryukotsuboreito (Japanese traditional herbal medicine, Chai-Hu-Jia-Long-Gu-Mu-Li-Tang in Chinese) for antipsychotic-induced sexual dysfunction in two male patients with schizophrenia. The first patient was a 28-year-old man with schizophrenia who suffered erectile dysfunction induced by olanzapine 10?mg/day; the erectile dysfunction significantly improved following the treatment of Saikokaryukotsuboreito 7.5?g/day. The other case was a 43-year-old man with schizophrenia who was receiving fluphenazine decanoate at 50?mg/month and had difficulties in ejaculation; add-on of Saikokaryukotsuboreito 7.5?g/day recovered his ejaculatory function. There has been no report on the effectiveness of Japanese herbal medicine formulations for antipsychotic-induced sexual dysfunction. Although the effectiveness of Saikokaryukotsuboreito needs to be tested in systematic clinical trials, this herbal medicine may be a treatment option to consider for this annoying side effect. PMID:24587934

Takashi, Tsuboi; Uchida, Hiroyuki

2014-01-01

399

‘Pack a more powerful punch’ and ‘lay the pipe’: erectile enhancement discourse as a body project for masculinity  

Microsoft Academic Search

In this article, we analyze erectile enhancement as a postmodern body project that (re)codes hegemonic masculinity through new means. Erectile enhancement Internet ads create a text of masculinity through constructing a crisis of masculinity and selling the solution. The crisis is loss of power, control and the ability to dominate; the solution is a larger and more powerful penis that

Sarah Jane Brubaker; Jennifer A. Johnson

2008-01-01

400

Endogenous Urotensin II Selectively Modulates Erectile Function through eNOS  

PubMed Central

Background Urotensin II (U-II) is a cyclic peptide originally isolated from the neurosecretory system of the teleost fish and subsequently found in other species, including man. U-II was identified as the natural ligand of a G-protein coupled receptor, namely UT receptor. U-II and UT receptor are expressed in a variety of peripheral organs and especially in cardiovascular tissue. Recent evidence indicates the involvement of U-II/UT pathway in penile function in human, but the molecular mechanism is still unclear. On these bases the aim of this study is to investigate the mechanism(s) of U-II-induced relaxation in human corpus cavernosum and its relationship with L-arginine/Nitric oxide (NO) pathway. Methodology/Principal Findings Human corpus cavernosum tissue was obtained following in male-to-female transsexuals undergoing surgical procedure for sex reassignment. Quantitative RT-PCR clearly demonstrated the U-II expression in human corpus cavernosum. U-II (0.1 nM–10 µM) challenge in human corpus cavernosum induced a significant increase in NO production as revealed by fluorometric analysis. NO generation was coupled to a marked increase in the ratio eNOS phosphorilated/eNOS as determined by western blot analysis. A functional study in human corpus cavernosum strips was performed to asses eNOS involvement in U-II-induced relaxation by using a pharmacological modulation. Pre-treatment with both wortmannin or geldanamycinin (inhibitors of eNOS phosphorylation and heath shock protein 90 recruitment, respectively) significantly reduced U-II-induced relaxation (0.1 nM–10 µM) in human corpus cavernosum strips. Finally, a co-immunoprecipitation study demonstrated that UT receptor and eNOS co-immunoprecipitate following U-II challenge of human corpus cavernosum tissue. Conclusion/Significance U-II is endogenously synthesized and locally released in human corpus cavernosum. U-II elicited penile erection through eNOS activation. Thus, U-II/UT pathway may represent a novel therapeutical target in erectile dysfunction. PMID:22319601

d'Emmanuele di Villa Bianca, Roberta; Mitidieri, Emma; Fusco, Ferdinando; D'Aiuto, Elena; Grieco, Paolo; Novellino, Ettore; Imbimbo, Ciro; Mirone, Vincenzo; Cirino, Giuseppe; Sorrentino, Raffaella

2012-01-01

401

Pelvic Floor Dysfunction  

MedlinePLUS

... pelvic floor dysfunction? For most people, having a bowel movement is a seemingly automatic function. For some individuals, ... incomplete emptying of the rectum when having a bowel movement. Incomplete emptying may result in the individual feeling ...

402

Sexual Dysfunction Following Vulvectomy  

Microsoft Academic Search

Objective. This is a pilot study to evaluate sexual dysfunction in women after vulvectomy.Methods. An 88-question survey was used to assess body image and the DSM IV criteria for sexual dysfunction on women who had undergone vulvectomy.Results. Forty-seven women agreed to participate in the study and 41 women (87%) returned the survey. There was a significant alteration of body image

Michael S. Green; R. Wendel Naumann; Mollie Elliot; James B. Hall; Robert V. Higgins; Jared H. Grigsby

2000-01-01

403

Norcantharidin inhibits tumor growth and vasculogenic mimicry of human gallbladder carcinomas by suppression of the PI3-K/MMPs/Ln-5?2 signaling pathway  

PubMed Central

Background Vasculogenic mimicry (VM) is a novel tumor blood supply in some highly aggressive malignant tumors. Recently, we reported VM existed in gallbladder carcinomas (GBCs) and the formation of the special passage through the activation of the PI3K/MMPs/Ln-5?2 signaling pathway. GBC is a highly aggressive malignant tumor with disappointing treatments and a poor prognosis. Norcantharidin (NCTD) has shown to have multiple antitumor activities against GBCs, etc; however the exact mechanism is not thoroughly elucidated. In this study, we firstly investigated the anti-VM activity of NCTD as a VM inhibitor for GBCs and its underlying mechanisms. Methods In vitro and in vivo experiments to determine the effects of NCTD on proliferation, invasion, migration, VM formation, hemodynamic and tumor growth of GBC-SD cells and xenografts were respectively done by proliferation, invasion, migration assays, H&E staining and CD31-PAS double stainings, optic/electron microscopy, tumor assay, and dynamic micro-MRA. Further, immunohistochemistry, immunofluorescence, Western blotting and RT-PCR were respectively used to examine expression of VM signaling-related markers PI3-K, MMP-2, MT1-MMP and Ln-5?2 in GBC-SD cells and xenografts in vitro and in vivo. Results After treatment with NCTD, proliferation, invasion, migration of GBC-SD cells were inhibited; GBC-SD cells and xenografts were unable to form VM-like structures; tumor center-VM region of the xenografts exhibited a decreased signal in intensity; then cell or xenograft growth was inhibited. Whereas all of untreated GBC-SD cells and xenografts formed VM-like structures with the same conditions; the xenograft center-VM region exhibited a gradually increased signal; and facilitated cell or xenograft growth. Furthermore, expression of MMP-2 and MT1-MMP products from sections/supernates of 3-D matrices and the xenografts, and expression of PI3-K, MMP-2, MM1-MMP and Ln-5?2 proteins/mRNAs of the xenografts were all decreased in NCTD or TIMP-2 group; (all P?

2014-01-01

404

Late-stage clinical development in lower urogenital targets: sexual dysfunction  

PubMed Central

In recent years, late-stage clinical drug development that primarily focuses on urogenital targets has centered around four areas of medical need (both unmet need and aiming to improve on existing therapies). These include male sexual dysfunction (MSD), female sexual dysfunction (FSD), prostatic pathology (neoplastic, pre-neoplasitic, and non-neoplastic), and improvement in lower urinary tract symptoms. Despite the regulatory approval of compounds to treat erectile dysfunction (ED), benign prostatic hyperplasia, a number of treatments for overactive bladder, and stress urinary incontinence, there remains a deficiency in addressing a number of conditions that arise out of pathophysiological dysfunction resulting in lower urogenital tract sexual conditions. In terms of late-stage clinical development, significant progress has most recently been made in MSD development, especially in understanding further a common and complex sexual dysfunction – that of premature ejaculation. The search also continues for compounds that improve ED in terms of better efficacy and superior safety profile compared to the currently marketed phosphodiesterase-5-inhibitors. Whilst there are no approved medications to treat the subtypes of FSD, there has been significant progress in attempting to better understand how to appropriately assess treatment benefit in clinical trial settings for this difficult to diagnose and treat condition. This review will focus on late-stage human clinical development pertaining to MSD and FSD. PMID:16465180

Azam, Usman

2006-01-01

405

Sexual dysfunction in patients with alcohol and opioid dependence.  

PubMed

There are limited numbers of studies which have evaluated the sexual dysfunction (SD) in patients with alcohol and opioids dependence. This article reviews the existing literature. Electronic searches were carried out using the PubMed, Google Scholar, and ScienceDirect to locate the relevant literature. Subjects addicted to heroin or on methadone maintenance treatment (MMT) or buprenorphine maintenance treatment (BMT) show higher rates of SD in comparison to the general population. SD rates have ranged 34-85% for heroin addicts, 14-81% for MMT, 36-83% for BMT, and 90% for naltrexone maintenance. The rates of SD in alcohol-dependent population have ranged 40-95.2%, with rates being consistently much higher in alcohol-dependent population than in the healthy controls or social drinkers. The common SDs reported have been erectile dysfunction followed by premature ejaculation, retarded ejaculation and decreased sexual desire among men, and dyspareunia and vaginal dryness a