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1

Endovascular treatment of vasculogenic erectile dysfunction  

PubMed Central

The treatment of erectile dysfunction (ED) has been a fascination involving multiple medical specialities over the past century with urologic, cardiac and surgical experts all contributing knowledge toward this multifactorial disease. With the well-described association between ED and cardiovascular disease, angiography has been utilized to identify vasculogenic impotence. Given the success of endovascular drug-eluting stent (DES) placement for the treatment of coronary artery disease, there has been interest in using this same technology for the treatment of vasculogenic ED. For men with inflow stenosis, DES placement to bypass arterial lesions has recently been reported with a high technical success rate. Comparatively, endovascular embolization as an approach to correct veno-occlusive dysfunction has produced astonishing procedural success rates as well. However, after a thorough literature review, arterial intervention is only recommended for younger patients with isolated vascular injuries, typically from previous traumatic experiences. Short-term functional outcomes are less than optimal with long-term results yet to be determined. In conclusion, the hope for a minimally invasive approach to ED persists but additional investigation is required prior to universal endorsement. PMID:25532580

Kim, Edward D; Owen, Ryan C; White, Gregory S; Elkelany, Osama O; Rahnema, Cyrus D

2015-01-01

2

Initial validation of a novel rat model of vasculogenic erectile dysfunction with generalized atherosclerosis  

Microsoft Academic Search

Although rats have been widely used in evaluating various causes of vasculogenic erectile dysfunction (VED), the atherosclerotic rat model has seldom been tried probably due to its inherent tolerance to a cholesterol diet. To enhance endothelial sensitivity to cholesterol diet, we tested the effects of transient interruption of nitric oxide synthase on atherogenesis induced by cholesterol diet in a rat

H Son; S W Kim; J-S Paick

2005-01-01

3

Vasculogenic female sexual dysfunction: The hemodynamic basis for vaginal engorgement insufficiency and clitoral erectile insufficiency  

Microsoft Academic Search

Objective: Organic female sexual dysfunction may be related in part to vasculogenic impairment of the hypogastric-vaginal\\/clitoral arterial bed. The aim was to develop an animal model of vaginal engorgement insufficiency and clitoral erectile insufficiency. Methods: Pelvic nerve stimulated vaginal engorgement and clitoral erection were achieved in control (normal diet, n=8) and atherosclerotic (balloon injury of aorto-iliac arteries and 0.5% cholesterol

I Goldstein; C Andry; MB Siroky; RJ Krane; KM Azadzoi

1997-01-01

4

Assessment of Mean Platelet Volume in men with vasculogenic and nonvasculogenic erectile dysfunction.  

PubMed

Mean platelet (PLT) activation has an important role in the development of vascular diseases. In this study, we aimed to investigate the PLT volume in patients with vasculogenic and nonvasculogenic erectile dysfunction (ED) and compare it with the control group. Mean PLT volume (MPV) levels were measured in 50 patients with vasculogenic ED, in 30 patients who developed ED after radical prostatectomy (nonvasculogenic) and in 40 healthy controls. Ages were similar between the three groups. The diagnosis of ED was based on detailed sexual history, physical examination, laboratory assessment and color Doppler ultrasonography and is defined as the inability to attain or maintain a penile erection that is sufficient for successful vaginal intercourse. The results are given as mean±s.d. of the mean. The mean age of the patients with vasculogenic ED, of patients with ED after radical prostatectomy and of the control group were 53.70±12.39 (range 24-77), 54.60±11.40 (range 43-61) and 53.85±9.5 (range 30-73), respectively (P=0.853). The MPV and PLT values were significantly higher in patients with vasculogenic ED than in patients with ED after radical prostatectomy and in control groups: 7.49±1.4, 6.43±1.19 and 6.85±1.2 for MPV and 262.97±68, 251.77±78 and 252.89±82 for PLT values, respectively (P=0.033). The MPV and PLT values were not statistically significant in postprostatectomy ED patients and in control groups (P=0.663). There was no significant difference among the three groups in terms of white blood cells and hemoglobin levels. PLT count and mean PLT volume were detected to be increased in patients with vasculogenic ED. This finding may suggest a role for PLT volume in the pathogenesis of vasculogenic ED. PMID:24871679

Ciftci, H; Gumu?, K; Yagmur, I; Sahabettin, S; Çelik, H; Yeni, E; Savas, M; Gulum, M

2015-01-01

5

The link between vasculogenic erectile dysfunction, coronary artery disease, and peripheral artery disease: role of metabolic factors and endovascular therapy.  

PubMed

Erectile dysfunction (ED) is estimated to affect 150 million people worldwide and may indicate diffuse systemic macrovascular disease. Endothelial dysfunction represents the probable pathophysiological link between vasculogenic ED, coronary artery disease (CAD), and peripheral artery disease (PAD), and the artery size hypothesis along with evidence-based research support ED as the incident clinical event. Given that many common risk factors for atherosclerosis, including smoking, diabetes mellitus, hyperlipidemia, and obesity are prevalent and causative in patients with ED, it is likely that metabolic factors play a crucial role in the link between the two disorders. The interplay of these factors provides a unifying physiological, endocrinological, and behavioral model for the association between ED, CAD, and PAD. Current therapy is unlikely to reverse the natural history of ED. Percutaneous revascularization may improve ED symptoms, and thereby quality of life, in a select group of patients. Large prospective studies are needed to define male pelvic arterial anatomy and thus enhance the utilization of internal pudendal angiography and revascularization. In this review, we provide an overview of normal erectile anatomy and physiology, the pathophysiology of ED, currently accepted diagnostic imaging modalities and treatments for ED, and recently investigated endovascular therapies for ED. PMID:23735361

Meller, Stephanie M; Stilp, Erik; Walker, Charles N; Mena-Hurtado, Carlos

2013-06-01

6

The direction and severity of penile curvature does not have an impact on concomitant vasculogenic erectile dysfunction in patients with Peyronie's disease.  

PubMed

Although the association between Peyronie's disease (PD) and erectile dysfunction (ED) is well established, limited data are available correlating penile curvature and penile hemodynamic parameters. We sought to examine this association in a cohort of PD men undergoing penile duplex Doppler ultrasound (PDDU). PD patients were retrospectively evaluated to correlate the extent and direction of penile curvature with measured vascular parameters. Demographic variables, disease characteristics and PDDU parameters were tabulated and statistically compared based on extent (?45° and >45°) and direction (dorsal, ventral, lateral, ventrolateral, dorsolateral) of curvature. A total of 220 PD patients (mean age of 55.0±9.2 years) underwent PDDU at one institution from January 2008 to December 2010. Overall, 69.5% of patients were found to have vasculogenic ED (arterial insufficiency (AI): 10%; veno-occlusive dysfunction (VOD): 43.2%; AI+VOD: 16.4%). Mean curvature was similar among all PDDU groups (AI: 41.7±5.2°; VOD: 41.3±2.5°; AI+VOD: 37±4.1°; no-ED: 37.3±3°; P>0.85). No significant differences were noted in the presence or type of ED among various directions of curvature (P=0.34) or when curvatures were stratified by ?45° and >45°. The direction and extent of penile curvature are not associated with altered rates of vasculogenic ED on PDDU in PD patients.International Journal of Impotence Research advance online publication, 17 July 2014; doi:10.1038/ijir.2014.25. PMID:25030909

Serefoglu, E C; Trost, L; Sikka, S C; Hellstrom, W J G

2014-07-17

7

Erectile dysfunctions.  

PubMed

Erectile dysfunction is one of the prime challenges confronting the treating physician. Its prevalence is directly proportional to aging. It is imperative to comprehend the intricate mechanism of erection in order to individualize the approach to management. Thus, it is appropriate to evaluate the etiology of erectile dysfunction. Normal aging, as well as psychogenic, vascular, neurogenic, and endocrinologic causes and/or those due to structural abnormalities of the penis should be considered when evaluating details to determine its probable cause. An increasing use of drugs, a legacy of civilization, has considerably compounded the problem. Therapy for erectile dysfunction, apart from psychosexual counseling, includes medical treatment by alpha adrenoceptor antagonists, dopamine agonists, phosphodiesterase type 5 inhibitors, sublingual apomorphine hydrochloride, or hormone therapy. Transdermal or transurethral corporeal drug delivery are other possible treatment modalities. Vacuum devices and surgical approaches are considered relevant only in refractory cases. PMID:14673246

Sehgal, Virendra N; Srivastava, Govind

2003-01-01

8

[Erectile dysfunction].  

PubMed

Erectile Dysfunction is one of the most prevalent sexual disorders in men. According to the current literature the prevalence is about 16% for all men. The diagnostic workup of a patient suffering from E.D. is a detailed anamnesis, a physical and endocrinological evaluation and the suggestion of the optimal therapeutic treatment. The therapeutic application of PDE-5 inhibitors has made the therapy of E.D. much easier. It is a safe and highly efficient therapeutic option. But man must not forget that in severe cases of erectile dysfunction, the application of SKAT therapy, penile implants or vacuum devices might be necessary. Since a functioning sex life is important not only for the men, but also for the couple, a more open attitude of us, physicians, is desirable to help more men who suffer from this sexual dysfunction. PMID:19997838

Esterbauer, Brigitte; Jungwirth, Andreas

2009-01-01

9

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

10

[Corpus cavernosum autoinjection therapy: initial experiences in erectile dysfunction].  

PubMed

The cause of erectile dysfunction was evaluated by a multidisciplinary approach in 120 impotent patients. Out of these, the CCAT was proposed to 20 patients with vasculogenic erectile dysfunction, 19 of them accepted this therapy. The dosage of phentolamine mesylate-papaverin hydrochloride injection required was determined in each patient individually. Usually we injected initially 1 cc in one corpus cavernosum. Eighteen patients followed the regimen successfully at home. In 2 patients prolonged erections were observed, which were successfully relieved by simple corpus puncture, however, discontinuation of therapy was not necessary. CCAT failed in 1/19 patients with a severe venous leak. Follow up was carried out weekly. PMID:2421473

Stief, C G; Bähren, W; Gall, H; Scherb, W; Gallwitz, A; Altwein, J E

1986-01-01

11

Endothelins & erectile dysfunction.  

PubMed

Erectile dysfunction (ED) is common and a significant contributor to poor quality of life and psychosocial morbidity in men. Normal erectile function requires effective co-ordination between a number of complex neural pathways. Penile tumescence occurs in response to rapid arterial inflow to the corpora cavernosa with simultaneous venous outflow restriction due to expansion of the lacunar spaces. This process is under both central and local neuromediation. Endothelins are potent vasoconstrictor peptides that cause strong, slowly developing but sustained contraction of trabecular smooth muscles cells of the corpora cavernosa. Multiple mechanisms of action are proposed, including transmembrane calcium flux, mobilisation of inositol triphosphate sensitive intracellular calcium stores and calcium sensitisation through the Rho-Rho kinase pathway. The exact role of endothelins in the pathogenesis of ED currently remains unclear. Elevated endothelin-1 levels are found in patients with diabetes mellitus and this alone may be sufficient to cause ED. However, this is not borne out in clinical studies. The resultant elevated intracellular calcium may, however, modulate gene expression sufficiently to cause smooth muscle proliferation. Alternatively, alterations in endothelin receptor sensitivity in conditions such as diabetes and hypertension may enhance vasoconstrictor processes. Currently there is contradictory evidence for the role of endothelin receptor antagonists in ED. Animals studies suggest they inhibit corporal vasoconstriction, improve erectile function and protect against diabetes-induced smooth muscle apoptosis. However, the results of clinical studies in ED have been less promising. Uncertainty regarding the exact role of endothelin in penile erection hampers progress in this area. It is possible that the endothelin system may only be relevant to ED in certain conditions where global endothelial dysfunction exists (e.g. diabetes mellitus, systemic sclerosis) and the use of endothelin antagonists in these patient groups may yield improved outcomes. PMID:21185376

Ritchie, Robert; Sullivan, Mark

2011-06-01

12

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

13

Psychological Aspects of Erectile Dysfunction  

Microsoft Academic Search

\\u000a Because the brain is intimately involved in the control of erections, a wide variety of psychological factors impact erectile\\u000a response and may lead to erectile dysfunction (ED). This chapter reviews the assessment of psychological factors in ED, the\\u000a immediate and underlying psychological conditions involved, and the development of ED over time. Outcome research on psychological\\u000a treatments for ED is also

Richard A. Carroll

14

The neuropathy of erectile dysfunction  

Microsoft Academic Search

These studies were intended to explore the relationship between autonomic neuropathy and erectile dysfunction (ED). Sensory thresholds reflecting the integrity of both large diameter, myelinated neurons (ie pressure, touch, vibration) and small diameter axons (ie hot and cold thermal sensation) were determined on the penis and finger. Data were compared across subjects with and without ED, controlling for age, hypertension

CB Bleustein; JC Arezzo; H Eckholdt; A Melman

2002-01-01

15

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

PubMed Central

Background Men with erectile dysfunction often have concurrent medical conditions. Conversely, men with these conditions may also have underlying erectile dysfunction. The prevalence of unrecognized erectile dysfunction in men with comorbidities commonly associated with erectile dysfunction was determined in men invited to participate in a double-blind, randomized, placebo-controlled trial of sildenafil citrate. Methods Men ?30 years old presenting with ?1 erectile dysfunction risk factor (controlled hypertension, hypercholesterolemia, smoking, metabolic syndrome, stable coronary artery disease, diabetes, depression, lower urinary tract symptoms, obesity [body mass index ?30 kg/m2] or waist circumference ?40 inches), and not previously diagnosed with erectile dysfunction were evaluated. The screening question, "Do you have erectile dysfunction?," with responses of "no," "yes," and "unsure," and the Erectile Function domain of the International Index of Erectile Function (IIEF-EF) were administered. Results Of 1084 men screened, 1053 answered the screening question and also had IIEF-EF scores. IIEF-EF scores indicating erectile dysfunction occurred in 71% (744/1053), of whom 54% (399/744) had moderate or severe erectile dysfunction. Of 139 answering "yes," 526 answering "unsure," and 388 answering "no," 96%, 90%, and 36%, respectively, had some degree of erectile dysfunction. The mean±SD (range) number of risk factors was 2.9 ± 1.7 (3-8) in the "yes" group, 3.2 ± 1.7 (3-9) in the "unsure" group, and 2.6 ± 1.5 (2-8) in the "no" group. Conclusion Although awareness of having erectile dysfunction was low, most men with risk factors had IIEF-EF scores indicating erectile dysfunction. Erectile dysfunction should be suspected and assessed in men with risk factors, regardless of their apparent level of awareness of erectile dysfunction. Trial registration ClinicalTrials.gov Identifier NCT00343200. PMID:21054874

2010-01-01

16

Computational tools in rehabilitation of erectile dysfunction  

Microsoft Academic Search

Erectile dysfunction (ED) is defined as the inability to achieve and maintain an erection adequate for satisfactory intercourse. It is a common problem among approximately 50% of men between the ages of 40 and 70. Erectile dysfunction is not only stressful to both the affected individual and his partner, but it can also negatively affect self-esteem. Biomechanical models have recently

A. Gefen; J. Chen; D. Elad

2001-01-01

17

Medical treatment of erectile dysfunction.  

PubMed Central

There has been a tremendous increase in demand for the treatment of erectile dysfunction in the last 10 years. This has occurred partly because of a greater understanding and awareness by both the general public and clinicians, and also because there now exists a range of effective treatments. The choice of treatments is increasing rapidly and novel delivery systems which may be more patient-friendly than intracavernosal injections are now becoming available. We review the published data on effectiveness and safety of the currently available treatments and discuss recent advances in oral therapy, as these drugs are likely to become available in the near future. Images Figure 1 Figure 2 PMID:9799886

Burns-Cox, N.; Gingell, C.

1998-01-01

18

Relationship Between Testosterone and Erectile Dysfunction  

PubMed Central

Although erectile function is clearly androgen dependent, is it just as clear at what level of testosterone erectile dysfunction (ED) begins? Does the decline in testosterone that occurs with aging always produce ED? Are exogenous androgens the answer to ED? The answers range from clear to complex. PMID:16985751

Rajfer, Jacob

2000-01-01

19

Animal models of erectile dysfunction  

PubMed Central

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

Gajbhiye, Snehlata V.; Jadhav, Kshitij S.; Marathe, Padmaja A.; Pawar, Dattatray B.

2015-01-01

20

Erectile dysfunction: anatomical parameters, etiology, diagnosis, and therapy.  

PubMed

Functional anatomy of the human penis involves various parameters: cavernous tissue, covering integument, prepuce foreskin, corpora cavernosa, corpus spongiosum, glans, facia, arterial supply, venous drainage, lymph drainage, musculature, and nerve supply. Several factors affect the expression/degree of erectile dysfunction (ED) endocrine profile, aging/senescence, demyelinating diseases, and surgery. Risk factors of ED are: age, vascular factors, metabolic diseases (diabetes mellitus), neurologic diseases, and HIV/AIDS. Several drugs are associated with ED: antiandrogenic, anticholinergic, antidepressants, antihypertensive, major tranquilizers, anxiolytics, and certain medicines/metabolites. The International Index of Erectile Function (IIEF) is a multidimensional scale for assessment of erectile dysfunction. The main structures mediating erection are the corpora cavernosa or "erectile bodies," which are fused distally for approximately three-quarters of their length. They separate proximally to fuse with each ischial tuberosity of the pelvis. On their ventral surface lies the corpus spongiosum, which surrounds the urethra. Coital dysfunction is classified into "erectile dysfunction" (psychosexual and endocrine/neuro-endocrine) and "ejaculatory dysfunction" (psychosexual, and genitourinary surgery). Vasculogenic impotence was evaluated by high-resolution ultrasonography and pulsed Doppler spectrum analysis. Cavernosal, alpha-blockade is a technique used to evaluate and treat ED. Another diagnostic procedure for ED involves color floro and spectural Doppler imaging after papaverine-induced erection in impotent men. Color Doppler and duplex ultrasonography are used to evaluate Peyronie's disease. Sildenafil cilrate (Viagra) is an effective therapy of ED in men. Vardenavil is a highly selective phosphodiesterase 5 (PDE5) inhibitor which improved ED. Prostagland E1, vasoactive intestinal polypeptide (VIP), and phentolamine mesylate (administered by autoinjectors) have been applied to treat ED in patients resistant to other intracavernosal agents. Clinical trials were conducted on self-injection of vasoactive drugs, apomorphine SL, and tadalafil in diabetic men. Medical therapy of ED includes: medicated urethral system for erection (MUSE), intravenous pharmacotherapy, arterial revascularization, vacuum devices, two- and three-component inflatable penile prosthesis, semi-rigid penile prosthesis in situ, and inflatable one-piece penile prosthesis. Surgical therapy include procedures to correct Peyronie's penile deformity and penile deformity, procedures to avoid inevitable shortening accompanying Nesbit's disease, and for penile lengthening. PMID:15764414

Hafez, E S E; Hafez, S D

2005-01-01

21

Evaluation and treatment of erectile dysfunction.  

PubMed

Erectile dysfunction has an organic etiology in most cases, with vascular disease the single most common cause. In addition to a thorough history and physical examination, clinical evaluation may include hormonal assessment, diabetes screening, nocturnal tumescence testing and color Doppler flow studies of the penile vasculature. Therapy for erectile dysfunction has progressed rapidly during the past decade, with alternatives including hormone supplements, vacuum constriction devices, penile self-injection therapy and penile prostheses. The majority of patients and their partners report satisfactory results with these treatments. PMID:8623722

DeWire, D M

1996-05-01

22

PDE5 inhibitors beyond erectile dysfunction  

Microsoft Academic Search

The phosphodiesterase type-5 (PDE5) inhibitors sildenafil, vardenafil and tadalafil are widely used first-line therapy for erectile dysfunction (ED). Since the advent of sildenafil in 1998, more than 40 million men worldwide have been successfully treated with these compounds. The safety and high tolerability of PDE5 inhibitors make them an attractive tool to investigate further physiological functions of PDE5, for example

P Sandner; J Hütter; H Tinel; K Ziegelbauer; E Bischoff

2007-01-01

23

[Endothelial microparticles and erectile dysfunction: an update].  

PubMed

Microparticles are submicron vesicles shed from plasma membranes in response to cell activation, injury and/or apoptosis. Microparticles of various cellular origins, such as platelets, leukocytes, and endothelial cells, are found in the plasma of healthy subjects, and their amount increases under pathological conditions. Recent studies show that endothelial microparticles, a kind of envelope particles derived from endothelial cells, not only constitute a marker of endothelial dysfunction, but also play a major biological role in the diagnostic and therapeutic approaches to erectile dysfunction. PMID:24218953

Li, Yong-Xian; Jiang, Rui; Yang, Guo-Sheng

2013-10-01

24

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

25

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

26

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. PMID:25243040

Brock, Gerald

2014-01-01

27

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

28

Penile low-intensity shock wave therapy: a promising novel modality for erectile dysfunction.  

PubMed

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

Abu-Ghanem, Yasmin; Kitrey, Noam D; Gruenwald, Ilan; Appel, Boaz; Vardi, Yoram

2014-05-01

29

Hidden Risks of Erectile Dysfunction "Treatments" Sold Online  

MedlinePLUS

... Updates by E-mail Consumer Updates RSS Feed Hidden Risks of Erectile Dysfunction "Treatments" Sold Online Search ... and Border Protection to develop a more effective network to successfully screen and stop these shipments from ...

30

[Evaluation of vasculogenic erectile impotence using DICC (dynamic infusion cavernosometry & cevernosography) with intracavernous injection of papaverine].  

PubMed

Dynamic infusion cavernosometry and cavernosography (DICC) with intracevernous injection of papaverine was performed in 28 men. The change of the corporal body pressure after injection of papaverine and the intracavernous pressure decrease within the first 30 seconds after discontinuation of saline infusion were observed. Four different patterns of cavernometric findings can be identified on the basis of the intracavernous pressure behavior in response to injection of papaverine, infusion of saline and discontinuation of infusion: pattern A represents no vasculogenic insufficiency, pattern B represents pure arterial insufficiency, pattern C clearly represents venous leak and pattern D represents venous leak and arterial insufficiency. Cavernosography has found out effectively the sites of venous leakage in most our cases. PMID:8345721

Yanagi, S; Suzuki, H; Namiki, T

1993-06-01

31

Drugs used to treat erectile dysfunction.  

PubMed

Knowledge of the drugs currently approved to treat erectile dysfunction (ED) is important for nurses who care for male patients, especially those men of middle age or older and those who have concurrent health problems or are taking medications that may contribute to ED. This article provides a very basic look at ED and the drugs currently approved and used for treatment. Informed nurses can increase patient understanding of ED, make suggestions for necessary referrals, and help patients and their sexual partners understand the appropriate use and cautions associated with drugs used to treat ED. On the surface, one might question why orthopaedic nurses would need knowledge about drugs currently used to treat ED. However, when one considers that a large proportion of patients in any orthopaedic setting are men, the need for knowledge about the use and safety of these medications becomes a valid component of total patient care. This is an especially important subject today, when media advertising has heightened public awareness of the medications used to treat ED but has not provided much toward a basic understanding about ED or the safe use of the advertised therapeutic agents. Nurses who have some knowledge about ED and the medications used to treat ED are better able to serve as a patient resource for education and referral. PMID:18521039

Turkoski, Beatrice B

2008-01-01

32

Cardiometabolic Risk Factors in Patients with Erectile Dysfunction  

PubMed Central

Introduction. There is an increasing interest in the association between erectile dysfunction (ED) and cardiovascular risk factor. Epicardial adipose tissue (EAT) is associated with insulin resistance, increased cardiometabolic risk, and coronary artery disease. Our aim was to investigate relationships between epicardial fat thickness (EFT) as a cardiometabolic risk factor and erectile dysfunction. Method. We selected 30 erectile dysfunction patients without comorbidities and 30 healthy individuals. IIEF-5 score was applied to all patients, and IIEF-5 score below 22 was considered as erectile dysfunction. EFT was measured by echocardiography. Results. Body mass index (BMI) was higher in ED patients than those without ED (28.19 ± 4.45?kg/m2 versus 23.84 ± 2.36?kg/m2, P = 0.001, resp.). Waist circumstance (WC) was higher in ED patients than those without ED (106.60 ± 5.90 versus 87.86 ± 14.51, P = 0.001, resp.). EFT was higher in ED patients compared to non-ED patients (0.49 ± 0.09?cm versus 0.45 ± 0.03?cm, P = 0.016, resp.). There was positive correlation among BMI, WC, and EFT. There was negative correlation between EFT and IIEF-5 score (r : ? 0.632, P = 0.001). Conclusion. EAT, BMI, and WC as cardiometabolic risk factors were higher in erectile dysfunction patients. PMID:24587762

Tanik, Serhat; Sarikaya, Savas; Zengin, Kür?ad; Albayrak, Sebahattin; Yilmaz, Yunus Keser; Akyol, Lutfi

2014-01-01

33

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

34

Biochemical and genetic markers of erectile dysfunction.  

PubMed

Erectile dysfunction (ED) is a very common pathology, affecting over 150 million men worldwide. The pathogenesis is typically multifactorial, involving a kaleidoscope of organic, endocrine, and psychogenic factors. In general, ED is divided into organic and psychogenic impotence, but most men with organic etiologies have an associated psychogenic component. Given the high frequency of this pathology, the identification of biochemical and genetic correlates and/or markers is of pivotal interest not only for treating preciously these patients and preventing serious psychological consequences but also for the high risk for occult cardiovascular disease (CVD) that often accompanies or follows this pathology. A variety of cardiovascular risk factors have been associated with both the onset and the severity of ED, including markers of endothelial function, thrombosis, and especially dyslipidemia, so that their measurement should now be considered as an important part of the increased global cardiometabolic risk profile in patients with ED. While nitric oxide (NO), asymmetric dimethylarginine (ADMA), and endothelin (ET) hold some promises as biochemical markers of both CVD and ED, there are several technical and clinical drawbacks that make their measurement overall meaningless in the clinical practice. As regards genetic polymorphisms, controversial results have been provided so far. Although some genetic markers were consistently associated with ED, other studies failed to demonstrate significant associations, highlighting a substantial bias in standardization of methodologies and patient enrolment. Nevertheless, further research in this area should be encouraged, since the first promising evidence that gene therapy might be effective to restore the decline in ED has been provided in the animal model. PMID:22870589

Lippi, Giuseppe; Plebani, Mario; Montagnana, Martina; Cervellin, Gianfranco

2012-01-01

35

The Molecular Basis of Erectile Dysfunction: From Bench to Bedside  

PubMed Central

Erectile dysfunction is a common problem affecting many men across all age groups. Its etiology is multifactorial. Hormonal, vascular, neurogenic, lifestyle, and psychological entities have all been implicated as causative agents. The molecular basis underlying its etiology and progression is complex and still challenges researchers in the field. Nonetheless, newly discovered common pathways and targets of its pathogenesis have opened a new era for both prevention and active treatment of the disease. This review describes some of the known molecular mechanisms contributing to erectile dysfunction and discusses the future of gene therapy for the disease. PMID:16985823

Mills, Jesse N; Barqawi, Albaha; Koul, Sweaty; Koul, Hari; Meacham, Randall B

2005-01-01

36

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

PubMed

Low-intensity shockwaves (LISW) are known to produce revascularization and have been in evaluation and in use to treat erectile dysfunction (ED). The present single-arm pilot study is aimed to assess the safety and efficacy of a dedicated shockwave device (Renova) on vasculogenic ED patients. Fifty-eight patients with mild to severe ED were treated by LISW and their erectile function was evaluated by the International Index of Erectile Function-Erectile Function Domain (IIEF-EF), Sexual Encounter Profile and Global Assessment Questions questionnaires, at baseline and at 1, 3 and 6 months post treatment. The average IIEF-EF increased significantly from 14.78 at baseline to 21.93 at 3 months post treatment and stabilized at 22.26 at 6 months post treatment. Out of 58 patients, 47 (81%) had a successful treatment. No adverse events were reported during the treatment and the follow-up duration. In conclusion, it suggests that the performance of LISW could add a new advanced treatment for ED.International Journal of Impotence Research advance online publication, 4 December 2014; doi:10.1038/ijir.2014.41. PMID:25471316

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

2014-12-01

37

Papaverine Topical Gel for Treatment of Erectile Dysfunction  

Microsoft Academic Search

Intracavernous injection of vasoactive substances has been shown to be an effective means of treatment of organic erectile dysfunction. However, up to 50% of men eventually discontinue treatment often because of lack of spontaneity and needle phobia. This study was done as a phase I, placebo controlled, nonblinded investigation of the safety and efficacy of a topical papaverine gel in

Edward D. Kim; Ragab El-Rashidy; Kevin T. McVary

1995-01-01

38

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

39

Review ERECTILE DYSFUNCTION IN DIABETES MELLITUS: NOVEL TREATMENTS  

Microsoft Academic Search

Erectile dysfunction (ED) is a common accompaniment of diabetes mellitus in males; prevalence of impotence being 35-50%. ED may be due to psychogenic or organic causes. Treatment of ED is a challenge because of its multifactorial causation in diabetics. Achievement of euglycemia is the foremost problem to be addressed. Psychosexual counseling, medical therapy and surgery form the alternatives for management

Satish K Agarwal; Anupam Prakash; Narinder P Singh

40

New therapies and delivery mechanisms for treatment of erectile dysfunction  

Microsoft Academic Search

Despite the successes of ViagraTM, the quest for new and better therapy for erectile dysfunction (ED) continues. In a recent survey of the first 220 patients placed on ViagraTM at our institution, 101 (46%) quit taking the drug: 76% of those who quit were not satisfied with the results. Patients clearly want an efficacious, safe, convenient medication with rapid onset.

JL Pryor; B Redmon

2000-01-01

41

Rise of herbal and traditional medicine in erectile dysfunction management.  

PubMed

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

Ho, Christopher C K; Tan, Hui Meng

2011-12-01

42

Sexual Intercourse Frequency in Men Presenting for Treatment of Erectile Dysfunction: Results from the Pan-European Erectile Dysfunction Observational Study  

Microsoft Academic Search

Factors that influence the number of sexual intercourse attempts among men with erectile dysfunction (ED) before initiation of ED treatment were investigated in a population of 4998 men enrolled in the (Erectile Dysfunctions) Observation Study (EDOS). Our results showed that increasing age, increasing severity and duration of ED, and decreasing satisfaction with one's sex life and partner were all associated

Alan Riley; Anthony Beardsworth; Stathis Kontodimas; David Suarez; Juan Vicente Torres; Josep Maria Haro

2007-01-01

43

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; Yücel, Selcuk

2013-01-01

44

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

45

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

PubMed

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

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

2009-01-01

46

Evaluation of penile revascularization for erectile dysfunction: a 10-year follow-up.  

PubMed

The objective of this study was to report long-term success rates for penile revascularization (PR) and investigate factors responsible for failures. During the past 10 y, data were obtained on 52 patients who underwent PR. Surgical technique was selected according to preoperative arteriographic findings. The mean age was 28.5 y and the mean follow-up was 70.8 months. Success was defined as satisfactory intercourse without additional therapy. Overall success was 48%. Patients under 28 y showed a 73% success rate vs 23% in the older ones (P=0.0003). Nonsmokers had a 57% success compared to 29% in smokers (P=0.05). The presence of venous leak and type of procedure had an insignificant impact on success (P=0.33 and 0.23 respectively). To conclude, this curative treatment option is limited to a selective population with vasculogenic erectile dysfunction. We found that the cure rate of this procedure is maintained and long-term follow-up shows good results, especially in the young nonsmokers. PMID:15073607

Vardi, Y; Gruenwald, I; Gedalia, U; Nassar, S; Engel, A; Har-Shai, Y

2004-04-01

47

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

48

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

49

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

50

Lifestyle modifications and erectile dysfunction: what can be expected?  

PubMed Central

Erectile dysfunction (ED) is a common medical disorder whose prevalence is increasing worldwide. Modifiable risk factors for ED include smoking, lack of physical activity, wrong diets, overweight or obesity, metabolic syndrome, and excessive alcohol consumption. Quite interestingly, all these metabolic conditions are strongly associated with a pro-inflammatory state that results in endothelial dysfunction by decreasing the availability of nitric oxide (NO), which is the driving force of the blood genital flow. Lifestyle and nutrition have been recognized as central factors influencing both vascular NO production, testosterone levels, and erectile function. Moreover, it has also been suggested that lifestyle habits that decrease low-grade clinical inflammation may have a role in the improvement of erectile function. In clinical trials, lifestyle modifications were effective in ameliorating ED or restoring absent ED in people with obesity or metabolic syndrome. Therefore, promotion of healthful lifestyles would yield great benefits in reducing the burden of sexual dysfunction. Efforts, in order to implement educative strategies for healthy lifestyle, should be addressed. PMID:25248655

Maiorino, Maria Ida; Bellastella, Giuseppe; Esposito, Katherine

2015-01-01

51

The corpus cavernous electromyography in the erectile dysfunction diagnosis.  

PubMed

The single potential analysis of cavernous electric activity (CC-EMG), registration bands were studied in 144 patients with erectile dysfunction followed from November 1992 to March 1993. We attempted to correlate abnormal electromyographic records with reduction of the cavernous bodies and albuginea expansibility, as measured by cavernosometry/rigidometry. In this selected group of patients, with venous leak of different flow, the main associated causes of the erectile dysfunction were cavernous neuromyopathy (91), diabetes mellitus (20), disturbances of the arterial influx (7), endocrinological factors (4), Peyronie's disease (3). Some patients (15) presented with a penile bend. A history of alcohol and tobacco use was obtained: 38 patients smoked 15 to 60 cigarettes/day and 43 patients drank moderate to heavy. The coexistence of other pathologies, has been investigated, showed many other associated diseases. The study attempts to determine if some electromyographic standards in patients with erectile dysfunction, could, by themselves, be a formal indication to penile implant, for a PGE1 self-injection program or for use of a vacuum device. Our results suggest that at least in some cases CC-EMG studies may be clinically relevant and allow choice of optimal therapy. PMID:7618375

Da Silva, J P; Santiago, L; Gonçalves, J C

1994-01-01

52

[Extracorporeal shockwave therapy for erectile dysfunction and Peyronie's disease].  

PubMed

Penile vascular endothelial damage, vasomotor dysfunction, and blood flow deficiency are the major causes of erectile dysfunction (ED). Current management of ED mostly depends on selective phosphodiesterase type 5- (PDE5) inhibitors, which fail for some ED patients. For Peyronie's disease-induced ED, surgical and physical therapies are used in addition to PDE5I medication, but frequently it is difficult to achieve satisfactory results. Recent studies show that the low-intensity extracorporeal shockwave therapy can promote angiogenesis and improve blood flow to the penis, which promises to be a novel effective therapy for ED and Peyronie's disease. PMID:25306816

Zhu, Ji-Yin; Jiang, Rui

2014-09-01

53

Sildenafil citrate can improve erectile dysfunction among chronic hemodialysis patients  

PubMed Central

Erectile dysfunction (ED) is common among patients with end-stage renal disease (ESRD), who undergo hemodialysis (HD). The aim of this study was to evaluate the safety and effectiveness of sildenafil in male HD patients with ED. Twenty-seven HD patients were recruited for this prospective, randomized, double-blind, placebo-controlled, clinical trial study of sildenafil during a period of 1 week. Efficacy was assessed by using the International Index of Erectile Function (IIEF) before and 1 week after treatment. Baseline demographic and clinical features were similar in both the groups. There was a weak correlation between ED and duration of undergoing dialysis (P = 0.073). There was significant relationship between sildenafil usage and improvement in erectile function (P < 0.0001). Placebo improved significantly the erectile function (P = 0.016), perhaps by psychological way. However, sildenafil had a more significant effect than placebo in increasing IIEF score among HD patients (P = 0.00 compared to 0.016). Sildenafil is effective and safe for treating ED among HD patients. PMID:21072154

Ghafari, A.; Farshid, B.; Afshari, A. T.; Sepehrvand, N.; Rikhtegar, E.; Ghasemi, K.; Hatami, S.

2010-01-01

54

[Erectile dysfunction after radical prostatectomy. Etiopathology and treatment].  

PubMed

Erectile dysfunction is one of the most common sequela from radical prostatectomy. The authors evaluate the incidence of erectile dysfunction after radical prostatectomy, study the likely causative vascular mechanisms and assess the efficacy of the treatments employed. Two hundred and four (204) radical prostatectomies were analyzed. 163 (80%) patients referred adequate erections prior to surgery. In 82 cases, surgery was performed with the intention of preserving one or both bands. For the remaining cases, radical surgery with exeresis of both bands was performed. Due to secondary erectile dysfunction, 75 patients were studied by preparing: clinical history, laboratory tests, penile neurophysiological studies and intracavernous prostaglandin E1 injection test. Dynamic drug-cavernosmetry was performed in 36 patients. After radical prostatectomy, only 9.2% previously potent patients retained adequate erections. Of the 82 cases where preservation of one or both bands was attempted, 9 (11%) patients retained their erections. Changes in neurophysiological parameters were found in 69.2% cases and general vascular injury detected in 23 (63.8%) patients by drug-cavernosmetry, the main injuries being cavernous arteries insufficiency in 58.3% and veno-occlusive failure in 33.3%. Of the 75 patients studied, 48 accepted the treatment: 40 (81.6%) used intracavernous auto-injection, 8 had penile prosthesis inserted, and one patient uses a vacuum device. Intracavernous Pg E1 auto-injection has provided adequate stiffness in 95% patients and, at 6 months from onset of treatment, a decrease of the minimal effective dose has been seen which is more noticeable in men under 60 and patients who start treatment within 6 months. PMID:9471875

Rodríguez Vela, L; Gonzalvo Ibarra, A; Bono Ariño, A; Benejam Gual, J; Cuesta Presedo, J M; Rioja Sanz, L A

1997-10-01

55

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

E-print Network

' cholesterol). In men with heart disease and hypertension, cigarette smoking was associated with a greater riskREVIEW 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

Cai, Long

56

Antidepressant-Related Erectile Dysfunction: Management via Avoidance, Switching Antidepressants, Antidotes, and Adaptation  

Microsoft Academic Search

The ideal antidepressant would control depression with no adverse effect on sexual function. Erectile dys- function and other sexual dysfunction associated with antidepressant medication treatment are problems with many antidepressants and can lead to patient dissatisfaction and decreased compliance with treatment. A com- puterized MEDLINE search (English language, 1966-2003) was performed using the terms antidepressive agents, erectile dysfunction, and sexual

Lawrence A. Labbate; Harry A. Croft; Marvin A. Oleshansky

2003-01-01

57

Is there a link between soft drinks and erectile dysfunction?  

PubMed Central

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

Adamowicz, Jan

2011-01-01

58

Sexual intercourse frequency in men presenting for treatment of erectile dysfunction: results from the pan-European erectile dysfunction observational study.  

PubMed

Factors that influence the number of sexual intercourse attempts among men with erectile dysfunction (ED) before initiation of ED treatment were investigated in a population of 4998 men enrolled in the (Erectile Dysfunctions) Observation Study (EDOS). Our results showed that increasing age, increasing severity and duration of ED, and decreasing satisfaction with one's sex life and partner were all associated with a reduced number of sexual intercourse attempts in the 4 weeks prior to enrollment in EDOS. PMID:17162484

Riley, Alan; Beardsworth, Anthony; Kontodimas, Stathis; Suarez, David; Torres, Juan Vicente; Haro, Josep Maria

2007-01-01

59

Detection of sildenafil analogues in herbal products for erectile dysfunction.  

PubMed

Sildenafil, the active ingredient in Viagra (Pfizer), is a prescription medicine used for erectile dysfunction. Compounds with chemical structures similar to that of sildenafil were isolated and purified during the analysis of some herbal products marketed for treatment of erectile dysfunction. Structural elucidation using liquid chromatography-diode array detection, infrared spectroscopy, liquid chromatography-tandem mass spectrometry, and nuclear magnetic resonance spectroscopy confirmed that the compounds were homosildenafil, hydroxyhomosildenafil, and acetildenafil. The implications of adulteration by compounds structurally related to prescription drugs are discussed. Unlike established drugs, the efficacy and safety of such analogues are largely unknown. This poses a great challenge for safety and health administrators to detect these modified structures and to regulate them. Consumers who use such adulterated products are at risk of developing serious adverse reactions, potentially leading to death. Greater collaboration and exchange of information between various health authorities, health professionals, academics, researchers, and industry, as well as public education, are key steps in the efforts to stem the growing trend of adulteration of herbal products by analogues of prescription drugs. PMID:16982533

Oh, Sharon Sze-Yin; Zou, Peng; Low, Min-Yong; Koh, Hwee-Ling

2006-11-01

60

Evaluation of young men with organic erectile dysfunction.  

PubMed

Erectile dysfunction (ED) in men under the age of 40 was once thought to be entirely psychogenic. Over the last few decades, advances in our understanding of erectile physiology and improvements in diagnostic testing have restructured our understanding of ED and its etiologies. Although psychogenic ED is more prevalent in the younger population, at least 15%-20% of these men have an organic etiology. Organic ED has been shown to be a predictor of increased future morbidity and mortality. As such, a thorough work-up should be employed for any man with complaints of sexual dysfunction. Oftentimes a treatment plan can be formulated after a focused history, physical exam and basic lab-work are conducted. However, in certain complex cases, more testing can be employed. The major organic etiologies can be subdivided into vascular, neurologic, and endocrine. Specific testing should be directed by clinical clues noted during the preliminary evaluation. These tests vary in degree of invasiveness, precision, and at times may not affect treatment. Results should be integrated into the overall clinical picture to assist in diagnosis and help guide therapy. PMID:25370205

Papagiannopoulos, Dimitri; Khare, Narenda; Nehra, Ajay

2015-01-01

61

Evaluation of young men with organic erectile dysfunction  

PubMed Central

Erectile dysfunction (ED) in men under the age of 40 was once thought to be entirely psychogenic. Over the last few decades, advances in our understanding of erectile physiology and improvements in diagnostic testing have restructured our understanding of ED and its etiologies. Although psychogenic ED is more prevalent in the younger population, at least 15%–20% of these men have an organic etiology. Organic ED has been shown to be a predictor of increased future morbidity and mortality. As such, a thorough work-up should be employed for any man with complaints of sexual dysfunction. Oftentimes a treatment plan can be formulated after a focused history, physical exam and basic lab-work are conducted. However, in certain complex cases, more testing can be employed. The major organic etiologies can be subdivided into vascular, neurologic, and endocrine. Specific testing should be directed by clinical clues noted during the preliminary evaluation. These tests vary in degree of invasiveness, precision, and at times may not affect treatment. Results should be integrated into the overall clinical picture to assist in diagnosis and help guide therapy. PMID:25370205

Papagiannopoulos, Dimitri; Khare, Narenda; Nehra, Ajay

2015-01-01

62

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

63

Crural ligation surgery for the young male with venogenic erectile dysfunction: technique.  

PubMed

Isolated crural venous leak is an uncommon cause of erectile dysfunction. Recent data have suggested that ligation of the crura in men with this condition may result in significant improvement in erectile function. This report outlines the criteria for patient selection and the technique we use to accomplish crural ligation. PMID:11763491

Mulhall, J P; Martin, D; Ergin, E; Kim, F

2001-12-01

64

Avanafil for treatment of erectile dysfunction: review of its potential  

PubMed Central

Avanafil is a medication that was recently approved by the US Food and Drug Administration for the management of erectile dysfunction. Avanafil is a new phosphodiesterase type 5 inhibitor similar to sildenafil and tadalafil. Avanafil was studied in over 1300 patients during clinical trials, including patients with diabetes mellitus and those who had undergone radical prostatectomy, and was found to be more effective than placebo in all men who were randomized to the drug. The medication was studied with on-demand dosing that may occur after food and/or alcohol. Avanafil is dosed as 50 mg, 100 mg, or 200 mg tablets. Avanafil may differentiate itself from the other phosphodiesterase type 5 inhibitors with its quicker onset and higher specificity for phosphodiesterase type 5 versus other phosphodiesterase subtypes, but may lead to complications of therapy. PMID:22973106

Burke, Ryan M; Evans, Jeffery D

2012-01-01

65

Internet websites selling herbal treatments for erectile dysfunction.  

PubMed

The objective of the study was to investigate the safety and reliability of internet websites selling and providing medical information regarding herbal substitutes for Viagra. Using keywords 'Herbal' and 'Viagra', websites selling and providing medical information regarding herbal substitutes were identified. The top 50 sequential sites were assessed for safety and reliability against the Health on the Net (HON) criteria. Medically trained staff provided information in only 21% of the sites yet just 24% stated that the information was not a replacement for medical advice. No sites warned patients about erectile dysfunction (ED)-associated cardiovascular disease. In all, 88 and 70% of sites indicated drug efficacy and ingredients but only 36 and 21% provided contraindications and side effects, respectively. All sites fell short of the HON requirements. In conclusion, acquiring medical information and herbal substitutes for ED from the internet is convenient and easy. However, patients should be cautious as safety and reliability of this approach is poor. PMID:15510178

Thurairaja, R; Barrass, B; Persad, R

2005-01-01

66

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

67

New Insights into Hypertension-Associated Erectile Dysfunction  

PubMed Central

Purpose of review Erectile dysfunction (ED) is recognized as a quality of life disorder that needs to be treated. Currently, it is estimated to affect as many as 30 million American men. Thirty percent of hypertensive patients complain of ED. The understanding of common mechanisms involved in the etiology of ED associated with hypertension, and the investigation of antihypertensive drugs that impact ED, will provide important tools toward indentifying new therapeutic targets that will improve the quality of life for patients in these conditions. Recent findings Hypertension and ED are closely intertwined diseases which have endothelium dysfunction as a common base. During hypertension and/or ED, disturbance of endothelium derived factors can lead to an increase in vascular smooth muscle (VSM) contraction. Hypertension can also lead to ED as a consequence of high blood pressure (BP) or due to antihypertensive treatment. However, growing evidence suggests ED as an early sign for hypertension. Also, some PDE-5 inhibitors used to treat ED can improve BP, but the link between these conditions has not been totally understood. Summary This review will discuss the interplay between hypertension and ED, exploring newest insights regarding hypertension-associated ED, as well as the effect of antihypertensive drugs in ED patients. PMID:22240443

Nunes, Kenia Pedrosa; Labazi, Hicham; Webb, R. Clinton

2014-01-01

68

Noninvasive treatment for erectile dysfunction in the neurogenically disabled population.  

PubMed

Erectile dysfunction is the most prevalent sexual dysfunction in neurogenically disabled men. Studies of rehabilitation patients indicate that the restoration of sexual functioning is considered an important priority. This article reports on a pilot study of vacuum tumescence constriction therapy as a noninvasive method for use by a population with traumatic or nontraumatic neurologic disorders such as spinal cord injury, stroke, multiple sclerosis, and diabetes mellitus. Of the 30 patients who participated in the study, 17 purchased the device and over 50% of them reported using the device on a long-term basis. Frequency of coitus increased from 0.3/wk to 1.5/wk. Included in the study are methods used by patients to integrate the device into their sex life, the role of the patient's partner in the decision to purchase the device, and the rate of partner satisfaction. There were no reports of substantial morbidity. Thus, this method shows promise as a noninvasive treatment for men who are moderately to severely neurogenically disabled. PMID:1404445

Aloni, R; Heller, L; Keren, O; Mendelson, E; Davidoff, G

1992-01-01

69

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

70

Prescription Opioids for Back Pain and Use of Medications for Erectile Dysfunction  

PubMed Central

Study Design Cross-sectional analysis of electronic medical and pharmacy records. Objective To examine associations between use of medication for erectile dysfunction or testosterone replacement and use of opioid therapy, patient age, depression, and smoking status Summary of Background Data Men with chronic pain may experience erectile dysfunction related to depression, smoking, age, or opioid-related hypogonadism. The prevalence of this problem in back pain populations and the relative importance of several risk factors are unknown. Methods We examined electronic pharmacy and medical records for men with back pain in a large group model HMO during 2004. Relevant prescriptions were considered for six months before and after the index visit. Results There were 11,327 men with a diagnosis of back pain. Men who received medications for erectile dysfunction or testosterone replacement (n = 909) were significantly older than those who did not, and had greater comorbidity, depression, smoking, and use of sedative-hypnotic medications. In logistic regressions, long-term opioid use was associated with greater use of medications for erectile dysfunction or testosterone replacement, compared to patients with no opioid use (OR 1.45, 95% CI 1.12, 1.87, p<0.01). Age, comorbidity, depression, and use of sedative-hypnotics were also independently associated with use of medications for erectile dysfunction or testosterone replacement. Patients prescribed daily opioid doses of 120 mg morphine-equivalent or more had greater use of medication for erectile dysfunction or testosterone replacement than patients without opioid use (OR 1.58, 95% CI 1.03, 2.43), even with adjustment for duration of opioid therapy. Conclusion Opioid dose and duration, as well as age, comorbidity, depression, and use of sedative-hypnotics were associated with evidence of erectile dysfunction. These findings may be important in the process of decision-making for long-term opioid use. PMID:23459134

Deyo, Richard A.; Smith, David H.M.; Johnson, Eric S.; Tillotson, Carrie J.; Donovan, Marilee; Yang, Xiuhai; Petrik, Amanda; Morasco, Benjamin J.; Dobscha, Steven K.

2013-01-01

71

Eroticization as a factor influencing erectile dysfunction treatment effectiveness.  

PubMed

We review both the medical and psychosocial literature on factors influencing male potency in order to better understand why erectile dysfunction (ED) treatments, PDE5 drugs in particular, are abandoned when otherwise effective. We incorporate anecdotal data from websites and list serves dedicated to helping patients deal with iatrogenic ED. Our goal is to distinguish between ED treatments that are medicalized versus eroticized, and how partner participation may influence their effectiveness. Recently it has been shown that ED treatment effectiveness is aided by the involvement of the patient's partner. This permits an erotic association between the partner and the ED 'aid'. We extend this idea to suggest that having the partner involved as early as possible in the discussion of treatment, and their presence at the time of prescription, should improve ED aid effectiveness. Eroticization of ED aids shifts the focus from a perceived disability of the patient toward the sexual pleasure provided by the partner. We further suggest that ED aids used without the partner's knowledge will undermine intimacy and ultimately the treatment's effectiveness. Unpartnered patients should be advised about the importance of informing potential partners about their use of such aids, as openness and honesty may increase intimacy in the long run. PMID:23823215

Kukula, K C; Jackowich, R A; Wassersug, R J

2014-01-01

72

Organic causes of erectile dysfunction in men under 40.  

PubMed

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

Ludwig, Wesley; Phillips, Michael

2014-01-01

73

Erectile Dysfunction among Yemenis: Does Chewing Khat Play a Role?  

PubMed Central

Objective: Khat, a type of plant that grows in Yemen and some African countries like Somalia, Ethiopia and Kenya, is considered to be addictive and contains some stimulating substances that may affect different body organs. This study was conducted to identify the causes of erectile dysfunction (ED) and to investigate the effect of chewing Khat on this disease in Yemenis. Materials and Methods: A total of 236 patients who were treated at University of Science and Technology Hospital and complained of ED were examined with penile Doppler ultrasonography (US). Biodata and health data were collected from the patients’ records and via mobile interviews. Results: The causes of ED were psychological causes (72%), venous leakage (19%) and arterial disease (9%). Psychological ED was most common in 15–29-year-olds, while pathological ED increased with increasing age (p=0.041). Heart diseases and diabetes showed a significant association with pathological ED (p<0.05). Although 81% of the ED patients in this study chewed Khat, there was no significant association between chewing Khat and either pathological or psychological ED (p>0.05). Conclusion: Psychological problems are the main causes of ED among Yemenis especially in the younger age group. It is too early to exclude Khat as a factor contributing to this health problem, and this topic warrants further case-control studies with a larger sample size. PMID:25610301

Nassar, Omar H.; Aklan, Hameed M.

2014-01-01

74

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

75

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

76

Stem Cell Therapy for Erectile Dysfunction: A Critical Review  

PubMed Central

Erectile dysfunction (ED) is a prevailing health problem that seriously impacts quality of life. Current treatment options are less effective for patients having cavernous nerve (CN) injury or diabetes mellitus-related ED. These 2 types of ED are thus the main focus of past and current stem cell (SC) therapy studies. In a total of 16 studies so far, rats were exclusively used as disease models and SCs were mostly derived from bone marrow, adipose tissue, or skeletal muscle. For tracking, SCs were labeled with LacZ, green fluorescent protein, 4’,6-diamidino-2-phenylindole, DiI, bromodeoxyuridine, or 5-ethynyl-2-deoxyuridine, some of which might have led to data misinterpretation. SC transplantation was done exclusively by intracavernous (IC) injection, which has been recently shown to have systemic effects. Functional assessment was done exclusively by measuring increases of IC pressure during electrostimulation of CN. Histological assessment usually focused on endothelial, smooth muscle, and CN contents in the penis. In general, favorable outcomes have been obtained in all trials so far, although whether SCs had differentiated into specific cell lineages remains controversial. Recent studies have shown that intracavernously injected SCs rapidly escaped the penis and homed into bone marrow. This could perhaps explain why intracavernously injected SCs had systemic antidiabetic effects and prolonged anti-ED effects. These hypotheses and the differentiation-versus-paracrine debate require further investigation. PMID:21793654

Xin, Zhong-Cheng; Wang, Zhong; Deng, Chunhua; Huang, Yun-Ching; Lin, Guiting; Lue, Tom F.

2012-01-01

77

Stem cells: novel players in the treatment of erectile dysfunction  

PubMed Central

Stem cells are defined by their capacity for both self-renewal and directed differentiation; thus, they represent great promise for regenerative medicine. Historically, stem cells have been categorized as either embryonic stem cells (ESCs) or adult stem cells (ASCs). It was previously believed that only ESCs hold the ability to differentiate into any cell type, whereas ASCs have the capacity to give rise only to cells of a given germ layer. More recently, however, numerous studies demonstrated the ability of ASCs to differentiate into cell types beyond their tissue origin. The aim of this review was to summarize contemporary evidence regarding stem cell availability, differentiation, and more specifically, the potential of these cells in the diagnosis and treatment of erectile dysfunction (ED) in both animal models and human research. We performed a search on PubMed for articles related to definition, localisation and circulation of stem cells as well as the application of stem cells in both diagnosis and treatment of ED. Strong evidence supports the concept that stem cell therapy is potentially the next therapeutic approach for ED. To date, a large spectrum of stem cells, including bone marrow mesenchymal stem cells, adipose tissue-derived stem cells and muscle-derived stem cells, have been investigated for neural, vascular, endothelial or smooth muscle regeneration in animal models for ED. In addition, several subtypes of ASCs are localized in the penis, and circulating endogenous stem cells can be employed to predict the outcome of ED and ED-related cardiovascular diseases. PMID:22002437

Zhang, Haiyang; Albersen, Maarten; Jin, Xunbo; Lin, Guiting

2012-01-01

78

Validation of the German version of the International Index of Erectile Function (IIEF) in patients with erectile dysfunction, Peyronie's disease and controls  

Microsoft Academic Search

The objective of this study was to validate the German translation of the International Index of Erectile Function (IIEF). The IIEF was administered to 59 patients with erectile dysfunction (ED), to 38 patients with Peyronie's disease and to 33 controls. All patients were investigated by standardized German versions of international questionnaires of anxiety, depression, social desirability, quality of partnership, physical

J Wiltink; E W Hauck; M Phädayanon; W Weidner; M E Beutel

2003-01-01

79

Activators of soluble guanylate cyclase for the treatment of male erectile dysfunction  

Microsoft Academic Search

Soluble guanylate cyclase (sGC) is an important enzyme in corpus cavernosum smooth muscle cells as it is one of the regulators of the synthesis of cGMP. The efficacy of sildenafil (Viagra™) in the treatment of male erectile dysfunction indicates the importance of the cGMP system in the erectile response as the increased levels of cGMP induce relaxation of the corpus

J D Brioni; M Nakane; G C Hsieh; R B Moreland; T Kolasa; J P Sullivan

2002-01-01

80

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

PubMed Central

Erectile dysfunction (ED) has been defined as the persistent inability to attain and maintain an erection sufficient to permit satisfactory sexual performance. By 2025, men with ED will be approximately 322 million, an increase of nearly 170 million men from 1995. The present study was aimed to evaluate the efficacy of Ashwagandha (Withania somnifera) in the management of psychogenic erectile dysfunction. In this study, a total of 95 patients with psychogenic erectile dysfunction satisfying the DSM IV TR diagnostic criteria were selected, out of them 86 patients completed the course of treatment. In Trial Group, Ashwagandha root powder and in Control group, Placebo (Wheat powder) were given for 60 days. Treatment selection and its allocation were done by following computerized randomization plan. Criterion of assessment was based on the scoring of International Index of Erectile Function (IIEF) Scale. Paired and Unpaired t test were used for statistical analysis. In Trial group (n=41), 12.6% and in Control group (n=45), 19.11% of improvement was observed with the significance of (P<0.001). There was no significant difference (P>0.05) found in between the two groups. Both Ashwagandha and Placebo provided no relief (<25% improvement on IIEF) in psychogenic erectile dysfunction. PMID:22529644

Mamidi, Prasad; Thakar, A B

2011-01-01

81

Carotid artery intima-media thickness and erectile dysfunction in patients with metabolic syndrome  

PubMed Central

Background Metabolic syndrome (MS) has become a pandemic in Turkey, as is the case globally. Increase in carotid artery intima-media thickness (CIMT) and erectile dysfunction (ED) may be evident before the clinical signs of cardiovascular disease appear. We aimed to investigate the prevalence of increased CIMT and ED as markers of atherosclerotic disease in patients with MS. Material/Methods Thirty-two patients with MS and 29 healthy controls were included. Anthropometric and biochemical parameters, along with total testosterone (TT), high sensitive C-reactive protein (hs-CRP), were recorded. Carotid artery intima-media thickness was measured. Erectile dysfunction was assessed with International Index of Erectile Function. Results Patients with MS had higher BMI, fasting plasma glucose, post-prandial plasma glucose, insulin, HOMA-IR, total cholesterol, triglycerides, hs-CRP, and CIMT, whereas TT levels were lower (p<0.0001). The prevalence and severity of erectile dysfunction were higher in patients with MS (p<0.0001). Erectile dysfunction scores correlated inversely with CIMT. MS patients with ED were older and had higher CIMT compared to those without ED. Increase in age and HOMA and decrease in TT increased the risk of ED. When KIMT exceeding the 95th percentile of healthy controls was accepted as a risk factor for CVD, presence of ED was the only determinant for this increase. Conclusions Erectile dysfunction was more prevalent and severe in patients with MS and correlated with subclinical endothelial dysfunction. Total testosterone deficiency was prominent among MS patients. Presence of ED points to an increased risk of cardiovascular disease when MS is present. PMID:24869934

Unal, Mustafa; Aksoy, Duygu Yazgan; Ayd?n, Yusuf; Tanriover, Mine Durusu; Berker, Dilek; Karakaya, Jale; Guler, Serdar

2014-01-01

82

Effect of sildenafil on platelet function and platelet cGMP of patients with erectile dysfunction.  

PubMed

To investigate the effect of sildenafil on platelet function and cyclic guanosine monophosphate (cGMP) levels in patients with erectile dysfunction, we evaluated the association between erectile function and platelet responses after administration of 100 mg sildenafil. Erectile responses were monitored after 8 daily doses of the drug. Adenosine diphosphate (ADP) and collagen-induced platelet aggregation and simultaneous adenosine triphosphate (ATP) release and cGMP levels were determined before and after sildenafil therapy. Basal levels for platelet aggregation, ATP release and cGMP were compared with age-matched controls. There was no difference among basal levels of platelet responses between patients and controls, except for ADP-induced platelet aggregation (P = 0.04). It was significantly higher in the patient group. Analysis of the responses to sildenafil revealed that for the patients who showed a positive erectile response, there was a significant increase in platelet cGMP (P = 0.028) and a decrease in ADP-induced platelet aggregation (P = 0.04). However, for those who showed a negative or poor erectile response, there was no change in platelet cGMP levels and platelet functions. Sildenafil did not affect collagen-induced platelet responses although cGMP levels of the responders increased. It is concluded that sildenafil increases platelet cGMP in the patients with positive erectile response. Therefore, it has been speculated that platelet cGMP may be used as an index for erectile response. PMID:25486996

Akand, M; Gencer, E; Yaman, O; Eri?gen, G; Tekin, D; Ozdiler, E

2014-12-01

83

Erectile Dysfunction in Opioid Users: Lack of Association with Serum Testosterone  

PubMed Central

This study describes the prevalence of erectile dysfunction (ED) among 57 men using illicit opioids who presented to a primary care program for buprenorphine therapy. Participants’ mean age was 40 years and 34% reported ED. Low total testosterone was detected in 17% of those reporting ED , but total testosterone was not significantly associated with ED. Examining multiple comorbidities and laboratory parameters, only older age was significantly associated with erectile dysfunction (r=.27, p<.05). ED is highly prevalent among males abusing opioids, but low total testosterone is rarely the cause. PMID:20924881

Cioe, Patricia A.; Friedmann, Peter D.; Stein, Michael D.

2010-01-01

84

An analysis of the effectiveness of two components in the treatment of erectile dysfunction  

Microsoft Academic Search

This study compared the effectiveness of two components, a ban on sexual intercourse and communication of sexual preferences, in the treatment of couples in which the male was experiencing erectile dysfunction. Sixteen couples were randomly assigned to one of two treatment conditions. In one condition spouses were asked to refrain from intercourse and to make an effort to communicate sexual

Janet Takefman; William Brender

1984-01-01

85

Erectile dysfunction and smoking among men with hypertension in primary care  

Microsoft Academic Search

Erectile dysfunction (ED) affects over 30 million men in the United States, profoundly affecting their quality of life. Although cigarette smoking and hypertension are well established risk factors for ED, the effect of cigarette smoking on ED has not been previously quantified among men in a primary care setting. We gathered information on 59 men (mean age 59 ± 12

John G. Spangler; Ronny Bell; John Summerson; Joseph C. Konen

2001-01-01

86

Appropriate Use of Exercise Testing Prior to Administration of Drugs for Treatment of Erectile Dysfunction  

Microsoft Academic Search

Selective inhibitors of phosphodiesterase type 5 prevent the breakdown of cyclic guanosine monophosphate resulting in enhanced penile erection and are used for the treatment of erectile dysfunction. Those agents, by way of vasodilator effects could interact with the systemic vasculature and could potentially affect the cardiac patient. During sexual intercourse, heart rate and blood pressure increase as with other forms

Adelaide M. Arruda-Olson; Patricia A. Pellikka

2003-01-01

87

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management  

Microsoft Academic Search

There is strong evidence from multiple epidemological studies that lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are correlated, independent of age or comorbidities as diabetes or hypertension. Although a direct causal relationship is not established yet, four pathophysiological mechanisms can explain the relationship. These include alteration in nitric oxide bioavailability, ?1-adrenergic receptor hyperactivity, pelvic atherosclerosis and sex hormones.

H Orabi; M Albersen; T F Lue

2011-01-01

88

Sex therapy for erectile dysfunction: Characteristics of couples, treatment outcome, and prognostic factors  

Microsoft Academic Search

Outcome and prognostic factors were studied in 36 couples who entered sex therapy because of the male partners' erectile dysfunction. Treatment was completed by two thirds. Noncompletion was associated with lower socioeconomic status, the female partner having a history of psychiatric treatment, pretreatment poorer motivation of the male partner, poor communication in the general relationship, and less sexual pleasure experienced

Keith Hawton; Jose Catalan; Joan Fagg

1992-01-01

89

The effect of DA8159, a novel PDE5 inhibitor, on erectile function in the rat model of hypercholesterolemic erectile dysfunction  

Microsoft Academic Search

This study examined the effects of a new phosphodiesterase type 5 inhibitor, DA-8159, on erectile function associated with hypercholesterolemia. First of all, in order to investigate whether chronic administration of DA-8159 prevents the development of erectile dysfunction associated with hypercholesterolemia, male SD rats were divided into four groups (normal control, hypercholesterolemic control, DA-8159 5 or 20 mg\\/kg\\/day). Over a 5-month

K K Kang; J Y Yu; M Yoo; J W Kwon

2005-01-01

90

Characterization of corpus cavernosum smooth muscle cell phenotype in diabetic rats with erectile dysfunction.  

PubMed

Phenotypic modulation from a contractile to a proliferative state within vascular smooth muscle cells has a critical role in the pathogenesis of a variety of cardiovascular diseases. To investigate the characterization of corpus cavernosum smooth muscle cell phenotype in diabetic rats with erectile dysfunction, a group of Sprague-Dawley rats (n=30) were induced by intraperitoneal injection of streptozotocin (60?mg?kg(-1)) and screened by subcutaneous injection of apomorphine (100??g?kg(-1)) for the measurement and comparison of the penile erections, and then three different groups were defined. Primary corpus cavernosum smooth muscle cells were cultured and passaged. The cavernous tissue segments were subjected to quantitative real-time polymerase chain reaction to determine the expressions of smooth muscle ?-actin (SMA), SM myosin heavy chain (SMMHC), smoothelin, calponin and myocardin. Cell contractility in vitro and western blot analysis of SMA and SMMHC in the cavernous tissues and cells were determined. Compared with the control group (n=8) and the diabetes mellitus group (n=5), the expressions of SMA, calponin, SMMHC, smoothelin and myocardin mRNA were decreased in the cavernous tissues in rats of the diabetic erectile dysfunction group (n=15; P=0.001 and 0.02, P=0.014 and 0.012, both P<0.001, P=0.005 and <0.001, P=0.003 and 0.035, respectively). The levels of SMA and SMMHC proteins showed a significant decrease in cavernous tissues and cultured cells in rats of the diabetic erectile dysfunction group. Cells of the diabetic erectile dysfunction group exhibited significantly less contractility compared with those of other groups (P<0.001). Corpus cavernosum SM cell possesses the ability to modulate the phenotype under hyperglycemic conditions, which could have a key role in the pathogenesis of diabetic erectile dysfunction. PMID:22592762

Wei, A-Y; He, S-H; Zhao, J-F; liu, Y; Liu, Y; Hu, Y-W; Zhang, T; Wu, Z-Y

2012-09-01

91

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

92

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

PubMed

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

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

2013-09-01

93

The promise of inhibition of smooth muscle tone as a treatment for erectile dysfunction: where are we now?  

Microsoft Academic Search

Ten years ago, the inhibition of Rho kinase by intracavernosal injection of Y-27632 was found to induce an erectile response. This effect did not require activation of nitric oxide-mediated signaling, introducing a novel target pathway for the treatment of erectile dysfunction (ED), with potential added benefit in cases where nitric oxide bioavailability is attenuated (and thus phosphodiesterase type 5 (PDE5)

X Jiang; K Chitaley

2012-01-01

94

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

95

Limited effect of testosterone treatment for erectile dysfunction caused by high-estrogen levels in rats.  

PubMed

Some studies suggest that high-estrogen levels lead to erectile dysfunction (ED); high-estrogen levels are known to decrease testosterone levels. However, no study has examined whether testosterone replacement can improve the ED induced by high-estrogen levels. We investigated the effects of testosterone on ED caused by high-estrogen levels in rats. Rats were distributed in the following groups: (1) control (vehicle for 2 weeks), (2) the estrogen-treated group (ES; estradiol (3 ?g kg(-1) day(-1)) for 2 weeks), and (3) the estrogen- and testosterone-treated group (ES+TE; estradiol (3 ?g kg(-1) day(-1)) and testosterone (3 mg kg(-1) day(-1)) for 2 weeks). We measured smooth muscle function via isometric tension and erectile function by measuring the intracavernosal pressure on cavernous nerve stimulation. In the ES group, the contraction of the corpus cavernosum smooth muscle increased in response to noradrenalin, and its relaxation decreased in response to the nitric oxide donor, sodium nitroprusside. Further, the erectile function was significantly decreased. In the ES+TE group, neither smooth muscle function nor erectile function was significantly improved. In conclusion, a high-estrogen milieu affected erectile function in rats, and testosterone treatment did not improve the ED caused by high-estrogen levels. PMID:23636276

Kataoka, T; Hotta, Y; Ohno, M; Maeda, Y; Kimura, K

2013-01-01

96

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

PubMed

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. PMID:25422647

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

2014-10-15

97

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. PMID:25422647

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

98

[Chronobiological approach to the treatment of patients with erectile dysfunction using a combination of local negative pressure and laser illumination].  

PubMed

It is shown that the synchronization of energetic, spectral, frequency, and temporal parameters of technique with biorhythms of physiological processes in the organ, which is target of impact, and in the human body as a whole, allows to significantly improve efficiency, and achieve stable and reproducible results of treatment. The article presents the results of study including 62 patients with vasculogenic ED. The study design included the randomization of patients into 3 groups depending on the complex of the therapy with the use of combined techniques, including negative pressure and laser illumination (LLNP) as a part of combined therapy and as monotherapy. Significant increase in the peak flow velocity after a course of treatment was observed in all three groups of patients. Improvement in erectile function was observed in all groups; according to IIEF score, erectile function has increased by 22.3 +/- 0.05% in group 1, by 34 +/- 1.5% in the group 2, and by 19 +/- 1.7% in the group 3, indicating the best results of treatment in the group receiving combined therapy. Combination of LLNP with the administration of PDE5 inhibitors significantly increases the effectiveness of treatment of vasculogenic ED due to the influence of physical factors on the stabilization of hemodynamics in the main arteries of the penis. After a course of therapy, increase in systemic vascular elasticity by 39.8 +/- 1.5% was also noted. The efficiency of the LLNP methodology in the treatment of patients with vasculogenic ED is demonstrated. The best results were obtained in the group of patients treated with combined therapy, including the use of LLNP and PDE-5 inhibitor. PMID:25211927

Moskvin, S V; Ivanchenko, L P

2014-01-01

99

Herpes simplex virus vector-mediated delivery of neurturin rescues erectile dysfunction of cavernous nerve injury  

Microsoft Academic Search

Neurturin (NTN), a member of glial cell line-derived neurotrophic factor (GDNF) family, is known as an important neurotrophic factor for penis-projecting neurons. We recently demonstrated significant protection from erectile dysfunction (ED) following a replication-defective herpes simplex virus (HSV) vector-mediated GDNF delivery to the injured cavernous nerve. Herein, we applied HSV vector-mediated delivery of NTN to this ED model. Rat cavernous

R Kato; D Wolfe; C H Coyle; J B Wechuck; P Tyagi; T Tsukamoto; J B Nelson; J C Glorioso; M B Chancellor; N Yoshimura

2009-01-01

100

Transition Stages in Adjustment of Wives With Their Husbands’ Erectile Dysfunction  

PubMed Central

Background: No study has been conducted yet on the process of adjustment of wives with their husbands’ erectile dysfunction in the transitional stages, and there is lack of understanding of this process in Iran. Objectives: A qualitative, grounded-theory study was designed to examine the process of adjustment of wives with their husbands’ erectile dysfunction in transitional stages. Materials and Methods: Purposive sampling was carried out in Tehran, Iran. Data collection occurred until the theoretical saturation was reached. A total of 16 semi structured in-depth interviews were conducted with 15 woman participants. The constant comparative method of data analysis was used. Results: The women were 29-53 years old and duration of marriage was 2-40 years. They had different educational status ranging from Illiterate to Master’s degree. The present study showed the process of adjustment of wives with husbands’ erectile dysfunction in categories of husband broken role, ups and downs in woman’s sexual life, passing through failure, and end of transition. Following erectile dysfunction (event) and the man’s reaction, broken role occurs (change). In response to this change, reactions due to loss of intimacy occur in the ups and downs of woman’s life. Some women, unable to get through the failure, continue low quality life with sexual and communicational problems (limbo). By the end of transition, some women manage to overcome this unpleasant state of limbo, and begin to experience a new life, with increased intimacy, with or without sexual intercourse (new beginning). Conclusions: If the process of transitional adjustment occurs in women, it will be effective in improving the relationship and increased intimacy, even sexual intimacy. With this understanding, better counseling and therapeutic interventions can be planned for these couples. PMID:24829790

Ozgoli, Giti; Ziaei, Saeideh; Ahmadi, Fazlollah; Azar, Mahyar

2014-01-01

101

Prevalence and Correlates of Erectile Dysfunction in Turkey: A Population-Based Study  

Microsoft Academic Search

Objectives: Epidemiologic data indicate that erectile dysfunction (ED) is a significant problem among men worldwide. However, data do not exist for Turkish men. This study was conducted to determine the prevalence and sociodemographic, medical, and lifestyle correlates of ED in Turkey.Methods: Information was gathered via physician-conducted interviews using a validated questionnaire. Respondents self-rated their ED as “none,” “minimal,” “moderate,” or

Emre Akkus; Ates Kadioglu; Adil Esen; Saban Doran; Ali Ergen; Kadri Anafarta; Halim Hattat

2002-01-01

102

Daily use of phosphodiesterase 5 inhibitors for erectile dysfunction and lower urinary tract symptoms  

Microsoft Academic Search

Erectile dysfunction is a prevalent disorder that not only affects men with the disorder but also their partners. Significant improvements in the sexual health of these couples have been achieved with the introduction of phosphodiesterase 5 (PDE5) inhibitors. Currently PDE5 inhibitors are used on an on-demand basis. New evidence regarding the effects of PDE5 inhibitors on the underlying pathophysiologic processes

H Pimentel; M Wald; C Niederberger

2008-01-01

103

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

104

Phosphodiesterase type 5 inhibitors for the treatment of erectile dysfunction in patients with diabetes mellitus  

Microsoft Academic Search

Sildenafil, a phosphodiesterase 5 (PDE5) inhibitor, has become a first-line therapy for diabetic patients with erectile dysfunction (ED). The efficacy in this subgroup, based on the Global Efficacy Question, is 56% vs 84% in a selected group of non-diabetic men with ED. Two novel PDE5 inhibitors, tadalafil (Lilly ICOS) and vardenafil (Bayer), have recently completed efficacy and safety clinical trials

M A Vickers; R Satyanarayana

2002-01-01

105

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

Microsoft Academic Search

The metabolic syndrome (MetS) is an insulin-resistant state characterized by a cluster of cardiovascular risk factors, including abdominal obesity, hyperglycemia, elevated blood pressure and combined dyslipidemia. In this review, we discuss the potential of farnesoid X receptor (FXR) agonists in the treatment of erectile dysfunction (ED), a multifactorial disorder often comorbid with MetS. FXR not only regulates lipid and glucose

Annamaria Morelli; Linda Vignozzi; Mario Maggi; Luciano Adorini

2011-01-01

106

[Medico legal considerations on prosthesis surgery of the erectile dysfunction in a La Peyronie disease case].  

PubMed

Peyronie's disease is characterized by the presence of an inelastic fibrous plaque of the penile tunica albuginea affecting 3-10% of the male population. The fibrous scar causes the curvature of the erect penis, which prevents the penetration. In the stabilization phase the plaque can cause a variable degree of erectile dysfunction (20-54%). In the treatment of the chronic disease, surgery is the gold standard and in case of concomitant erectile dysfunction the placement of a penile prosthesis is indicated. This surgery is loaded with an increase of the variables which can affect the outcome, such as individual clinical features and functionality of the device. The present case concerns a patient suffering from erectile dysfunction associated with Peyronie's disease who underwent surgery for implantation of hydraulic three-component penile prosthesis. After surgery a malfunction of the prosthesis was detected, which required unloading measures under sedation and a surgical revision of the scrotal pump. The latter was followed by the displacement of the prosthesis' cylinder and by a new surgical treatment for the reintegration of the prosthesis and the repair of the left corpus cavernosum. After two months a wrong positioning of the two cylinders inserted into the corpora cavernosa, with the left cranial extreme positioned 2 cm below the contralateral, was detected. In this case the failure of surgical treatment highlights a negligent behavior and the responsibility of the doctors by failing to examine adequately the variables, both clinical and not clinical, that might affect the outcome of the intervention. PMID:23612236

Ricci, S; Massoni, F; Simeone, C; Letizia, P; Alei, G

2013-04-01

107

[Combined treatment of patients with lower urinary tract symptoms and erectile dysfunction].  

PubMed

In men of middle and older age group, urination disorders and erectile dysfunction are often combined. The role of phosphodiesterase type 5 inhibitors in the treatment of these patients remains uninvestigated. Prospective study included 38 patients with urination disorders and erectile dysfunction. The average age of the patients was 63.6 +/- 5.3 years. During first three months of observation, all patients have received alpha-adrenoblocker doxazosin at a dose of 4 mg once daily per os, the next three months--phosphodiesterase type 5 inhibitor udenafil at a dose of 50 mg once daily per os was added to doxazosin. 3 months after treatment, majority of patients reported improvement of urination. The statistically significant changes in BP and heart rate were not recorded, indicating a satisfactory tolerability and safety of doxazosin. Against the background of combined treatment during next 3 months, progressive improvement of erectile function (IIEF score 12.8 +/- 3.4 vs 18.4 +/- 3.7; p < 0.05), and regression of urination disorders, according to IPSS score (13.4 +/- 1.2 vs 11.2 +/- 1.7; p < 0.05) were observed. Uroflowmetric indicators were not significantly changed. Based on experimental and clinical studies, it was suggested that the dysregulation of NO--cGMP system, pathological activation of Rho-kinase pathways, hyperactivity of autonomic innervation, atherosclerosis and impaired blood flow in the pelvic organs are the common pathophysiological mechanisms for LUTS and erectile dysfunction. The clinical efficacy of phosphodiesterase type 5 inhibitors in the treatment of patients with these diseases is explained by its effects on these mechanisms. PMID:24437244

Tomilov, A A; Golubtsova, E N

2013-01-01

108

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

PubMed Central

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

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

2007-01-01

109

Long-term results of dorsal penile vein ligation for symptomatic treatment of erectile dysfunction.  

PubMed

About 20% of patients with erectile dysfunction do not react to intracavernous pharmacological treatment (SKAT) because of a cavernous leak. The first attempt to treat venous insufficiency goes back as far as the beginning of the century. Ligature and resection of the superficial and deep veins of the penis (DPVL) were performed in 122 patients (nonresponders to SKAT with a maintenance flow of less than 40 ml min-1). Twenty-four patients suffered from primary dysfunction and 98 from secondary dysfunction. The average age of the patients was 49 years, and the average duration of the preoperative erectile dysfunction 4.4 years. Postoperative follow-up was carried out for 70 months. In 98% of the patients, cavernosography revealed a dorsal leak. Twenty-six per cent had ectopic veins, 38% a leakage through the crural veins and 24% a glandular or spongiosal shunt. After the 70-month follow-up, only 14% of the 122 patients were able to achieve an adequate spontaneous erection and 19% also responded to SKAT. Depending upon the time elapsed since the operation, the rate of spontaneous reaction was reduced. It was found that younger patients with a short history of erectile dysfunction, no arterial cofactor, a maintenance flow of less than 100 ml min-1 and a severe dorsal leakage from a DPVL were the most likely to benefit from this procedure. Since degeneration of smooth muscle cells of the cavernosa is in most patients the cause of the venous leakage, penis vein surgery is to be regarded as symptomatic treatment. PMID:10643523

Popken, G; Katzenwadel, A; Wetterauer, U

1999-01-01

110

Circulating endothelial progenitor cells and erectile dysfunction: possibility of nutritional intervention?  

PubMed

To provide an overview of molecular and cellular processes involved in erectile dysfunction (ED) with emphasis on circulating endothelial progenitor cells (EPC) and discuss possible nutraceutical means of intervention. A review of literature on Pubmed related to EPC and ED was conducted. Patients with ED appear to possess a reduced number of circulating EPC, which is associated with poor endothelial function possibly as a result of underlying low-grade inflammation. Several studies support the possibility of improving erectile function by inhibition of inflammation as well as administration of various stem cell types. One particularly interesting approach is nutraceutical supplementation to increase circulating EPC, as demonstrated in the product Stem-Kine. Interventions aimed at increasing circulating EPC may have potential in treatment of vascular ED. PMID:20657539

Ichim, T E; Zhong, Z; Mikirova, N A; Jackson, J A; Hunninghake, R; Mansilla, E; Marín, G; Núñez, L; Patel, A N; Angle, N; Murphy, M P; Dasanu, C A; Alexandrescu, D T; Bogin, V; Riordan, N H

2010-06-01

111

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

112

Androgens and penile erection: evidence for a direct relationship between free testosterone and cavernous vasodilation in men with erectile dysfunction  

Microsoft Academic Search

Summary OBJECTIVE Androgens are essential in the mainte- nance of nitric oxide-mediated erectile activity in the rat. The objective of the present study was to inves- tigate the role of androgens in regulating trabecular smooth muscle relaxation in the corpus cavernosum in response to vasoactive challenge in men with erectile dysfunction (ED). DESIGN Retrospective, double-blind correlation analyses. PATIENTS Fifty-two impotent

A. Aversa; A. M. Isidori; M. U. De Martino; M. Caprio; E. Fabbrini; M. Rocchietti-March; G. Frajese; A. Fabbri

2000-01-01

113

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

PubMed

Autonomic nervous system dysfunction occurs rarely after botulinum toxin type A (BTX-A) intramuscular injections. We report a case of a 23-year-old man with spastic diplegia who had transient erectile dysfunction after intramuscular injection of BTX-A (total dosage, 300 IU, body weight 95 kg) in both hamstring muscles. Some investigators believe that the local spread of the toxin is responsible for autonomic dysfunction, while others believe that the transportation of the toxin to the spinal cord via retrograde flow or via the blood flow after entering the circulation are possible mechanisms of neurologic side effects. On the basis of our case, a retrograde axoplasmic flow to the spinal cord could probably occur because the spinal cord level of hamstring muscles is close to spinal cord levels responsible for erection control. PMID:12741592

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

2002-01-01

114

Erectile Dysfunction in the Elderly: An Old Widespread Issue with Novel Treatment Perspectives  

PubMed Central

Erectile dysfunction (ED) is one of the most common chronic diseases affecting men and its prevalence increases with aging. It is also the most frequently diagnosed sexual dysfunction in the older male population. A number of different diseases potentially worsening sexual function may occur in elderly people, together with polypharmacy. Related causes of ED are variable and can include arterial, neurogenic, hormonal, cavernosal, iatrogenic, and psychogenic causes. The aim of the present review was to examine the main aspects of erectile dysfunction going through epidemiology and pathophysiology and revise most of ED in elderly disabled men and in those affected with psychiatric disorders. Lastly we tried to focus on the main aspects of nonpharmacological and pharmacological treatments of ED and the recreational use in the elderly. Phosphodiesterase-5 inhibitors (PDE5-I) are commonly used for on-demand or chronic treatment of ED. It is widely known that PDE5-I have lower response rates in older men than in younger patients, but they have the advantages of ease of use and excellent safety profile, also in the elderly. The old and new PDE5-I as well as the alternative treatments for ED are extensively discussed. PMID:24744785

De Fazio, Pasquale

2014-01-01

115

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

PubMed Central

Purpose. To evaluate association between erectile dysfunction (ED) and neovascular age-related macular degeneration (AMD). Methods. 195 men enrolled in this cross-sectional study. 90 of them had neovascular AMD and 105 of them were healthy volunteers. The International Index of Erectile Function (IIEF) questionnaire's erectile function (EF) domain was used to assess ED. The patients in the study and control groups were statistically compared according to visual acuity, EF score, and body mass index. Results. The mean ages were 62 (54.5–73) and 60 (54–68), in the neovascular AMD and control groups, respectively. The total EF scores were 9 (6–16) in neovascular AMD and 18 (9.5–27) in control group. The results of IIEF questionnaire on neovascular AMD patients revealed that 85 men (94.4%) had some degree of ED, whereas 68 men (64.8%) had some degree of ED on control group. Patients with neovascular AMD had a significantly higher incidence of ED than control patients (P < 0.01). There was a significant association between ED and neovascular AMD (P < 0.01). Conclusions. Our results suggested that neovascular AMD has a high association with ED. PMID:24191192

Çakmak, Harun; Kocatürk, Tolga; Dündar, Sema Oruç; Dündar, Mehmet; Karabulut, Müjdat

2013-01-01

116

2015 update of erectile dysfunction management following radical prostatectomy: from basic research to clinical management.  

PubMed

Radical prostatectomy (RP) is the most commonly employed curative intervention for the treatment of prostate cancer. However, due to the proximity of the cavernous nerves (CN) to the prostate, RP results in transient and/often permanent erectile dysfunction (ED). While the prevention of traction injuries during the RP is critical for the preservation of erectile function, several preclinical studies have demonstrated the beneficial effects of neuroprotective (or neuroregenerative) agents in mitigating neuronal injuries sustained during RP. The maintenance or restoration of erectile function after injury may be enhanced in the postoperative period by the stimulation of neurogenesis to protect and restore injured nerves from further deterioration. The present review aims to evaluate and summarize research of these treatment strategies as published in the National Library of Medicine (Pubmed) from 2000 to 2015. The keywords used for the search were ED, RP, CN injury, immunophilin ligands, neurotrophins and phosphodiesterase (PDE)5 inhibitors, and animal models. Current guidelines for treatment targeting CN recovery recommend the use of immunophilin ligands, neurotrophins, brain-derived neurotrophic factor, glial cell-line derived neurotrophic factor, sonic hedgehog (Shh), Rho-kinase, PDE5 inhibitors, erythropoietin (EPO), hyperbaric oxygen, gene, stem cells, and triiodothyronine (T3) therapy. Additionally, this review identifies remaining gaps in general knowledge and recent updates recognizing the need for further preclinical and clinical trials. PMID:25354178

Gur, Serap; C Sikka, Suresh; Kadowitz, Philip J; Silberstein, Jonathan; Hellstrom, Wayne J G

2015-01-01

117

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

PubMed

A number of circulating and imaging biomarkers are robustly associated with cardiovascular (CV) risk. The overall expectation from a biomarker in the erectile dysfunction (ED) setting is to enhance the optimal management of a man with this disorder but no clinical atherosclerosis. Evidence demonstrating that these biomarkers enhance risk prediction for individuals with ED is at this stage still limited for most of them. A better identification of the subsets of the ED population that require further risk stratification, as well as the initiation of randomized trials that will formally test the ability of biomarkers to predict CV risk, could make biomarker-guided prevention an attainable goal. PMID:25412676

Vlachopoulos, Charalambos; Ioakeimidis, Nikolaos; Stefanadis, Christodoulos

2015-01-01

118

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

119

[Evaluation of preoperative cavernosometry and cavernosography in erectile dysfunction of presumed venous origin].  

PubMed

During the period November 1988 to September 1992, 42 patients with erectile dysfunction underwent preoperative dynamic cavernosometry and cavernosography. Radiologically visible venous leakage was demonstrated in all cases but one. At a maintenance flow of more than 20 ml/min, venous leakage was always demonstrable and the types of veins opacified were stereotype. Therefore, clinically relevant leakage can be documented on the basis of cavernosometry. A surgical approach to penile venous leakage with resection of the deep dorsal vein and ligation of all superficial anastomoses including the superficial dorsal vein will eliminate the most common types of radiologically visible veins. PMID:8066878

Jensen, P R; Jensen, K M

1994-06-13

120

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

PubMed

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. 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

121

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

PubMed Central

A number of circulating and imaging biomarkers are robustly associated with cardiovascular (CV) risk. The overall expectation from a biomarker in the erectile dysfunction (ED) setting is to enhance the optimal management of a man with this disorder but no clinical atherosclerosis. Evidence demonstrating that these biomarkers enhance risk prediction for individuals with ED is at this stage still limited for most of them. A better identification of the subsets of the ED population that require further risk stratification, as well as the initiation of randomized trials that will formally test the ability of biomarkers to predict CV risk, could make biomarker-guided prevention an attainable goal. PMID:25412676

Vlachopoulos, Charalambos; Ioakeimidis, Nikolaos; Stefanadis, Christodoulos

2015-01-01

122

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

PubMed Central

Our aim was to assess the impact of the association between elevated oestradiol (E2) and low testosterone (T) levels on erectile dysfunction (ED) severity. A total of 614 male patients with ED and a normal or low T level in association with normal or elevated E2 levels were enrolled. Patients underwent routine laboratory investigations in addition to measurements of total T, total E2, follicle-stimulating hormone (FSH), luteinizing hormone (LH) and prolactin. We compared the responses to the erectile function domain, Q3 (achieving erection) and Q4 (maintaining erection) of the International Index for Erectile Function (IIEF) score in patients with the following: normal T and E2 levels; low T level; low T level and elevated E2 level; and elevated E2 level. Of the patients included, 449 (73.1%) had normal T and E2 levels, 110 (17.9%) had a low T level, 36 (5.9%) had a low T level and an elevated E2 level, and 19 (3.1%) had an elevated E2 level. Increased ED severity was significantly associated with low T levels, elevated E2 levels, and both a low T level and an elevated E2 level. Additionally, the mean values of the EF-domain, Q3 and Q4 were significantly lower in patients with both a low T level and an elevated E2 level compared to patients with any condition alone. In conclusion, a low T level had the primary effect on erectile function; however, a concomitantly elevated E2 level had an additive impairment effect. PMID:23644871

El-Sakka, Ahmed I

2013-01-01

123

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

PubMed

The metabolic syndrome (MetS) is an insulin-resistant state characterized by a cluster of cardiovascular risk factors, including abdominal obesity, hyperglycemia, elevated blood pressure and combined dyslipidemia. In this review, we discuss the potential of farnesoid X receptor (FXR) agonists in the treatment of erectile dysfunction (ED), a multifactorial disorder often comorbid with MetS. FXR not only regulates lipid and glucose homeostasis but also influences endothelial function and atherosclerosis, suggesting a regulatory role for this hormone nuclear receptor in the cardiovascular complications associated with the MetS, including ED. MetS induces ED via several mechanisms, and in particular through endothelial dysfunction in penile vessels. In a high-fat diet rabbit model of MetS, a 3-month treatment with the potent and selective FXR agonist INT-747 restores endothelium-dependent relaxation in isolated cavernous tissue, normalizing responsiveness to acetylcholine and to electrical field stimulation. Accordingly, eNOS expression in the penis is greatly up-regulated by INT-747 treatment. Experiments in a rat model of chemically-induced type 1 diabetes further demonstrate that INT-747 treatment preserves erectile function induced by electrical stimulation of the cavernous nerve. These results add a new facet to the pleiotropic activities mediated by FXR, and reveal novel beneficial effects of FXR activation with potential clinical relevance. This article is part of a Special Issue entitled: Translating nuclear receptors from health to disease. PMID:21056655

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

2011-08-01

124

Avanafil for the Treatment of Erectile Dysfunction: A Multicenter, Randomized, Double-Blind Study in Men With Diabetes Mellitus  

PubMed Central

Objective To prospectively assess the safety and effectiveness of the investigational phosphodiesterase 5 inhibitor avanafil to treat erectile dysfunction in men with diabetes mellitus. Patients and Methods This 12-week, multicenter, double-blind, placebo-controlled study conducted between December 15, 2008, and February 11, 2010, randomized 390 men with diabetes and erectile dysfunction 1:1:1 to receive avanafil, 100 mg (n=129), avanafil, 200 mg (n=131), or placebo (n=130). Coprimary end points assessed changes in the percentage of sexual attempts in which men were able to maintain an erection of sufficient duration to have successful intercourse (Sexual Encounter Profile [SEP] 3), percentage of sexual attempts in which men were able to insert the penis into the partner's vagina (SEP 2), and International Index of Erectile Function erectile function domain score. Results Compared with placebo, least-squares mean change from baseline to study end in SEP 3, SEP 2, and International Index of Erectile Function erectile function domain score were significantly improved with both avanafil, 100 mg (P?.002), and avanafil, 200 mg (P<.001). Additional analyses indicated that successful intercourse could be initiated in 15 minutes or less through more than 6 hours after avanafil dosing. Adverse events most commonly reported with avanafil treatment were headache, nasopharyngitis, flushing, and sinus congestion. Conclusion Avanafil was safe and effective for treating erectile dysfunction in men with diabetes and was effective as early as 15 minutes and more than 6 hours after dosing. The adverse events seen with avanafil were similar to those seen with other phosphodiesterase 5 inhibitors. Trial Registration clinicaltrials.gov Identifier NCT00809471. PMID:22857780

Goldstein, Irwin; Jones, LeRoy A.; Belkoff, Laurence H.; Karlin, Gary S.; Bowden, Charles H.; Peterson, Craig A.; Trask, Brenda A.; Day, Wesley W.

2012-01-01

125

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

PubMed

Abstract Objective. The aim of this study was to investigate whether low-intensity extracorporeal shockwave therapy (LI-ESWT) can be used as a treatment for men with erectile dysfunction of organic origin. Materials and methods. This prospective, randomized, blinded, placebo-controlled study included 112 men unable to have intercourse either with or without medication. Erectile dysfunction was assessed at screening and 5, 12 and 24 weeks after treatment. Assessment was performed by interview and using the Erection Hardness Scale (EHS) and the International Index of Erectile Function (IIEF-15) questionnaire. The men were randomly assigned either to LI-ESWT (n = 51, active group) or placebo (n = 54, placebo group). They received five treatments over 5 weeks. Both the participants and the doctors were blinded to the treatment. After 10 weeks, the placebo group received active treatment (active placebo group). Results. Twenty-nine men (57%, active group) were able to obtain an erection after treatment and to have sexual intercourse without the use of medication. In the placebo group, only five men (9%) showed similar results (p = 0.0001). The EHS after 5 weeks showed that men in the active group experienced a significant improvement in their erectile dysfunction, but no significant result was found with the use of the IIEF - Erectile Function domain. Conclusions. This placebo-controlled study over 5 weeks shows that 57% of the men who suffered from erectile dysfunction had an effect from LI-ESWT. After 24 weeks, seven (19%, active group) and nine (23%, active placebo group) men were still able to have intercourse without medication. This study shows a possible cure in some patients, but more research, longer follow-up in the placebo group and an international multicentre randomized study are needed. PMID:25470423

Olsen, Anne B; Persiani, Marie; Boie, Sidsel; Hanna, Milad; Lund, Lars

2014-12-01

126

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

Microsoft Academic Search

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

A. Graham. Macdonald; Mira Keyes; Alexandra Kruk; Graeme Duncan; Veronika Moravan; W. James Morris

2005-01-01

127

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

Microsoft Academic Search

Purpose: The etiology of erectile dysfunction after definitive local therapy for carcinoma of the prostate gland represents a multifactorial phenomenon including neurogenic compromise, venous insufficiency, local trauma, and psychogenic causes. It has been suggested that impotence after prostate brachytherapy is a consequence of excessive radiation dose to the neurovascular bundles (NVB). Herein we evaluate the potential relationship between radiation dose

Gregory S Merrick; Wayne M Butler; Anthony T Dorsey; Jonathan H Lief; Joseph G Donzella

2000-01-01

128

The Unexpected Evolution of Basic Science Studies about Cyclic Nucleotide Action into a Treatment for Erectile Dysfunction.  

PubMed

In these Reflections, I describe my perceived role in discoveries made in the cyclic nucleotide field that culminated in the advent of PDE5 inhibitors that treat erectile dysfunction, such as Viagra, Levitra, and Cialis. The discoveries emphasize the critical role of basic science, which often evolves in unpredictable and circuitous paths, in improving human health. PMID:25505249

Corbin, Jackie

2015-01-16

129

Erectile Dysfunction and Essential Hypertension: The Same Aging-related Disorder?  

PubMed Central

An erection is a mechanical event dependent primarily on corporeal vascular dynamics wherein arterial inflow and storage of blood within the corpora is greater than the egress of blood from the corpora. The most common cause of erectile dysfunction (ED) is the inability of the corporal tissue to store the blood within the corporal sinusoids once inflow into the corpora begins. This failure to store is primarily due to a corporal smooth muscle dysfunction and, in most men, is most likely an aging-related occurrence. Because the corporal smooth muscle is embryologically and physiologically indistinguishable from the smooth muscle within our arterial system, the authors hypothesize that the aging-related dysfunction that occurs within the penis also occurs within the arterial system, and that this smooth muscle dysfunction within the arterial media is most likely the cause of what is called essential hypertension. This panvascular smooth muscle myopathy could explain why hypertension is the most common comorbidity associated with ED and appears to indicate that both ED and essential hypertension are the same disorder, albeit in two different organ systems. PMID:25548543

Clavijo, Raul I; Miner, Martin M; Rajfer, Jacob

2014-01-01

130

Erectile Dysfunction  

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131

Erectile dysfunction following radical retropubic prostatectomy: epidemiology, pathophysiology and pharmacological management.  

PubMed

Radical prostatectomy has been the time-honoured and standard treatment option for prostate cancer. Erectile dysfunction (ED) is one of the common quality-of-life issues following radical prostatectomy. The recovery of potency following radical prostatectomy varies from 16% to 86%. Although major modifications in surgical technique appear to be promising, the reported ED rates are still high. The time period required for the recovery of erectile function after surgery varies from 6 to 24 months. During this period of neuropraxia lack of natural erections produces cavernosal hypoxia. This cavernosal hypoxia has been implicated as one of the most important factors in the pathophysiology of ED. Cavernosal hypoxia predisposes to cavernosal fibrosis, ultimately producing venous leak and long-term ED. Interruption of this cascade of events has been the major challenge for physicians. Physicians have several options available for the treatment of ED. However, oral treatment options have quickly become established as first-line treatment options. Sildenafil has been most extensively studied in the radical prostatectomy population. In patients who do not respond to oral therapy alone, standard treatment options (intracavernosal injections, vacuum constriction devices and intraurethral alprostadil) are useful. Use of penile prostheses is one of the oldest treatment options available for the treatment of ED but is used only as a last resort. Initial attempts to promote the earlier recovery of erectile function appear to be promising. However, further confirmatory studies are essential. The roles of gene transfer and growth factors are still in experimental stages. In this review we discuss the epidemiology, pathophysiology and treatment options available for ED following radical prostatectomy. PMID:16536634

Nandipati, Kalyana C; Raina, Rupesh; Agarwal, Ashok; Zippe, Craig D

2006-01-01

132

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

PubMed

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

133

Plasma myeloperoxidase in patients with erectile dysfunction of arteriogenic- and non-arteriogenic origin: association with markers of endothelial dysfunction.  

PubMed

Endothelial dysfunction and the disruption of the nitric oxide-cyclic guanosine monophosphate (cGMP) pathway have been considered the early mechanisms for the development of erectile dysfunction (ED). Myeloperoxidase (MPO), a heme-containing enzyme mainly released by activated neutrophils and monocytes, may contribute to endothelial dysfunction by promoting oxidation of different substrates and thus may play a role in ED. MPO level and its correlation with different plasma biomarkers of endothelial dysfunction were studied in patient with ED of arteriogenic (A-ED) and non-arteriogenic (NA-ED) to assess potential differences between the two ED subgroups. Diagnosis of ED was based on the International Index of Erectile Function Score. Its etiology was classified with penile echo-color Doppler at baseline and after intracavernous injection of prostaglandin E1. MPO, soluble (s) cGMP, sICAM-1, sVCAM-1 and sP-Selectin were measured by enzyme-linked immunosorbent assay. MPO concentration in A-ED was significantly higher compared to control subjects and NA-ED patients. Plasmatic cGMP level resulted lower both in A-ED and in NA-ED patients, whereas no difference has been observed between the two ED groups. sICAM-1 concentration resulted higher in A-ED compared both to controls and NA-ED. sVCAM-1 level was the same in controls, A-ED and NA-ED patients. sP-Selectin concentration resulted higher both in A-ED and in NA-ED patients than in controls, whereas no difference has been observed between the two ED groups. Correlation analysis indicated a positive correlation between plasmatic MPO, sICAM-1 and sP-Selectin levels. MPO may represent an important link between oxidation, inflammation and cardiovascular diseases and may also represent a potential marker to distinguish between the two subgroups of ED patients. Moreover, in ED subjects circulating cGMP may reflect the local signaling dysfunction. The use cGMP as a potential marker for monitoring the disease needs further investigation. PMID:24152842

Dozio, E; Barassi, A; Marazzi, M G; Vianello, E; Colpi, G M; Solimene, U; Melzi D'Eril, G L; Corsi Romanelli, M M

2013-01-01

134

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

135

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

PubMed

The erect penis has always been a symbol of power, virility, and fertility. Inability to obtain or maintain an erection, known clinically as erectile dysfunction, is a major health problem. It can cause considerable distress, unhappiness, and relationship problems. The search has therefore continued from time immemorial to find an effective safe, and easy to administer treatment for erectile problems. Although a number of these treatments became available in the last two decades, they all had problems with efficacy, safety, or ease of administration. Clinicians in this field often are told at the end of an assessment interview, "I wish you have a magic pill". An effective and safe oral treatment is, no doubt, the most acceptable and easy to use option. Finding such a treatment has always been the dream of many scientists, and many attempts have been made over the years. These ranged from herbal remedies used by native healers, mostly in Eastern countries, to the more sophisticated designer drugs, which are based on a better understanding of the physiological mechanism of erection. This article describes some of these attempts. PMID:9611686

Guirguis, W R

1998-01-01

136

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

137

Orally disintegrating vardenafil tablets for the treatment of erectile dysfunction: efficacy, safety, and patient acceptability  

PubMed Central

Background: Erectile dysfunction (ED) is a well-documented medical condition that is expected to increase significantly over the next several decades, especially as men live longer and the prevalence of diabetes and cardiovascular diseases increase. Pharmacology agents are often the first line treatment approach. Newer solid dosage forms, known as orally disintegrating tablets (ODT), are now available as one treatment option. Objectives: To review the drug delivery mechanisms of ODTs in general and to review safety and efficacy of vardenafil ODT (a PDE-5 inhibitor) as a treatment option for management of ED. Method: Literature reviews were performed of pharmaceutical dosage forms and the POTENT I (n = 358 subjects) and POTENT II (n = 337 subjects) studies that investigated vardenafil ODT. Results: Vardenafil ODT has been successfully used in multiple age groups and in multiple settings with men from various ethnic backgrounds. Efficacy of vardenafil ODT, as measured using the International Index of Erectile Function (IIEF-EF) and from the Sexual Encounter Profile (SEP) was significantly greater than placebo (P < 0.0001) at 12 weeks. Safety profiles were similar to film-coated dosage forms with no patient deaths reported. Conclusion: Vardenafil ODT offers a convenient, ready-to-use approach for combating ED. Safety concerns are similar to other PDE-5 inhibitors and practitioners should counsel patients accordingly. PMID:21573049

Green, Roger; Hicks, Rodney W

2011-01-01

138

Erectile dysfunction and sexual health after radical prostatectomy: impact of sexual motivation.  

PubMed

The life expectancy of patients with localized prostate cancer at treatment initiation has increased, and post-treatment quality of life has become a key issue. The aim of this study is to assess the impact of Radical prostatectomy (RP) on patients' sexual health and satisfaction according to sexual motivation using a self-administered questionnaire completed by two groups of RP patients, with high or lower levels of sexual motivation. A total of 63 consecutive patients were included (mean age, 63.9 years), of whom 74.6% were being treated for erectile dysfunction (ED). After RP, patients reported lower sexual desire (52.4%), reduced intercourse frequency (79.4%), anorgasmia (39.7%), less satisfying orgasm (38.1%), climacturia (25.4%), greater distress (68.3%) and/or lower partner satisfaction (56.5%). Among the most sexually motivated patients, 76.0% reported loss of masculine identity, 52% loss of self-esteem and 36.0% anxiety about performance. These rates were lower among less motivated patients (52.6, 28.9, and 18.4%, respectively). Mean overall satisfaction score was 4.8 ± 2.9. The score was significantly lowered in motivated than less motivated patients (3.4 vs 5.8) (P = 0.001). In conclusion, RP adversely affected erectile and orgasmic functions but also sexual desire, self-esteem and masculinity. The more motivated patients experienced greater distress and were less satisfied. PMID:21471982

Messaoudi, R; Menard, J; Ripert, T; Parquet, H; Staerman, F

2011-01-01

139

Long-term outcomes of penile prostheses for the treatment of erectile dysfunction.  

PubMed

Since their introduction 60 years ago, penile prostheses have remained the standard therapy for the management of refractory erectile dysfunction, with multiple long-term series reporting outcomes. A PubMed search was performed from 1990 to present, and outcomes of penile prosthetics were reviewed. Studies with <12 months follow-up were excluded. Overall mechanical survival of three-piece prostheses range from 81-94, 68-89 and 57-76% at 5, 10 and 15 years, respectively. Contemporary infection rates following recent device modifications are 1-2% (low risk) to 2-3% (high risk). Patient satisfaction ranges from 75-100% and varies by prosthetic device. Outcomes are further reviewed among specialized populations (revision surgery, Peyronie's disease, priapism, corporal fibrosis and neurologic impairments). Penile prostheses remain a viable surgical treatment option with excellent mechanical reliability, low infection rates and significant patient/partner satisfaction. PMID:23668707

Trost, Landon W; McCaslin, Ross; Linder, Brian; Hellstrom, Wayne J G

2013-05-01

140

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

141

Development of UK recommendations on treatment for post-surgical erectile dysfunction  

PubMed Central

Aim To develop a management strategy (rehabilitation programme) for postsurgical erectile dysfunction (ED) among men experiencing ED associated with treatment of prostate, bladder or rectal cancer that is suitable for use in a UK NHS healthcare context. Methods PubMed literature searches of ED management together with a survey of 13 experts in the management of ED from across the UK were conducted. Results Data from 37 articles and completed questionnaires were collated. The results discussed in this study demonstrate improved objective and subjective clinical outcomes for physical parameters, sexual satisfaction, and rates of both spontaneous erections and those associated with ED treatment strategies. Conclusion Based on the literature and survey analysis, recommendations are proposed for the standardisation of management strategies employed for postsurgical ED. PMID:24188207

Kirby, M G; White, I D; Butcher, J; Challacombe, B; Coe, J; Grover, L; Hegarty, P; Jackson, G; Lowndes, A; Payne, H; Rees, J; Sangar, V; Thompson, A

2014-01-01

142

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

143

The future is today: emerging drugs for the treatment of erectile dysfunction  

PubMed Central

Erectile Dysfunction (ED) is the most common male sexual dysfunction presented for treatment, and the most thoroughly studied sexual dysfunction in men. In the late 20th century, important discoveries were made regarding both the physiologic processes of penile erection and the pathophysiology of ED. These discoveries led to the commercial introduction of the phosphodiesterase type 5 inhibitors (PDE5I), a class of medications which now accounts for the largest segment of the ED market. While these drugs are highly efficacious for many men, a relatively large subset of ED patients who do not respond to PDE5I has been identified. Recognition of this subset of the ED population and the ageing of the population has driven researchers to investigate novel treatment targets for ED. Increased research efforts have resulted in the development of several orally available compounds that combine high efficacy with low rates of adverse events. In this review we report on various compounds that regulate penile erection both centrally (Clavulanic acid, Dopamine and Melanocortin receptor agonists) and peripherally (novel PDE5I, soluble and particulate Guanylil Cyclase activators, Rho-kinase inhibitors and Maxi-K channel openers), and discuss the preclinical and clinical evidence supporting the development of these emerging drugs for ED. PMID:20415601

Albersen, Maarten; Shindel, Alan; Mwamukonda, Kuwong; Lue, Tom

2011-01-01

144

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

145

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

PubMed

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

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

2012-02-01

146

Low-intensity shock wave therapy and its application to erectile dysfunction.  

PubMed

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; Xin, Zhongcheng

2013-12-01

147

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

148

Microarray analysis reveals novel gene expression changes associated with erectile dysfunction in diabetic rats  

PubMed Central

To investigate the full range of molecular changes associated with erectile dysfunction (ED) in type 1 diabetes, we examined alterations in penile gene expression in streptozotocin-induced diabetic rats and littermate controls. Using Affymetrix GeneChip arrays and statistical filtering, 529 genes/transcripts were considered to be differentially expressed in the diabetic rat cavernosum as compared to control. Gene Ontology (GO) classification indicated that there was a decrease in numerous extracellular matrix genes (e.g., collagen and elastin related) and an increase in oxidative-stress genes in the diabetic rat cavernosum. In addition, PubMatrix literature mining identified differentially expressed genes previously shown to mediate vascular dysfunction (e.g., Cp, Lpl, Cd36) as well as genes involved in modulation of smooth muscle phenotype (e.g., Klf5, Cx3cl1). Real-time PCR was used to confirm changes in expression for 23 relevant genes. Further validation of ceruloplasmin (Cp) expression in the diabetic rat cavernosum demonstrated increased mRNA levels of the secreted and anchored splice variants of Cp. CP protein levels showed a 1.9-fold increase in tissues from diabetic rats versus controls. Immunohistochemistry demonstrated localization of CP protein in the cavernosal sinusoids of control and diabetic animals, including the endothelial and smooth muscle layers. Overall, this study broadens the scope of candidate genes and pathways that may be relevant to the pathophysiology of diabetes-induced ED as well as highlights the potential complexity of this disorder. PMID:16118269

Sullivan, Chris J.; Teal, Thomas H.; Luttrell, Ian P.; Tran, Khoa B.; Peters, Mette A.; Wessells, Hunter

2014-01-01

149

Assessing the Influence of Benign Prostatic Hyperplasia (BPH) on Erectile Dysfunction (ED) among patients in Poland  

PubMed Central

Introduction Erectile dysfunction (ED) and the lower urinary tract symptoms caused by benign prostatic hyperplasia (LUTS/BPH) are highly prevalent among aging men. More data are needed from studies evaluating the impact of LUTS/BPH on ED. This study aimed to assess ED in patients with LUTS/BPH independent of comorbidities. Material and methods During 2007 and 2008, we examined 10,932 patients aged 50 to 69 years with LUTS/BPH (IPSS = 8-19 points) using questionnaires: Sex-Score and International Index of Erectile Function 5 (IIEF-5). Patients who used alcohol and/or cigarettes and those with hypertension, diabetes, or hyperlipidemia and cholesterolemia were excluded from meta analyses, which left 4,354 patients with LUTS/BPH without any comorbidity for the analyses. The main survey instruments used were the Sex-Score and IIEF-5. Results Regarding sexual coexistence, 1,497 (34.4%) and 2,638 (60.6%) patients considered it very important or important respectively; however, 219(5%) patients reported no sexual activity. After excluding sexually inactive patients, only 1,088 (25%) patients had the ability to obtain an erection during sexual activity always or nearly always. However, that erection was only strong enough to penetrate their partner almost always or most of the time in 218 (5%) and 826 (19%) patients respectively and only 610 (14%) patients were always able to maintain their erection during sexual intercourse. While only 87 (2%) patients had no difficulty maintaining their erection until the completion of intercourse, 174 (4%) and 914 (21%) patients stated that sexual intercourse gave satisfaction nearly always or most of the time respectively. Conclusions The impact of ED on patients with LUTS/BPH is evident across domains. PMID:24578949

Skawi?ski, Dariusz; Duda, Wies?aw; Duda, Magdalena

2012-01-01

150

Lower Urinary Tract Symptoms, Erectile Dysfunction, and Their Correlation in Men Aged 50 Years and Above: A Cross-Sectional Survey in Beijing, China  

PubMed Central

Background The aim of this study was to investigate the correlation between incidence of lower urinary tract symptoms and erectile dysfunction in men aged ?50 years. Material/Methods A cross-sectional study was performed in 1644 men aged >50 years in Beijing. The International Index of Erectile Function (IIEF)-5 and International Prostate Symptom Score were recorded for each patient. Pearson’s chi-square test and Spearman correlation coefficients were used to analyze the International Prostate Symptom Scores and lower urinary tract symptoms, and their correlations with erectile dysfunction. Results The incidence rates of erectile dysfunction among men with mild, moderate, and severe lower urinary tract symptoms were 85.7, 93.7, and 97.9%, respectively. Interestingly, the total IIEF-5 score significantly correlated with the total International Prostate Symptom Score (r=?0.335; P<0.01), obstructive symptoms (r=?0.276; P<0.01), and irritative symptoms (r=?0.326; P<0.01). The correlation between the severity of lower urinary tract symptoms and that of erectile dysfunction was consistently maintained (r=0.304; P<0.01). Age significantly correlated with International Prostate Symptom Score (r=0.388; P<0.01), lower urinary tract symptoms severity (r=0.457; P<0.01), total IIEF-5 score (r=?0.533; P<0.01), and erectile dysfunction severity (r=0.529; P<0.01). Conclusions The incidence of lower urinary tract symptoms and erectile dysfunction in aging men increase with age, and the severity of erectile dysfunction is positively correlated with the severity of lower urinary tract symptoms. PMID:25543209

Song, Jian; Shao, Qiang; Tian, Ye; Chen, Shan

2014-01-01

151

Lower urinary tract symptoms, erectile dysfunction, and their correlation in men aged 50 years and above: a cross-sectional survey in beijing, china.  

PubMed

Background The aim of this study was to investigate the correlation between incidence of lower urinary tract symptoms and erectile dysfunction in men aged ?50 years. Material and Methods A cross-sectional study was performed in 1644 men aged >50 years in Beijing. The International Index of Erectile Function (IIEF)-5 and International Prostate Symptom Score were recorded for each patient. Pearson's chi-square test and Spearman correlation coefficients were used to analyze the International Prostate Symptom Scores and lower urinary tract symptoms, and their correlations with erectile dysfunction. Results The incidence rates of erectile dysfunction among men with mild, moderate, and severe lower urinary tract symptoms were 85.7, 93.7, and 97.9%, respectively. Interestingly, the total IIEF-5 score significantly correlated with the total International Prostate Symptom Score (r=-0.335; P<0.01), obstructive symptoms (r=-0.276; P<0.01), and irritative symptoms (r=-0.326; P<0.01). The correlation between the severity of lower urinary tract symptoms and that of erectile dysfunction was consistently maintained (r=0.304; P<0.01). Age significantly correlated with International Prostate Symptom Score (r=0.388; P<0.01), lower urinary tract symptoms severity (r=0.457; P<0.01), total IIEF-5 score (r=-0.533; P<0.01), and erectile dysfunction severity (r=0.529; P<0.01). Conclusions The incidence of lower urinary tract symptoms and erectile dysfunction in aging men increase with age, and the severity of erectile dysfunction is positively correlated with the severity of lower urinary tract symptoms. PMID:25543209

Song, Jian; Shao, Qiang; Tian, Ye; Chen, Shan

2014-01-01

152

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

Microsoft Academic Search

Purpose: Recent studies have implicated the proximal penis as a potential site-specific structure for radiation-related erectile dysfunction (ED). In this study, we evaluated by means of a validated patient-administered questionnaire whether radiation doses to the bulb of the penis and\\/or the proximal corporeal bodies were predictive for the development of brachytherapy-induced ED.Methods and Materials: Thirty patients who underwent permanent prostate

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

2002-01-01

153

Determination of changes in blood pressure during administration of sildenafil (Viagra®) in patients with spinal cord injury and erectile dysfunction  

Microsoft Academic Search

Study design:Prospective, open-label, comparative study, to assess the effects of sildenafil on blood pressure in a population of patients with spinal cord injury (SCI).Objectives:To determine the effect of sildenafil on blood pressure in patients with erectile dysfunction secondary to SCI by comparing changes in blood pressure in SCI patients with a neurologic level below T5 versus higher levels. To establish

A M García-Bravo; D Suárez-Hernández; M A Ruiz-Fernández; O Silva González; E Bárbara-Bataller; J L Méndez Suárez

2006-01-01

154

A new therapeutic approach to erectile dysfunction: urotensin-II receptor high affinity agonist ligands.  

PubMed

Urotensin-II (U-II) is a cyclic peptide that acts through a G protein-coupled receptor (urotensin-II receptor [UTR]) mainly involved in cardiovascular function in humans. The urotensinergic system is also implicated in the urogenital tract. Indeed, U-II relaxes human corpus cavernosum strips and causes an increase in intracavernous pressure (ICP) in rats. In light of this, the U-II/UTR pathway can be considered a new target for the treatment of erectile dysfunction. On this hypothesis, herein we report on two new UTR high affinity-agonists, P5U (H-Asp-c[Pen-Phe-Trp-Lys-Tyr-Cys]-Val-OH) and UPG84(H-Asp-c[Pen-Phe-DTrp-Orn-(pNH 2 ) Phe-Cys]-Val-OH). The effects of P5U and UPG84 were each compared separately with U-II by monitoring the ICP in anesthetized rats. Intracavernous injection of U-II (0.03-1 nmol), P5U (0.03-1 nmol) or UPG84 (0.03-1 nmol) caused an increase in ICP. P5U, in particular, elicited a significant increase in ICP as compared to U-II. The observed effect by using P5U at a dose of 0.1 nmol per rat was comparable to the effect elicited by U-II at a dose of 0.3 nmol. Moreover, UPG84 at the lowest dose (0.03 nmol) showed an effect similar to the highest dose of U-II (1 nmol). Furthermore, UPG84 was found to be more effective than P5U. Indeed, while the lowest dose of P5U (0.03 nmol) did not affect the ICP, UPG84, at the same dose, induced a prominent penile erection in rat. These compounds did not modify the blood pressure, which indicates a good safety profile. In conclusion, UPG84 and P5U may open new perspectives for the management of erectile dysfunction. PMID:25080929

di Villa Bianca, Roberta d'Emmanuele; Mitidieri, Emma; Donnarumma, Erminia; Fusco, Ferdinando; Longo, Nicola; Rosa, Giuseppe De; Novellino, Ettore; Grieco, Paolo; Mirone, Vincenzo; Cirino, Giuseppe; Sorrentino, Raffaella

2014-07-23

155

A new therapeutic approach to erectile dysfunction: urotensin-II receptor high affinity agonist ligands  

PubMed Central

Urotensin-II (U-II) is a cyclic peptide that acts through a G protein-coupled receptor (urotensin-II receptor [UTR]) mainly involved in cardiovascular function in humans. The urotensinergic system is also implicated in the urogenital tract. Indeed, U-II relaxes human corpus cavernosum strips and causes an increase in intracavernous pressure (ICP) in rats. In light of this, the U-II/UTR pathway can be considered a new target for the treatment of erectile dysfunction. On this hypothesis, herein we report on two new UTR high affinity-agonists, P5U (H-Asp-c[Pen-Phe-Trp-Lys-Tyr-Cys]-Val-OH) and UPG84(H-Asp-c[Pen-Phe-DTrp-Orn-(pNH2) Phe-Cys]-Val-OH). The effects of P5U and UPG84 were each compared separately with U-II by monitoring the ICP in anesthetized rats. Intracavernous injection of U-II (0.03–1 nmol), P5U (0.03–1 nmol) or UPG84 (0.03–1 nmol) caused an increase in ICP. P5U, in particular, elicited a significant increase in ICP as compared to U-II. The observed effect by using P5U at a dose of 0.1 nmol per rat was comparable to the effect elicited by U-II at a dose of 0.3 nmol. Moreover, UPG84 at the lowest dose (0.03 nmol) showed an effect similar to the highest dose of U-II (1 nmol). Furthermore, UPG84 was found to be more effective than P5U. Indeed, while the lowest dose of P5U (0.03 nmol) did not affect the ICP, UPG84, at the same dose, induced a prominent penile erection in rat. These compounds did not modify the blood pressure, which indicates a good safety profile. In conclusion, UPG84 and P5U may open new perspectives for the management of erectile dysfunction. PMID:25080929

di Villa Bianca, Roberta d’Emmanuele; Mitidieri, Emma; Donnarumma, Erminia; Fusco, Ferdinando; Longo, Nicola; De Rosa, Giuseppe; Novellino, Ettore; Grieco, Paolo; Mirone, Vincenzo; Cirino, Giuseppe; Sorrentino, Raffaella

2015-01-01

156

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

157

Detection of undeclared erectile dysfunction drugs and analogues in dietary supplements by ion mobility spectrometry.  

PubMed

An ion mobility spectrometry (IMS) method was developed to screen for the presence of undeclared synthetic erectile dysfunction (ED) drugs or drug analogues in herbal dietary supplements claiming to enhance male sexual performance. Ion mobility spectra of authenticated reference materials including three FDA approved drugs (sildenafil citrate, tadalafil, vardenafil hydrochloride trihydrate) and five previously identified synthetic analogues (methisosildenafil, homosildenafil, piperidenafil, thiosildenafil, thiomethisosildenafil) were measured to determine their reduced ion mobilities (K(0)). All eight compounds exhibited reduced mobilities between 0.8257 and 1.2876 cm(2)/(Vs). Twenty-six herbal products were then screened for the presence of these compounds, and 15 of the 26 products tested positive for the presence of ED drug or drug analogue adulterants based on their reduced ion mobilities. IMS results were compared against the results obtained from an independent LC/MS reference method for the identical samples. Herbal dietary supplements containing adulterants were classified with 100% accuracy and most of the adulterants were correctly identified by a comparison of the K(0) of the adulterant to the K(0) of the authenticated reference material. The results demonstrate that IMS is a viable method for screening herbal dietary supplements for the presence of ED drug or drug analogue adulterants. PMID:19150190

Gryniewicz, Connie M; Reepmeyer, John C; Kauffman, John F; Buhse, Lucinda F

2009-04-01

158

The Princeton III Consensus Recommendations for the Management of Erectile Dysfunction and Cardiovascular Disease  

PubMed Central

The Princeton Consensus (Expert Panel) Conference is a multispecialty collaborative tradition dedicated to optimizing sexual function and preserving cardiovascular health. The third Princeton Consensus met November 8 to 10, 2010, and had 2 primary objectives. The first objective focused on the evaluation and management of cardiovascular risk in men with erectile dysfunction (ED) and no known cardiovascular disease (CVD), with particular emphasis on identification of men with ED who may require additional cardiologic work-up. The second objective focused on reevaluation and modification of previous recommendations for evaluation of cardiac risk associated with sexual activity in men with known CVD. The Panel's recommendations build on those developed during the first and second Princeton Consensus Conferences, first emphasizing the use of exercise ability and stress testing to ensure that each man's cardiovascular health is consistent with the physical demands of sexual activity before prescribing treatment for ED, and second highlighting the link between ED and CVD, which may be asymptomatic and may benefit from cardiovascular risk reduction. PMID:22862865

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

2012-01-01

159

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

PubMed Central

Selective phosphodiesterase type 5 inhibitors (PDE5Is) have revolutionized the treatment of erectile dysfunction (ED) in men. As an on-demand treatment, PDE5Is have excellent efficacy and safety in the treatment of ED due to a broad spectrum of etiologies. Nevertheless, these drugs do have side-effect profiles that are troublesome to some patients, eg, headache, dyspepsia, myalgia, etc. Furthermore, many patients and their partners dislike the necessity of on-demand treatment for ED, citing a desire for greater spontaneity with sexual interactions. In 2008, approximately 10 years after the release of the first commercially available PDE5I, a paradigm shift in the management of ED occurred with the approval of once-daily dose of tadalafil by the US Food and Drug Administration for the management of ED. The prolonged half-life of tadalafil lends itself well to this dosing regimen and conveys the advantage of separating medication from sexual interactions; lower dose therapy also carries the theoretical benefit of lower incidence of side effects. In this study, we review the current state of the art with respect to this new management strategy for ED, highlighting published reports of the efficacy and tolerability of the daily dose tadalafil regimen. PMID:20856843

Washington, Samuel L; Shindel, Alan W

2010-01-01

160

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

161

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

162

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

PubMed Central

Psychogenic erectile dysfunction (ED) is defined as a male sexual dysfunction characterized by a persistent or recurrent inability to attain adequate penile erection due predominantly or exclusively to psychological or interpersonal factors. Previous fMRI studies were based on the common occurrence in the male sexual behaviour represented by the sexual arousal and penile erection related to viewing of erotic movies. However, there is no experimental evidence of altered brain networks in psychogenic ED patients (EDp). Some studies showed that fMRI activity collected during non sexual movie viewing can be analyzed in a reliable manner with independent component analysis (ICA) and that the resulting brain networks are consistent with previous resting state neuroimaging studies. In the present study, we investigated the modification of the brain networks in EDp compared to healthy controls (HC), using whole-brain fMRI during free viewing of an erotic video clip. Sixteen EDp and nineteen HC were recruited after RigiScan evaluation, psychiatric, and general medical evaluations. The performed ICA showed that visual network (VN), default-mode network (DMN), fronto-parietal network (FPN) and salience network (SN) were spatially consistent across EDp and HC. However, between-group differences in functional connectivity were observed in the DMN and in the SN. In the DMN, EDp showed decreased connectivity values in the inferior parietal lobes, posterior cingulate cortex and medial prefrontal cortex, whereas in the SN decreased and increased connectivity was observed in the right insula and in the anterior cingulate cortex respectively. The decreased levels of intrinsic functional connectivity principally involved the subsystem of DMN relevant for the self relevant mental simulation that concerns remembering of past experiences, thinking to the future and conceiving the viewpoint of the other’s actions. Moreover, the between group differences in the SN nodes suggested a decreased recognition of autonomical and sexual arousal changes in EDp. PMID:25126947

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

2014-01-01

163

Aberrant expression of Wnt family contributes to the pathogenesis of diabetes-induced erectile dysfunction.  

PubMed

Diabetic erectile dysfunction (ED) has multiple causative factors, such as endothelial and smooth muscle dysfunction and cavernous fibrosis. Wnt signalling is essential for normal embryonic development and for tissue homeostasis in adults. Aberrant activation of Wnt family members has been implicated in tissue fibrosis and in angiogenesis. In this study, we investigated the differential expression of Wnts in the penises of mice with streptozotocin-induced diabetic ED. We also examined the effect of transforming growth factor-?1 (TGF-?1) on the expression of Wnts in primary cultured fibroblasts isolated from human tunica albuginea. Among the mouse and human Wnts tested, 16 mouse Wnts and 14 human Wnts were detected in the corpus cavernosum tissue of normal mice and in fibroblasts derived from human tunica albuginea respectively. We observed up-regulation of Wnt10b (known to be involved in tissue fibrosis) and down-regulation of Wnt16 (known to be involved in vasculogenesis and hematopoiesis), both in the diabetic condition in vivo and with treatment of fibroblasts with TGF-?1 in vitro. Wnt10b was mainly expressed in fibroblasts and Wnt16 was colocalized with smooth muscle cells in the corpus cavernosum tissue. Cavernous TGF-?1 protein expression and the degree of cavernous fibrosis determined by the ratio of collagen to smooth muscle content were significantly higher in diabetic mice than in controls. Cavernous endothelial content was significantly decreased by the diabetic condition. Overexpression of Wnt16 with plasmid vector accelerated tube formation in primary cultured mouse cavernous endothelial cells. However, down-regulation of Wnt10b with small interfering RNA did not decrease the production of extracellular matrix protein in human fibroblasts. This is the first report demonstrating the differential expression of Wnts in diabetic mouse penis. Aberrant Wnt expression might contribute to the pathogenesis of ED. PMID:24265248

Shin, S H; Kim, W J; Choi, M J; Park, J-M; Jin, H-R; Yin, G N; Ryu, J-K; Suh, J-K

2014-01-01

164

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

PubMed

Psychogenic erectile dysfunction (ED) is defined as a male sexual dysfunction characterized by a persistent or recurrent inability to attain adequate penile erection due predominantly or exclusively to psychological or interpersonal factors. Previous fMRI studies were based on the common occurrence in the male sexual behaviour represented by the sexual arousal and penile erection related to viewing of erotic movies. However, there is no experimental evidence of altered brain networks in psychogenic ED patients (EDp). Some studies showed that fMRI activity collected during non sexual movie viewing can be analyzed in a reliable manner with independent component analysis (ICA) and that the resulting brain networks are consistent with previous resting state neuroimaging studies. In the present study, we investigated the modification of the brain networks in EDp compared to healthy controls (HC), using whole-brain fMRI during free viewing of an erotic video clip. Sixteen EDp and nineteen HC were recruited after RigiScan evaluation, psychiatric, and general medical evaluations. The performed ICA showed that visual network (VN), default-mode network (DMN), fronto-parietal network (FPN) and salience network (SN) were spatially consistent across EDp and HC. However, between-group differences in functional connectivity were observed in the DMN and in the SN. In the DMN, EDp showed decreased connectivity values in the inferior parietal lobes, posterior cingulate cortex and medial prefrontal cortex, whereas in the SN decreased and increased connectivity was observed in the right insula and in the anterior cingulate cortex respectively. The decreased levels of intrinsic functional connectivity principally involved the subsystem of DMN relevant for the self relevant mental simulation that concerns remembering of past experiences, thinking to the future and conceiving the viewpoint of the other's actions. Moreover, the between group differences in the SN nodes suggested a decreased recognition of autonomical and sexual arousal changes in EDp. PMID:25126947

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

2014-01-01

165

PA01.18. Practical application of uttrabasti in klaibya w.s.r. to erectile dysfunction  

PubMed Central

Purpose: Though both, nonsurgical and surgical treatments are in practice for the management of erectile dysfunction in allopathic system, but each of them is having its own limitations and demerits. The nonsurgical treatment are having poor efficacy with systemic and local side effects. The surgical treatments are associated with complications, change in the shape of the penis and they are unaffordable by the common people. Method: Patient is selected as per the classical signs and symptoms of Klaibya. Phala Ghrita is used for the Uttarabasti in the dose of 30 ml for each episode. Uttarabasti is given in two divided courses as: 4 consecutive days in the 1st course followed by 4 days of rest; and again 4 consecutive days of Uttarabasti. The criterion for assessment of results is based on the scoring of International Index of Erectile Function (IIEF). Result: Uttarabasti with Phala Ghrita has shown encouraging results on Erectile Dysfunction as well as Seminal parameters. Photos & videos of the procedures carried out by me will be discussed and shown during my full paper presentation. Conclusion: Hence Uttarabasti is an effective, safe and affordable therapy to manage this troublesome problem.

Meti, Prakash

2012-01-01

166

Cutaneous microcirculatory function predicts the responsiveness to tadalafil in patients with erectile dysfunction and coronary artery disease.  

PubMed

Despite the proven clinical efficacy of phosphodiesterase inhibitors in the treatment of erectile dysfunction (ED), some patients do not respond to the medication. By means of nailfold capillary microscopy in patients with concomitant coronary artery disease (CAD) and ED, it was evaluated whether the extent of microvascular dysregulation predicts the responsiveness to tadalafil (TAD) in terms of erectile function. The ED of each patient was assessed by the International Index of Erectile Function (IIEF). Patients presenting both, documented CAD and ED, showed a significantly reduced capillary red blood cell velocity (v(RBC)) at rest and after 3 min of ischemia compared with age-matched controls. At 2 h after intake of 20 mg of TAD, a significant increase of v(RBC) at rest as well as during postischemic hyperemia was found. Patients who reported no improvement of their ED after the use of TAD demonstrated no changes in the duration of postischemic (DpH) hyperemia, or even a reduction of the DpH. The majority of the patients, who reported at least one successful sexual intercourse due to TAD, had a prolongation of DpH. We conclude that assessment of microvascular regulation by nailfold capillary microscopy can predict the probability of a treatment failure with phosphodiesterase inhibitors in patients with ED. Moreover, as endothelial dysfunction is the common underlying pathophysiological process of ED and cardiovascular diseases, the test may help to identify patients at risk for the development of atherosclerosis and following cardiovascular events. PMID:17703223

Park, J-W; Leithäuser, B; Mrowietz, C; Jung, F

2008-01-01

167

Erectile dysfunction and coronary artery disease prediction: evidence-based guidance and consensus.  

PubMed

* A significant proportion of men with erectile dysfunction (ED) exhibit early signs of coronary artery disease (CAD), and this group may develop more severe CAD than men without ED (Level 1, Grade A). * The time interval among the onset of ED symptoms and the occurrence of CAD symptoms and cardiovascular events is estimated at 2-3 years and 3-5 years respectively; this interval allows for risk factor reduction (Level 2, Grade B). * ED is associated with increased all-cause mortality primarily due to increased cardiovascular mortality (Level 1, Grade A). * All men with ED should undergo a thorough medical assessment, including testosterone, fasting lipids, fasting glucose and blood pressure measurement. Following assessment, patients should be stratified according to the risk of future cardiovascular events. Those at high risk of cardiovascular disease should be evaluated by stress testing with selective use of computed tomography (CT) or coronary angiography (Level 1, Grade A). * Improvement in cardiovascular risk factors such as weight loss and increased physical activity has been reported to improve erectile function (Level 1, Grade A). * In men with ED, hypertension, diabetes and hyperlipidaemia should be treated aggressively, bearing in mind the potential side effects (Level 1, Grade A). * Management of ED is secondary to stabilising cardiovascular function, and controlling cardiovascular symptoms and exercise tolerance should be established prior to initiation of ED therapy (Level 1, Grade A). * Clinical evidence supports the use of phosphodiesterase 5 (PDE5) inhibitors as first-line therapy in men with CAD and comorbid ED and those with diabetes and ED (Level 1, Grade A). * Total testosterone and selectively free testosterone levels should be measured in all men with ED in accordance with contemporary guidelines and particularly in those who fail to respond to PDE5 inhibitors or have a chronic illness associated with low testosterone (Level 1, Grade A). * Testosterone replacement therapy may lead to symptomatic improvement (improved wellbeing) and enhance the effectiveness of PDE5 inhibitors (Level 1, Grade A). * Review of cardiovascular status and response to ED therapy should be performed at regular intervals (Level 1, Grade A). PMID:20584218

Jackson, G; Boon, N; Eardley, I; Kirby, M; Dean, J; Hackett, G; Montorsi, P; Montorsi, F; Vlachopoulos, C; Kloner, R; Sharlip, I; Miner, M

2010-06-01

168

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

PubMed

Extracorporeal shock wave therapy improves erectile function in patients with Peyronie's disease. However, erectile dysfunction still persists in many cases. We aimed to investigate the effects of extracorporeal shock wave therapy plus tadalafil 5 mg once daily in the management of patients with Peyronie's disease and erectile dysfunction not previously treated. One hundred patients were enrolled in a prospective, randomized, controlled study. Patients were randomly allocated to receive either extracorporeal shock wave therapy alone for 4 weeks (n = 50) or extracorporeal shock wave therapy plus tadalafil 5 mg once daily for 4 weeks (n = 50). Main outcome measures were: erectile function (evaluated through the shortened version of the International Index of Erectile Function), pain during erection (evaluated through a Visual Analog Scale), plaque size, penile curvature and quality of life (evaluated through an internal questionnaire). Follow-up evaluations were performed after 12 and 24 weeks. In both groups, at 12 weeks follow-up, mean Visual Analog Scale score, mean International Index of Erectile Function score and mean quality of life score ameliorated significantly while mean plaque size and mean curvature degree were unchanged. Intergroup analysis revealed a significantly higher mean International Index of Erectile Function score and quality of life score in patients receiving the combination. After 24 weeks, intergroup analysis revealed a significantly higher mean International Index of Erectile Function score and mean quality of life score in patients that received extracorporeal shock wave therapy plus tadalafil. In conclusion extracorporeal shock wave therapy plus tadalafil 5 mg once daily may represent a valid conservative strategy for the management of patients with Peyronie's disease and erectile dysfunction. PMID:22085227

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

2012-04-01

169

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

170

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

171

Prognostic factors for the postoperative outcome of penile venous surgery for venogenic erectile dysfunction.  

PubMed

Since penile venous surgery is usually associated with a poor postoperative outcome, a study was done to evaluate possible prognostic factors for this procedure. A total of 77 patients with erectile dysfunction underwent ligation of all dorsal penile veins and resection of the deep dorsal penile vein for venous incompetence. In all patients a comprehensive evaluation was done preoperatively. All patients did not respond to pharmacotherapy and had a venous leak. After a followup of 6 months, patients were classified as having full spontaneous erections, failure and response to pharmacotherapy. Of the 77 patients 31 (40.3%) had full spontaneous erections, 8 (10.3%) were currently responding to pharmacotherapy and 38 (49.4%) failed. The maintenance flow was 75 +/- 45 ml. per minute in the group with spontaneous erections and 103 +/- 60 ml. per minute in the failure group (p = 0.20). Mean patient age was 49.8 +/- 11.7 and 49.1 +/- 10.2 years, respectively (p = 0.23). Of the 41 patients wih normal single potential analysis of cavernous electrical activity 28 had full erections postoperatively, 5 responded to pharmacotherapy and 8 failed, compared to 3, 3 and 30, respectively, of the 36 patients with abnormal single potential analysis of cavernous electrical activity. After a mean followup of 21 months (range 6 to 47 months), 4 patients with full erections at 6 months postoperatively currently require intracavernous pharmacotherapy. Our results indicate that single potential analysis of cavernous electrical activity seems to be an important prognostic factor for the postoperative outcome of penile venous surgery for venogenic impotence. PMID:8126816

Stief, C G; Djamilian, M; Truss, M C; Tan, H; Thon, W F; Jonas, U

1994-04-01

172

[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

173

Identification of counterfeit medicines for erectile dysfunction from an illegal supply chain.  

PubMed

The appearance of counterfeit medicines in supply chains is a global public health problem that may seriously affect patients. Counterfeit drugs do not meet quality standards and do not declare their real composition and/or source for the purposes of fraud. They may be generic or innovative, they may contain genuine constituents in a fake packaging, or wrong ingredients, or inactive ingredients, or an incorrect quantity of the active substance. In Croatia, no cases of counterfeit medicines have been detected so far, but the Agency for Medicinal Products and Medical Devices has received 34 samples of medicines and other products for testing from Zagreb City Police. The samples included medicines for erectile dysfunction: sildenafil, tadalafil, and vardenafil. Twenty-three samples of tablets without marketing authorisation in Croatia were tested with high-performance liquid chromatography (HPLC) for the declared sildenafil and tadalafil content. Samples labelled 1 (batch T/33), 3 (batch T/33), 5 (batch 4), 6 (batch M0016J), 10 (batch T-070235), 12 (batch T-070544), 15 (batch 314833201), 16 (batch 832718474), and 17 (batch 504830028) containing sildenafil and samples labelled 20 (batch 070356), 21 (batch 05668), and 22 (batch T 378 5) containing tadalafil did not contain the active substance within the acceptable 95 % to 105 % margin of deviation from the declared content. While most samples cannot be described as fake with a reasonable amount of certainty, there is still a suspicion of counterfeit. A correct conclusion can be drawn only with the assistance of the manufacturers and by conducting additional laboratory tests. PMID:20338870

Tomi?, Sinisa; Milci?, Neven; Sokoli?, Milenko; Martinac, Adrijana Ili?

2010-03-01

174

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

175

Long-term results of combined tunica albuginea plication and penile prosthesis implantation for severe penile curvature and erectile dysfunction.  

PubMed

Penile prosthesis implantation is the recommended treatment in patients with penile curvature and severe erectile dysfunction (ED) not responding to pharmacotherapy. Most patients with mild-to-moderate curvature can expect cylinder insertion to correct both ED and penile curvature. In patients with severe curvature and in those with persistent curvature after corporeal dilation and prosthesis placement, intraoperative penile "modelling" over the inflated prosthesis has been introduced as an effective treatment. We report for the first time the long-term results of a patient treated with combined penile plication and placement of an inflatable penile prosthesis. PMID:24790766

Cormio, Luigi; Massenio, Paolo; Di Fino, Giuseppe; Lucarelli, Giuseppe; Mancini, Vito; Liuzzi, Giuseppe; Carrieri, Giuseppe

2014-01-01

176

Long-Term Results of Combined Tunica Albuginea Plication and Penile Prosthesis Implantation for Severe Penile Curvature and Erectile Dysfunction  

PubMed Central

Penile prosthesis implantation is the recommended treatment in patients with penile curvature and severe erectile dysfunction (ED) not responding to pharmacotherapy. Most patients with mild-to-moderate curvature can expect cylinder insertion to correct both ED and penile curvature. In patients with severe curvature and in those with persistent curvature after corporeal dilation and prosthesis placement, intraoperative penile “modelling” over the inflated prosthesis has been introduced as an effective treatment. We report for the first time the long-term results of a patient treated with combined penile plication and placement of an inflatable penile prosthesis. PMID:24790766

Massenio, Paolo; Di Fino, Giuseppe; Mancini, Vito; Carrieri, Giuseppe

2014-01-01

177

Erectile dysfunction in the type II diabetic db/db mouse: impaired venoocclusion with altered cavernosal vasoreactivity and matrix.  

PubMed

The number of men with type II diabetes-associated erectile dysfunction (ED) continues to grow rapidly; however, the majority of basic science studies has examined mechanisms of ED in animal models of type I diabetes. In this study, we first establish an in vivo mouse model of type II diabetic ED using the leptin receptor mutated db/db and wild-type control BKS mouse. Furthermore, we hypothesized that dual mechanistic impairments contribute to the impaired erectile function in the type II diabetic mouse, altered vasoreactivity, and venoocclusive disorder. In vivo erectile function was measured as intracavernosal pressure (ICP) normalized to mean arterial pressure (MAP) following electrical stimulation of the cavernosal nerve. Venoocclusion was assessed by the maintenance of elevated in vivo ICP following intracorporal saline infusion. Vasoreactivity of isolated cavernosum in response to contractile and dilatory stimulation was examined in vitro by myography. Collagen and elastin content were evaluated by quantification of hydroxyproline and desmosine, respectively, as well as by quantitative PCR and histological analysis of isolated cavernosum. Erectile function was significantly decreased in db/db vs. BKS mice in a manner consistent with impairments in venoocclusive ability and decreased inflow. Heightened vasoconstriction and attenuated dilation in cavernosum of db/db vs. BKS mice suggest an overall lowered relaxation ability and thus impaired filling of the cavernosal spaces. A decrease in desmosine and hydroxyproline as well as lowered mRNA levels for tropoelastin, fibrillin-1, and alpha1(I) collagen were detected. These vasoreactive and sinusoidal matrix alterations may alter tissue compliance dispensability, preventing the normal expansion necessary for erection. PMID:18326798

Luttrell, Ian P; Swee, Mei; Starcher, Barry; Parks, William C; Chitaley, Kanchan

2008-05-01

178

Evaluation of a multi-herb supplement for erectile dysfunction: a randomized double-blind, placebo-controlled study  

PubMed Central

Background Evidence is lacking for multi-ingredient herbal supplements claiming therapeutic effect in sexual dysfunction in men. We examined the safety and efficacy of VigRX Plus (VXP) – a proprietary polyherbal preparation for improving male sexual function, in a double blind, randomized placebo-controlled, parallel groups, multi-centre study. Methods 78 men aged 25–50?years of age; suffering from mild to moderate erectile dysfunction (ED), participated in this study. Subjects were randomized to receive VXP or placebo at a dose of two capsules twice daily for 12?weeks. The international index of erectile function (IIEF) was the primary outcome measure of efficacy. Other efficacy measures were: Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS), Serum testosterone, Semen analysis, Investigator’s Global assessment and Subjects’ opinion. Results In subjects receiving VXP, the IIEF-Erectile Function (EF) scores improved significantly as compared to placebo. After 12?weeks of treatment, the mean (sd) IIEF-EF score at baseline increased from 16.08 (2.87) to 25.08 (4.56) in the VXP group versus 15.86 (3.24) to 16.47 (4.25) in the placebo group (P?

2012-01-01

179

[Determination of apomorphine, sildenafil and alprostadil in medicines for erectile dysfunction by high performance liquid chromatography-mass spectrometry].  

PubMed

A high performance liquid chromatography-mass spectrometry (LC-MS) analytical method for illicit drugs, apomorphine, sildenafil and alprostadil, in medicines for erectile dysfunction has been developed. The samples were extracted with methanol using ultrasound-assisted extraction. The chromatographic separation was performed on a Zorbax Eclipse XDB-C18 column using acetonitrile-0.5% formic acid aqueous solution as mobile phase. The three compounds were identified by retention time and m/z and quantified by peak area. The results demonstrated that the linear ranges were 50.0 - 5 000.0 microg/L, 10.0 - 1 000.0 microg/L, 40.0 - 4 000.0 microg/L, with detection limits of 20.0, 4.0, 10.0 microg/L for apomorphine, sildenafil and alprostadil, respectively. The average recoveries and the relative standard deviations were 89% - 95% and 9.5% - 11%. The method is simple, rapid, accurate and suitable for the simultaneous determination of these drugs in medicines for erectile dysfunction. PMID:16498994

Xu, Yuanjin; Xu, Guiping

2005-11-01

180

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

PubMed

We evaluated penile prosthesis implantation with tunica albuginea-relaxing incisions without grafting in the treatment of Peyronie's disease associated with erectile dysfunction. Between April 2005 and June 2011, 62 patients underwent surgery due to severe Peyronie's disease associated with erectile dysfunction. Malleable and inflatable penile prostheses were inserted in 49 and 13 cases, respectively. Penile prostheses were inserted into the corpora cavernosa using the standard ventral approach. After lifting the neurovascular bundle, the tunica albuginea was incised and opened at the plaque region to correct the deformities and to lengthen the penis. Subsequently, the wide neurovascular bundle was replaced, and all incisions of the tunica albuginea were covered to prevent corporal grafting. In the median follow-up of 35 months (range 14-82 months), the penis was completely straightened in 59 (95%) patients. Numbness of the glans, which the patients found initially upsetting, decreased or disappeared spontaneously 3-6 months later. Penile prosthesis implantation with tunica albuginea incisions is a viable alternative in the treatment of Peyronie's disease because the extensive dissection of the neurovascular bundle allows a good approach to the plaque and provides excellent covering of the incised tunica albuginea without additional grafting. PMID:23435473

Djordjevic, Miroslav L; Kojovic, Vladimir

2013-05-01

181

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

182

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

183

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

PubMed Central

We evaluated penile prosthesis implantation with tunica albuginea-relaxing incisions without grafting in the treatment of Peyronie's disease associated with erectile dysfunction. Between April 2005 and June 2011, 62 patients underwent surgery due to severe Peyronie's disease associated with erectile dysfunction. Malleable and inflatable penile prostheses were inserted in 49 and 13 cases, respectively. Penile prostheses were inserted into the corpora cavernosa using the standard ventral approach. After lifting the neurovascular bundle, the tunica albuginea was incised and opened at the plaque region to correct the deformities and to lengthen the penis. Subsequently, the wide neurovascular bundle was replaced, and all incisions of the tunica albuginea were covered to prevent corporal grafting. In the median follow-up of 35 months (range 14–82 months), the penis was completely straightened in 59 (95%) patients. Numbness of the glans, which the patients found initially upsetting, decreased or disappeared spontaneously 3–6 months later. Penile prosthesis implantation with tunica albuginea incisions is a viable alternative in the treatment of Peyronie's disease because the extensive dissection of the neurovascular bundle allows a good approach to the plaque and provides excellent covering of the incised tunica albuginea without additional grafting. PMID:23435473

Djordjevic, Miroslav L; Kojovic, Vladimir

2013-01-01

184

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

185

Penile prosthesis implantation in Chinese patients with severe erectile dysfunction: 10-year experience  

PubMed Central

We retrospectively evaluated the clinical outcome of penile prosthesis implantation (PPI) in Chinese patients with severe erectile dysfunction (SED). From July 2000 to December 2011, 224 patients (mean age: 35.9±11.8 years, range: 20–75 years) with SED underwent PPI by experienced surgeon according to standard PPI procedure at our centre. A malleable prosthesis (AMS 650) was implanted in 45 cases (20.1%), and a three-piece inflatable prosthesis (AMS 700 CXM or AMS 700 CXR) was implanted in 179 cases (79.9%). Surgical outcomes, including postoperative complications, clinical efficacy and couple satisfaction, were evaluated over than 6 months postoperatively using medical record abstraction, IIEF-5, quality of life (QoL) scores, and the patient/partner sexual satisfaction score proposed by Bhojwani et al. Of the 224 patients eligible for the study, 201 subjects (89.7%) completed follow-up. All of patients could perform sexual intercourse post PPI with the mean postoperative IIEF-5 and QoL scores were 20.02±2.32 and 5.28±0.76, respectively, which were significantly improved compared with the preoperative scores (6.29±1.5 and 2.13±0.84, P<0.01). Of the 201 men, mechanical malfunction occurred in four cases (2.0%) and three cases were re-implanted new device, and two cases (1.0%) developed a mild curvature of the penis. Scrotal erosion with infection occurred in one case with diabetes mellitus (0.5%) and required complete removal of the implanted AMS 700 CXM. Satisfactory sexual intercourse at least twice per month was reported by 178 men (88.6%), and overall satisfaction with the PPI surgery was reported by 89.0% of men and 82.5% of partners. Patient satisfaction in the three-piece inflatable prosthesis group was higher than in the malleable prosthesis group (P<0.05). Satisfaction, however, between the types of prostheses, did not differ in the partner survey. PPI is a safe and effective treatment option for Chinese patients with SED and experienced surgeon perform PPI according to standard PPI procedure could reduce the postoperative complications of PPI and could improve patient satisfaction ratio and QoL. PMID:23872664

Song, Wei-Dong; Yuan, Yi-Ming; Cui, Wan-Shou; Wu, Alex K; Zhu, Yi-Chen; Liu, Jing; Wang, Lin; Bai, Guang-Yi; Peng, Jing; Zhang, Zhi-Chao; Gao, Bing; Guo, Ying-Lu; Lue, Tom F; Xin, Zhong-Cheng

2013-01-01

186

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

187

Why do patients with heart failure suffer from erectile dysfunction? A critical review and suggestions on how to approach this problem  

Microsoft Academic Search

Chronic heart failure (HF) is an increasingly common cardiovascular disorder. The goal of health-care providers is to optimize quality of life in this population, including sexual health. Up to 75% of patients with HF report erectile dysfunction (ED). As HF is a condition with distinct physiologic sequelae, some unique organic and psychological factors contributing to ED in this patient population

S Rastogi; J J Rodriguez; V Kapur; E R Schwarz

2005-01-01

188

The engineering analysis of bioheat equation and penile hemodynamic relationships in the diagnosis of erectile dysfunction: part II—model optimization using the ANOVA and Taguchi method  

Microsoft Academic Search

The authors aimed to study the skin surface bioheat perfusion model described in part I numerically. The influence of each constituent in the determination of surface temperature profile was statistically examined. The theoretically derived data will then be benchmarked with clinically measured data to develop the artificial intelligence system for the diagnosis of erectile dysfunction (ED). The new approach is

E Y K Ng; W K Ng; J Huang; Y K Tan; EYK Ng

2008-01-01

189

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

190

[TECAR therapy for Peyronie’s disease: a phase-one prospective study. Great evidence in patients with erectile dysfunction].  

PubMed

Our phase-one prospective study wants to evaluate the safety and tolerability of TECAR therapy in the treatment of Peyronie’s disease. From June 2011 to September 2012 we enrolled 70 patients. Each patient had been previously subjected to andrological examination, to a questionnaire for the evaluation of IPP and ED, and the SF-36 (V1) for the evaluation of the general state of health. The evaluation of pain was made using the VAS scale of pain. Every patient was subjected to TECAR treatment of the fibrotic plaque (both in resistive mode and in capacitive mode) for a total of three sessions carried out on consecutive days. We recorded a good compliance by patients; none of them reported side effects. Pain was decreased by the technique in 80% of the cases.The whole sample completed the study. Surprisingly enough those patients who complained also of erectile dysfunction, reported an improvement in sexual potency. PMID:23423676

Pavone, Carlo; Castrianni, Davide; Romeo, Salvatore; Napoli, Enrica; Usala, Manuela; Gambino, Giuseppa; Scaturro, Dalila; Letizia Mauro, Giulia

2013-01-01

191

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. PMID:25452706

Udeoji, Dioma U; Schwarz, Ernst R

2014-01-01

192

An LC-MS/MS method for the determination of five erectile dysfunction drugs and their selected metabolites in hair.  

PubMed

The abuse of sildenafil and its analogous, accelerated by their inappropriate or illegal distribution, is a serious social issue globally. However, no studies have been conducted to monitor these drugs simultaneously in hair, which can provide valuable information on chronic drug use. In the present study, an LC-MS/MS method was developed for the simultaneous determination in hair of five erectile dysfunction drugs having a high risk for abuse (mirodenafil, sildenafil, tadalafil, udenafil and vardenafil) and their selected metabolites (SK3541, desmethylsildenafil, DA8164 and desethylvardenafil). The novel method was fully validated after optimizing matrix effects and extraction efficiency. The optimized sample preparation included acidic methanol extraction followed by solid phase extraction using C18 mixed mode strong cation exchange polymeric cartridges. The prepared samples were analyzed by LC-MS/MS with electrospray ion source in the positive ionization mode. The validation results proved the method to be selective, sensitive, accurate and precise, with acceptable linearity within calibration ranges. LODs ranged from 0.05 (DA8164) to 1ng/10mg hair (tadalafil). LOQs were 1ng/10mg hair except for DA8164 and vardenafil, of which they were 2.5ng/10mg hair. No significant variations were observed by different sources of matrices in both human and rat hair, except for tadalafil, for which a stable isotope-labeled internal standard was effective. The animal study suggested hair pigmentation was a major factor for the incorporation of the drugs and metabolites into hair. However, a wide variation of the sildenafil-to-desmethylsildenafil ratios was observed in human hair samples. The developed method will be very useful for monitoring the abuse of erectile dysfunction drugs for both legal and public health aspects. PMID:25531864

Lee, Sooyeun; Choi, Boyeon; Kim, Jihyun; In, Sanghwan; Baeck, Seungkyung; Oh, Seung Min; Chung, Kyu Hyuck

2015-01-26

193

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

194

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

PubMed Central

Oxidative stress (OS) and production of NO, by endothelium nitric oxide synthetase (eNOS), are involved in the pathophysiology of erectile dysfunction (ED). Moreover, OS induces modifications of the physicochemical properties of erythrocyte (RBC) plasma membranes and of the enzyme content of the same membranes. Due to their role in signalling early membrane alterations in OS-related pathologies, several plasma membrane and cytosolic glycohydrolases of human RBC have been proposed as new markers of cellular OS. In RBC, NOS can be activated and deactivated by phosphorylation/glycosylation. In this regulatory mechanism O-?-N-AcetylGlucosaminidase is a key enzyme. Cellular levels of O-GlcNAcylated proteins are related to OS; consequently dysfunctional eNOS O-GlcNAcylation seems to have a crucial role in ED. To elucidate the possible association between RBC glycohydrolases and OS, plasma hydroperoxides and antioxidant total defenses (Lag-time), cytosolic O-?-N-AcetylGlucosaminidase, cytosolic and membrane Hexosaminidase, membrane ?-D-Glucuronidase, and ?-D-Glucosidase have been studied in 39 ED patients and 30 controls. In ED subjects hydroperoxides and plasma membrane glycohydrolases activities are significantly increased whereas Lag-time values and cytosolic glycohydrolases activities are significantly decreased. These data confirm the strong OS status in ED patients, the role of the studied glycohydrolases as early OS biomarker and suggest their possible use as specific marker of ED patients, particularly in those undergoing nutritional/pharmacological antioxidant therapy. PMID:25165407

Massaccesi, L.; Melzi d'Eril, G. V.; Colpi, G. M.; Tettamanti, G.; Goi, G.; Barassi, A.

2014-01-01

195

Pathophysiology of erectile dysfunction: the contributions of trabecular structure to function and the role of functional antagonism.  

PubMed

Erectile dysfunction (ED) is estimated to impact more than 150 million men this year worldwide. An understanding of the pathophysiology of ED both furthers the basic scientific knowledge of disease processes and provides a rational design of pharmacotherapy. At present, there are two major views regarding the pathophysiology of ED. In the first hypothesis, the oxygen tension-dependent changes in the penis during erection are proposed to impact corpus cavernosum structure by inducing various cytokines, vasoactive factors and growth factors at the two different oxygen tensions (flaccidity and erection) which, in turn, alter smooth muscle metabolism and connective tissue synthesis. Decreases in the corpus cavernosum smooth muscle/connective tissue ratio have been correlated with an increased likelihood of diffuse venous leak and a failure of the veno-occlusive mechanism in prospective patient studies. Evidence for such a hypothesis incorporates nocturnal penile tumescence and circadian changes in oxygenation as important in maintaining erectile health. The alternate hypothesis proposes that ED is the result of a metabolic imbalance between relaxatory and contractile processes within the trabecular smooth muscle such that contractile processes predominate. Based on this hypothesis, therapy can be accomplished via drugs which shift this balance towards vasodilatation, or by gene therapy approaches to supplement the deficient components favoring smooth muscle relaxation. Both of these hypotheses predict a management strategy for ED that impacts pharmacotherapeutics. In this review of the pathophysiology of ED, each hypothesis will be examined and a synthesis devised incorporating both views. The future of research in this area as well as pharmacotherapy in ED in terms of pathophysiology is discussed including the merits and drawbacks of prophylaxis and prevention of ED. International Journal of Impotence Research (2000) 12, Suppl 4, S39-S46. PMID:11035385

Moreland, R B

2000-10-01

196

A Rho-kinase inhibitor, soluble guanylate cyclase activator and nitric oxide-releasing PDE5 inhibitor: novel approaches to erectile dysfunction.  

PubMed

Approximately 50% of men aged over 40 suffer from male erectile dysfunction. Treatment options have widened since the launch of the phosphodiesterase type 5 (PDE5) inhibitor, sildenafil citrate (Viagra trade mark ). However, a certain portion of the patient population, such as diabetics, do not gain significant benefit from PDE5 inhibitors, possibly due to a lack of endogenous nitric oxide. Therefore, new treatment modalities based on the absence of endogenous nitric oxide have been developed. Among them are Rho-kinase inhibitors, soluble guanylate cyclase activators and nitric oxide-releasing PDE5 inhibitors. The available data concerning these compounds will be summarised and their therapeutic potential for male erectile dysfunction will be discussed. PMID:12437503

Cellek, Selim; Rees, Rowland W; Kalsi, Jas

2002-11-01

197

A double-blind, placebo-controlled, efficacy and safety study of topical gel formulation of 1% alprostadil (Topiglan) for the in-office treatment of erectile dysfunction  

Microsoft Academic Search

Objectives. To asses the efficacy and safety of Topiglan (1% alprostadil in a formulation with 5% SEPA [soft enhancer of percutaneous absorption]) or placebo gel (0.25 mL) applied to the glans penis only in 60 patients with moderate to severe erectile dysfunction in a two-visit, in-office clinical trial.Methods. During the first visit, open-label placebo gel was applied. At the second

Irwin Goldstein; Terry R Payton; Paul J Schechter

2001-01-01

198

Cardiovascular effects of sildenafil in hypertensive men with erectile dysfunction and different alleles of the type 5 cGMP-specific phosphodiesterase (PDE5)  

Microsoft Academic Search

Erectile dysfunction (ED) is frequent in patients with essential hypertension (EH); a likely common pathogenetic pathway could be a reduced ability of arteriolar vascular smooth muscle (VSM) to relax. Increasing intracellular levels of cGMP reduce the contractile status of VSM; on the contrary, type 5 cGMP-specific phosphodiesterase (PDE5, codified by PDE5A gene) regulates cGMP levels through its clearance. The PDE5A

F Salvi; R Sarzani; R Giorgi; G Donatelli; F Pietrucci; A Micheli; M Baldoni; D Minaroli; P Dessì-Fulgheri; M Polito; G Muzzonigro; A Rappelli

2004-01-01

199

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

200

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

201

Standard of care of erectile dysfunction in U.S. Air Force aircrew and active duty not on flying status.  

PubMed

In 2011, over 3,000 active duty U.S. Air Force (USAF) members were prescribed a phosphodiesterase inhibitor (PDEI). PDEIs are first-line therapy for treating erectile dysfunction and can have significant side effects that could impact aircrew performance. In total, 200 eligible subject records were randomly sampled from the active duty USAF population of those males filling a prescription for a PDEI in June 2011; 100 of those records were from aviators. The electronic records were reviewed and scored to determine if USAF aeromedical standards for prescribing PDEIs were followed, with a minimum score of 0 for no standards met and a maximum of 3 for all standards met. The average score for both groups was 1, with no significant difference between the group scores. A proper aeromedical disposition was documented in 67% of the aviator records. Although there was no significant difference in standard of care for aviators and nonaviators, the overall documented standard of care was poor. Lack of documentation was the primary reason for the low scores and the low percentage of properly rendered aeromedical dispositions. Proper medical record documentation is important for evaluating quality of care and ensuring compliance with regulations in an Air Force aviator population. PMID:25373059

Nast, Justin B

2014-11-01

202

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

203

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

204

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

PubMed

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

Ichim, Thomas E; Warbington, Timothy; Cristea, Octav; Chin, Joseph L; Patel, Amit N

2013-01-01

205

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

PubMed Central

Introduction We studied the possible correlation between age, testosterone deficiency, cavernosal fibrosis and erectile dysfunction (ED). Methods 47 patients with ED were enrolled between September 2010 and October 2011. IIEF-EF score, NPTR test using the Rigiscan method, total and free testosterone levels, and cavernosum biopsy were carried out on all patients. Patients aged 65 or over were defined as Old Age (OA) while patients under 65 were defined Young age (YA). The strength of the relationships found was estimated by Odds Ratio. Results 74% of patients with values of over 52% collagen fibers in the corpora cavernosa were found to have organic ED. A significant difference was found in age, percentage of collagen fibers, testosterone levels between patients with Positive Rigiscan (PR) and Negative Rigiscan (NR). Hypotestosteronaemia increased the risk of ED with PR (OR: 21.4, 95% CI: 20.2-22.6) and in both young age patients (OR: 4.3, 95% CI: 2.4-6.2) and old age patients (OR: 15.5, 95% CI: 13.4-17.6). Moreover cavernosal fibrosis increased the risk of ED with PR in both young age patients (OR: 8.2, 95% CI: 6.4-10.0 and old age patients (OR: 24.6, 95% CI: 20.8-28.4). Conclusions This study demonstrates a strong association among age, testosterone deficiency, cavernosal fibrosis and ED with PR. Age, testosterone deficiency and cavernosal fibrosis are potentially correctable factors of cavernosal fibrosis and organic ED. Further, prospective studies are needed to evaluate if testosterone treatment, alone or in association with PDE5 inhibitors, may lower the risk of cavernosal fibrosis or decrease the severity the fibrosis in ED patients. PMID:23173727

2012-01-01

206

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

207

Bladder outlet obstruction triggers neural plasticity in sensory pathways and contributes to impaired sensitivity in erectile dysfunction.  

PubMed

Lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are common problems in aging males worldwide. The objective of this work was to evaluate the effects of bladder neck nerve damage induced by partial bladder outlet obstruction (PBOO) on sensory innervation of the corpus cavernosum (CC) and CC smooth muscle (CCSM) using a rat model of PBOO induced by a partial ligation of the bladder neck. Retrograde labeling technique was used to label dorsal root ganglion (DRG) neurons that innervate the urinary bladder and CC. Contractility and relaxation of the CCSM was studied in vitro, and expression of nitric oxide synthase (NOS) was evaluated by Western blotting. Concentration of the sensory neuropeptides substance P (SP) and calcitonin gene-related peptide was measured by ELISA. Partial obstruction of the bladder neck caused a significant hypertrophy of the urinary bladders (2.5-fold increase at 2 wk). Analysis of L6-S2 DRG sections determined that sensory ganglia received input from both the urinary bladder and CC with 5-7% of all neurons double labeled from both organs. The contractile responses of CC muscle strips to KCl and phenylephrine were decreased after PBOO, followed by a reduced relaxation response to nitroprusside. A significant decrease in neuronal NOS expression, but not in endothelial NOS or protein kinase G (PKG-1), was detected in the CCSM of the obstructed animals. Additionally, PBOO caused some impairment to sensory nerves as evidenced by a fivefold downregulation of SP in the CC (P ? 0.001). Our results provide evidence that PBOO leads to the impairment of bladder neck afferent innervation followed by a decrease in CCSM relaxation, downregulation of nNOS expression, and reduced content of sensory neuropeptides in the CC smooth muscle. These results suggest that nerve damage in PBOO may contribute to LUTS-ED comorbidity and trigger secondary changes in the contraction/relaxation mechanisms of CCSM. PMID:23535456

Malykhina, Anna P; Lei, Qi; Chang, Shaohua; Pan, Xiao-Qing; Villamor, Antonio N; Smith, Ariana L; Seftel, Allen D

2013-05-15

208

Erectile dysfunction in hypertensive rats results from impairment of the relaxation evoked by neurogenic carbon monoxide and nitric oxide.  

PubMed

Erectile dysfunction (ED) with aging and diabetes mellitus is caused by impairment of the relaxation evoked by nitric oxide (NO) of penile cavernous smooth muscles and arterioles. However, the mechanism of ED in hypertension is unknown. Carbon monoxide (CO), which is produced by heme oxygenase (HO)-2 in the neuronal system is a neurotransmitter and a vasodilator. We examined the neurogenic role of CO in penile erection and the neurogenic mechanisms of ED in hypertension, using spontaneously hypertensive rats (SHR) or Wistar-Kyoto rats (WKY). The isometric tension of corpus cavernosum tissues from both strains was recorded after guanethidine and atropine treatment. Relaxation in response to electrical field stimulation (EFS) in WKY was suppressed dose-dependently by HO inhibitors both in the absence and presence of an NO synthase (NOS) inhibitor. Reverse transcription-polymerase chain reaction (RT-PCR) showed that the HO-2 gene was expressed in the corpus cavernosum. CO-saturated solution induced a concentration-dependent relaxation in WKY. The neurogenic relaxation to EFS in SHR was impaired as compared with that in WKY after the age of 5 weeks, when blood pressure began to be elevated, due to the attenuated relaxation in response to neurogenic NO and CO. In the corpus cavernosum of SHR, expression of the HO-2 and nNOS genes was similar, and NOx levels after EFS were similar to those of WKY. cGMP levels after EFS and the relaxation evoked by the NO donor was lower in SHR than WKY. Thiobarbituric acid-reacting substance (TBARS) levels were increased, and superoxide dismutase (SOD) activity was suppressed in SHR, as compared with those in WKY, suggesting that the increasing oxidative stress partially causes the impairment of NO-dependent relaxation. These findings suggest that CO regulates the relaxation evoked by EFS in the rat corpus cavernosum, and that ED in hypertension in rats results from an impairment of the relaxation induced by neurogenic CO and NO. PMID:15127883

Ushiyama, Masayuki; Morita, Toshisuke; Kuramochi, Tomoya; Yagi, Shinji; Katayama, Shigehiro

2004-04-01

209

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

PubMed

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

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

2014-01-01

210

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

PubMed Central

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

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

2014-01-01

211

Development of UK guidance on the management of erectile dysfunction resulting from radical radiotherapy and androgen deprivation therapy for prostate cancer  

PubMed Central

Aim To develop a management strategy (rehabilitation programme) for erectile dysfunction (ED) after radiotherapy (RT) or androgen deprivation therapy (ADT) for prostate cancer that is suitable for use in a UK NHS healthcare context. Methods PubMed literature searches of ED management in this patient group together with a survey of 28 experts in the management of treatment-induced ED from across the UK were conducted. Results Data from 19 articles and completed questionnaires were collated. The findings discussed in this article confirm that RT/ADT for prostate cancer can significantly impair erectile function. While many men achieve erections through PDE5-I use, others need combined management incorporating exercise and lifestyle modifications, psychosexual counselling and other erectile aids. This article offers a comprehensive treatment algorithm to manage patients with ED associated with RT/ADT. Conclusion Based on published research literature and survey analysis, recommendations are proposed for the standardisation of management strategies employed for ED after RT/ADT. In addition to implementing the algorithm, understanding the rationale for the type and timing of ED management strategies is crucial for clinicians, men and their partners. PMID:25283500

White, I D; Wilson, J; Aslet, P; Baxter, A B; Birtle, A; Challacombe, B; Coe, J; Grover, L; Payne, H; Russell, S; Sangar, V; Van As, N; Kirby, M

2015-01-01

212

New advances in erectile technology  

PubMed Central

New discoveries and technological advances in medicine are rapid. The role of technology in the treatment of erectile dysfunction (ED) will be widened and more options will be available in the years to come. These erectile technologies include external penile support devices, penile vibrators, low intensity extracorporeal shockwave, tissue engineering, nanotechnology and endovascular technology. Even for matured treatment modalities for ED, such as vacuum erectile devices and penile implants, there is new scientific information and novel technology available to improve their usage and to stimulate new ideas. We anticipate that erectile technologies may revolutionize ED treatment and in the very near future ED may become a curable condition. PMID:24489605

Stein, Marshall J.; Lin, Haocheng

2014-01-01

213

Advances in the Management of Post-Radical Prostatectomy Erectile Dysfunction: Treatment Strategies When PDE-5 Inhibitors Don’t Work  

PubMed Central

Phosphodiesterase type-5 (PDE-5) inhibitors have revolutionized the treatment of post-radical prostatectomy erectile dysfunction. For those patients who undergo a non-nerve-sparing radical prostatectomy or whose condition fails to respond to PDE-5 inhibitors, alternative treatment with intracavernous injection therapy, transurethral alprostadil, vacuum erection devices, and recently described combination therapy is available. The goals of therapy are to provide the patient with a means of obtaining an erection so that the patient and his partner may resume sexual relations as soon as possible following radical prostatectomy. There is evidence that early institution of treatment may promote improvement in the return of spontaneous erections in patients who have undergone nerve preservation. In patients who undergo non-nerve-sparing procedures, therapy may improve penile rigidity. Intracavernous injection therapy, transurethral alprostadil, and vacuum devices are highly effective in the management of post-prostatectomy erectile dysfunction. High dropout rates, which are not related to adverse effects, have been described with all 3 modalities. Pre- and postoperative counseling may improve patient and partner satisfaction. PMID:16985897

Kava, Bruce R

2005-01-01

214

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

PubMed Central

Introduction There has been an increase in the prevalence of erectile dysfunction (ED) in the general population especially among Diabetic patients. This seems to be neglected problem in low-income countries. This study aims at establishing the prevalence of ED and associated risk factors in diabetic patients attended at Diabetic Clinic at Muhimbili National Hospital. Methods A cross-sectional hospital based study was conducted among 312 diabetic patients attending diabetic clinic at Muhimbili National Hospital between May and December 2011. Results More than half (55.1%) of the patients were found to have some form of ED (12.8% had mild dysfunction, 11.5% moderate and 27.9% severe dysfunction). The severity of ED was correlated with increased age. Multivariate logistic regression revealed that ED was significantly predicted by old age (odds ratio (OR) = 7.1, 95% CI 1.2-40.7), evidence of peripheral neuropathy (OR) =5.9, 95% CI 1.6-21.3), and evidence of peripheral vascular disease (OR =2.5, 95% CI 1.2-5.3). Also longer duration of DM was marginally associated with ED (p=0.056). Patients with ED were also more likely to suffer other sexual domains (p<0.001). No lifestyle factor was associated with ED. Conclusion The prevalence of ED is high among DM patients. Interventions aimed at prevention, early diagnosis and detection of DM and its complications, and adherence to treatment to prevent complications should be implemented. Further studies should emphasize on temporal variation to show true causality of DM on erectile dysfunction. PMID:25170371

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

2014-01-01

215

Hemodiyaliz tedavisi uygulanan non-diyabetik hastalarda erektil ve cinsel fonksiyon bozuklu?u için risk faktörleri Risk factors associated with erectile and sexual dysfunction among non-diabetic hemodialysis patients  

Microsoft Academic Search

Objective: Erectile dysfunction (ED) is a commonly encoun- tered complaint among chronic renal failure (CRF) patients. Uremia, psychogenic factors, neuroendocrinologic distur- bances, and atherosclerosis are known etiologic factors that lead to ED in CRF patients. The purpose of the current pro- spective study was to evaluate clinical properties and labora- tory findings that are associated with ED in non-diabetic CRF

Ömer Demir; Ahmet Cihan; Mustafa Seçil; Ali Çelik; Tevfik Demir; Abdurrahman Çömlekçi; A. Adil Esen

216

Erectile dysfunction in a Mediterranean country: results of an epidemiological survey of a representative sample of men  

Microsoft Academic Search

The purpose of this study was to determine the prevalence of ED and its health-related correlates in a nonselected population from a Mediterranean country. The abridged 5-item version of the international index of erectile function (IIEF-5) was used as a diagnostic tool. A total of 905 men aged 18 years and above from Jordan were included in the study and

I F Ghalayini; M A Al-Ghazo; R Al-Azab; I Bani-Hani; Y S Matani; A-E Barham; M N A Harfeil; Y Haddad

2010-01-01

217

Erectile Dysfunction (ED)  

MedlinePLUS

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218

An open-label, multicenter, randomized, crossover study comparing sildenafil citrate and tadalafil for treating erectile dysfunction in Chinese men naïve to phosphodiesterase 5 inhibitor therapy.  

PubMed

The study was to compare treatment preference, efficacy, and tolerability of sildenafil citrate (sildenafil) and tadalafil for treating erectile dysfunction (ED) in Chinese men na?ve to phosphodiesterase 5 (PDE5) inhibitor therapies. This multicenter, randomized, open-label, crossover study evaluated whether Chinese men with ED preferred 20-mg tadalafil or 100-mg sildenafil. After a 4 weeks baseline assessment, 383 eligible patients were randomized to sequential 20-mg tadalafil per 100-mg sildenafil or vice versa for 8 weeks respectively and then chose which treatment they preferred to take during the 8 weeks extension. Primary efficacy was measured by Question 1 of the PDE5 Inhibitor Treatment Preference Questionnaire (PITPQ). Secondary efficacy was analyzed by PITPQ Question 2, the International Index of Erectile Function (IIEF) erectile function (EF) domain, sexual encounter profile (SEP) Questions 2 and 3, and the Drug Attributes Questionnaire. Three hundred and fifty men (91%) completed the randomized treatment phase. Two hundred and forty-two per 350 (69.1%) patients preferred 20-mg tadalafil, and 108/350 (30.9%) preferred 100-mg sildenafil (P < 0.001) as their treatment in the 8 weeks extension. Ninety-two per 242 (38%) patients strongly preferred tadalafil and 37/108 (34.3%) strongly the preferred sildenafil. The SEP2 (penetration), SEP3 (successful intercourse), and IIEF-EF domain scores were improved in both tadalafil and sildenafil treatment groups. For patients who preferred tadalafil, getting an erection long after taking the medication was the most reported reason for tadalafil preference. The only treatment-emergent adverse event reported by > 2% of men was headache. After tadalafil and sildenafil treatments, more Chinese men with ED na?ve to PDE5 inhibitor preferred tadalafil. Both sildenafil and tadalafil treatments were effective and safe. PMID:25370206

Bai, Wen-Jun; Li, Hong-Jun; Dai, Yu-Tian; He, Xue-You; Huang, Yi-Ran; Liu, Ji-Hong; Sorsaburu, Sebastian; Ji, Chen; Jin, Jian-Jun; Wang, Xiao-Feng

2015-01-01

219

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

PubMed

We compared the efficacy and safety between once-daily dosing and on-demand use of udenafil for type 2 diabetic patients with erectile dysfunction (ED). A multi-center, randomized, open-label, parallel-group, 12-week study was conducted. 161 patients who improved with on-demand 200 mg of udenafil according to Sexual Encounter Profile (SEP) diary Question 2 and 3 (Q2 and Q3) were randomized into 200 mg on-demand (n = 80) or 50 mg once-daily (n = 81) dosing groups for 8 weeks. The dosing period was followed by a 4-week treatment-free period. The primary efficacy endpoint was the change of the International Index of Erectile Function (IIEF) erectile function domain (EFD) score. The secondary efficacy endpoints included changes to the SEP diary Q2, Q3, IIEF Q3, Q4, other domains of IIEF, Global Assessment Question, and shift to the normal rate (EFD ? 26). Vascular endothelial markers were also assessed. The IIEF-EFD score of both groups improved after 8 weeks of treatment (P < 0.0001). There was no statistically significant difference between two groups. Improvement was not maintained after the treatment-free follow-up period. Similar results were observed in the secondary efficacy endpoints. There was also no significant difference in vascular endothelial markers. Daily udenafil was well-tolerated, and there was no significant difference in the adverse drug reactions and adverse events between the two groups. Flushing and headache were the most frequent adverse events. Both regimens improved ED in diabetic patients and were well-tolerated. Further studies are needed to assess the effect of daily udenafil treatment in diabetic patients. PMID:25155105

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

2015-01-01

220

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

PubMed Central

Diabetes-induced oxidative stress plays a critical role in the mobilisation of endothelial progenitor cells (EPCs) from the bone marrow to the circulation. This study was designed to explore the effects of chronic melatonin administration on the promotion of the mobilisation of EPCs and on the preservation of erectile function in type I diabetic rats. Melatonin was administered to streptozotocin-induced type I diabetic rats. EPCs levels were determined using flow cytometry. Oxidative stress in the bone marrow was indicated by the levels of superoxide dismutase and malondialdehyde. Erectile function was evaluated by measuring the intracavernous pressure during an electrostimulation of the cavernous nerve. The density of the endothelium and the proportions of smooth muscle and collagen in the corpus cavernosum were determined by immunohistochemistry. The administration of melatonin increased the superoxide dismutase level and decreased the malondialdehyde level in the bone marrow. This effect was accompanied by an increased level of circulating EPCs in the diabetic rats. The intracavernous pressure to mean arterial pressure ratio of the rats in the treatment group was significantly greater, compared with diabetic control rats. The histological analysis demonstrated an increase in the endothelial density of the corpus cavernosum after the administration of melatonin. However, melatonin treatment did not change the proportions of smooth muscle and collagen in the corpus cavernosum of diabetic rats. Chronic administration of melatonin has a beneficial effect on preventing erectile dysfunction (ED) in type I diabetic rats. Promoting the mobilisation of EPCs is one of the possible mechanisms involved in the improvement of ED. PMID:22367180

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

2012-01-01

221

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

PubMed

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

Liu, Guihua; Sun, Xiangzhou; Bian, Jun; Wu, Rongpei; Guan, Xuan; Ouyang, Bin; Huang, Yanping; Xiao, Haipeng; Luo, Daosheng; Atala, Anthony; Zhang, Yuanyuan; Deng, Chunhua

2013-01-01

222

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

223

An open-label, multicenter, randomized, crossover study comparing sildenafil citrate and tadalafil for treating erectile dysfunction in Chinese men naïve to phosphodiesterase 5 inhibitor therapy  

PubMed Central

The study was to compare treatment preference, efficacy, and tolerability of sildenafil citrate (sildenafil) and tadalafil for treating erectile dysfunction (ED) in Chinese men naïve to phosphodiesterase 5 (PDE5) inhibitor therapies. This multicenter, randomized, open-label, crossover study evaluated whether Chinese men with ED preferred 20-mg tadalafil or 100-mg sildenafil. After a 4 weeks baseline assessment, 383 eligible patients were randomized to sequential 20-mg tadalafil per 100-mg sildenafil or vice versa for 8 weeks respectively and then chose which treatment they preferred to take during the 8 weeks extension. Primary efficacy was measured by Question 1 of the PDE5 Inhibitor Treatment Preference Questionnaire (PITPQ). Secondary efficacy was analyzed by PITPQ Question 2, the International Index of Erectile Function (IIEF) erectile function (EF) domain, sexual encounter profile (SEP) Questions 2 and 3, and the Drug Attributes Questionnaire. Three hundred and fifty men (91%) completed the randomized treatment phase. Two hundred and forty-two per 350 (69.1%) patients preferred 20-mg tadalafil, and 108/350 (30.9%) preferred 100-mg sildenafil (P < 0.001) as their treatment in the 8 weeks extension. Ninety-two per 242 (38%) patients strongly preferred tadalafil and 37/108 (34.3%) strongly the preferred sildenafil. The SEP2 (penetration), SEP3 (successful intercourse), and IIEF-EF domain scores were improved in both tadalafil and sildenafil treatment groups. For patients who preferred tadalafil, getting an erection long after taking the medication was the most reported reason for tadalafil preference. The only treatment-emergent adverse event reported by > 2% of men was headache. After tadalafil and sildenafil treatments, more Chinese men with ED naïve to PDE5 inhibitor preferred tadalafil. Both sildenafil and tadalafil treatments were effective and safe. PMID:25370206

Bai, Wen-Jun; Li, Hong-Jun; Dai, Yu-Tian; He, Xue-You; Huang, Yi-Ran; Liu, Ji-Hong; Sorsaburu, Sebastian; Ji, Chen; Jin, Jian-Jun; Wang, Xiao-Feng

2015-01-01

224

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

PubMed Central

We compared the efficacy and safety between once-daily dosing and on-demand use of udenafil for type 2 diabetic patients with erectile dysfunction (ED). A multi-center, randomized, open-label, parallel-group, 12-week study was conducted. 161 patients who improved with on-demand 200 mg of udenafil according to Sexual Encounter Profile (SEP) diary Question 2 and 3 (Q2 and Q3) were randomized into 200 mg on-demand (n = 80) or 50 mg once-daily (n = 81) dosing groups for 8 weeks. The dosing period was followed by a 4-week treatment-free period. The primary efficacy endpoint was the change of the International Index of Erectile Function (IIEF) erectile function domain (EFD) score. The secondary efficacy endpoints included changes to the SEP diary Q2, Q3, IIEF Q3, Q4, other domains of IIEF, Global Assessment Question, and shift to the normal rate (EFD ? 26). Vascular endothelial markers were also assessed. The IIEF-EFD score of both groups improved after 8 weeks of treatment (P < 0.0001). There was no statistically significant difference between two groups. Improvement was not maintained after the treatment-free follow-up period. Similar results were observed in the secondary efficacy endpoints. There was also no significant difference in vascular endothelial markers. Daily udenafil was well-tolerated, and there was no significant difference in the adverse drug reactions and adverse events between the two groups. Flushing and headache were the most frequent adverse events. Both regimens improved ED in diabetic patients and were well-tolerated. Further studies are needed to assess the effect of daily udenafil treatment in diabetic patients. PMID:25155105

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

2015-01-01

225

Effects of intracavernous injection of P2X3 and NK1 receptor antagonists on erectile dysfunction induced by spinal cord transection in rats.  

PubMed

This study aimed to explore the effects of intracavernous injection (ICI) of P2X3 and NK1 receptor antagonists on erectile dysfunction (ED) induced by spinal cord transection in rats. Sixty male Sprague-Dawley (SD) rats were randomly divided into the following three groups (20 rats each group): sham operation group (C group), thoracic spinal cord transection group (T group) and sacral spinal cord transection group (S group). An ED model was established through complete transection of the thoracic or sacral spinal cord. Intracavernous pressure (ICP) with and without injection of P2X3 (Suramin) or NK1 (GR82334) receptor antagonists was recorded 3 weeks after surgery. Immunohistochemistry was employed to detect the expression of P2X3 and NK1 receptors in the dorsal root ganglion (DRG) and smooth muscle of corpus cavernosum. Data were processed with SPSS 17.0. ICI with Suramin (0.1, 0.3 and 1 mm) or GR82334 (0.1, 0.3 and 1 mm) increased ICP dose dependently in the T and S groups. The expression of P2X3 and NK1 receptors in DRG and smooth muscle of corpus cavernosum was up-regulated in the T and S groups. It is concluded that ICI of P2X3 and NK1 receptor antagonists may improve the recovery of erectile function in a rat model with ED after spinal cord transection. PMID:24387161

Li, C-L; Yang, X-L; Wang, J-J; Du, G-H; Yang, W-M; Zhang, H-P

2015-02-01

226

Comparative efficacy of tadalafil once daily in men with erectile dysfunction who demonstrated previous partial responses to as-needed sildenafil, tadalafil, or vardenafil.  

PubMed

Abstract Objective: Phosphodiesterase type-5 inhibitors (PDE5Is) are first-line therapies for erectile dysfunction (ED). Sildenafil (SIL) and vardenafil (VAR) are approved for as-needed (PRN) dosing; tadalafil (TAD) is approved for both PRN and once-a-day (OaD) dosing for ED. Recent evidence suggests that TAD-OaD may be effective as therapy in men with an incomplete response to PRN-PDE5I therapy. This study evaluated whether TAD-OaD provides similar efficacy in men with ED who had previously demonstrated a partial response to PRN-PDE5I therapy. Research design and methods: In this randomized, double-blind, placebo-controlled trial, men with a ?3 month ED history received SIL 100?mg, TAD 20?mg, or VAR 20?mg during a 4 week open-label lead-in period. Those with International Index of Erectile Function - Erectile Function (IIEF-EF) domain scores <26 following lead-in treatment completed a 4 week washout period, then randomized to TAD 2.5?mg up-titrated to 5?mg, TAD 5?mg, or placebo (PBO) OaD for 12 weeks. Main outcome measures obtained from patients treated with TAD-OaD were compared to PBO-treated patients. Additionally, results of treatment with TAD-OaD were compared to results obtained from 4 week PRN-PDE5I therapy to determine whether OaD and PRN regimens provided comparable efficacy. Clinical trial registration: NCT01130532. Main outcome measures: International Index of Erectile Function (IIEF) domain scores; Sexual Encounter Profile (SEP) questions 2-5. Results: Endpoint data was obtained from 590 men (391 TAD; 199 PBO). Results for all IIEF and SEP measures were significantly better for TAD-OaD (p?

Kim, Edward; Seftel, Allen; Goldfischer, Evan; Baygani, Simin; Burns, Patrick

2014-12-01

227

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

228

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

PubMed Central

A strong and independent association between lower urinary tract symptoms suggestive of benign prostatic hyperplasia (LUTS/BPH) and erectile dysfunction (ED) has been widely evidenced in several clinical epidemiologic studies. Preclinical animal models have provided a great deal of information on potential common pathogenic mechanisms underlying these two clinical identities. Although the efficacy of the most commonly used treatments for LUTS/BPH is well defined, the negative impact of these treatments on sexual function – in particular, on ED – has triggered the search for new treatment options. In this regard, a new role for phosphodiesterase type 5 inhibitors in the treatment of LUTS/BPH and ED has been claimed. Tadalafil is one of the most extensively investigated phosphodiesterase type 5 inhibitors for this new indication. All evidence reported to date suggests that tadalafil 5 mg once daily is a safe and effective treatment option for both LUTS/BPH and ED. PMID:24400241

Gacci, Mauro; Salvi, Matteo; Sebastianelli, Arcangelo; Vignozzi, Linda; Corona, Giovanni; McVary, Kevin T; Kaplan, Steven A; Maggi, Mario; Carini, Marco; Oelke, Matthias

2013-01-01

229

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

230

Implications for Differentiation of Endogenous Stem Cells: Therapeutic Effect from Icariside II on a Rat Model of Postprostatectomy Erectile Dysfunction.  

PubMed

Self-renewal and differentiation of endogenous stem cells (SCs) are essential for adult tissue homoeostasis and intrinsic healing capacity. In this study, we hypothesize that penis contains a small population of endogenous SCs, which might help rejuvenation of damaged erectile function. In this study, 60 newborn male rats were intraperitoneally injected with 5-ethynyl-2-deoxyuridine (EdU; 50?mg/kg) for the purpose of tracking endogenous SCs. Twelve weeks later, 48 rats underwent bilateral cavernous nerves injury and were randomized into gavage feeding of solvent (vehicle group) or icariside II (0.5, 1.5, and 4.5?mg/kg/day, respectively). Twelve sham-operated rats received vehicle treatment and served as control. The treatments were continued for 4 weeks followed by a washout period of 72?h. Results showed that ICA II treatment significantly restored erectile function and effectively prevented distortion of normal neural anatomy, smooth muscle atrophy, and collagen deposition compared with the vehicle group. The numbers of label-retaining cells (LRCs) coexpressing EdU and differentiated phenotypes (smooth muscle marker ?-SMA or Schwann cell marker S100) were significantly higher in the three ICA II-treated groups than those in vehicle group in a dose-dependent manner. In addition, the changing trend of p38 mitogen-activated protein kinase (MAPK) activity in the penis between groups was same as that of the number of differentiated LRCs. Together, these results suggest that the underlying mechanisms of ICA II in ameliorating erectile function and pathological changes appear to involve enhanced endogenous SCs differentiation, which might be regulated by p38 MAPK signaling pathway. PMID:25365340

Xu, Yongde; Guan, Ruili; Lei, Hongen; Gao, Zhezhu; Li, Huixi; Hui, Yu; Zhou, Feng; Wang, Lin; Lin, Guiting; Xin, Zhongcheng

2014-11-01

231

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

232

Erectile Dysfunction in Young Non-Obese Type II Diabetic Goto-Kakizaki Rats is Associated with Decreased eNOS Phosphorylation at Ser1177  

PubMed Central

Introduction Diabetes mellitus (DM) is a risk factor for erectile dysfunction (ED). Although type 2 DM is responsible for 90–95% diabetes cases, type 1 DM experimental models are commonly used to study diabetes-associated ED. Aim Goto-Kakizaki (GK) rat model is relevant to ED studies since the great majority of patients with type 2 diabetes display mild deficits in glucose-stimulated insulin secretion, insulin resistance, and hyperglycemia. We hypothesized that GK rats display ED which is associated with decreased nitric oxide (NO) bioavailability. Methods Wistar and GK rats were used at 10 and 18 weeks of age. Changes in the ratio of intracavernosal pressure/mean arterial pressure (ICP/MAP) after electrical stimulation of cavernosal nerve were determined in vivo. Cavernosal contractility was induced by electrical field stimulation (EFS) and phenylephrine (PE). In addition, nonadrenergic-noncholinergic (NANC)- and sodium nitroprusside (SNP)-induced relaxation were determined. Cavernosal neuronal nitric oxide synthase (nNOS) and endothelial nitric oxide synthase (eNOS) mRNA and protein expression were also measured. Main Outcome Measure GK diabetic rats display ED associated with decreased cavernosal expression of eNOS protein. Results GK rats at 10 and 18 weeks demonstrated impaired erectile function represented by decreased ICP/MAP responses. Ten-week-old GK animals displayed increased PE responses and no changes in EFS-induced contraction. Conversely, contractile responses to EFS and PE were decreased in cavernosal tissue from GK rats at 18 weeks of age. Moreover, GK rats at 18 weeks of age displayed increased NANC-mediated relaxation, but not to SNP. In addition, ED was associated with decreased eNOS protein expression at both ages. Conclusion Although GK rats display ED, they exhibit changes in cavernosal reactivity that would facilitate erectile responses. These results are in contrast to those described in other experimental diabetes models. This may be due to compensatory mechanisms in cavernosal tissue to overcome restricted pre-penile arterial blood supply or impaired veno-occlusive mechanisms. PMID:20807325

Carneiro, Fernando S.; Giachini, Fernanda R.C.; Carneiro, Zidonia N.; Lima, Victor V.; Ergul, Adviye; Webb, R. Clinton; Tostes, Rita C.

2011-01-01

233

Adipose tissue-derived stem cell therapy for prevention and treatment of erectile dysfunction in a rat model of Peyronie's disease.  

PubMed

Peyronie's disease (PD) is a localized connective tissue disorder that involves the tunica albuginea (TA) of the penis. While surgical correction remains the gold standard, the search for an effective and less invasive therapy continues. The objective of this study was to evaluate the effects of intratunical injection of adipose tissue-derived stem cells (ADSCs) for the prevention and treatment of erectile dysfunction in a rat model of PD. Twenty-four male Sprague-Dawley rats (300-350 g) were randomly divided into four groups: sham, PD, PD + ADSC (prevention) and PD + ADSC (treatment). All rats underwent penile injections into the TA with 50 ?L vehicle (sham) or 0.5 ?g transforming growth factor (TGF)-?1 (remaining groups). The ADSC groups received intratunical injections with 0.5 million rat-labelled ADSCs on day 0 (prevention) or day 30 (treatment). Forty-five days following TGF-?1 injection, rats underwent cavernous nerve stimulation (CNS) with total intracavernous-to-mean arterial pressure ratio (ICP/MAP) and total ICP recorded to measure response to therapy. Tissues were evaluated histologically and for mRNA expression of tissue inhibitors of metalloproteinases (TIMPs), matrix metalloproteinases (MMPs) and zymographic activity of MMPs. Statistical analysis was performed by analysis of variance followed by the Tukey test for post hoc comparisons. In both prevention and treatment groups, intratunical injection of ADSCs resulted in significantly higher ICP/MAP and total ICP in response to CNS compared with the PD group. Local injection of ADSCs prevented and/or reduced Peyronie's-like changes by decreasing the expression of TIMPs, and stimulating expression and activity of MMPs. This study documents the preventive and therapeutic benefits of ADSC on penile fibrosis and erectile function in an animal model of PD. PMID:24574095

Gokce, A; Abd Elmageed, Z Y; Lasker, G F; Bouljihad, M; Kim, H; Trost, L W; Kadowitz, P J; Abdel-Mageed, A B; Sikka, S C; Hellstrom, W J

2014-03-01

234

A double blind, placebo controlled study of intracavernosal vasoactive intestinal polypeptide and phenotolamine mesylate in a novel auto-injector for the treatment of non-psychogenic erectile dysfunction  

Microsoft Academic Search

Three hundred and four patients with non-psychogenic erectile dysfunction (ED) completed a dose assessment phase with intracavernosal injection utilizing 25 µg vasoactive intestinal polypeptide (VIP) combined with phentolamine mesylate 1.0 mg (VIP\\/P-1) or 2.0 mg (VIP\\/P-2) in an auto-injector for a response rate of 83.9%. In a sub-group of 183 patients who withdrew from one or more previous ED therapies,

D Sandhu; E Curless; J Dean; G Hackett; S Liu; D Savage; R Oakes; G Frentz

1999-01-01

235

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

236

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

237

Vasculogenic Cytokines in Wound Healing  

PubMed Central

Chronic wounds represent a growing healthcare burden that particularly afflicts aged, diabetic, vasculopathic, and obese patients. Studies have shown that nonhealing wounds are characterized by dysregulated cytokine networks that impair blood vessel formation. Two distinct forms of neovascularization have been described: vasculogenesis (driven by bone-marrow-derived circulating endothelial progenitor cells) and angiogenesis (local endothelial cell sprouting from existing vasculature). Researchers have traditionally focused on angiogenesis but defects in vasculogenesis are increasingly recognized to impact diseases including wound healing. A more comprehensive understanding of vasculogenic cytokine networks may facilitate the development of novel strategies to treat recalcitrant wounds. Further, the clinical success of endothelial progenitor cell-based therapies will depend not only on the delivery of the cells themselves but also on the appropriate cytokine milieu to promote tissue regeneration. This paper will highlight major cytokines involved in vasculogenesis within the context of cutaneous wound healing. PMID:23555076

Crawford, Jeffrey D.

2013-01-01

238

Clinical significance of erectile dysfunction developing after acute coronary event: exception to the rule or confirmation of the artery size hypothesis?  

PubMed Central

Erectile dysfunction (ED) has been found to frequently precedes the onset of coronary artery disease (CAD), representing an early marker of subclinical vascular disease, included CAD. Its recognition is, therefore, a “window opportunity” to prevent a coronary event by aggressive treatment of cardiovascular risk factors. The artery size hypothesis (ASH) has been proposed as a putative mechanism to explain the relationship between ED and CAD. Since atherosclerosis is a systemic disorder all major vascular beds should be affected to the same extent. However, symptoms at different points in the system rarely become evident at the same time. This is likely the result of smaller vessels (i.e. the penile artery) being able to less well tolerate the same amount of plaque when compared with larger ones (i.e. the coronary artery). If true, ED will develop before CAD. We present a case in which ED developed after a coronary event yet before a coronary recurrence potentially representing a late marker of vascular progression. Reasons for this unusual sequence are discussed as they might still fit the ASH. PMID:25337840

Montorsi, Piero; Ravagnani, Paolo M; Vlachopoulos, Charalambos

2015-01-01

239

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

240

Clinical significance of erectile dysfunction developing after acute coronary event: exception to the rule or confirmation of the artery size hypothesis?  

PubMed

Erectile dysfunction (ED) has been found to frequently precedes the onset of coronary artery disease (CAD), representing an early marker of subclinical vascular disease, included CAD. Its recognition is, therefore, a "window opportunity" to prevent a coronary event by aggressive treatment of cardiovascular risk factors. The artery size hypothesis (ASH) has been proposed as a putative mechanism to explain the relationship between ED and CAD. Since atherosclerosis is a systemic disorder all major vascular beds should be affected to the same extent. However, symptoms at different points in the system rarely become evident at the same time. This is likely the result of smaller vessels (i.e. the penile artery) being able to less well tolerate the same amount of plaque when compared with larger ones (i.e. the coronary artery). If true, ED will develop before CAD. We present a case in which ED developed after a coronary event yet before a coronary recurrence potentially representing a late marker of vascular progression. Reasons for this unusual sequence are discussed as they might still fit the ASH. PMID:25337840

Montorsi, Piero; Ravagnani, Paolo M; Vlachopoulos, Charalambos

2015-01-01

241

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

242

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

243

The engineering analysis of bioheat equation and penile hemodynamic relationships in the diagnosis of erectile dysfunction: part II-model optimization using the ANOVA and Taguchi method.  

PubMed

The authors aimed to study the skin surface bioheat perfusion model described in part I numerically. The influence of each constituent in the determination of surface temperature profile was statistically examined. The theoretically derived data will then be benchmarked with clinically measured data to develop the artificial intelligence system for the diagnosis of erectile dysfunction (ED). The new approach is based on the hypothesis that there exists a constitutive relationship between surface temperature profiles and the etiology of ED. By considering the penis model as a group of reservoirs with irregular cavities, we built a numerical model, simplified to save computational costs while still realistically able to represent the actual for partial differential calculation. Incompressible blood flow was assumed coupled with the classical bioheat transfer equation which was solved using the finite element method. Isotropic homogeneous heat diffusivity was assigned to each tissue layer. The results of simulations were tested for sensitivity analysis and further optimized to obtain the 'best' signal from the simulations using the Taguchi method. Four important parameters were identified and analysis of variance was performed using the 2(n) design (n=number of parameters, in this case, 4). The implications of these parameters were hypothesized based on physiological observations. Our results show that for an optimum signal-to-noise (S/N) ratio, the noise factors (thermal conductivity of skin, A and tunica albuginea, B) must be set high and low, respectively. Hence, at this setting, the signal will be captured based on the perfusion rate of the boundary layer of the sinusoidal space and the blood pressure (perfusion of sinusoidal space, C and blood pressure, D) will be optimal as their S/N ratios (C (low) and D (low)) are larger than the former. PMID:18075508

Ng, E Y K; Ng, W K; Huang, J; Tan, Y K

2008-01-01

244

Efficacy and safety of long-term tadalafil 5 mg once daily combined with sildenafil 50 mg as needed at the early stage of treatment for patients with erectile dysfunction.  

PubMed

This study aimed to evaluate the efficacy and safety of long-term and low-dose tadalafil combined with sildenafil as needed at the early stage of treatment for erectile dysfunction (ED). We enrolled 180 patients with ED 1 : 1 to tadalafil 5 mg once daily or once-a-day tadalafil 5 mg combined with sildenafil 50 mg as needed. The efficacy measures included the 5-item version of the International Index of Erectile Function (IIEF-5) and the Sexual Encounter Profile (SEP). The safety was assessed by observing drug tolerability and adverse events. Total IIEF-5 scores of patients with severe ED in combined medication group were significantly higher than in tadalafil alone group. Question 2 scores of IIEF-5 of patients with moderate and severe ED in combined medication group were significantly higher than in tadalafil alone group. The significant improvement in question 3 scores of IIEF-5 existed only in patients with severe ED receiving combined medication. The percentage of 'yes' responses to SEP4, SEP5 and partner's SEP3 were improved significantly in combined medication group. There was no difference between two groups in the incidence of adverse events. Our results suggest that combined medication can better improve erectile function, especially for patients with severe ED. PMID:24387078

Cui, H; Liu, B; Song, Z; Fang, J; Deng, Y; Zhang, S; Wang, H; Wang, Z

2015-02-01

245

The relationship between resting heart rate variability and erectile tumescence among men with normal erectile function  

PubMed Central

Introduction Individuals with erectile dysfunction have been shown to display lower heart rate variability (HRV), suggesting dysregulation of cardiac autonomic function. No studies have explored whether HRV is predictive of erectile response among men with clinically normal erectile function. Aim To examine associations between resting HRV and objective measures of genital response (i.e., resting penile circumference; erectile tumescence) and self-reported sexual function. Methods The sample comprised 59 male community volunteers (mean age = 20.15 years; SD = 2.52) selected from the control conditions of two previously published studies. Participants reported erectile function in the normal range (scoring ? 26 on the International Index of Erectile Function [IIEF]) and had no history of cardiovascular disease or myocardial infarct. During a laboratory visit, self-report, anthropometric, cardiovascular, and electrocardiographic data were assessed, as well as resting penile circumference and erectile tumescence in response to viewing an erotic film. Main Outcome Measures Resting penile responses, erectile tumescence (circumferential change via penile plethysmography), self-reported sexual function per the IIEF, and both time-domain (standard deviation of beat-to-beat [NN] intervals [SDNN], square root of the mean squared difference of successive NN intervals [RMSSD], and percent of NN intervals for which successive heartbeat intervals differed by at least 50 msec [pNN50]) and frequency-domain (low frequency [LF], high frequency [HF], LF/HF ratio) parameters of HRV were assessed. Results Higher resting HF power and lower resting LF/HF ratio were associated with greater erectile tumescence. There were marginally significant positive associations between mean NN interval and pNN50 and penile tumescence. HRV was not associated with self-reported sexual function or with resting penile circumference. Conclusions Results suggested that, among men without erectile dysfunction, relatively elevated parasympathetic tone was predictive of larger erectile tumescence. Limited variance in sexual function scores may have accounted for the lack of association between HRV and IIEF scores. PMID:23802770

Harte, Christopher B.

2013-01-01

246

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

247

Cardiovascular Implications of Erectile Dysfunction  

MedlinePLUS

... most common cause is a problem with the blood vessels called atherosclerosis. Previous Section Next Section What Is Atherosclerosis? With atherosclerosis, the blood vessels are not able to dilate properly, which is ...

248

Erectile Dysfunction (ED): Surgical Management  

MedlinePLUS

... venous occlusion , necessary for sufficient firmness, depends on arterial blood flow and relaxation of the spongy tissue in ... arterial: Relating to, affecting or used in arteries. arteries: Blood vessels that carry blood from the heart to ...

249

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.  

PubMed

Saffron (Crocus sativus Linn.) have been perceived by the public as a strong aphrodisiac herbal product. However, studies addressing the potential beneficial effects of saffron on erectile function (EF) in men with ED are lacking. Our aim was to evaluate the efficacy and safety of saffron administration on EF in men with ED. After a 4-week baseline assessment, 346 men with ED (mean age 46.6+/-8.4 years) were randomized to receive on-demand sildenafil for 12 weeks followed by 30 mg saffron twice daily for another 12 weeks or vice versa, separated by a 2-week washout period. To determine the type of ED, penile color duplex Doppler ultrasonography before and after intracavernosal injection with 20 microg prostaglandin E(1), pudendal nerve conduction tests and impaired sensory-evoked potential studies were performed. Subjects were assessed with an International Index of Erectile Function (IIEF) questionnaire, Sexual Encounter Profile (SEP) diary questions, patient and partner versions of the Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire and the Global Efficacy Question (GEQ) 'Has the medication you have been taking improved your erections?' No significant improvements were observed with regard to the IIEF sexual function domains, SEP questions and EDITS scores with saffron administration. The mean changes from baseline values in IIEF-EF domain were +87.6% and +9.8% in sildenafil and placebo groups, respectively (P=0.08). We did not observe any improvement in 15 individual IIEF questions in patients while taking saffron. Treatment satisfaction as assessed by partner versions of EDITS was found to be very low in saffron patients (72.4 vs 25.4, P=0.001). Mean per patient 'yes' responses to GEQ was 91.2 and 4.2% for sildenafil and saffron, respectively (P=0.0001). These findings do not support a beneficial effect of saffron administration in men with ED. PMID:20520621

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

2010-01-01

250

Phentolamine re-dosing during penile dynamic colour Doppler ultrasound: a practical method to abolish a false diagnosis of venous leakage in patients with erectile dysfunction.  

PubMed

Increased sympathetic tone may cause an equivocal response to a prostaglandin E1 (PGE1) penile Doppler ultrasound (US) examination interpreted as a venous leak. We evaluated the US parameters and erectile response to the addition of phentolamine to a PGE1 penile Doppler US examination to ascertain whether addition of phentolamine would abolish a suboptimal response. 32 patients (median age 29 years, range 17-70 years) with either a previous Doppler US pattern of venous leakage or a clinical suspicion of venogenic impotence, underwent Doppler US after a total dose of 20 microg of PGE1. Peak systolic velocity (PSV), end diastolic velocity (EDV) and grade of erection were documented. If erectile response was suboptimal irrespective of the EDV measurement, 2 mg-intracavernosal phentolamine was administered and measurements repeated. Six patients had a normal erectile response, the remaining 26 received phentolamine. A significant increase in PSV between baseline and 20 microg PGE1 (p<0.001) was observed in all cases. Following phentolamine there was a significant increase in grade of erection (p=0.0001) and a significant reduction in the EDV (p=0.0001). A reduction of the EDV to below 0.0 cm s(-1) was observed in 16 patients. Four patients with EDV <5.0 cm s(-1) but >0.0 cm s(-1) had improved erectile response following phentolamine while six showed persistent EDV elevation >5 cm s(-1). No priapism was documented. It is essential to ensure cavernosal relaxation using phentolamine before a Doppler US diagnosis of venous leak is made. This two-stage assessment will allow this to be done efficiently and with a low risk of priapism. PMID:15507415

Gontero, P; Sriprasad, S; Wilkins, C J; Donaldson, N; Muir, G H; Sidhu, P S

2004-11-01

251

Effect of levitra on sustenance of erection (EROS): an open-label, prospective, multicenter, single-arm study to investigate erection duration measured by stopwatch with flexible dose vardenafil administered for 8 weeks in subjects with erectile dysfunction.  

PubMed

To investigate the change of erection duration measured by stopwatch with flexible dose vardenafil administered for 8 weeks in subjects with erectile dysfunction (ED). Effect of levitra on sustenance of erection was an open-label, prospective, multicenter and single-arm study designed to measure the duration of erection in men with ED receiving a flexible dose of vardenafil over an 8-week treatment period. Patients were instructed to take vardenafil 10?mg 60?min before attempting the intercourse. Vardenfil could be increased to 20?mg or decreased to 5?mg concerning patients' efficacy and safety. Following the initial screening, patients entered a 4-week treatment-free run-in phase and 8-week treatment period, during which they were instructed to attempt intercourse at least four times on four separate days. A total of 95 men were enrolled in 10 centers. After the 8 weeks treatment, the mean duration of erection leading to successful intercourse was statistically superior when patients were treated with vardenafil. After an 8-week treatment, the duration of erection leading to successful intercourse was 9.39?min. There were significant benefits with vardenafil in all domains of International Index of Erectile Function. Secondary efficacy end points included success rate of penetration, maintaining erection, ejaculation and satisfaction were superior when patients were treated with vardenafil. There was a significant correlation between duration of erection with other sexual factors. Also partner's sexual satisfaction was increased with vardenafil. Most adverse events were mild or moderate in severity. Vardenafil was safe and well tolerated. Vardenafil therapy provided a statistically superior duration of erection leading to successful intercourse in men with ED with female partner.International Journal of Impotence Research advance online publication, 4 December 2014; doi:10.1038/ijir.2014.39. PMID:25471318

Shin, Y S; Lee, S W; Park, K; Chung, W S; Kim, S W; Hyun, J S; Moon, D G; Yang, S-K; Ryu, J K; Yang, D Y; Moon, K H; Min, K S; Park, J K

2014-12-01

252

Novel nitric oxide signaling mechanisms regulate the erectile response  

Microsoft Academic Search

Nitric oxide (NO) is a physiologic signal essential to penile erection, and disorders that reduce NO synthesis or release in the erectile tissue are commonly associated with erectile dysfunction. NO synthase (NOS) catalyzes production of NO from L-arginine. While both constitutively expressed neuronal NOS (nNOS) and endothelial NOS (eNOS) isoforms mediate penile erection, nNOS is widely perceived to predominate in

A L Burnett

2004-01-01

253

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

254

Incidentally diagnosed Peyronie's disease in men presenting with erectile dysfuntion  

Microsoft Academic Search

The aim of this study was to analyze characteristics of patients with Peyronie's disease (PD) diagnosed during a standart evaluation for erectile dysfunction (ED) and compare them with patients presenting with the classical complaints of PD. During a 10-y period, a total of 448 patients were evaluated at our two outpatient clinics, directed by the same author (AK). They were

A Kadioglu; T Oktar; E Kandirali; M Kendirci; O Sanli; C Ozsoy

2004-01-01

255

JAMA Patient Page: Male Sexual Dysfunction  

MedlinePLUS

... share with patients. Any other print or online reproduction is subject to AMA approval. To purchase bulk reprints, call 718/946-7424. • Low libido (sexual interest) • Erectile dysfunction (ED, difficulty achieving or maintaining ...

256

[Selective arteriography in the study of arterial vasculogenic impotence].  

PubMed

According to the fundamental circulatory nature of penile erection, insufficiency of the arterial blood supply to the corpora cavernosa caused by an organic arterial disease is found in a large fraction of case, overall among the patients aged more than 40. It is possible to evaluate arterial origin of erectile dysfunction by using of noninvasive methods, but to obtain the necessary panoramicity and the characterization of the lesions it needs the use of angiography. Performance of standard arteriography leads to insufficient visualization of pudendal and penile vessels and risks false positive results. Because of penile hemodynamic variability in its different states is necessary the use of pharmacologic devices to perform a diagnostic arteriography. For the selective study of the pudenda and peniena vascularization we perform a selective arteriography bilaterally, with the catheter tip placed in the proximal part of the internal iliac artery. We use a contrast medium particularly diluted and mixed with xylocaine. We perform angiographic sequences after intracavernous injection of 8-10 mgr of papaverine to obtain the maximum blood flow and to prevent spasm of the terminal arterioles. Arteriography gives a complete study of the pudenda arterial tree and its terminal ramifications, and it is able to supply all the necessary informations regarding the planning of revascularization procedures. Treatment of arterial lesions is possible with surgical and radiologic methods. As in other arteries, percutaneous transluminal angioplasty (P.T.A.) can be applied in the therapy of impotence caused by arterial insufficiency. P.T.A. is the election treatment in the stenosis of the common iliac and internal iliac arteries.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1411602

Urigo, F; Pischedda, A; Carpanese, L; Rovasio, S S; Migaleddu, V; Canalis, G C

1992-06-01

257

Peyronie's disease and erectile failure  

SciTech Connect

A total of 20 patients with Peyronie's disease, including 15 with erectile failure and 5 with normal potency, underwent evaluation with dynamic xenon washout and infusion cavernosography. Abnormal drainage from the cavernous body was found in 13 of the 15 patients with erectile failure and in none of the 5 potent patients, indicating that this condition seems to be the underlying pathological mechanism leading to erectile impotence in patients with Peyronie's disease.

Metz, P.; Ebbehoj, J.; Uhrenholdt, A.; Wagner, G.

1983-12-01

258

Erectile impotence: a clinical challenge  

PubMed Central

The wide range of factors that may contribute to impotence is reviewed in an attempt to establish a systematized approach for assessing etiologic factors. The effects on potency of ageing, general fitness, weight, debilitating disease, use of therapeutic and other drugsincluding alcohol and neurogenic, vasculogenic, endocrine/metabolic, urogenital and psychogenic factors are considered and discussed. The review also affords a rationale for the methodology employed. PMID:6337695

McKendry, J.B. Ralph; Collins, W. Edgar; Silverman, Marvin; Krul, L. Edward; Collins, John P.; Irvine, Alan H.

1983-01-01

259

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

260

Characterization of Erectile Function in Elastin Haploinsufficicent Mice  

PubMed Central

Introduction Elastin fibers confer passive recoil to many tissues including the lung, skin, and arteries. In the penis, elastin is present in sinusoids, arterioles, and in the tunica albuginea. Although decreased penile elastin has been reported in men with erectile dysfunction, the exact role of elastin in physiologic processes integral to erection remains speculative. Aim The aim of this study was to characterize erectile function in elastin-deficient mice. Methods Elastin haploinsufficient mice (Eln+/?) and aged match Eln+/+ (Wt) mice were used. Cavernosum was removed from some mice for quantification of elastin, collagen, and smooth muscle actin. Ex vivo assessment of contractile force generation was performed by myography. In vivo assessment of intracorporal pressure normalized to mean arterial pressure in response to electrical stimulation of the cavernosal nerve was measured. Veno-occlusive function was determined by cavernosography. Main Outcome Measures The main outcome measures of this study were the in vitro and in vivo assessment of cavernosal vasoreactivity, veno-occlusive function and erection in mice deficient in elastin. Results Eln+/? mice exhibited ~33% less penile elastin than Wt mice, with no change in collagen. Cavernosal tissue from Eln+/? mice has a significantly heightened contractile response, explained in part by increased smooth muscle cell content. Veno-occlusive function was significantly altered in Eln+/? mice. Interestingly, erectile function was impaired only at submaximal voltage (1 V) stimulation (there was no impairment during the higher 2-V stimulus). Conclusions Eln+/? mice display a cavernosal phenotype consistent with developmental changes attributable to the loss of elastin. These alterations confer a degree of altered erectile function that is able to be overridden by maximal stimulatory input. Altogether, these data suggest that elastin is important for erectile function. PMID:21883953

Hidalgo-Tamola, Josephine; Luttrell, Ian; Jiang, Xiaogang; Li, Dean; Mecham, Robert P.; Chitaley, Kanchan

2013-01-01

261

Skin necrosis caused by use of negative pressure device for erectile impotence.  

PubMed

We report a case of skin necrosis as a result of the use of a negative pressure device for erectile dysfunction. To our knowledge this is the first report of such a complication. The patient was paraplegic with hypesthesia and analgesia of the genital area. PMID:2398575

Meinhardt, W; Kropman, R F; Lycklama à Nijeholt, A A; Zwartendijk, J

1990-10-01

262

[Surgical treatment of venous-induced erectile impotence in the male].  

PubMed

In 14 out of 94 patients with erectile dysfunction a venous insufficiency was suspected. Localization and securing of the venous leak were done by dynamic cavernosography. An insufficient penile blood supply could excluded by Doppler ultrasonography and measurement of the penile-brachial artery-pressure index. In 7 out of 13 patients treated by ligation of penile veins the erectile function was normalized after operation, in 4 cases an additional intracavernous injection therapy was necessary and in 2 patients the operation was unsuccessful. If impotence occurs once more due to venous collaterals the implantation of a penile prosthesis should considered. PMID:2652944

Török, A; Lenk, S; Székely, J; Götz, F

1989-01-01

263

Role of Adenosine Signaling in Penile Erection and Erectile Disorders  

PubMed Central

Introduction Penile erection is a hemodynamic process, which results from increased flow and retention of blood in the penile organ due to the relaxation of smooth muscle cells. Adenosine, a physiological vasorelaxant, has been shown to be a modulator of penile erection. Aim To summarize the research on the role of adenosine signaling in normal penile erection and erectile disorders. Main Outcome Measures Evidence in the literature on the association between adenosine signaling and normal and abnormal penile erection, i.e., erectile dysfunction (ED) and priapism. Methods The article reviews the literature on the role of endogenous and exogenous adenosine in normal penile erection, as well as in erectile disorders namely, ED and priapism. Results Adenosine has been shown to relax corpus cavernosum from various species including human in both in vivo and in vitro studies. Neuromodulatory role of adenosine in corpus cavernosum has also been demonstrated. Impaired adenosine signaling through A2B receptor causes partial resistance of corpus cavernosum, from men with organic ED, to adenosine-mediated relaxation. Increased level of adenosine has been shown to be a causative factor for priapism. Conclusion Overall, the research reviewed here suggests a general role of exogenous and endogenous adenosine signaling in normal penile erection. From this perspective, it is not surprising that impaired adenosine signaling is associated with ED, and excessive adenosine signaling is associated with priapism. Adenosine signaling represents a potentially important diagnostic and therapeutic target for the treatment of ED and priapism. PMID:19889148

Phatarpekar, Prasad V.; Wen, Jiaming; Xia, Yang

2010-01-01

264

Quantitation of pharmacologically-induced penile erections: the value of radionuclide phallography in the objective evaluation of erectile haemodynamics.  

PubMed

This study combines the pharmacologically-induced penile erection (PIPE) technique with radionuclide phallography (RNP) for the non-invasive study of penile haemodynamic changes during erection. Penile erections produced by the intracavernosal injections of two different vasoactive drugs, prostaglandin E1 (PGE1) and papaverine HCl (PPV) were assessed by quantitation of the dynamic RNP and parameters of erection were defined and compared. PGE1 intracavernosal injections were seen to elicit a better erectile response than PPV. Dynamic radionuclide phallography was performed using 99Tcm-labelled autologous RBCs in five normally potent volunteers, sixteen patients with psychogenic impotence, seven patients with vasculogenic impotence (three arteriogenic, four venous leakage) and one patient with neurogenic impotence. Physical parameters of erection including the penile length and circumference changes during erection and the erectile angle were compared with the indices of penile blood flow and volume derived through quantitation of the RNP. There was a close correlation between the penogram index (an index of penile blood volume) and penile circumference increase during erection (r = 0.77, p less than 10(-6). The erectile angle, a measure of penile rigidity, correlated strongly (r = 0.82, p less than 10(-6) with the flow index, a measure of penile blood volume. Patterns specific to various categories of impotence were observed and these aided in the diagnosis, especially in equivocal cases with a suboptimal clinical response to the intracavernosal injection. Quantitative RNP offers a non-invasive method which allows direct objective assessment of the erectile response providing several quantitative parameters for analysis. PMID:2385430

Siraj, Q H; Bomanji, J; Akhtar, M A; Rana, M H; Sadiq, M; Ahmed, M

1990-06-01

265

Impact of an educational initiative on applied knowledge and attitudes of physicians who treat sexual dysfunction  

Microsoft Academic Search

A randomized, blinded, multicenter, controlled study was undertaken to assess the impact of a multiyear continuing medical education (CME) initiative on physician knowledge and behavior in the treatment of erectile dysfunction (ED). The objective of this study was to assess the efficacy of CME and compare applied knowledge and attitude scores of participants in the Consortium for Improvement in Erectile

Ridwan Shabsigh; Richard Sadovsky; R C Rosen; C C Carson; A D Seftel; M Noursalehi

2009-01-01

266

The post-investigation questionnaire (PIO-R): a practical instrument to assess erectile response after intracavernous injection.  

PubMed

Erectile response to intracavernous pharmacological stimulation is highly susceptible to stress and anxiety provoked by the test-situation. To reduce false-positive diagnosis of veno-occlusive dysfunction and to limit the need for high-dosage pharmacotesting, we developed the Post-Investigation Questionnaire (PIQ-R), a self-report instrument to assess erectile response to pharmacological stimulation after the patient has left the office. In this study veno-occlusive sufficiency was not demonstrated in 80 of 105 patients with erectile dysfunction at the time of pharmaco-penile duplex ultrasonography. PIQ-R detected sufficient erectile response in 40 of these patients, thus reducing false-positive diagnosis of veno-occlusive dysfunction by 50%. We also found that reports of sexual activity after investigation increased interest in auto-injection therapy. PIQ-R is a practical self-report measure to assess erectile response after clinical pharmacotesting, and to more carefully select patients for auto-injection therapy. PMID:8858391

Vruggink, P A; Diemont, W L; Meuleman, E J

1996-06-01

267

Zoledronic acid inhibits vasculogenic mimicry in murine osteosarcoma cell line in vitro  

PubMed Central

Background To study the effects of zoledronic acid (ZA) on the vasculogenic mimicry of osteosarcoma cells in vitro. Methods A Three-dimensional culture of LM8 osteosarcoma cells on a type I collagen matrix was used to investigate whether osteosarcoma cells can develop vasculogenic mimicry, and to determine the effects of ZA on this process. In addition, the cellular ultrastructural changes were observed using scanning electron microscopy and laser confocal microscopy. The effects of ZA on the translocation of RhoA protein from the cytosol to the membrane in LM8 cells were measured via immunoblotting. Results ZA inhibited the development of vasculogenic mimicry by the LM8 osteosarcoma cells, decreased microvilli formation on the cell surface, and disrupted the F-actin cytoskeleton. ZA prevented translocation of RhoA protein from the cytosol to the membrane in LM8 cells. Conclusions ZA can impair RhoA membrane localization in LM8 cells, causing obvious changes in the ultrastructure of osteosarcoma cells and induce cell apoptosis, which may be one of the underlying mechanisms by which the agent inhibits the development of vasculogenic mimicry by the LM8 cells. PMID:21718535

2011-01-01

268

Vascular endothelial growth factor (VEGF) gene therapy using a nonviral gene delivery system improves erectile function in a diabetic rat model  

Microsoft Academic Search

Erectile dysfunction (ED) is a cause of decreased quality of life in more than 70% of diabetic men. Vascular endothelial growth factor (VEGF) has shown to improve overall endothelial and smooth muscle cell dysfunction in models of ED. We describe a novel technique for nonviral, in vivo gene transfection of VEGF in the rat corpus cavernosum. Diabetic rats were transfected

J E Dall'Era; R B Meacham; J N Mills; S Koul; S N Carlsen; J B Myers; H K Koul

2008-01-01

269

A Pilot Study of Vasculogenic Mimicry Immunohistochemical Expression in Hepatocellular Carcinoma  

PubMed Central

Context The “de novo” formation of fluid-conducting patterns by tumor cells, termed vasculogenic mimicry (VM), is associated with increased mortality in many different solid tumors. Objective To identify VM patterns in hepatocellular carcinoma (HCC) and to determine whether these patterns were associated with more rapid tumor recurrence after orthotopic liver transplantation. Design Subjects included 20 patients who underwent orthotopic liver transplantation and were found to have HCC in the liver explant. Samples from 5 normal postmortem livers and 5 explanted livers with hepatitis C virus cirrhosis without HCC served as control tissues. Patterned matrix VM expression in HCC was identified by the presence of laminin-positive loops surrounding packets of tumor cells. Time to HCC recurrence after orthotopic liver transplantation was compared between patients with and without patterned VM expression. The relationships among VM in HCC, cause of chronic liver disease, serum ?-fetoprotein level at the time of diagnosis, tissue expression by epidermal growth factor receptor, and endothelial markers including vascular endothelial growth factor and CD31 were assessed. Results Patterned matrix VM was identified in 11 of 20 primary HCC tissue samples. Vasculogenic mimicry was absent in all 10 control cases and was not identified in any area of dysplasia. The expression of VM in HCC lesions in liver explants was associated with more rapid posttransplant recurrence (P = .01). Vasculogenic mimicry was not associated with the cause of liver disease, serum ?-fetoprotein level at time of diagnosis, or expression of epidermal growth factor receptor, vascular endothelial growth factor, or CD31. Conclusions Vasculogenic mimicry of the patterned matrix type is present in hepatocellular carcinoma and is associated with tumor recurrence after orthotopic liver transplantation. Vasculogenic mimicry lesions are not associated with endothelial markers in HCC. PMID:18081435

Guzman, Grace; Cotler, Scott J.; Lin, Amy Y.; Maniotis, Andrew J.; Folberg, Robert

2008-01-01

270

Obesity and sexual dysfunction, male and female  

Microsoft Academic Search

Obesity has become a worldwide public health problem of epidemic proportions, as it may decrease life expectancy by 7 years at the age of 40 years: excess bodyweight is now the sixth most important risk factor contributing to the overall burden of disease worldwide. Overweight and obesity may increase the risk of erectile dysfunction (ED) by 30–90% as compared with

K Esposito; F Giugliano; M Ciotola; M De Sio; M D'Armiento; D Giugliano

2008-01-01

271

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

272

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

273

Prevalence of Sexual Dysfunctions  

PubMed Central

Ten years of research that has provided data regarding the prevalence of sexual dysfunctions is reviewed. A thorough review of the literature identified 52 studies that have been published in the 10 years since an earlier review by Spector and Carey (1990). Community samples indicate a current prevalence of 0 - 3% for male orgasmic disorder, 0 - 5% for erectile disorder, and 0 - 3% for male hypoactive sexual desire disorder. Pooling current and 1-year figures provides community prevalence estimates of 7 - 10% for female orgasmic disorder and 4 - 5% for premature ejaculation. Stable community estimates of the current prevalence for the other sexual dysfunctions remain unavailable. Prevalence estimates obtained from primary care and sexuality clinic samples are characteristically higher. Although a relatively large number of studies have been conducted since Spector and Carey’s (1990) review, the lack of methodological rigor of many studies limits the confidence that can be placed in these findings. PMID:11329727

Simons, Jeffrey; Carey, Michael P.

2008-01-01

274

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

275

Retrospective analysis of medicolegal cases and evaluation for erectile function.  

PubMed

Erectile function (EF) is an important question in lawsuits for divorce, rape, and damages. In this study, a method to evaluate medicolegal cases is defined, and the characteristics of the 265 cases screened for EF between 1989 and 1997 were analyzed. Interview, physical examination, psychometric evaluation, nocturnal penile tumescence, serum hormone levels and blood chemistry, intracavernosal drug injection, penile Doppler ultrasonography, and pharmacocavernosometry and pharmacocavernosography tests were used for diagnosis. The tests performed were selected according to the age of the subject. Of the 265 cases 128 (48.3%) were for divorce, 116 (43.7%) were for rape, and 21 (8%) were for indemnity relating to lawsuits for damages. In only 7 cases (2.7%) was the defendant <15 years of age. Organic pathology for erectile dysfunction (ED) was present in 22% of lawsuits for divorce, 40.5% of lawsuits for rape, and 33.4% of lawsuits for damages. Three men in cases of divorce and 2 men after genital trauma due to traffic accident suffered psychological ED. This study indicates that lawyers may abuse the assertion of ED in lawsuits for divorce and rape. In 128 divorce cases the defendant was accused of being impotent, but evaluation proved that 75.8% had normal EF. In lawsuits for rape, 59.5% of defendants had normal EF although the lawyers of the rapist claimed their clients were impotent. The investigation, interpretation, and characteristics of medicolegal cases may differ in countries with different cultures. PMID:10414654

Ozkara, H; A?icioglu, F; Alici, B; Akku?, E; Hattat, H

1999-06-01

276

Mechanisms Predisposing Penile Fracture and Long-Term Outcomes on Erectile and Voiding Functions  

PubMed Central

Purpose. To determine the mechanisms predisposing penile fracture as well as the rate of long-term penile deformity and erectile and voiding functions. Methods. All fractures were repaired on an emergency basis via subcoronal incision and absorbable suture with simultaneous repair of eventual urethral lesion. Patients' status before fracture and voiding and erectile functions at long term were assessed by periodic follow-up and phone call. Detailed history included cause, symptoms, and single-question self-report of erectile and voiding functions. Results. Among the 44 suspicious cases, 42 (95.4%) were confirmed, mean age was 34.5 years (range: 18–60), mean follow-up 59.3 months (range 9–155). Half presented the classical triad of audible crack, detumescence, and pain. Heterosexual intercourse was the most common cause (28 patients, 66.7%), followed by penile manipulation (6 patients, 14.3%), and homosexual intercourse (4 patients, 9.5%). “Woman on top” was the most common heterosexual position (n = 14, 50%), followed by “doggy style” (n = 8, 28.6%). Four patients (9.5%) maintained the cause unclear. Six (14.3%) patients had urethral injury and two (4.8%) had erectile dysfunction, treated by penile prosthesis and PDE-5i. No patient showed urethral fistula, voiding deterioration, penile nodule/curve or pain. Conclusions. “Woman on top” was the potentially riskiest sexual position (50%). Immediate surgical treatment warrants long-term very low morbidity. PMID:24822062

Reis, Leonardo O.; Cartapatti, Marcelo; Marmiroli, Rafael; de Oliveira Júnior, Eduardo Jeronimo; Saade, Ricardo Destro; Fregonesi, Adriano

2014-01-01

277

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

PubMed Central

Background The International Index of Erectile Function has been proposed as a method for assessing sexual function assisting the diagnosis and classification of erectile dysfunction. However, IIEF was not validated for the Portuguese language. Objective Validate the International Index of Erectile Function in patients with cardiopulmonary and metabolic diseases. Methods The sample consisted of 108 participants of to Cardiopulmonary and Metabolic program Rehabilitation (CPMR) in southern Brazil. The clarity assessment of the instrument was performed using a scale ranging from zero to 10. The construct validity was carried out by confirmatory factor analysis (KMO = 0.85; Barllet p < 0.001), internal consistency by Cronbach's alpha and reproducibility and interrater reliability via the test retest method. Results The items were considered very clear with averages superior to 9. The internal consistency resulted in 0.89. The majority of items related correctly with their domains, with exception of three questions from sexual satisfaction domain, and one from erectile function. All items showed excellent stability of measure and substantial to almost perfect agreement. Conclusion The present study showed that the IIEF is valid and reliable for use in participants of a cardiopulmonary and metabolic rehabilitation program. PMID:23842798

Gonzáles, Ana Inês; Sties, Sabrina Weiss; Wittkopf, Priscilla Geraldine; de Mara, Lourenço Sampaio; Ulbrich, Anderson Zampier; Cardoso, Fernando Luiz; de Carvalho, Tales

2013-01-01

278

The association between erectile function and severity of lower urinary tract symptoms.  

PubMed

It is unclear whether the erectile dysfunction (ED) that frequently occurs with lower urinary tract symptoms (LUTS) may have a common causative factor: sympathetic overactivity. The aim of this study was to evaluate the association between ED and LUTS. From June 1998 to March 2000, 75 male patients, presenting with LUTS, enrolled into the present study. A total of 63 patients were included into the study, age ranging from 51 - 74 years (mean 61.5). Allpatients completed an American Urological Association (AUA) symptom severity index and IIEF-5 questionnaires. The results from the present study demonstrated that the AUA symptom and IIEF-5 scores do not correlate with increasing age. When the statistical analyses were performed for each age group, there were no significant differences in mean IIEF-5 values between any degree of AUA symptom score in the same age group (p > 0.05). The present results indicate that there is no association between the degree of LUTS and the erectile function. Moreover, the statistical analyses of the association between any degree of erectile function and the mean A UA symptom score either for obstructive or irritative symptoms revealed no significant differences (p > 0.05). The present study demonstrates that there is no association between BPH and erectile function in any age group, inconsistent with the sympathetic overactivity theory. PMID:15960225

Leungwattanakij, Somboon; Roongreungsilp, Ubolrat; Lertsithichai, Panuwat; Ratana-Olarn, Krisda

2005-01-01

279

Erectile impotence: evaluation and management.  

PubMed

Dramatic progress in the understanding and treatment of erectile impotence has occurred over the past decade. Most cases have an organic cause that is related to vascular (arterial or venous) supply, innervation, or the hormonal milieu of the penis. Multifactorial causes of organic impotence are common and include diabetes mellitus, alcoholism, renal failure, and liver failure. Medications may cause impotence by a variety of mechanisms. The history and physical examination, along with simple laboratory tests, are the mainstay of evaluation and may be performed appropriately by family physicians. Successful new forms of nonsurgical treatment include penile self-injection with papaverine (sometimes with phentolamine) and penile-suction devices. Penile prostheses have been improved greatly in recent years. The patient may select among semirigid, multicomponent inflatable, and self-contained inflatable devices. New surgical treatments include penile arterial revascularization (for atherosclerosis) and ligation of the dorsal vein of the penis (for venous leak). PMID:3279158

Heller, J E; Gleich, P

1988-03-01

280

Xanthone isolated from Securidaca longependunculata with activity against erectile dysfunction.  

PubMed

1,7-Dimethoxy-2-hydroxy-xanthone and 1,4-dihydroxy-7-methoxy-xanthone isolated from Securidaca longependunculata were tested for their activity on rabbit corpus cavernosum in vitro. Only the former relaxed the corpus cavernosum by 63% at 1.8 x 10(-5) mg/ml. PMID:15261388

Rakuambo, N C; Meyer, J J M; Hussein, A

2004-07-01

281

Cardiovascular Issues in the Treatment of Erectile Dysfunction  

Microsoft Academic Search

\\u000a The cardiovascular response to sexual activity worries a lot of men and women, particularly if a coronary or vascular event\\u000a has already occurred. The fear of inducing another cardiac episode is fuelled by many myths including the assumption that\\u000a sex is an extreme stress to the heart, driven to some extent by media\\/internet distortion. Adding the anxiety that treating\\u000a ED

Graham Jackson

282

Beware When Buying "All Natural" Erectile Dysfunction Products  

MedlinePLUS

... Follow FDA En Español Enter Search terms Home Food Drugs Medical Devices Radiation-Emitting Products Vaccines, Blood & Biologics Animal & Veterinary Cosmetics Tobacco Products For Consumers Home For Consumers Protect Yourself Health Fraud Section Contents Menu Protect Yourself Health Fraud For ...

283

[Treatment of erectile dysfunction with vacuum constriction device].  

PubMed

The vacuum constriction device (VCD) is a noninvasive mechanical device which may produce an erection by creating a vacuum of up to 250 mm Hg and with a rubber ring to maintain this state by constricting the base of the penis. We tested the VCD on 150 men who presented with organic and psychogenic impotence in our outpatient clinic between the years 1986 and 1992. Of the 150 men, 113 (75%) achieved an adequate erection with the VCD. However, only 72 patients agreed to buy the device and use it regularly. During follow-up of from 3 months to 5 1/2 years (mean 25 months), 65 men were using the VCD regularly and reported satisfying intercourse at least once every 2 weeks. Complications were minimal and consisted of mild numbness of the penis in 7 patients, mild cyanosis in 17, and 10 cases of painless ecchymoses and petechiae which disappeared without any treatment. From our experience, the VCD appears to be a safe, inexpensive, and easy method for impotent men to engage in sexual intercourse without, of course, eliminating other therapeutic options, including surgery. PMID:8495930

Segenreich, E; Shmuely, J; Israilov, S; Raz, D; Servadio, C

1993-03-15

284

Vcsa1 Acts as a Marker of Erectile Function Recovery After Gene Therapeutic and Pharmacological Interventions  

PubMed Central

Purpose We identified molecular markers of erectile function, particularly those responding to erectile dysfunction treatment. Materials and Methods Sprague-Dawley retired breeder rats were intracorporeally injected with pVAX-hSlo, pSMAA-hSlo or the control plasmid pVAX. One week later the intracorporeal pressure-to-blood pressure ratio and gene expression were determined by microarray analysis and quantitative reverse transcriptase-polymerase chain reaction. Rat corporeal cells were transfected in vitro with pVAX-hSlo, pSMAA-hSlo or pVAX and the change in gene expression was determined. We also determined whether Vcsa1 expression was changed after pharmacotherapy using tadalafil. Results Animals treated with vectors expressing hSlo had significantly improved erectile function compared to that in controls, accompanied by changed expression of a subset of genes. Vcsa1 was one of the genes that was most changed in expression (the third of approximately 31,000 with greater than 10-fold up-regulation). Changes in gene expression were different than those observed in corporeal cells transfected in vitro, distinguishing gene expression changes that were a direct effect of hSlo over expression. When tadalafil was administered in retired breeder rats, the Vcsa1 transcript increased 4-fold in corporeal tissue compared to that in untreated controls. Conclusions Our study identifies a set of genes that are changed in response to improved erectile function, rather than as a direct effect of treatment. We noted Vcsa1 may act as marker of the restoration of erectile function after gene transfer and pharmacotherapy. PMID:19375734

Calenda, Giulia; Tong, Yuehong; Tar, Moses; Lowe, Daniel; Siragusa, Joseph; Melman, Arnold; Davies, Kelvin P.

2010-01-01

285

The effects of sex education on women with secondary orgasmic dysfunction  

Microsoft Academic Search

This study evaluated the effects of sex education on 48 couples in which the women reported secondary orgasmic dysfunction. None of the males had a problem with premature ejaculation or with erectile dysfunction. Couples received two, two-hour sessions of sex education during a one-week period. From measures administered before and after treatment, the women reported significantly increased orgasmic frequency and

Peter R. Kilmann; Katherine H. Mills; Bonnie Bella; Charlene Caid; Edward Davidson; Gerald Drose; Richard Wanlass

1983-01-01

286

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

Microsoft Academic Search

Sexual dysfunction is a major contributor to treatment discontinuation and nonadherence among patients treated with selective serotonin reuptake inhibitors (SSRIs). The mechanisms by which depressive symptoms in general, as well as SSRI exposure in particular, may worsen sexual function are not known. We examined genetic polymorphisms, including those of the serotonin and glutamate systems, for association with erectile dysfunction, anorgasmia,

Roy H Perlis; Gonzalo Laje; Jordan W Smoller; Maurizio Fava; A John Rush; Francis J McMahon

2009-01-01

287

Male sexual dysfunction in Asia  

PubMed Central

Sex has always been a taboo subject in Asian society. However, over the past few years, awareness in the field of men's sexual health has improved, and interest in sexual health research has recently increased. The epidemiology and prevalence of erectile dysfunction, hypogonadism and premature ejaculation in Asia are similar in the West. However, several issues are specific to Asian males, including culture and beliefs, awareness, compliance and the availability of traditional/complementary medicine. In Asia, sexual medicine is still in its infancy, and a concerted effort from the government, relevant societies, physicians and the media is required to propel sexual medicine to the forefront of health care. PMID:21643001

Ho, Christopher CK; Singam, Praveen; Hong, Goh Eng; Zainuddin, Zulkifli Md

2011-01-01

288

Estimating the risk of long-term erectile, urinary and bowel symptoms resulting from prostate cancer treatment  

Microsoft Academic Search

Reports on long-term complications resulting from treatment for localized prostate cancer are very inconsistent. In order to estimate the risks of long-term erectile dysfunction, urine symptoms and bowel symptoms following prostatectomy (RP), external conventional or conformal beam radiation (ERT or CRT) and brachytherapy (BRT), 98 papers from the PubMed and Cochrane Clinical Trial databases were selected, reviewed and critically evaluated.

V Bhatnagar; S T Stewart; V Huynh; G Jorgensen; R M Kaplan

2006-01-01

289

Neurovascular bundle block as predictor of postoperative erectile function after radical prostatectomy.  

PubMed

We assessed audiovisually induced erections after nerve block of the neurovascular bundle during prostate biopsy. We evaluated neurovascular bundle nerve block to mimic non-nerve-sparing radical prostatectomy in an experimental setup. Patients undergoing a transrectal ultrasound-guided prostate biopsy were randomized to bilateral injection of 5 ml ropivacaine hydrochloride 0.75% or NaCl 0.9% into the neurovascular bundle. The patients completed the International Index of Erectile Function 5-item questionnaire (IIEF-5) questionnaire, and a detailed patient history was obtained. A routine prostate biopsy was performed. Thereafter, patients were exposed to 60 min of audiovisual stimulation. Erections were recorded using a Rigiscan-Plus device. A total of 11 patients were randomized. Five patients received NaCl (group 1) and six patients ropivacaine (group 2). Patient characteristics were comparable in terms of age (group 1: 59.8 y; group 2: 61.8 y), mean PSA (4.1 vs 4.7 ng/ml), mean IIEF-5 score (20.5 vs 22) and risk factors for erectile dysfunction, respectively. Patients of group 1 showed significantly stronger and longer erections after audiovisual stimulation than patients in group 2. Patients with bilateral infiltration of saline solution to the neurovascular bundle showed significantly stronger erections than patients receiving local anesthesia of the neurovascular bundle. Thus, this experiment might serve as a model to assess postoperative erectile function after a unilateral nerve-sparing radical prostatectomy. PMID:15902278

Strebel, R T; Muentener, M; Fatzer, M; Crott, C; John, H; Hauri, D; Schmid, D M

2005-01-01

290

Efficacy of a novel water-soluble curcumin derivative versus sildenafil citrate in mediating erectile function.  

PubMed

The present study was conducted to assess the efficacy of a novel curcumin derivative (NCD) versus sildenafil citrate in erectile signaling. The study was conducted on 10 control male rats and 50 diabetic male rats divided into the following groups: diabetic, curcumin, NCD, sildenafil and NCD combined with sildenafil. Cavernous tissue (CC) gene expression levels of heme oxygenase (HO)-1, Nrf2, NF-?? and p38, enzyme activities of HO and nitric oxide synthase (NOS), cyclic guanosine monophosphate (cGMP) and intracavernosal pressure (ICP) were assessed. Results showed that 12 weeks after induction of diabetes, erectile dysfunction was confirmed by the significant decrease in ICP, a significant decrease in cGMP, NOS, HO enzyme activities, a significant decrease in HO-1 gene and a significant elevation of NF-??, p38 genes. Administration of all therapeutic interventions led to a significant elevation in ICP, cGMP levels, a significant increase in HO-1 and NOS enzymes, a significant increase in HO-1 and Nrf2 gene expression, and a significant decrease in NF-??, p38 gene expression. NCD or its combination with sildenafil showed significant efficacy and more prolonged duration of action. In conclusion, NCD could enhance erectile function with more efficacy and more prolonged duration of action. PMID:25099638

Zaahkouk, A M S; Abdel Aziz, M T; Rezq, A M; Atta, H M; Fouad, H H; Ahmed, H H; Sabry, D; Yehia, M H

2015-01-01

291

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

PubMed Central

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

292

Diabetes and sexual dysfunction: current perspectives  

PubMed Central

Diabetes mellitus is one of the most common chronic diseases in nearly all countries. It has been associated with sexual dysfunction, both in males and in females. Diabetes is an established risk factor for sexual dysfunction in men, as a threefold increased risk of erectile dysfunction was documented in diabetic men, as compared with nondiabetic men. Among women, evidence regarding the association between diabetes and sexual dysfunction are less conclusive, although most studies have reported a higher prevalence of female sexual dysfunction in diabetic women as compared with nondiabetic women. Female sexual function appears to be more related to social and psychological components than to the physiological consequence of diabetes. Hyperglycemia, which is a main determinant of vascular and microvascular diabetic complications, may participate in the pathogenetic mechanisms of sexual dysfunction in diabetes. Moreover, diabetic people may present several clinical conditions, including hypertension, overweight and obesity, metabolic syndrome, cigarette smoking, and atherogenic dyslipidemia, which are themselves risk factors for sexual dysfunction, both in men and in women. The adoption of healthy lifestyles may reduce insulin resistance, endothelial dysfunction, and oxidative stress – all of which are desirable achievements in diabetic patients. Improved well-being may further contribute to reduce and prevent sexual dysfunction in both sexes. PMID:24623985

Maiorino, Maria Ida; Bellastella, Giuseppe; Esposito, Katherine

2014-01-01

293

Targeting the Tumor Microenvironment with Chemically Modified Tetracyclines: Inhibition of Laminin 5 2 Chain Promigratory Fragments and Vasculogenic Mimicry1  

Microsoft Academic Search

The laminin 5 (Ln-5) 2 chain and matrix metalloproteinases (MMPs) MMP-2 and membrane type 1 (MT1)-MMP act cooperatively and are required for highly aggressive melanoma cells to engage in vasculogenic mimicry when cultured on a three- dimensional matrix. Furthermore, generation of Ln-5 2 chain promigratory fragments by MMP-2 and MT1- MMP proteolysis is necessary for an aggressive tumor cell-preconditioned matrix

Richard E. B. Seftor; Elisabeth A. Seftor; Dawn A. Kirschmann; Mary J. C. Hendrix

294

HIF-1? induces VE-cadherin expression and modulates vasculogenic mimicry in esophageal carcinoma cells  

PubMed Central

AIM: To investigate whether hypoxia inducible factor (HIF)-1? modulates vasculogenic mimicry (VM) by upregulating VE-cadherin expression in esophageal squamous cell carcinoma (ESCC). METHODS: Esophageal squamous cancer cell lines Eca109 and TE13 were transfected with plasmids harboring small interfering RNAs targeting HIF-1? or VE-cadherin. The proliferation and invasion of esophageal carcinoma cells were detected by MTT and Transwell migration assays. The formation of tubular networks of cells was analyzed by 3D culture in vitro. BALB/c nude mice were used to observe xenograft tumor formation. The relationship between the expression of HIF-1? and VE-cadherin, ephrinA2 (EphA2) and laminin5?2 (LN5?2) was measured by Western blot and real-time polymerase chain reaction. RESULTS: Knockdown of HIF-1? inhibited cell proliferation (32.3% ± 6.1% for Eca109 cells and 38.6% ± 6.8% for TE13 cells, P < 0.05). Both Eca109 and TE13 cells formed typical tubular networks. The number of tubular networks markedly decreased when HIF-1? or VE-cadherin was knocked down. Expression of VE-cadherin, EphA2 and LN5?2 was dramatically inhibited, but the expression of matrix metalloproteinase 2 had no obvious change in HIF-1?-silenced cells. Knockdown of VE-cadherin significantly decreased expression of both EphA2 and LN5?2 (P < 0.05), while HIF-1? expression was unchanged. The time for xenograft tumor formation was 6 ± 1.2 d for Eca109 cells and Eca109 cells transfected with HIF-1? Neo control short hairpin RNA (shRNA) vector, and 8.4 ± 2.1 d for Eca109 cells transfected with an shRNA against HIF-1?. Knockdown of HIF-1? inhibited vasculogenic mimicry (VM) and tumorigenicity in vivo. CONCLUSION: HIF-1? may modulate VM in ESCC by regulating VE-cadherin expression, which affects VM formation through EphA2 and LN5?2.

Tang, Na-Na; Zhu, Hong; Zhang, Hong-Jie; Zhang, Wei-Feng; Jin, Hai-Lin; Wang, Lu; Wang, Pin; He, Gui-Jun; Hao, Bo; Shi, Rui-Hua

2014-01-01

295

Molecular Pathways: Vasculogenic Mimicry in Tumor Cells: Diagnostic and Therapeutic Implications  

PubMed Central

Tumor cell vasculogenic mimicry (VM) describes the functional plasticity of aggressive cancer cells forming de novo vascular networks, thereby providing a perfusion pathway for rapidly growing tumors -- transporting fluid from leaky vessels and/or connecting with endothelial-lined vasculature. The underlying induction of VM appears to be related to hypoxia, which may also promote the plastic, transendothelial phenotype of tumor cells capable of VM. Since its introduction in 1999 as a novel paradigm for melanoma tumor perfusion, many studies have contributed new insights into the underlying molecular pathways supporting VM in a variety of tumors, including melanoma, glioblastoma, carcinomas, and sarcomas. In particular, critical VM modulating genes are associated with vascular (VE-cadherin, EphA2, VEGFR1), embryonic/stem cell (Nodal, Notch4), and hypoxia-related (HIF, Twist1) signaling pathways. Each of these pathways warrants serious scrutiny as potential therapeutic, vascular targets and diagnostic indicators of plasticity, drug resistance and the aggressive metastatic phenotype. PMID:22474319

Kirschmann, Dawn A.; Seftor, Elisabeth A.; Hardy, Katharine M.; Seftor, Richard E.B.; Hendrix, Mary J.C.

2012-01-01

296

Revisiting cardiovascular regeneration with bone marrow-derived angiogenic and vasculogenic cells  

PubMed Central

Cell-based therapy has emerged as a promising therapy for cardiovascular disease. Particularly, bone marrow (BM)-derived cells have been most extensively investigated and have shown encouraging results in preclinical studies. Clinical trials, however, have demonstrated split results in post-myocardial infarction cardiac repair. Mechanistically, transdifferentiation of BM-derived cells into cardiovascular tissue demonstrated by earlier studies is now known to play a minor role in functional recovery, and humoral and paracrine effects turned out to be main mechanisms responsible for tissue regeneration and functional recovery. With this advancement in the mechanistic insight of BM-derived cells, new efforts have been made to identify cell population, which can be readily isolated and obtained in sufficient quantity without mobilization and have higher therapeutic potential. Recently, haematopoietic CD31+ cells, which are more prevalent in bone marrow and peripheral blood, have been revealed to have angiogenic and vasculogenic activities and strong potential for therapeutic neovascularization in ischaemic tissues. This article will cover the recent advances in BM-derived cell-based therapy and implication of CD31+ cells. LINKED ARTICLES This article is part of a themed section on Regenerative Medicine and Pharmacology: A Look to the Future. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2013.169.issue-2 PMID:22250888

Lee, Sangho; Yoon, Young-sup

2013-01-01

297

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

298

The Impact of Mental Illness on Sexual Dysfunction  

Microsoft Academic Search

Sexual dysfunction is prevalent among psychiatric patients and may be related to both the psychopathology and the pharmacotherapy. The negative symptoms of schizophrenia limit the capability for interpersonal and sexual relationships. The first-generation antipsychotics cause further deterioration in erectile and orgasmic function. Due to their weak antagonistic activity at D2 receptors, second-generation antipsychotics are associated with fewer sexual side effects,

Zvi Zemishlany; Abraham Weizman

2008-01-01

299

A new herbal combination, Etana, for enhancing erectile function: an efficacy and safety study in animals.  

PubMed

We present herein a new herbal combination called Etana that is composed of five herbal extracts including Panax quinquelotius (Ginseng), Eurycoma longifolia (Tongkat Ali), Epimedium grandiflorum (Horny goat weed), Centella asiatica (Gotu Kola) and flower pollen extracts. Most of the above-mentioned extracts have a long historical and traditional use for erectile dysfunction (ED). On the basis of the mechanism of action of each of the above, a combination is introduced to overcome several physiological or induced factors of ED. This study was conducted to show an enhancement of erectile function in male rats. The animals were observed for 3 h after each administration for penile erection, genital grooming and copulation mounting, and the penile erection index (PEI) was calculated. The maximum response was observed at the concentration of 7.5 mg kg(-1) of Etana. At a 7.5 mg kg(-1) single dose, the percentage of responding rats was 53+/-7 with a PEI of 337+/-72 compared with 17+/-6 with a PEI of 30+/-10 for control animals. This PEI was significantly (P<0.001) higher than each single component and than the sum of any two herbal components of Etana. When compared with sildenafil citrate, Etana induced more pronounced PEI than 0.36 mg kg(-1), but similar to 0.71 mg kg(-1) of sildenafil. Furthermore, full acute and sub-acute toxicity studies showed no toxic effects of Etana. In conclusion, this study describes a new and safe combination of herbal components that enhance erectile function in male rats. Clinical studies are warranted for evaluating Etana's significance in ED. PMID:19494825

Qinna, N; Taha, H; Matalka, K Z; Badwan, A A

2009-01-01

300

Association between renal function, erectile function and coronary artery disease: Detection with coronary angiography  

PubMed Central

Purpose Many patients admitted for acute myocardial infarction (AMI) have chronic renal insufficiency and erectile dysfunction (ED). This study aimed to evaluate the relationship between ED and the glomerular filtration rate (GFR) in patients with coronary artery disease. Materials and Methods We studied 183 patients undergoing coronary angiography owing to AMI. The GFR was calculated and the International Index of Erectile Function-5 (IIEF-5) was used to evaluate ED. The relations between erectile function, GFR, and the number of occluded coronary arteries were evaluated. Results Of 183 patients with a mean age of 55.2±11.16 years who underwent coronary angiography owing to AMI, 100 (54.64%) had ED. The ED rate was 45.36% (44/97) in patients with single-vessel disease, 64.5% (31/48) in patients with two-vessel disease, and 65.7% (25/38) in patients with three-vessel disease. The ED rate in patients with single-vessel disease was significantly lower than in the other groups (p<0.001). The mean IIEF scores were 24.2±4.3, 20.4±4.9, and 20.5±4.2 in the three groups, respectively (p<0.001). Mean GFRs were similar in patients with single-vessel disease, two-vessel disease, and three-vessel disease (128.2±46.8, 130.8±70.9, and 110.8±44.6, respectively, p=0.171). The GFR was significantly lower in the presence of ED only for single-vessel disease (p=0.001). Conclusions This study confirmed that the presence and severity of ED are linked to the number of occluded vessels as documented by coronary angiography. The presence of ED and reduced GFR are associated with single-vessel coronary artery disease. This relationship can be used to predict the likelihood of coronary artery disease. PMID:25598940

Canat, Masum; Guner, Bayram; Gurbuz, Cenk; Ca?kurlu, Turhan

2015-01-01

301

Male sexual dysfunction and HIV--a clinical perspective.  

PubMed

Sexual dysfunction in men with HIV is often overlooked by clinicians owing to many factors, including the taboo of sexuality. The improved life expectancy of patients with HIV requires physicians to consider their general wellbeing and sexual health with a renewed interest. However, data on sexual dysfunction in those with HIV are scarce. Erectile dysfunction (ED) is the most common sexual dysfunction in men, with a prevalence of ?30-50% and is frequent even in men <40 years of age. HIV infection itself is the strongest predictor of ED, and many factors related to the infection-fear of virus transmission, changes in body image, HIV-related comorbidities, infection stigma, obligatory condom use-all impair erectile function. The diagnosis and treatment of sexual dysfunction is based on a multidisciplinary approach, which involves specialists in both infectious diseases and sexual medicine. Particular attention should be paid to the promotion of safer sex in these patients. This Review, describes the issues surrounding sexual dysfunction in men with HIV and aims to provide clinical advice for the physician treating these patients. PMID:24394405

Santi, Daniele; Brigante, Giulia; Zona, Stefano; Guaraldi, Giovanni; Rochira, Vincenzo

2014-02-01

302

Frequency of sexual problems and sexual dysfunction in middle-aged Danish men  

Microsoft Academic Search

The frequency of sexual dysfunction of a representative group of Danish middle-aged men was recorded, using a questionnaire and an interview that contained, respectively, 12 and 23 questions about sexual problems. The study sample consisted of 439 51-year-old men, all of whom received the questionnaire. Of these men, 100 were also interviewed. Interviewed men more frequently reported erectile dysfunction and

Kim Solstad; Preben Hertoft

1993-01-01

303

Cilengitide downmodulates invasiveness and vasculogenic mimicry of neuropilin 1 expressing melanoma cells through the inhibition of ?v?5 integrin.  

PubMed

During melanoma progression, tumour cells show increased adhesiveness to the vascular wall, invade the extracellular matrix (ECM) and frequently form functional channels similar to vascular vessels (vasculogenic mimicry). These properties are mainly mediated by the interaction of integrins with ECM components. Since we had previously identified neuropilin 1 (NRP-1), a coreceptor of vascular endothelial growth factor A (VEGF-A), as an important determinant of melanoma aggressiveness, aims of this study were to identify the specific integrins involved in the highly invasive phenotype of NRP-1 expressing cells and to investigate their role as targets to counteract melanoma progression. Melanoma aggressiveness was evaluated in vitro as cell ability to migrate through an ECM layer and to form tubule-like structures using transfected cells. Integrins relevant to these processes were identified using specific blocking antibodies. The ?v?5 integrin was found to be responsible for about 80% of the capability of NRP-1 expressing cells to adhere on vitronectin. In these cells ?v?5 expression level was twice higher than in low-invasive control cells and contributed to the ability of melanoma cells to form tubule-like structures on matrigel. Cilengitide, a potent inhibitor of ?? integrins activation, reduced ECM invasion, vasculogenic mimicry and secretion of VEGF-A and metalloproteinase 9 by melanoma cells. In conclusion, we demonstrated that ???5 integrin is involved in the highly aggressive phenotype of melanoma cells expressing NRP-1. Moreover, we identified a novel mechanism that contributes to the antimelanoma activity of the ?v integrin inhibitor cilengitide based on the inhibition of vasculogenic mimicry. PMID:25284767

Ruffini, Federica; Graziani, Grazia; Levati, Lauretta; Tentori, Lucio; D'Atri, Stefania; Lacal, Pedro M

2015-03-15

304

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

305

Nicotinamide inhibits vasculogenic mimicry, an alternative vascularization pathway observed in highly aggressive melanoma.  

PubMed

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

Itzhaki, Orit; Greenberg, Eyal; 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

306

ROCK Is Involved in Vasculogenic Mimicry Formation in Hepatocellular Carcinoma Cell Line  

PubMed Central

Ras homolog family member A (RhoA) and Rho-associated coiled coil-containing protein kinases 1 and 2 (ROCK1 and 2) are key regulators of focal adhesion, actomyosin contraction and cell motility. RhoA/ROCK signaling has emerged as an attractive target for the development of new cancer therapeutics. Whether RhoA/ROCK is involved in regulating the formation of tumor cell vasculogenic mimicry (VM) is largely unknown. To confirm this hypothesis, we performed in vitro experiments using hepatocellular carcinoma (HCC) cell lines. Firstly, we demonstrated that HCC cells with higher active RhoA/ROCK expression were prone to form VM channels, as compared with RhoA/ROCK low-expressing cells. Furthermore, Y27632 (a specific inhibitor of ROCK) rather than exoenzyme C3 (a specific inhibitor of RhoA) effectively inhibited the formation of tubular network structures in a dose-dependent manner. To elucidate the possible mechanism of ROCK on VM formation, real-time qPCR, western blot and immunofluorescence were used to detect changes of the key VM-related factors, including VE-cadherin, erythropoietin-producing hepatocellular carcinoma-A2 (EphA2), phosphoinositide 3-kinase (PI3K), matrix metalloproteinase (MMP)14, MMP2, MMP9 and laminin 5?2-chain (LAMC2), and epithelial-mesenchymal-transition (EMT) markers: E-cadherin and Vimentin. The results showed that all the expression profiles were attenuated by blockage of ROCK. In addition, in vitro cell migration and invasion assays showed that Y27632 inhibited the migration and invasion capacity of HCC cell lines in a dose-dependent manner markedly. These data indicate that ROCK is an important mediator in the formation of tumor cell VM, and suggest that ROCK inhibition may prove useful in the treatment of VM in HCC. PMID:25238232

Zhang, Qi-Di; Gu, Sheng-Ying; Wu, Xin; Zhu, Guan-Hua; Li, Qin; Liu, Gao-Lin

2014-01-01

307

Vasculogenic mimicry is a prognostic factor for postoperative survival in patients with glioblastoma.  

PubMed

A previous report has confirmed the existence and clinical significance of vasculogenic mimicry (VM) in glioma. However, its conclusions about the negative clinical significance of VM in glioblastoma are based on a small group of patients and, thus, might be unconvincing. The aim of the present study was to reevaluate the clinical significance of VM in glioblastoma. Patients were classified as VM-positive or VM-negative according to CD34 and periodic acid-Schiff staining. The association between VM and the clinical characteristics of the patients was analyzed. Univariate and multivariate analyses were carried out to identify the independent prognostic factors for overall survival using the Cox regression hazard model. Survival times were estimated using the Kaplan-Meier method and compared using the log-rank test. Of all 86 glioblastomas, 23 were found to have VM. The presence of VM in glioblastoma was not associated with gender, age, Karnofsky performance status, hydrocephalus, tumor burden, microvessel density, tumor relapse, or the extent of tumor resection. The univariate and multivariate analyses revealed that VM is an independent prognostic factor for overall survival. The median survival time for patients with VM was 11.17 months compared with 16.10 months for those without VM (P = 0.017). In addition to VM, an age of 65 years or older, a KPS of 60 or less, a large tumor burden are significant prognostic factors for patient survival. Our data suggest that VM might be an independent adverse prognostic factor in newly diagnosed GBM, further prospective studies are needed to answer this question. PMID:23417321

Wang, Shi-Yong; Ke, Yi-Quan; Lu, Guo-Hui; Song, Zhen-Hua; Yu, Li; Xiao, Sha; Sun, Xin-Lin; Jiang, Xiao-Dan; Yang, Zhi-Lin; Hu, Chang-Chen

2013-05-01

308

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)

2007-03-01

309

Human peripheral blood-derived CD31+ cells have robust angiogenic and vasculogenic properties and are effective for treating ischemic vascular disease  

PubMed Central

Objectives This study aimed to determine if CD31 is a novel marker of a circulating angio-vasculogenic cell population and to establish their therapeutic effects on experimental ischemia. Background Emerging evidence suggested that therapeutic mechanisms underlying various bone marrow (BM)-derived cells are due to paracrine effects. Furthermore, the vasculogenic potential of these cells is under debate. CD31 is a well known marker for endothelial cells (ECs) but is also expressed in a fraction of peripheral blood (PB) mononuclear cells. Methods CD31+ cells were isolated from human PB by magnetic-activated cell sorting (MACS). The gene expression profile was examined by DNA microarray and real-time RT-PCR (qRT-PCR). Various in vitro endothelial differentiation or vasculogenic assays were conducted. Finally, cells were directly implanted into a mouse hindlimb ischemia (HLI) model to test angiogenic-vasculogenic and therapeutic effects. Results Fluorescent-activated cell sorter (FACS) analysis revealed that PB-CD31+ cells exhibited endothelial and hematopoietic stem/progenitor markers. CD31+ cells had higher levels of expression of pro-angiogenic genes on microarray and qRT-PCR and generated higher numbers of endothelial progenitor cells (EPCs) compared to CD31? cells. CD31+ cells spontaneously formed vascular tube-like structures and exhibited an endothelial cell phenotype in vitro. In a HLI model, CD31+ cell transplantation augmented blood perfusion and prevented limb loss. Both angiogenic cytokines and capillary density were increased, suggesting CD31+ cells augmented neovascularization. Conclusions CD31 is a novel marker that designates circulating angiogenic and vasculogenic cells. These cells are easily isolated from human PB and thus are a novel candidate for treatment of ischemic cardiovascular disease. PMID:20688215

Kim, Sung-Whan; Kim, Hyongbum; Cho, Hyun-Jai; Lee, Jung-Uek; Levit, Rebecca; Yoon, Young-sup

2010-01-01

310

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

311

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

312

Management of sexual dysfunction in Parkinson’s disease  

PubMed Central

Nonmotor symptoms, among them sexual dysfunction, are common and underrecognized in patients with Parkinson disease; they play a major role in the deterioration of quality of life of patients and their partners. Loss of desire and dissatisfaction with their sexual life is encountered in both genders. Hypersexuality (HS), erectile dysfunction and problems with ejaculation are found in male patients, and loss of lubrication and involuntary urination during sex are found in female patients. Tremor, hypomimia, muscle rigidity, bradykinesia, ‘clumsiness’ in fine motor control, dyskinesias, hypersalivation and sweating may interfere with sexual function. Optimal dopaminergic treatment should facilitate sexual encounters of the couple. Appropriate counselling diminishes some of the problems (reluctance to engage in sex, problems with ejaculation, lubrication and urinary incontinence). Treatment of erectile dysfunction with sildenafil and apomorphine is evidence based. HS or compulsive sexual behaviour are side effects of dopaminergic therapy, particularly by dopaminergic agonists, and should be treated primarily by diminishing their dose. Neurologists should actively investigate sexual dysfunction in their Parkinsonian patients and offer treatment, optimally within a multidisciplinary team, where a dedicated professional would deal with sexual counselling. PMID:22164191

Vodušek, David B.

2011-01-01

313

Vasculogenic Mimicry of HT1080 Tumour Cells In Vivo: Critical Role of HIF-1?-Neuropilin-1 Axis  

PubMed Central

HT1080 - a human fibrosarcoma-derived cell line – forms aggressive angiogenic tumours in immuno-compromised mice. In spite of its extensive use as a model of tumour angiogenesis, the molecular event(s) initiating the angiogenic program in these cells are not known. Since hypoxia stimulates tumour angiogenesis, we examined the hypoxia-induced events evoked in these cells. In contrast to cells grown under normoxic conditions, hypoxia-primed (1% O2) HT1080 cells formed robust tubules on growth factor-reduced matrigel and formed significantly larger tumours in xenograft models in a chetomin-sensitive manner, indicating the role of HIF-1?-mediated transcription in these processes. Immuno-histochemical analyses of tumours formed by GFP-expressing HT1080 cells clearly showed that the tumour cells themselves expressed various angiogenic markers including Neuropilin-1 (NRP-1) and formed functional vessels containing red blood cells, thereby unambiguously demonstrating the vasculogenic mimicry of HT1080 cells in vivo. Experiments performed with the HT1080 cells stably transfected with plasmid constructs expressing shNRP-1 or full-length NRP-1 clearly established that the HIF1?-mediated up-regulation of NRP-1 played a deterministic role in the process. Hypoxia-exposure resulted in an up-regulation of c-Myc and OCT3/4 and a down-regulation of KLF4 mRNAs, suggesting their involvement in the tumour formation and angiogenesis. However, silencing of NRP-1 alone, though not affecting proliferation in culture, was sufficient to abrogate the tumour formation completely; clearly establishing that the hypoxia-mediated HIF-1?-dependent up-regulation of NRP-1 is a critical molecular event involved in the vasculogenic mimicry and tumor formation by HT1080 cells in vivo. PMID:23185562

Misra, Roli M.; Bajaj, Manmohan S.; Kale, Vaijayanti P.

2012-01-01

314

Does erectile tissue angioarchitecture modify with aging? An immunohistological and morphometric approach.  

PubMed

Introduction. Erectile dysfunction is a common problem in aged men; however, which vascular cavernosal alterations occur with age progression remain unclarified. Aim. Using cavernosal tissue from rats of various ages, we aimed to thoroughly assess erectile vascular-associated morphologic, immunohistological, and morphometric alterations during aging. Methods. Male Wistar rats were divided according to age in groups of 2, 6, 12, 18, 24 months old (N = 5). Cavernosal tissue of all groups was collected and processed for morphologic evaluation, immunodetection of alpha-smooth muscle actin and von Willebrand factor and morphometric quantification of vascular and smooth muscle cell (SMC) areas. Main Outcome Measures. The morphometric assessment of age-related alterations in cavernosal vascular and SMCs using the ImageJ image-processing program. Results. Morphologic and immunohistological evaluation showed a similar structure of erectile tissue among all age groups, divided in two cavernosal bodies containing numerous sinusoidal vascular spaces surrounded by SMCs. Additionally, we observed a reduction of SMC content and an increase in the caliber of vascular spaces, with aging. This was confirmed by the morphometric quantification of the vascular and SMC areas (mean area x10(3) microm(2) +/- x10(3) standard error). Two-month-old animals had a mean vascular area of 4.21 +/- 0.51, approximately 3.5-fold less than the 6-month-old group. The differences increased when comparing the youngest groups with the 12-, 18-, and 24-month-old animals, with mean measurements of 18.99 +/- 1.91, 25.23 +/- 2.76, and 26.34 +/- 2.97. Conversely, SMC areas progressively decreased between 2- and 6-month-old animals, from 6.75 +/- 0.90 to 6.38 +/- 1.24. The elderly 12-, 18-, and 24-month-old groups presented an approximated 1.5-fold reduction on SMCs area, showed by the respective measurements of 4.11 +/- 0.50, 4.01 +/- 0.35, and 4.02 +/- 0.44. Conclusions. We demonstrated that cavernosal angioarchitecture was modified with aging. The decrease in SMCs and the considerable enlargement of vascular lumens may limit the basic function of penile vascular tree in the elderly. PMID:18221283

Costa, Carla; Vendeira, Pedro

2008-04-01

315

Gustatory dysfunction  

PubMed Central

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.

2014-01-01

316

Curcumin suppresses invasiveness and vasculogenic mimicry of squamous cell carcinoma of the larynx through the inhibition of JAK-2/STAT-3 signaling pathway  

PubMed Central

To determine the role of JAK-2/STAT-3 signaling pathway in invasion and vasculogenic mimicry of laryngeal squamous cell carcinoma. HEp-2 cells were treated with 1 or 10 ?mol/L curcumin and AG490 (the inhibitor of JAK-2) for 48 h, the invasion and vasculogenic mimicry of tumor cells were tested with Transwell chamber test and tube formation experiment. RT-PCR was used to measure the expression of MMP-2 and VEGF. Western blot assay was employed to determine the expression of JAK-2, STAT3, p-STAT3, MMP-2 and VEGF. Compared to control group?there were less tumor cells permeating membrane and less formed tubes after curcumin or AG490 treatment, RT-PCR showed that the expression of MMP-2 and VEGF at mRNA level were decreased (P < 0.01). Western blotting indicated that the expression of JAK-2, p-STAT3, MMP-2 and VEGF at protein levels were decreased (P < 0.01), while that of STAT-3 protein had no difference among each group (P > 0.05). Immunofluorescence staining demonstrated that the expression of eNOS was down-regulated (P < 0.01). Curcumin and AG490 significantly inhibits invasion and vasculogenic mimicry of laryngeal squamous cell carcinoma in vitro, and JAK-2/STAT-3 signaling pathway promotes above processes.

Hu, An; Huang, Jing-Juan; Jin, Xiao-Jie; Li, Ji-Ping; Tang, Yuan-Jia; Huang, Xin-Fang; Cui, Hui-Juan; Xu, Wei-Hua; Sun, Guang-Bin

2015-01-01

317

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; ?ahin, Ali; Ozcift, Burak; Pekta?, Abdulkadir; Turan, Tahir; Gümü?, Bilal H; Can, Ertan; Bolukbasi, Ahmet; Erol, Haluk; Esen, Adil

2013-01-01

318

Excess adenosine in murine penile erectile tissues contributes to priapism via A2B adenosine receptor signaling  

PubMed Central

Priapism, abnormally prolonged penile erection in the absence of sexual excitation, is associated with ischemia-mediated erectile tissue damage and subsequent erectile dysfunction. It is common among males with sickle cell disease (SCD), and SCD transgenic mice are an accepted model of the disorder. Current strategies to manage priapism suffer from a poor fundamental understanding of the molecular mechanisms underlying the disorder. Here we report that mice lacking adenosine deaminase (ADA), an enzyme necessary for the breakdown of adenosine, displayed unexpected priapic activity. ADA enzyme therapy successfully corrected the priapic activity both in vivo and in vitro, suggesting that it was dependent on elevated adenosine levels. Further genetic and pharmacologic evidence demonstrated that A2B adenosine receptor–mediated (A2BR-mediated) cAMP and cGMP induction was required for elevated adenosine–induced prolonged penile erection. Finally, priapic activity in SCD transgenic mice was also caused by elevated adenosine levels and A2BR activation. Thus, we have shown that excessive adenosine accumulation in the penis contributes to priapism through increased A2BR signaling in both Ada–/– and SCD transgenic mice. These findings provide insight regarding the molecular basis of priapism and suggest that strategies to either reduce adenosine or block A2BR activation may prove beneficial in the treatment of this disorder. PMID:18340377

Mi, Tiejuan; Abbasi, Shahrzad; Zhang, Hong; Uray, Karen; Chunn, Janci L.; Xia, Ling Wei; Molina, Jose G.; Weisbrodt, Norman W.; Kellems, Rodney E.; Blackburn, Michael R.; Xia, Yang

2008-01-01

319

Incidence and prevalence of the sexual dysfunctions: A critical review of the empirical literature  

Microsoft Academic Search

The research which has assessed the incidence and prevalence of sexual dysfunctions is reviewed. Twenty-three studies are evaluated. Studies completed with community samples indicate a current prevalence of 5–10% for inhibited female orgasm, 4–9% for male erectile disorder, 4–10% for inhibited male orgasm, and 36–38% for premature ejaculation. Stable community estimates with regard to the current prevalence of female sexual

Ilana P. Spector; Michael P. Carey

1990-01-01

320

Analysis of Erectile Responses to Imatinib in the Rat  

PubMed Central

OBJECTIVE To investigate the erectile and cardiovascular responses to the tyrosine kinase inhibitor imatinib in the rat. MATERIALS AND METHODS The effect of intracavernosal injection of imatinib on the intracavernosal pressure (ICP), ICP/mean arterial pressure (MAP) ratio, area under the curve, and duration of the increase in ICP and the effect of intravenous injection of imatinib on the MAP, cardiac output, and total peripheral resistance were investigated. The effect of the nitric oxide synthase inhibitor NG-nitro-L-arginine methyl ester on the responses to imatinib was investigated. RESULTS Intracavernosal injection of imatinib produced significant dose-related increases in the ICP, ICP/MAP ratio, area under the curve, and duration of the increase in ICP and decreases in the MAP. The erectile responses to imatinib were rapid in onset and short in duration. The erectile responses to imatinib were not significantly altered by NG-nitro-L-arginine methyl ester or cavernosal nerve crush injury, and imatinib was significantly less potent than the nitric oxide donor sodium nitroprusside in inducing erection. Intravenous injection of imatinib produced significant dose-related decreases in the MAP without significantly changing the cardiac output, and imatinib was significantly less potent than sodium nitroprusside in decreasing the MAP. Systemic vascular resistance was decreased in a significant dose-related manner, and the vaso-dilator responses to imatinib were not altered by NG-nitro-L-arginine methyl ester. CONCLUSION The present results have indicated that imatinib has significant erectile and systemic vasodilator activity in the rat that is not dependent on nitric oxide release. Another tyrosine kinase inhibitor, nilotinib, also increased the ICP and decreased the MAP in the rat. These data suggest that tyrosine kinases might play a constitutive role in maintaining penile tumescence and the baseline vasoconstrictor tone in the peripheral vascular bed. PMID:23806406

Pankey, Edward A.; Lasker, George F.; Gur, Serap; Hellstrom, Wayne J. G.; Kadowitz, Philip J.

2013-01-01

321

[Results of surgical therapy for venous insufficiency as a cause of erectile disorders].  

PubMed

Since penile vein ligation is usually associated with a poor postoperative outcome, a study was undertaken to evaluate possible prognostic factors for this procedure. A total of 44 patients with erectile dysfunction underwent ligation of all dorsal penile veins and resection of the deep dorsal penile vein for venous impotence. A comprehensive study of all patients was made. All patients did not respond to pharmacotherapy and had a venous leak. With a minimum follow-up period of 6 months, patients were categorized as follows: full spontaneous erections, those patients responding to pharmacotherapy and those showing no improvement. Out of 44 patients, 13 had full spontaneous erections postoperatively, 5 now responded to pharmacotherapy and 26 showed no improvement. The maintenance flow was 89 +/- 50 ml/min in the group with spontaneous erections and 85 +/- 49 ml/min in those showing no improvement (P = 0.78). Out of the 20 patients with normal single potential analysis of cavernous electric activity (SPACE), 12 had full erections postoperatively, 4 showed no improvement and 4 responded to pharmacotherapy. Of the 24 patients with abnormal SPACE, 1 developed full erections, 1 now responds to pharmacotherapy and 22 showed no improvement. Our results indicate that SPACE seems to be an important prognostic factor for the postoperative outcome of penile vein ligations for venous impotence. PMID:8372413

Djamilian, M; Freymann, H; Thon, W F; Krah, H; Schlik, R; Stief, C G; Jonas, J

1993-07-01

322

Sexual Dysfunction and Infertility  

MedlinePLUS

... asrm.org PATIENT FACT SHEET Sexual Dysfunction and Infertility You probably don't realize how many people ... talk to a sex therapist. Sexual dysfunction and infertility Sexual dysfunction may cause problems getting pregnant (infertility). ...

323

Pyrazolopyrimidines in 'all-natural' products for erectile dysfunction treatment: the unreliable quality of dietary supplements.  

PubMed

A herbal food supplement advertised as a potency pill was screened for the presence of PDE5 inhibitors. The resulting signals were characterised by UV, LC-MS in ESI-negative mode, and NMR spectroscopy using 1D and 2D experiments. Several substances were identified, bearing the basic chemical structure of sildenafil, but were not supposed to exhibit PDE5 inhibition. These compounds may be process-related impurities or by-products of different reaction steps in the synthesis of PDE5 analogues. As they were found to be present in different capsules at different concentrations, this is an example of the unreliable quality of dietary supplements. PMID:25517174

Schramek, Nicholas; Wollein, Uwe; Eisenreich, Wolfgang

2015-02-01

324

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

E-print Network

. Some can lead to ED, such as high blood pressure diabetes, when your blood glucose, also called blood sugar, is too high clogged arteries heart and blood vessel disease chronic kidney disease multiple

Baker, Chris I.

325

[Cardiovascular-protective effect of tadalafil in the treatment of erectile dysfunction].  

PubMed

The enzyme phosphodiesterase-5 (PDE-5), widely distributed in the heart, smooth muscle, and blood vessels, catalyzes the hydrolysis of cyclic guanosine monophosphate (cGMP), a potent vasodilator, and is also a nitric oxide (NO) donor. Tadalafil is the first PDE 5 inhibitor approved by FDA for the treatment of ED. Recent studies have shown several pleiotropic beneficial effects of PDE-5 inhibitors in patients with cardiovascular diseases (coronary heart disease, hypertension, heart failure, and pulmonary arterial hypertension) and diabetes mellitus. It has been demonstrated that tadalafil can not only improve sexual function, but also elevate the endothelial cell-derived NO level, activate protein kinase A, upregulate the intracellular Ca2+ concentration, and improve hemodynamic indexes. Thus, the PDE-5 inhibitor tadalafil, with its cardiovascular-protective effect, can be a therapeutic option for the treatment of ED patients with cardiovascular disease. PMID:24432631

Liu, Yuan

2013-12-01

326

Chronic High Dose Intraperitoneal Bisphenol A (BPA) Induces Substantial Histological and Gene Expression Alterations in Rat Penile Tissue Without Impairing Erectile Function  

PubMed Central

Introduction Bisphenol A (BPA), released from plastics and dental sealants, is a suspected endocrine disruptor and reproductive toxicant. In occupationally exposed workers, BPA has been associated with erectile dysfunction (ED). Aims To determine whether long-term exposure to high doses of BPA in the rat affects serum levels of testosterone (T) and estradiol (E2), and induces corporal histopathology and resultant ED. Methods Young rats were injected intraperitoneal (IP) injection daily with BPA at 25 mg/kg/day or vehicle (n = 8/group). Erectile function was measured at 3 months by cavernosometry and electrical field stimulation (EFS). BPA was assayed in serum, urine, and penile tissue, and serum T and E2 were determined. Quantitative Masson trichrome, terminal deoxynucleotidyl transferase dUTP nick end labeling, Oil Red O, immunohistochemistry for calponin, ?-smooth muscle actin, and Oct 4 were applied to penile tissue sections. Protein markers were assessed by Western blots and 2–D minigels, and RNA by DNA microarrays. Main Outcome Measures Erectile function, histological, and biochemical markers in corporal tissue. Results In the BPA-treated rats, total and free BPA levels were increased in the serum, urine, and penile tissue while serum T and E2 levels were reduced. In addition, the corpora cavernosa demonstrated a reduction in smooth muscle (SM) content, SM/collagen ratio, together with an increase in myofibroblasts, fat deposits, and apoptosis, but no significant change in collagen content or stem cells (nuclear/perinuclear Oct 4). In the penile shaft, BPA induced a downregulation of Nanog (stem cells), neuronal nitric oxide synthase (nitrergic terminals), and vascular endothelial growth factor (angiogenesis), with genes related to SM tone and cytoskeleton upregulated 5- to 50-fold, accompanied by changes in the multiple protein profile. However, both cavernosometry and EFS were unaltered by BPA. Conclusions While rats treated chronically with a high IP dose of BPA developed hypogonadism and a corporal histo- and molecular-pathology usually associated with ED, no changes were detected in erectile function as measured by EFS and cavernosometry. Further studies using alternate routes of BPA administration with various doses and length of exposure are needed to expand these findings. Kovanecz I, Gelfand R, Masouminia M, Gharib S, Segura D, Vernet D, Rajfer J, Li DK, Liao CY, Kannan K, and Gonzalez-Cadavid NF. Chronic high dose intraperitoneal bisphenol A (BPA) induces substantial histological and gene expression alterations in rat penile tissue without impairing erectile function. PMID:24134786

Kovanecz, Istvan; Gelfand, Robert; Masouminia, Maryam; Gharib, Sahir; Segura, Denesse; Vernet, Dolores; Rajfer, Jacob; Li, De-Kun; Liao, Chun Yang; Kannan, Kurunthachalam; Gonzalez-Cadavid, Nestor F.

2014-01-01

327

Abanoquil, a new alpha-1 adrenoceptor antagonist. In vitro and in vivo effect on erectile tissue  

Microsoft Academic Search

Using an organ bath model with porcine cavernosal tissue strips and an in vivo monkey model we demonstrated that abanoquil, a novel alpha adrenoceptor antagonist, is able to relax contracted tissue strips and induce erectile response when injected intracorporally. The erectile response in the monkeys was not dose-related and compared to the effect of papaverine injections, abanoquil induced a lower

A Giraldi; M Wyllie; G Wagner

2000-01-01

328

The incidence and correlates of erectile problems in patients with Alzheimer's disease  

Microsoft Academic Search

Loss of erection was reported in 53% of 55 male Alzheimer's disease patients with a mean age of 70.25. Loss of erection is not related to degree of cognitive impairment, age, or depression. Modal time of onset of erectile problems is concurrent with onset of Alzheimer's symptoms. Patients with erectile problems were not taking more medications overall than those without

Antonette M. Zeiss; Helen D. Davies; Mary Wood; Jared R. Tinklenberg

1990-01-01

329

Epidermal growth factor/heat shock protein 27 pathway regulates vasculogenic mimicry activity of breast cancer stem/progenitor cells.  

PubMed

Tumor vascularization, which is mainly contributed by angiogenesis and vascularization, is necessary for tumor maintenance and progression. Vasculogenic mimicry (VM), vascular-like channels which are lack of the involvement of endothelial cells, has been observed in aggressive cancers and also involves in tumor vascularization. Breast cancer stem/progenitor cells (BCSCs) have been identified as a subpopulation of breast cancer cells with markers of CD24(-)CD44(+), high aldehyde dehydrogenase activity (ALDH(+)) or could be enriched by mammosphere cultivation. These cells have been proven to be associated with tumor vascularization. Here we investigated the molecular mechanisms in VM activity of BCSCs. By periodic acid-Schiff or hematoxylin-eosin stain, we found that there were VM structures in two xenografted human breast cancer tissues established from CD24(-)CD44(+) or ALDH(+) cells. Only ALDH(+) or mammosphere-forming BCSCs could form tube structures on matrigel-coated surface as similar as microvascular endothelial cells. Inhibition of the phosphorylation of epidermal growth factor receptor (EGFR) by gefitinib or knockdown of EGFR by lentiviral shRNA abolished the in vitro VM activity of BCSCs. By quercetin treatment, a plant flavonoid compound which is known to suppress heat shock proteins, or siRNA-mediated gene silencing, both Hsp27 expression and VM capability of BCSCs were suppressed. Forced expression of phosphor-mimic form of Hsp27 in ALDH(+) BCSCs could overcome the inhibitory effect of gefitinib. In conclusion, our data demonstrate that VM activity of BCSCs is mediated by EGF/Hsp27 signaling and targeting this pathway may benefit to breast cancer therapy. PMID:24950183

Lee, Che-Hsin; Wu, Yu-Ting; Hsieh, Hung-Chun; Yu, Yun; Yu, Alice L; Chang, Wen-Wei

2014-09-01

330

Doxycycline as an Inhibitor of the Epithelial-to-Mesenchymal Transition and Vasculogenic Mimicry in Hepatocellular Carcinoma.  

PubMed

This study was conducted to examine the effects of doxycycline on the survival time and proliferation of hepatocellular carcinoma (HCC) in vivo and on the biologic functions of HCC in vitro. This study was also designed to evaluate the effects of doxycycline on epithelial-to-mesenchymal transition (EMT)- and vasculogenic mimicry (VM)-related protein expression and on matrix metalloproteinase (MMP) and DNA methyltransferase (DNMT) activity in vitro. Human MHCC97H cells were injected into BALB/c mice, which were divided into treatment and control groups. Doxycycline treatment prolonged the mouse survival time and partly suppressed the growth of engrafted HCC tumor cells, with an inhibition rate of 43.39%. Higher amounts of VM and endothelium-dependent vessels were found in the control group than the treatment group. IHC indicated that epithelial (E)-cadherin expression was increased in the doxycycline-treated mice compared with the control group. In in vitro experiments, doxycycline promoted HCC cell adhesion but inhibited HCC cell viability, proliferation, migration, and invasion. Western blot analysis, semiquantitative RT-PCR, qRT-PCR, and immunofluorescence demonstrated that doxycycline inhibited the degradation of the epithelial marker E-cadherin and downregulated the expression levels of EMT promoters, the mesenchymal marker vimentin, and the VM-associated marker vascular endothelial (VE)-cadherin. Furthermore, the activities of MMPs and DNMTs were examined in different groups via gelatin zymography and a DNMT activity assay kit. A methylation-specific PCR was performed to assess the promoter methylation of CDH1 (the gene encoding E-cadherin). Doxycycline prolonged the mouse survival time by inhibiting EMT progression and VM formation. Mol Cancer Ther; 13(12); 3107-22. ©2014 AACR. PMID:25277383

Meng, Jie; Sun, Baocun; Zhao, Xiulan; Zhang, Danfang; Zhao, Xueming; Gu, Qiang; Dong, Xueyi; Zhao, Nan; Liu, Peimei; Liu, Yanrong

2014-12-01

331

Inhibitory effects of B-cell lymphoma 2 on the vasculogenic mimicry of hypoxic human glioma cells  

PubMed Central

The aim of this study was to investigate the mechanisms and effects of B-cell lymphoma 2 (Bcl-2) on the vasculogenic mimicry (VM) of human glioma cells. U87 cells were cultured under hypoxic conditions and then divided into four groups: Control, 3-(5-hydroxymethyl-2-furyl)-1-benzylindazole (YC-1), ABT-737 and YC-1 + ABT-737. These groups were treated with the corresponding simulators. The expression of hypoxia-inducible factor-1? (HIF-1?), matrix metalloproteinase (MMP)-2, MMP-14 and Bcl-2 in each group was determined using a reverse transcription-quantitative polymerase chain reaction and western blot analysis. Compared with that in the control group, the mRNA and protein expression of MMP-2, MMP-14 and Bcl-2 in the YC-1 and ABT-737 groups was significantly reduced. The expression of HIF-1?, however, was only significantly reduced in the YC-1 group (P<0.05). Compared with those in the YC-1 + ABT-737 group, the expression levels of the four proteins in the YC-1 and ABT-737 groups were not significantly different, with the exception of the expression of HIF-1? in the ABT-737 group, which was significantly enhanced (P<0.05). The mRNA expression levels of HIF-1?, MMP-2 and MMP-14 in the YC-1 group were significantly different from those in the ABT-737 group (P<0.01); however, no significant difference was observed in the expression of Bcl-2. In conclusion, Bcl-2 may be an important factor in the VM formation of human malignant glioma U87 cells under hypoxic conditions. Certain functions of Bcl-2 may be attributed to the HIF-1?-MMP-2-MMP-14-VM channel, whereas other functions may be independent of the channel.

LI, JIANWEN; KE, YIQUAN; HUANG, MIN; HUANG, SHUYUN; LIANG, YIMING

2015-01-01

332

PA01.55. Efficacy of ‘Ashwa’ capsule in male sexual dysfunction  

PubMed Central

Purpose: 1. Now a day's erectile dysfunction is very common Problem among The people and available measures or managament are not up to the mark & hence this disease still having ray of hope & Ayurveda could be the solution. 2. To put forth effect of Cap. Ashwa in such way to accept the medicine in the modern era. Method: Open Uncontrolled study with 30 Sample size of age group 24 70 years treated with Cap. Ashwa 1 gm BD with milk (Shatavari, Aswagandha, gokshur, Kronchbeej 250 mg each) Parameters assessed were subjective and haematological and tolerability and International Index of erectile function (IIEF) Result: Cap. Ashwa helps to significantly increase sexual desire, increase quality and sustainability of erection, increase intravaginal ejaculatory latency time & correct the premature ejaculation. No severe adverse effect was observed and the treatment was very well tolerated and safe. Conclusion: Cap. Ashwa is Very good for erectile dysfunction (66.70%) and very safe drug. It significantly increases intravaginal ejaculatory latency time. This clinical trial must be tested on more sample size, with Controlled and multicenteric level trial.

Padavi, D. M.; Rathod, Amarsing

2012-01-01

333

N-cadherin participated in invasion and metastasis of human esophageal squamous cell carcinoma via taking part in the formation of vasculogenic mimicry.  

PubMed

Vasculogenic mimicry (VM) refers to the unique ability of highly aggressive tumor cells to mimic the pattern of embryonic vasculogenic networks, and the presence of VM correlates to an increased risk of metastasis and poor clinical outcome of cancers. Several key molecules, including N-cadherin, have been implicated in VM. However, the role of N-cadherin in the formation of VM in esophageal squamous cell carcinoma (ESCC) had not been elucidated. In this study, firstly we aimed to identify VM patterns in ESCC tissues and to explore their clinical significance. VM was present in 12 out of 56 samples, and ESCC with lymph node metastasis had a higher incidence of VM than that without lymph node metastasis. More importantly, VM channels were associated with the expression of N-cadherin in ESCC tissues. In order to further explore the role of N-cadherin in VM formation and invasion and metastasis in ESCC, secondly, we silenced the expression of N-cadherin with small hairpin RNA in ESCC cell line KYSE-70; herein, we showed that KYSE-70 cells with N-cadherin silencing lost not only the capacity to form tube-like structures on collagen (VM) but also the invasion, metastasis and proliferation ability in KYSE-70 cells in vitro. Taken together, antivascular therapies targeting tumor cell VM may be an effective approach to the treatment of patients with highly metastatic ESCC. PMID:25575439

Wang, Feng; Li, Xiang-Ke; Xu, Hong-Yan; Shan, Zheng-Zheng; Wang, Tao; Yang, Zi-Chang; He, Wei; Wang, Liu-Xing; Fan, Qing-Xia

2015-02-01

334

Sexual dysfunction (K?cchra Vyav?ya) in obesity (Sthaulya): Validation by an observational study  

PubMed Central

Objective: The present study intends to evaluate the relationship between Sthaulya (obesity) and K?cchra Vyav?ya (sexual dysfunction) with respect to different phases of sexual intercourse through a single-centered, observational study in male patients of obesity. Materials and Methods: The study involved 33 obese males from the outpatient department of the Institution whose sexual functioning was assessed using an International Index of Erectile Function questionnaire, which was meant to assess five specific areas of sexual functioning. Results: A varying degree of sexual dysfunction was observed in four out of five areas of sexual functioning viz. erectile function (P < 0.02), orgasmic function (P < 0.02), sexual desire (P < 0.08), and overall satisfaction (P < 0.000) in obese individuals. Statistically significant dysfunction was not observed in intercourse satisfaction. Conclusions: Varying degree of sexual dysfunction is present in obese males, suggesting that obesity has a possible role in reducing the quality of sexual functioning in males as indicated in the classical ayurvedic literature. PMID:24167331

Geetha, Parampalli; Aravind, B.S.; Pallavi, G.; Rajendra, V.; Rao, Radhakrishna; Akhtar, Naseema

2012-01-01

335

Sexual dysfunction and cardiovascular diseases: a systematic review of prevalence.  

PubMed

The aim of this study was to conduct a systematic review of the literature regarding the prevalence of sexual dysfunction in patients with cardiovascular diseases. An article search of the ISI Web of Science and PubMed databases using the search terms "sexual dysfunction", "cardiovascular diseases", "coronary artery disease", "myocardial infarct" and "prevalence" was performed. In total, 893 references were found. Non-English-language and repeated references were excluded. After an abstract analysis, 91 references were included for full-text reading, and 24 articles that evaluated sexual function using validated instruments were selected for this review. This research was conducted in October 2012, and no time restrictions were placed on any of the database searches. Reviews and theoretical articles were excluded; only clinical trials and epidemiological studies were selected for this review. The studies were mostly cross-sectional, observational and case-control in nature; other studies used prospective cohort or randomized clinical designs. In women, all domains of sexual function (desire, arousal, vaginal lubrication, orgasm, sexual dissatisfaction and pain) were affected. The domains prevalent in men included erectile dysfunction and premature ejaculation and orgasm. Sexual dysfunction was related to the severity of cardiovascular disease. When they resumed sexual activity, patients with heart disease reported significant difficulty, including a lack of interest in sex, sexual dissatisfaction and a decrease in the frequency of sexual activity. PMID:24270960

Nascimento, Elisabete Rodrigues; Maia, Ana Claudia Ornelas; Pereira, Valeska; Soares-Filho, Gastão; Nardi, Antonio Egidio; Silva, Adriana Cardoso

2013-11-01

336

Sexual dysfunction and cardiovascular diseases: a systematic review of prevalence  

PubMed Central

The aim of this study was to conduct a systematic review of the literature regarding the prevalence of sexual dysfunction in patients with cardiovascular diseases. An article search of the ISI Web of Science and PubMed databases using the search terms "sexual dysfunction”, “cardiovascular diseases”, “coronary artery disease", “myocardial infarct" and “prevalence” was performed. In total, 893 references were found. Non-English-language and repeated references were excluded. After an abstract analysis, 91 references were included for full-text reading, and 24 articles that evaluated sexual function using validated instruments were selected for this review. This research was conducted in October 2012, and no time restrictions were placed on any of the database searches. Reviews and theoretical articles were excluded; only clinical trials and epidemiological studies were selected for this review. The studies were mostly cross-sectional, observational and case-control in nature; other studies used prospective cohort or randomized clinical designs. In women, all domains of sexual function (desire, arousal, vaginal lubrication, orgasm, sexual dissatisfaction and pain) were affected. The domains prevalent in men included erectile dysfunction and premature ejaculation and orgasm. Sexual dysfunction was related to the severity of cardiovascular disease. When they resumed sexual activity, patients with heart disease reported significant difficulty, including a lack of interest in sex, sexual dissatisfaction and a decrease in the frequency of sexual activity. PMID:24270960

Nascimento, Elisabete Rodrigues; Maia, Ana Claudia Ornelas; Pereira, Valeska; Soares-Filho, Gastão; Nardi, Antonio Egidio; Silva, Adriana Cardoso

2013-01-01

337

Antioxidant treatment with alpha-tocopherol improves erectile function in hypertensive rats.  

PubMed

There is no known treatment for erectile dysfunction (ED) in hypertensive patients. We tested whether or not antioxidative therapy improves ED in the setting of hypertension. Spontaneously hypertensive rats (SHRs) were treated with a control chow or an alpha-tocopherol-enriched chow (12 or 24 mg/100 g chow) for 8 weeks. The isometric tension of corpus cavernosum strips from these SHRs was recorded. nNOS and HO-2 gene expression and NOx, cGMP, thiobarbituric acid-reacting substance (TBARS), and superoxide dismutase (SOD) activity levels were determined in serum and tissue. Relaxation in response to electrical field stimulation (EFS) in the corpus cavernosum increased after the administration of alpha-tocopherol at a dose of 24 mg/100 g chow. This effect was inhibited by a nitric oxide synthase (NOS) inhibitor and by a heme oxygenase (HO) inhibitor, nNOS and HO-2 gene expression and NOx concentrations in the corpus cavernosum were similar between 24 mg alpha-tocopherol-fed SHRs and controls. Tissue cGMP levels were greater in alpha-tocopherol-fed SHRs than in controls. Treatment with 24 mg alpha-tocopherol decreased TBARS levels and increased SOD activity in the serum and corpus cavernosum. Relaxation in response to acetylcholine chloride in the corpus cavernosum was improved with alpha-tocopherol treatment at each dose. These results suggest that alpha-tocopherol treatment increases the diminished relaxation in the corpus cavernosum of SHRs by improving neuronal or endothelial function related to nitric oxide and carbon monoxide. This, in turn, indicates that antioxidant therapy may play a role in treatment for ED in hypertensive patients. PMID:18712056

Ushiyama, Masayuki; Kuramochi, Tomoya; Yagi, Shinji; Katayama, Shigehiro

2008-05-01

338

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

339

Suppressor of fused (Sufu) represses Gli1 transcription and nuclear accumulation, inhibits glioma cell proliferation, invasion and vasculogenic mimicry, improving glioma chemo-sensitivity and prognosis  

PubMed Central

Glioblastoma are highly aggressive brain tumors with poor prognosis. While various dysregulation of signaling pathways in gliomas have been described, the identification of biomarkers and therapy targets remains an important task for novel diagnostic and therapeutic approaches. Here we described that the Suppressor of fused (also known as Sufu) is significantly down-regulated in high-grade gliomas, correlating with a poor prognosis. We demonstrated that ectopic expression of Sufu inhibited cell proliferation, invasion and vasculogenic mimicry. In addition, overexpression of Sufu reduced Gli reporter gene transcription activity and prevented Gli1 nuclear accumulation, whereas knockdown of Sufu reversed these effects. Furthermore, overexpressed Sufu sensitized glioblastoma to Temozolomide and Cyclopamine. Thus, Sufu is potential tumor suppressor and therapeutic target in glioblastoma. PMID:25373737

Chen, Lingchao; Wang, Guangzhi; Cui, Yuqiong; Liu, Yang; Dou, Zhijin; Wang, Hongjun; Zhang, Ping; Chang, Liang; Yi, Liye; Cai, Jinquan; Jiang, Chuanlu

2014-01-01

340

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

PubMed Central

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

Harte, Christopher B.; Meston, Cindy M.

2012-01-01

341

Treatment of Bladder Dysfunction Using Stem Cell or Tissue Engineering Technique  

PubMed Central

Tissue engineering and stem cell transplantation are two important options that may help overcome limitations in the current treatment strategy for bladder dysfunction. Stem cell therapy holds great promise for treating pathophysiology, as well as for urological tissue engineering and regeneration. To date, stem cell therapy in urology has mainly focused on oncology and erectile dysfunction. The therapeutic potency of stem cells (SCs) was originally thought to derive from their ability to differentiate into various cell types including smooth muscle. The main mechanisms of SCs in reconstituting or restoring bladder function are migration, differentiation, and paracrine effects. Nowadays, paracrine effects of stem cells are thought to be more prominent because of their stimulating effects on stem cells and adjacent cells. Studies of stem cell therapy for bladder dysfunction have been limited to experimental models and have been less focused on tissue engineering for bladder regeneration. Bladder outlet obstruction is a representative model. Adipose-derived stem cells, bone marrow stem cells (BMSCs), and skeletal muscle-derived stem cells or muscle precursor cells are used for transplantation to treat bladder dysfunction. The aim of this study is to review stem cell therapy and updated tissue regeneration as treatments for bladder dysfunction and to provide the current status of stem cell therapy and tissue engineering for bladder dysfunction including its mechanisms and limitations. PMID:24741410

Kim, Jae Heon; Lee, Hong Jun

2014-01-01

342

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

343

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

344

Anxiety-induced failure in erectile response to intracorporeal prostaglandin-E1 in non-organic male impotence: a new diagnostic approach.  

PubMed

Intracavernous injection (ICI) of prostaglandin-E1 (PGE1) is used widely as the first diagnostic test in the study of erectile dysfunction. However, a lack of full erection after a maximal dose is frequent. As well as vascular incompetence, this may be due to stress-induced changes, related to the ICI procedure. The aim of this study was to investigate the influence of emotional disturbances on erectile response to ICI in impotent patients. Initially, 24 young men with non-organic impotence (age 34.6 +/- 1.5 years; mean +/- SEM) were selected and randomized single-blind to pharmacoerection with PGE1 alone (20 micrograms/mL) or a mixture (cocktail) containing 20 micrograms PGE1 plus an alpha-adrenergic receptor blocker, phentolamine (Phe, 0.5 mg/mL). Additional studies were also performed double-blind on 10 men with non-organic impotence (age 37.6 +/- 1.2 years) utilizing higher PGE1 dosages for ICI (25 micrograms/mL alone or in combination with Phe, 0.5 mg/mL). After a 7-day interval, all subjects were crossed-over to receive the alternative treatment. The presence of emotional disturbances was assessed in all patients by the administration of rapid tests (Stai-X1 and Stai-X1r for state-anxiety before and after ICI, respectively; Stai-X2 for trait-anxiety; Zung-test for depression) at the first and at the remaining (Stai-X1 and Stai-X1r) ICI sessions. ICI with 20 and 25 micrograms/mL PGE1 led to a comparable percentage of patients who reported a valid-for-intromission (VFI) erection (63 and 60%, respectively). In contrast, use of the cocktails significantly increased the percentage of subjects with a VFI (87 and 90% of the total number of patients tested, respectively; p < 0.05). Moreover, a strong inverse correlation between state-anxiety scores (Stai-X1) and the erectile response to ICI with 20 and 25 micrograms PGE1 was found (r = -0.69, p < 0.001); such a correlation was not present in patients who underwent ICI with the cocktails. Two cases of prolonged erection occurred (one after 20 micrograms PGE1 and the other after 20 micrograms PGE1 plus Phe) which were reversed promptly by the intracavernous injection of metharaminol. It is concluded that the lack of a full erectile response after ICI with PGE1 can be related to the presence of a high 'state-anxiety' in the patients. In such patients, a VFI erectile response can be induced by the administration of a cocktail test-dose. PMID:8985780

Aversa, A; Rocchietti-March, M; Caprio, M; Giannini, D; Isidori, A; Fabbri, A

1996-10-01

345

Switching to moclobemide to reverse fluoxetine-induced sexual dysfunction in patients with depression.  

PubMed Central

OBJECTIVE: To determine the efficacy of substituting moclobemide, a reversible monoamine oxidase-A inhibitor, for fluoxetine to reverse fluoxetine-induced sexual dysfunction in patients with depression. DESIGN: Prospective open trial. SETTING: Outpatient treatment. PARTICIPANTS: Five patients with depressive disorder who experienced sexual side effects during treatment with standard doses of fluoxetine (20 to 40 mg per day). INTERVENTION: Discontinuation of fluoxetine and replacement with moclobemide (300 to 600 mg per day) after a 2-week washout period. OUTCOME MEASURES: Libido, orgasmic function (in women) or erectile and ejaculatory function (in men), and overall improvement in sexual function during a follow-up period of 2 months to 3 years. RESULTS: Among patients receiving fluoxetine questioned about sexual side effects, 4 (1 man and 3 women) had treatment-related diminished libido with poor orgasmic response or partial erectile failure, and 1 female patient had enhanced sexual desire with intense clitoral stimulation. In all patients, sexual disturbances resolved completely after a 2-week washout period and a switch to treatment with moclobemide. Moclobemide was well tolerated. The antidepressant effect of moclobemide was comparable to that of fluoxetine. CONCLUSIONS: Moclobemide may be preferred as a treatment for depression in patients with fluoxetine-induced sexual dysfunction. PMID:9987207

Ramasubbu, R

1999-01-01

346

The effects of sex education on women with secondary orgasmic dysfunction.  

PubMed

This study evaluated the effects of sex education on 48 couples in which the women reported secondary orgasmic dysfunction. None of the males had a problem with premature ejaculation or with erectile dysfunction. Couples received two, two-hour sessions of sex education during a one-week period. From measures administered before and after treatment, the women reported significantly increased orgasmic frequency and decreased sexual anxiety. The males reported a significant increase in the duration of intercourse and in oral-genital sexual stimulation. None of the subject characteristics significantly predicted overall change. The findings underscored the important role of sex education in facilitating positive changes in a woman's orgasmic frequency and in a sexual relationship. Future research should assess the relative meaningfulness of the various components of the sex education package. PMID:6663641

Kilmann, P R; Mills, K H; Bella, B; Caid, C; Davidson, E; Drose, G; Wanlass, R

1983-01-01

347

Pitfalls of conservative treatments of multiple probable cerebral cavernous malformations (CCMs): clinicopathological features of CCMs coexisting with vasculogenic mimicry in an anaplastic oligodendroglioma.  

PubMed

Developments in magnetic resonance imaging (MRI) techniques have dramatically increased the detection of cerebral cavernous malformations (CCMs). Conservative treatment is often recommended for asymptomatic cases. However, CCMs occasionally harbor malignant gliomas. Here, we describe a rare case of multiple probable CCMs and an anaplastic oligodendroglioma (AO) showing vasculogenic mimicry (VM) and discuss the potential pitfalls of conservative treatments. A 42-year-old otherwise healthy woman presented with generalized seizures. Magnetic resonance imaging (MRI) revealed multiple parenchymal hypointensities, particularly in the right frontal lobe, with hyperintensity on fluid-attenuated inversion recovery (FLAIR) images. The patient was diagnosed with multiple probable CCMs, and conservative treatment was administered. However, follow-up MRI showed a slightly enlarged hyperintense area in the right frontal lobe. The patient then underwent surgery; histological diagnosis was CCMs and AO with VM. The patient subsequently underwent radiotherapy and chemotherapy. No neurological deficits or tumor recurrence were evident 21 months after surgery. We present this rare case and emphasize the possibility of the coexistence of malignant gliomas with CCMs. Close observation with MRI is essential in cases of multiple probable CCMs, and a histological confirmation should be considered in cases showing any enlargement of hyperintensity on FLAIR images. PMID:24337536

Yamamoto, Junkoh; Shimajiri, Shohei; Miyaoka, Ryo; Nishizawa, Shigeru

2014-07-01

348

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

349

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

350

Vajikarana: Treatment of sexual dysfunctions based on Indian concepts  

PubMed Central

Vajikarana or Vrishya chikitsa is a one of eight major specialty of the Ashtanga Ayurveda. This subject is concerned with aphrodisiacs, virility and improving health of progeny. As per Charak Samhita, by proper use of these formulations, one becomes endowed with good physique, potency, strength, and complexion and sexually exhilarated and sexually potent. This in turn is helpful in many common sexual dysfunctions, including Infertility, Premature Ejaculation and Erectile dysfunction. The therapy is preceded by living in strict compliance with the directions mentioned in Ayurvedic classics, various methods of body cleansing and other non-medicinal strategies like sexual health promoting conduct, behavior and diet. Certain individualized herbal and herbo-mineral combinations are administered as per the nature of a person according to the Ayurveda. Many limitations need to be considered before considering the use of theses therapy like lack of scientific studies, possibilities of adulteration in the herbal and herbo-mineral combinations available in market and possibilities of unexpected side-effects etc., The article calls upon initiating research in this area so that claims of ancient Ayurvedic texts could be substantiated and vajikaran therapy may be utilized by modern medicine. PMID:23858267

Dalal, P. K.; Tripathi, Adarsh; Gupta, S. K.

2013-01-01

351

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 among women. This review suggests that long-term use of alcohol and opioids are associated with SD in almost all domains of sexual functioning. There is a need to increase the awareness of clinicians about this association as many times SD in patients with substance abuse lead to poor treatment compliance and relapse. Further, there is a need to carry out more number of studies to understand the relationship in a better way. PMID:25336765

Grover, Sandeep; Mattoo, Surendra K; Pendharkar, Shreyas; Kandappan, Venkatesh

2014-10-01

352

Temporomandibular Joint Dysfunction  

MedlinePLUS

The temporomandibular joint (TMJ) connects your jaw to the side of your head. When it works well, it enables you to ... For people with TMJ dysfunction, problems with the joint and muscles around it may cause Pain that ...

353

Pelvic Floor Dysfunction  

MedlinePLUS

... Cancer Hemorrhoids Hemorrhoids: Expanded Version Irritable Bowel Syndrome Ostomy Pelvic Floor Dysfunction Pilonidal Disease Polyps of the ... on the surface of the skin around the opening to the rectum (anus) and on the abdominal ...

354

Contrasting effects of vasculogenic induction upon biaxial bioreactor stimulation of mesenchymal stem cells and endothelial progenitor cells cocultures in three-dimensional scaffolds under in vitro and in vivo paradigms for vascularized bone tissue engineering.  

PubMed

Clinical translation of bone tissue engineering approaches for fracture repair has been hampered by inadequate vascularization required for maintaining cell survival, skeletal regeneration, and remodeling. The potential of vasculature formation within tissue-engineered grafts depends on various factors, including an appropriate choice of scaffold and its microarchitectural design for the support of tissue ingrowth and vessel infiltration, vasculogenic potential of cell types and mechanostimulation on cells to enhance cytokine expression. Here, we demonstrated the effect of biomechanical stimulation on vasculogenic and bone-forming capacity of umbilical-cord-blood endothelial progenitor cells (UCB-EPC) and human fetal bone marrow-derived mesenchymal stem cell (hfMSC) seeded within macroporous scaffolds and cocultured dynamically in a biaxial bioreactor. Dynamically cultured EPC/hfMSC constructs generated greater mineralization and calcium deposition consistently over 14 days of culture (1.7-fold on day 14; p<0.05). However, in vitro vessel formation was not observed as compared to an extensive EPC-vessel network formed under static culture on day 7. Subsequent subcutaneous implantations in NOD/SCID mice showed 1.4-fold higher human:mouse cell chimerism (p<0.001), with a more even cellular distribution throughout the dynamically cultured scaffolds. In addition, there was earlier evidence of vessel infiltration into the scaffold and a trend toward increased ectopic bone formation, suggesting improved efficacy and cellular survival through early vascularization upon biomechanical stimulation. The integrative use of bioreactor culture systems with macroporous scaffolds and cocultured osteogenic and vasculogenic cells promotes maturation of EPC/hfMSC-scaffold grafts necessary for vascularized bone tissue engineering applications. PMID:23102089

Liu, Yuchun; Teoh, Swee-Hin; Chong, Mark S K; Yeow, Chen-Hua; Kamm, Roger D; Choolani, Mahesh; Chan, Jerry K Y

2013-04-01

355

The selective rho-kinase inhibitor Azaindole-1 has long lasting erectile activity in the rat  

PubMed Central

Objectives To investigate the effects of the selective Rho-kinase (ROCK) inhibitor azaindole-1 on erectile function under physiologic and pathophysiologic conditions in the rat. Methods The effect of intracavernosal (i.c.) injections of azaindole-1 on change in ICP, ICP/MAP, AUC, and response duration were investigated in the anesthetized rat under control conditions and when NANC neurotransmission and cholinergic function or sGC were inhibited or after cavernosal nerve crush injury. Results The i.c. injections of azaindole-1 produced dose-related increases in ICP/MAP and AUC that were long lasting at the highest doses studied when compared with the prototypical ROCK-inhibitor fasudil. Erectile responses were not altered by 7-NI and atropine in doses that reduced the response to cavernosal nerve stimulation by 86%, indicating that they were independent of NO release by cavernosal nerves or activation of muscarinic receptors in the corpora cavernosa. Erectile responses to azaindole-1 were not altered by the sGC inhibitor ODQ in a dose that attenuated responses to the NO donor SNP indicating that they were independent of an action on sGC. The erectile response to ic injections of azaindole-1 or Y-27632 which was reported to be NO/cGMP- dependent were not attenuated after cavernosal nerve crush injury. Conclusions The present studies indicate azaindole-1 has long lasting erectile activity that is independent of NO release, muscarinic receptor, or sGC activation or the integrity of the cavernosal nerves. PMID:23374844

Lasker, George F.; Pankey, Edward A.; Allain, Alexander V.; Murthy, Subramanyam N.; Stasch, Johannes-Peter; Kadowitz, Philip J.

2013-01-01

356

[Preeclampsia and tubular dysfunction].  

PubMed

Renal involvement associated with preeclampsia is well investigated, especially from the aspect of glomerular lesion and coagulation. On the other hand, only a few studies on tubular dysfunction during normal pregnancy and preeclampsia have been reported. The first study was carried out to clarify and estimate the chronological changes in tubular function. Pregnant women without obvious tubular dysfunction and toxemia (group A) were investigated using serum Cl, Na minus Cl (Na-Cl index), uric acid and urinary beta 2-microglobulin (u-beta-MG) at the 10th, 20th, 30th and 36th weeks of gestation. The second study was carried out to determine the significance of tubular dysfunction accompanied by preeclampsia. Patients with severe preeclampsia (group B) and normal pregnancy (group C) were examined by the same index of tubular dysfunction. The diagnosis of severe preeclampsia was confirmed with hypertension (over 170/110 mmHg), proteinuria (beyond 3 g/day) and severe edema. The following results were obtained: Urinary beta-MG and serum Cl increased during the third trimester in group A, but the Na-Cl index decreased. The serum uric acid concentration increased during the third trimester in group A. Tubular dysfunction was evident during the third trimester in normal pregnancy. Every index of tubular dysfunction including u-beta-MG, serum Cl, Na-Cl index and uric acid in group B was significantly higher than in group C. In group B, 4 fetuses died and 7 out of 15 cases required Cesarean sections. The critical line of tubular dysfunction for fetal prognosis was Cl 110 mEq/l, Na-Cl index 28 mEq/l, uric acid 6.0 mg/dl and u-beta-MG 1,000 micrograms/l.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3546534

Yoshida, A; Morozumi, K; Shinmura, I; Yagami, Y

1987-01-01

357

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

358

Norcantharidin enhances TIMP?2 anti?vasculogenic mimicry activity for human gallbladder cancers through downregulating MMP?2 and MT1?MMP.  

PubMed

Vasculogenic mimicry (VM) is a tumor microcirculation pattern in highly aggressive gallbladder cancers (GBCs). We recently reported the anti?VM activity of norcantharidin (NCTD) in highly aggressive GBC?SD cells and xenografts. In this study, we further investigated that NCTD enhanced tissue inhibitor of matrix metalloproteinase?2 (TIMP?2) anti?VM activity for GBCs and the underlying mechanisms. In vivo and in vitro experiments were performed to determine the effects of NCTD in combination with TIMP?2 on tumor growth, host survival, VM formation, hemodynamic of GBC?SD xenografts, and VM?like networks and malignant phenotypes of GBC?SD cells. Expression of matrix metalloproteinase (MMP)?2 and membrane type 1?MMP (MT1?MMP) among human GBCs, GBC?SD cells and xenografts were determined, respectively. The results showed that expression of MMP?2 and MT1?MMP in human GBCs, GBC?SD cells and xenografts was significantly related to VM in GBCs; a shorter survival time of VM?positive patients with high expression of MMP?2 or MT1?MMP compared to that of the patients with low expression. After treatment with NCTD+TIMP?2, tumor growth, VM formation, VM hemodynamic of the xenografts in vivo were significantly inhibited as compared to control, NCTD or TIMP?2 group, with a prolonged survival time of the xenograft mice (log?rank test, P=0.0115); and these observations were confirmed by VM?like networks by 3?D matrices and showed that proliferation, apoptosis, invasion, migration of GBC?SD cells in vitro were markedly affected. Furthermore, expression of MMP?2 and MT1?MMP in VM formation of the xenografts in vivo and GBC?SD cells in vitro was downregulated as compared to control, NCTD or TIMP?2 group. Thus, we concluded that NCTD enhances TIMP?2 antitumor and anti?VM activities in GBCs through downregulating MMP?2 and MT1?MMP. PMID:25405519

Zhu, Wei; Sun, Wei; Zhang, Jing-Tao; Liu, Zhong-Yan; Li, Xin-Ping; Fan, Yue-Zu

2015-02-01

359

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. PMID:25405189

Alves, Jorge; Petrosyan, Agavni; Magalhães, Rosana

2014-01-01

360

In vitro effect of medicinal plants used to treat erectile dysfunction on smooth muscle relaxation and human sperm.  

PubMed

Chloroform and ethanol extracts of root bark of Securidaca longepedunculata, Wrightia natalensis and Rhoicissus tridentata were investigated for their in vitro activity on the contraction of corpus cavernosal smooth muscle of white New Zealand rabbits. Some of the extracts of these plants relaxed the corpus cavernosal smooth muscle at low concentrations. The highest activity was obtained from Securidaca longepedunculata chloroform extracts at a concentration of 13.0 mg/ml, which induced 66.6% relaxation. Viagra was used as a positive control in this study. Extracts of Securidaca longepedunculata added to human spermatozoa affected certain sperm parameters negatively at 6.5 mg/ml and higher whilst there was no effect at 1.0 mg/ml. PMID:16309865

Rakuambo, N C; Meyer, J J M; Hussein, A; Huyser, C; Mdlalose, S P; Raidani, T G

2006-04-21

361

Functional electromyostimulation of the corpus cavernosum penis — preliminary results of a novel therapeutic option for erectile dysfunction  

Microsoft Academic Search

Transcutaneous application of low-frequency electric current in the treatment of partially or temporarily denervated striated muscles is widely used to prevent or treat muscular atrophy. Due to the high regenerative capacity of smooth-muscle cells, this approach should be beneficial in the treatment of diseases with smooth-muscle degeneration due to partial denervation. Our study was done to evaluate the possible beneficial

C. G. Stief; E. Weller; T. Noack; M. Djamilian; M. Meschi; M. Truss; U. Jonas

1995-01-01

362

High Rate of Sexual Dysfunction Following Surgery for Rectal Cancer  

PubMed Central

Purpose Although rectal cancer is a very common malignancy and has an improved cure rate in response to oncological treatment, research on rectal-cancer survivors' sexual function remains limited. Sexual dysfunction (SD) after rectal cancer treatment was measured, and possible predisposing factors that may have an impact on the development of this disorder were identified. Methods Patients undergoing curative rectal cancer surgery from January 2012 to September 2013 were surveyed using questionnaires. The female sexual function index or the International Index of Erectile Function was recorded. A multiple logistic regression was used to test associations of clinical factors with outcomes. Results Fifty-six men (56%) and 28 women (44%) who completed the questionnaire were included in the study. A total of 76 patients of the 86 patients (90.5%) with the diagnosis of rectal cancer who were included in this study reported different levels of SD after radical surgery. A total of 64 patients (76%) from the whole cohort reported moderate to severe SD after treatment of rectal cancer. Gender (P = 0.011) was independently associated with SD. Female patients reported significantly higher rates of moderate to severe SD than male patients. Patients were rarely treated for dysfunction. Conclusion Sexual problems after surgery for rectal cancer are common, but patients are rarely treated for SD. Female patients reported higher rates of SD than males. These results point out the importance of sexual (dys)function in survivors of rectal cancer. More attention should be drawn to this topic for clinical and research purposes. PMID:25360427

Ertekin, Caglar; Tinay, Ilker; Yegen, Cumhur

2014-01-01

363

The cone dysfunction syndromes  

PubMed Central

The cone dystrophies comprise a heterogeneous group of disorders characterised by visual loss, abnormalities of colour vision, central scotomata, and a variable degree of nystagmus and photophobia. They may be stationary or progressive. The stationary cone dystrophies are better described as cone dysfunction syndromes since a dystrophy often describes a progressive process. These different syndromes encompass a wide range of clinical and psychophysical findings. The aim is to review current knowledge relating to the cone dysfunction syndromes, with discussion of the various phenotypes, the currently mapped genes, and genotype-phenotype relations. The cone dysfunction syndromes that will be discussed are complete and incomplete achromatopsia, oligocone trichromacy, cone monochromatism, blue cone monochromatism, and Bornholm eye disease. Disorders with a progressive cone dystrophy phenotype will not be discussed. PMID:14736794

Michaelides, M; Hunt, D M; Moore, A T

2004-01-01

364

Sexual dysfunctions in depression.  

PubMed

The incidence of sexual dysfunctions in a group of 51 drug-free depressed patients and in age- and sex-matched controls was studied. Three groups of sexual dysfunction were assessed: alterations of libido, genital symptoms, and menstrual irregularities. The Beck Rating Scale for Depression, the Eysenck Personality Inventory (EPI), and the State-Trait Anxiety Inventory were completed on each participant. Depressed patients obtained significantly higher scores on anxiety, depression, and alterations of libido than controls. Rating scale scores for anxiety and depression were strongly intercorrelated, making the separation of depression-related symptoms from anxiety difficult. In males, the genital symptoms correlated inversely with the L (lie) score of the Eysenck Personality Inventory. There were no interrelationships between the three groups of sexual dysfunction. PMID:7149967

Mathew, R J; Weinman, M L

1982-08-01

365

Immune dysfunction in cirrhosis.  

PubMed

Innate and adaptive immune dysfunction, also referred to as cirrhosis-associated immune dysfunction syndrome, is a major component of cirrhosis, and plays a pivotal role in the pathogenesis of both the acute and chronic worsening of liver function. During the evolution of the disease, acute decompensation events associated with organ failure(s), so-called acute-on chronic liver failure, and chronic decompensation with progression of liver fibrosis and also development of disease specific complications, comprise distinct clinical entities with different immunopathology mechanisms. Enhanced bacterial translocation associated with systemic endotoxemia and increased occurrence of systemic bacterial infections have substantial impacts on both clinical situations. Acute and chronic exposure to bacteria and/or their products, however, can result in variable clinical consequences. The immune status of patients is not constant during the illness; consequently, alterations of the balance between pro- and anti-inflammatory processes result in very different dynamic courses. In this review we give a detailed overview of acquired immune dysfunction and its consequences for cirrhosis. We demonstrate the substantial influence of inherited innate immune dysfunction on acute and chronic inflammatory processes in cirrhosis caused by the pre-existing acquired immune dysfunction with limited compensatory mechanisms. Moreover, we highlight the current facts and future perspectives of how the assessment of immune dysfunction can assist clinicians in everyday practical decision-making when establishing treatment and care strategies for the patients with end-stage liver disease. Early and efficient recognition of inappropriate performance of the immune system is essential for overcoming complications, delaying progression and reducing mortality. PMID:24627592

Sipeki, Nora; Antal-Szalmas, Peter; Lakatos, Peter L; Papp, Maria

2014-03-14

366

Dysfunction Travel-associated  

E-print Network

Multiorgan Dysfunction Caused by Travel-associated African Trypanosomiasis Lucy E. Cottle, Joanna RMED-mail in persons who had traveled to this region. Trypanosomiasis remains rare in travelers but should be considered in febrile patients who have returned from trypanosomiasis-endemic areas of Africa. We describe

Steve Kemp

367

Perceptual-Motor Dysfunction.  

ERIC Educational Resources Information Center

Discussed are theoretical and treatment aspects of perceptual motor dysfunction and rehabilitation in 4- to 12-year-old academically failing children involved in a 3-year investigation at the University of Kansas. The program is said to stress increasing the amount of stimulation received by sensory receptors of the vestibular, reflex, and haptic…

Pyfer, Jean L.

368

Mitochondrial Dysfunction in Cancer  

PubMed Central

A mechanistic understanding of how mitochondrial dysfunction contributes to cell growth and tumorigenesis is emerging beyond Warburg as an area of research that is under-explored in terms of its significance for clinical management of cancer. Work discussed in this review focuses less on the Warburg effect and more on mitochondria and how dysfunctional mitochondria modulate cell cycle, gene expression, metabolism, cell viability, and other established aspects of cell growth and stress responses. There is increasing evidence that key oncogenes and tumor suppressors modulate mitochondrial dynamics through important signaling pathways and that mitochondrial mass and function vary between tumors and individuals but the significance of these events for cancer are not fully appreciated. We explore the interplay between key molecules involved in mitochondrial fission and fusion and in apoptosis, as well as in mitophagy, biogenesis, and spatial dynamics of mitochondria and consider how these distinct mechanisms are coordinated in response to physiological stresses such as hypoxia and nutrient deprivation. Importantly, we examine how deregulation of these processes in cancer has knock on effects for cell proliferation and growth. We define major forms of mitochondrial dysfunction and address the extent to which the functional consequences of such dysfunction can be determined and exploited for cancer diagnosis and treatment. PMID:24350057

Boland, Michelle L.; Chourasia, Aparajita H.; Macleod, Kay F.

2013-01-01

369

Adolescent TBI-induced hypopituitarism causes sexual dysfunction in adult male rats.  

PubMed

Adolescents are at greatest risk for traumatic brain injury (TBI) and repeat TBI (RTBI). TBI-induced hypopituitarism has been documented in both adults and juveniles and despite the necessity of pituitary function for normal physical and brain development, it is still unrecognized and untreated in adolescents following TBI. TBI induced hormonal dysfunction during a critical developmental window has the potential to cause long-term cognitive and behavioral deficits and the topic currently remains unaddressed. The purpose of this study was to determine if four mild TBIs delivered to adolescent male rats disrupts testosterone production and adult behavioral outcomes. Plasma testosterone was quantified from 72 hrs preinjury to 3 months postinjury and pubertal onset, reproductive organ growth, erectile function and reproductive behaviors were assessed at 1 and 2 months postinjury. RTBI resulted in both acute and chronic decreases in testosterone production and delayed onset of puberty. Significant deficits were observed in reproductive organ growth, erectile function and reproductive behaviors in adult rats at both 1 and 2 months postinjury. These data suggest adolescent RTBI-induced hypopituitarism underlies abnormal behavioral changes observed during adulthood. The impact of undiagnosed hypopituitarism following RTBI in adolescence has significance not only for growth and puberty, but also for brain development and neurobehavioral function as adults. © 2014 Wiley Periodicals, Inc. Develop Neurobiol 75: 193-202, 2015. PMID:25066665

Greco, Tiffany; Hovda, David A; Prins, Mayumi L

2015-02-01

370

Mitochondrial dysfunction in neurodegenerative diseases  

Microsoft Academic Search

A potential pivotal role for mitochondrial dysfunction in neurodegenerative diseases is gaining increasing acceptance. Mitochondrial dysfunction leads to a number of deleterious consequences including impaired calcium buffering, generation of free radicals, activation of the mitochondrial permeability transition and secondary excitotoxicity. Neurodegenerative diseases of widely disparate genetic etiologies may share mitochondrial dysfunction as a final common pathway. Recent studies using cybrid

M. Flint Beal

1998-01-01

371

Injection of skeletal muscle-derived cells into the penis improves erectile function  

Microsoft Academic Search

We investigated the effect of intrapenile injection of muscle-derived cells (MDC) on the erectile function in rats with bilateral cavernous nerve injury. Rat MDC were harvested and transduced with a retrovirus expressing the lacZ gene. Hanks’ balanced salt solution (HBSS) (20 ?l) or MDC (1 × 106 cells\\/side) were injected in each corpora cavernosa immediately before bilateral cavernous nerve transection.

Y Kim; F de Miguel; I Usiene; D Kwon; N Yoshimura; J Huard; M B Chancellor

2006-01-01

372

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

373

Female Sexual Dysfunction  

Microsoft Academic Search

The focus of this book is men and their sexual function and dysfunction, however, many women will also develop some degree\\u000a of sexual health problems concerned with sexual desire, arousal, orgasm, and\\/or pain. The goal is to make relevant evidence-based\\u000a clinical information to help identify and treat specific biologically based pathophysiologies available to the motivated health\\u000a care professional. The prevalence

Irwin Goldstein

374

The frequency of sexual dysfunctions in patients attending a sex therapy clinic in north India.  

PubMed

Analyzed data on 1000 consecutive patients with sexual disorders attending the psychosexual clinic at the All India Institute of Medical Sciences. The majority of patients were educated males between 21 and 30 years of age, belonging to the middle class. There was a slight preponderance of married patients. Fifty-two percent of patients had premarital or extramarital sexual contact; less than 5% had had homosexual contact; 10% had no sexual contact. Most patients had more than one complaint. Premature ejaculation (77.6%) and nocturnal emission (71.3%) were the most frequent problems followed by a feeling of guilt about masturbation (33.4%) and small size of the penis (30%). Erectile dysfunction was a complaint of 23.6%. Excessive worry about nocturnal emission, abnormal sensations in the genitals, and venereophobia was reported in 19.5, 13.6, and 13% of patients, respectively. Only 36 female patients attended the clinic with their spouses. PMID:9604119

Verma, K K; Khaitan, B K; Singh, O P

1998-06-01

375

Dysfunctional penile cholinergic nerves in diabetic impotent men  

SciTech Connect

Impotence in the diabetic man may be secondary to a neuropathic condition of the autonomic penile nerves. The relationship between autonomic neuropathy and impotence in diabetes was studied in human corporeal tissue obtained during implantation of a penile prosthesis in 19 impotent diabetic and 15 nondiabetic patients. The functional status of penile cholinergic nerves was assessed by determining their ability to accumulate tritiated choline (34), and synthesize (34) and release (19) tritiated-acetylcholine after incubation of corporeal tissue with tritiated-choline (34). Tritiated-choline accumulation, and tritiated-acetylcholine synthesis and release were significantly reduced in the corporeal tissue from diabetic patients compared to that from nondiabetic patients (p less than 0.05). The impairment in acetylcholine synthesis worsened with the duration of diabetes (p less than 0.025). No differences in the parameters measured were found between insulin-dependent (11) and noninsulin-dependent (8) diabetic patients. The ability of the cholinergic nerves to synthesize acetylcholine could not be predicted clinically with sensory vibration perception threshold testing. It is concluded that there is a functional penile neuropathic condition of the cholinergic nerves in the corpus cavernosum of diabetic impotent patients that may be responsible for the erectile dysfunction.

Blanco, R.; Saenz de Tejada, I.; Goldstein, I.; Krane, R.J.; Wotiz, H.H.; Cohen, R.A. (Boston Univ. School of Medicine, MA (USA))

1990-08-01

376

The evaluation of sexual dysfunction in male patients with migraine and tension type headache  

PubMed Central

Background Erectile dysfunction (ED), defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual performance, is a common condition. The psychological, hormonal, neurogenic and arterial pathologies, medications, chronic diseases have been reported in the etiology of the ED. This paper aims to study sexual dysfunction in the male patients with migraine and Tension type headache (TTH). Methods 30 migraine cases (Group M), 31 TTH cases (Group T) and 30 control cases (Group C) were included in the study. Patients were evaluated with medical history, physical examination, body mass index (BMI), Beck Depression Inventory, biochemical analysis and hormone profiles. ED was evaluated via International Index of Erectile Function Scale (IIEF). In statistical analysis, variant analysis, post-hoc tukey test, Pearson correlation test, t-test, and fisher's exact chi-square test were used. Results The patients' mean age was 34.96+/?1.30, 35.54+/?1.52 and 32.26+/?1.38 for group M,T and C, respectively. There was no significant difference between the groups in terms of testosterone levels. Mean IIEF scores was 19.83+/?2.2, 20.39+/?1.35 and 27.83+/?0.34 in groups M,T,C. When M and T groups were compared with group C, there were significant differences, and there was no statistical difference when T and M groups were compared to each other. Beck Depression Scores were not significantly different in groups M, T and C. Conclusion In this study, it was shown that, migraine and TTH affects the sexual functions negatively in male patients. Chronic diseases may cause sexual disorders in patients because of despair, guilt, and fear of death or pain. Our results suggest that, along with the effect of chronic disease and pain, there must be other complicated factors exist causing the development of SD in patients with migraine and TTH. PMID:23718759

2013-01-01

377

The Impact of Body Awareness on Sexual Arousal in Women with Sexual Dysfunction  

PubMed Central

Introduction The impact of self-awareness during sexual activity has been widely discussed. However, research has been largely focused on the effects of performance anxiety in male erectile functioning. It has been suggested that physical appearance concerns may have a similar influence on sexual function in women as does men’s self-awareness about erectile function. However, the role that physical appearance or awareness of one’s body may play in female sexual response has received little empiric attention. Aim To examine the effects of body awareness and self-report levels of body esteem on sexual response in 21 sexually dysfunctional women. Methods Body awareness was induced in one of two counterbalanced sessions. A full-length mirror was placed in front of participants throughout the experimental session, and participants were instructed to use the mirror to place 10 electrodes on each side of their bodies to prepare for a possible electrocardiogram. This methodology was used to ensure that women looked at themselves in the mirror and became more aware of their bodies during the experimental session. Main Outcome Measures Self-reported mental arousal, perceptions of physical arousal, physiological sexual arousal, affect, anxiety, and cognitive distraction responses to erotica. Results Results showed that subjective mental sexual arousal and perceptions of physical sexual arousal increased in response to erotica in the Body Awareness condition compared to in the No Body Awareness condition. These results were not accounted for by level of body esteem. There were no changes in physiological sexual arousal, affect, anxiety, or level of cognitive distraction across the two conditions. Conclusions Findings suggest that awareness of one’s body is related to increased subjective sexual response in conditions where cognitive distraction does not occur. It is particularly noteworthy that the current sample was made up of sexually dysfunctional women, all of whom had relatively low body image. PMID:17627744

Seal, Brooke N.; Meston, Cindy M.

2010-01-01

378

Inhibition of tumor vasculogenic mimicry and prolongation of host survival in highly aggressive gallbladder cancers by norcantharidin via blocking the ephrin type a receptor 2/focal adhesion kinase/paxillin signaling pathway.  

PubMed

Vasculogenic mimicry (VM) is a newly-defined tumor microcirculation pattern in highly aggressive malignant tumors. We recently reported tumor growth and VM formation of gallbladder cancers through the contribution of the ephrin type a receptor 2 (EphA2)/focal adhesion kinase (FAK)/Paxillin signaling pathways. In this study, we further investigated the anti-VM activity of norcantharidin (NCTD) as a VM inhibitor for gallbladder cancers and the underlying mechanisms. In vivo and in vitro experiments to determine the effects of NCTD on tumor growth, host survival, VM formation of GBC-SD nude mouse xenografts, and vasculogenic-like networks, malignant phenotypes i.e., proliferation, apoptosis, invasion and migration of GBC-SD cells. Expression of VM signaling-related markers EphA2, FAK and Paxillin in vivo and in vitro were examined by immunofluorescence, western blotting and real-time polymerase chain reaction (RT-PCR), respectively. The results showed that after treatment with NCTD, GBC-SD cells were unable to form VM structures when injecting into nude mouse, growth of the xenograft was inhibited and these observations were confirmed by facts that VM formation by three-dimensional (3-D) matrix, proliferation, apoptosis, invasion, migration of GBC-SD cells were affected; and survival time of the xenograft mice was prolonged. Furthermore, expression of EphA2, FAK and Paxillin proteins/mRNAs of the xenografts was downregulated. Thus, we concluded that NCTD has potential anti-VM activity against human gallbladder cancers; one of the underlying mechanisms may be via blocking the EphA2/FAK/Paxillin signaling pathway. PMID:24811250

Wang, Hui; Sun, Wei; Zhang, Wen-Zhong; Ge, Chun-Yan; Zhang, Jing-Tao; Liu, Zhong-Yan; Fan, Yue-Zu

2014-01-01

379

Inhibition of Tumor Vasculogenic Mimicry and Prolongation of Host Survival in Highly Aggressive Gallbladder Cancers by Norcantharidin via Blocking the Ephrin Type a Receptor 2/Focal Adhesion Kinase/Paxillin Signaling Pathway  

PubMed Central

Vasculogenic mimicry (VM) is a newly-defined tumor microcirculation pattern in highly aggressive malignant tumors. We recently reported tumor growth and VM formation of gallbladder cancers through the contribution of the ephrin type a receptor 2 (EphA2)/focal adhesion kinase (FAK)/Paxillin signaling pathways. In this study, we further investigated the anti-VM activity of norcantharidin (NCTD) as a VM inhibitor for gallbladder cancers and the underlying mechanisms. In vivo and in vitro experiments to determine the effects of NCTD on tumor growth, host survival, VM formation of GBC-SD nude mouse xenografts, and vasculogenic-like networks, malignant phenotypes i.e., proliferation, apoptosis, invasion and migration of GBC-SD cells. Expression of VM signaling-related markers EphA2, FAK and Paxillin in vivo and in vitro were examined by immunofluorescence, western blotting and real-time polymerase chain reaction (RT-PCR), respectively. The results showed that after treatment with NCTD, GBC-SD cells were unable to form VM structures when injecting into nude mouse, growth of the xenograft was inhibited and these observations were confirmed by facts that VM formation by three-dimensional (3-D) matrix, proliferation, apoptosis, invasion, migration of GBC-SD cells were affected; and survival time of the xenograft mice was prolonged. Furthermore, expression of EphA2, FAK and Paxillin proteins/mRNAs of the xenografts was downregulated. Thus, we concluded that NCTD has potential anti-VM activity against human gallbladder cancers; one of the underlying mechanisms may be via blocking the EphA2/FAK/Paxillin signaling pathway. PMID:24811250

Ge, Chun-Yan; Zhang, Jing-Tao; Liu, Zhong-Yan; Fan, Yue-Zu

2014-01-01

380

Managing female sexual dysfunction.  

PubMed

Female sexual dysfunctions (FSDs) range from short-term aggravations to major emotional disturbances adversely affecting family and workplace. This review highlights diagnosis and management of the four most widely diagnosed FSDs. It initially focuses on hypoactive sexual desire disorder (HSDD) as a driving force at the heart of all other FSDs; nothing happens without sexual desire. Successful resolution of HSDD frequently facilitates resolution of other disorders. Central to understanding HSDD is the impact of aging female sexual endocrinology and its effect on both prevalence and expression patterns of FSD. Advances in this field have enabled introduction of some the most effective treatments yet described for HSDD. Sexual arousal disorder, though commonly affected by the same factors as HSDD, is heavily associated with psychotropic drugs and mood elevators. Orgasmic disorder is frequently the downstream result of other sexual dysfunctions, particularly HSDD, or the result of a major psychosexual trauma. Successful management of the underlying disorder often resolves orgasmic disorder. Sexual pain disorder is frequently the result of a gynecologic disorder, such as endometriosis, that can be substantially managed through successful treatment of that disorder. This article ends with the article's most important note: how to initiate the conversation. PMID:24074537

Buster, John E

2013-10-01

381

[Thyroid dysfunction in pregnancy].  

PubMed

Thyroid dysfunction may impair fertility, course of pregnancy and fetal development. Physiological alterations of thyroid function parameters, that occur during pregnancy need to be distinguished from pathophysiological states of hypo- and hyperthyroidism. We performed a literature search (PubMed 1990-2013) and review relevant publications as well as consensus and practice guidelines of international thyroid/endocrine societies. Interpretation of thyroid function values in pregnancy must be based on trimester-specific TSH and T4 ranges. Alterations in thyroid function are present in up to 15% of pregnancies (0.4% overt hypothyroidism, 0.1-0.4% hyperthyroidism) and may lead to preventable complications in the pregnant woman and the fetus. Hypothyroidism is associated with an increased risk for abortion, premature delivery and stillbirth, besides impairment of neurocognitive development. The latter has also been shown in situations of grave iodine deficiency. In addition to new-born screening directed at early recognition of congenital hypothyroidism (incidence 0.03%), universal screening of all pregnant women should be implemented in health care guidelines. Newly diagnosed overt hypothyroidism in a pregnant woman requires immediate levothyroxine substitution at adequate doses. In subclinical hypothyroidism thyroid hormone replacement should be considered. Iodine supplementation is strongly recommended in all pregnant and breast-feeding women. Pregnancy causes a number of, that need to be of thyroid dysfunction. Both hypothyroidism and thyrotoxicosis may impair the course of pregnancy and may negatively affect the fetus. In particular, maternal hypothyroidism may lead to irreparable and detrimental deficits in the neurocognitive development of the fetus. Autoimmune thyroid disease is the most common cause of thyroid dysfunction in pregnancy. Hashimoto's thyroiditis is associated with impaired fertility and miscarriage, and may first manifest in pregnancy due to the increased thyroid hormone requirement. Graves' disease often shows a characteristic course in pregnancy with amelioration of thyrotoxicosis in the second half of pregnancy and exacerbation after delivery. In addition transplacental passage of maternal TSH receptor antibodies may lead to thyrotoxicosis in the fetus and/or newborn. PMID:25289925

Führer, D; Mann, K; Feldkamp, J; Krude, H; Spitzweg, C; Kratzsch, J; Schott, M

2014-10-01

382

Erectile function and male reproduction in men with spinal cord injury: a review.  

PubMed

Spinal cord injury (SCI) in men results in defects in erectile function, ejaculatory process and male reproductive potential. There are alterations in the capacity of men with SCI to achieve reflexogenic, psychogenic and nocturnal erections. The sexual function in different stages after SCI and the types of erections depend mainly on the completeness of the injury and the level of neurological damage. Furthermore, most of the SCI men demonstrate defects concerning the entrance of semen into the posterior urethra and the expulsion of the semen through the penile urethra and the urethral orifice. In addition, SCI men develop defects in the secretory function of the Leydig cells, Sertoli cells and the male accessory genital glands. The overall result is a decreased quality of the semen is recovered either with penile vibratory stimulation (PVS) or with electroejaculation. Nowadays the therapeutic andrological approach of SCI men focuses on achievement of erectile function, recovery of spermatozoa and assisted reproductive technology. The first line of therapy recommended for infertility in SCI men is collection of semen via PVS with concomitant evaluation of total motile sperm yields for assisted conception which may include intravaginal insemination, intrauterine insemination, or in vitro fertilisation/intracytoplasmic sperm injection. Patients failing PVS may be referred for electroejaculation or surgical sperm retrieval. PMID:20500744

Dimitriadis, F; Karakitsios, K; Tsounapi, P; Tsambalas, S; Loutradis, D; Kanakas, N; Watanabe, N T; Saito, M; Miyagawa, I; Sofikitis, N

2010-06-01

383

Understanding brain dysfunction in sepsis  

PubMed Central

Sepsis often is characterized by an acute brain dysfunction, which is associated with increased morbidity and mortality. Its pathophysiology is highly complex, resulting from both inflammatory and noninflammatory processes, which may induce significant alterations in vulnerable areas of the brain. Important mechanisms include excessive microglial activation, impaired cerebral perfusion, blood–brain-barrier dysfunction, and altered neurotransmission. Systemic insults, such as prolonged inflammation, severe hypoxemia, and persistent hyperglycemia also may contribute to aggravate sepsis-induced brain dysfunction or injury. The diagnosis of brain dysfunction in sepsis relies essentially on neurological examination and neurological tests, such as EEG and neuroimaging. A brain MRI should be considered in case of persistent brain dysfunction after control of sepsis and exclusion of major confounding factors. Recent MRI studies suggest that septic shock can be associated with acute cerebrovascular lesions and white matter abnormalities. Currently, the management of brain dysfunction mainly consists of control of sepsis and prevention of all aggravating factors, including metabolic disturbances, drug overdoses, anticholinergic medications, withdrawal syndromes, and Wernicke’s encephalopathy. Modulation of microglial activation, prevention of blood–brain-barrier alterations, and use of antioxidants represent relevant therapeutic targets that may impact significantly on neurologic outcomes. In the future, investigations in patients with sepsis should be undertaken to reduce the duration of brain dysfunction and to study the impact of this reduction on important health outcomes, including functional and cognitive status in survivors. PMID:23718252

2013-01-01

384

Strapping for temporomandibular joint dysfunction.  

PubMed

Temporomandibular joint dysfunction (TMJD) is a common problem seen in many of the dental clinics. Management of this depends on an accurate diagnosis of the cause for the TMJD. Physical therapy and rehabilitation play a vital role in the management of these dysfunctions. Physical therapy is useful in treating post-traumatic stiffness of the TMJ while strapping of the TMJ for a dysfunction along with conventional physical therapy is of benefit in terms of reduction in click, decrease in pain, and an improvement in function. PMID:18797110

Babu, Abraham Samuel; John, Sandhya Mary; Unni, Amith

2008-01-01

385

Sexual Dysfunction Related to Drugs: A Critical Review. Part IV: Cardiovascular Drugs.  

PubMed

Introduction: Sexual dysfunction is a potential side effect of cardiovascular drugs: this article is a critical review of the current literature. Many studies have been published on this topic. Most of these studies are not methodologically robust, few are RCTs and most did not use a validated rating scale to evaluate sexual functioning. In addition, other methodological flaws limit greatly the conclusions of these studies. Most studies relate to male populations and only a few have been conducted on women. Also, the majority of studies on sexual dysfunction induced by cardiovascular drugs relate to antihypertensive drugs. While there is evidence to suggest that older antihypertensive drugs (diuretics, beta-blockers, centrally acting agents) have a negative impact on erectile function, newer agents seem to have either neutral (ACE inhibitors, calcium antagonists) or beneficial effects (i.?e., angiotensin receptor blockers, nebivolol). Other cardiovascular drugs analyzed in this review also appear to have an inhibitory action on sexual function. For men, there is some weak evidence supporting the use of specific treatment strategies for sexual dysfunction associated with these drugs. Methods: This study was conducted in 2014 using the paper and electronic resources of the library of the "Azienda Provinciale per i Servizi Sanitari (APSS)" in Trento, Italy (http://atoz.ebsco.com/Titles/2793). The library has access to a wide range of databases including DYNAMED, MEDLINE Full Text, CINAHL Plus Full Text, The Cochrane Library, Micromedex healthcare series, BMJ Clinical Evidence. The full list of available journals can be viewed at http://atoz.ebsco.com/Titles/2793 or at the APSS web site (http://www.apss.tn.it). In completing this review, a literature search was conducted using the key words "cardiovascular", "adrenergic beta antagonist", "?1-adrenoceptor antagonist", "angiotensin converting enzyme inhibitor", "angiotensin receptor antagonist", "angiotensin receptor blocker", "beta blocker", "beta receptor antagonist", "calcium channel blocker", "diuretic", "antihypertensive", "sexual dysfunction", "sexual side effects", "treatment-emergent sexual dysfunction". All resulting listed articles were reviewed. Conclusion: The review includes studies that investigated the relationship between these drug treatments and sexual dysfunction. The purpose was to identify possible intervention strategies for sexual dysfunction related to these drugs. PMID:25405774

La Torre, A; Giupponi, G; Duffy, D; Conca, A; Catanzariti, D

2014-11-18

386

Mitochondrial dysfunction in gliomas.  

PubMed

Mitochondrial (mt) dysfunction in gliomas has been linked to abnormalities of mt energy metabolism, marked by a metabolic shift from oxidative phosphorylation to glycolysis ("Warburg effect"), disturbances in mt membrane potential regulation and apoptotic signaling, as well as to somatic mutations involving the Krebs cycle enzyme isocitrate dehydrogenase. Evolving biological concepts with potential therapeutic implications include interaction between microtubule proteins and mitochondria (mt) in the control of closure of voltage-dependent anion channels and in the regulation of mt dynamics and the mt-endoplasmic reticulum network. The cytoskeletal protein ?III-tubulin, which is overexpressed in malignant gliomas, has emerged as a prosurvival factor associated in part with mt and also as a marker of chemoresistance. Mt-targeted therapeutic strategies that are discussed include the following: (1) metabolic modulation with emphasis on dichloroacetate, a pyruvate dehydrogenase kinase inhibitor; (2) tumor cell death via apoptosis induced by tricyclic antidepressants, microtubule-modulating drugs, and small molecules or compounds capable of inflicting reactive oxygen species-dependent tumor cell death; and (3) pretreatment mt priming and mt-targeted prodrug cancer therapy. PMID:24331363

Katsetos, Christos D; Anni, Helen; Dráber, Pavel

2013-09-01

387

Psychoanalysis: a dysfunctional family?  

PubMed

The discussion opens with an account of the author's mother's bizarre family in which a strong, charismatic grandmother maintained absolute control over her large family by encouraging a neurotic dependence in them through daily reports of their complaints. Getting interested in psychoanalysis in an effort to understand the dynamics of this dysfunctional family, the author, a biographer, turned to the study of Melanie Klein, becoming entranced by her ideas. Her research also revealed how Klein had discouraged her followers from developing ideas that diverged in any way from her own. Her portrait of the pioneer analyst provoked intense indignation. A similar pattern of absolute loyalty to his person and theories was to be found in Freud's Secret Committee, formed primarily as a means of getting rid of Jung who had been showing disturbing signs of independence. When Ferenczi and Rank began to pursue independent lines of enquiry in their work, they too were though to be undermining the foundations of classical psychoanalysis. Finally, the author concludes that though there have been sorry incidents in psychoanalysis, we should be mature enough to accept both the contributions of the early pioneers and the realizations that new ideas must be permitted to evolve. PMID:9531859

Grosskurth, P

1998-01-01

388

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

PubMed Central

Consuming a high-fructose diet induces metabolic syndrome (MS)-like features, including endothelial dysfunction. Erectile dysfunction is an early manifestation of endothelial dysfunction and systemic vascular disease. Because mineral deficiency intensifies the deleterious effects of fructose consumption and mineral ingestion is protective against MS, we aimed to characterize the effects of 8 weeks of natural mineral-rich water consumption on the structural organization and expression of vascular growth factors and receptors on the corpus cavernosum (CC) in 10% fructose-fed Sprague-Dawley rats (FRUCT). Differences were not observed in the organization of the CC either on the expression of vascular endothelial growth factor (VEGF) or the components of the angiopoietins/Tie2 system. However, opposing expression patterns were observed for VEGF receptors (an increase and a decrease for VEGFR1 and VEGFR2, respectively) in FRUCT animals, with these patterns being strengthened by mineral-rich water ingestion. Mineral-rich water ingestion (FRUCTMIN) increased the proportion of smooth muscle cells compared with FRUCT rats and induced an upregulatory tendency of sirtuin 1 expression compared with the control and FRUCT groups. Western blot results were consistent with the dual immunofluorescence evaluation. Plasma oxidized low-density lipoprotein and plasma testosterone levels were similar among the experimental groups, although a tendency for an increase in the former was observed in the FRUCTMIN group. The mineral-rich water-treated rats presented changes similar to those observed in rats treated with MS-protective polyphenol-rich beverages or subjected to energy restriction, which led us to hypothesize that the effects of mineral-rich water consumption may be more vast than those directly observed in this study. PMID:24625878

Pereira, Cidália D; Severo, Milton; Rafael, Luísa; Martins, Maria João; Neves, Delminda

2014-01-01

389

Posterior Tibial Tendon Dysfunction (PTTD)  

MedlinePLUS

... ACFAS | Información en Español Advanced Search Home » Foot & Ankle Conditions » Posterior Tibial Tendon Dysfunction (PTTD) Text Size ... the arch, and an inward rolling of the ankle. As the condition progresses, the symptoms will change. ...

390

[Penile venous outflow occlusion: a comparison of erectile function and cavernosometry before and after percutaneous interventions].  

PubMed

After percutaneous transpenile or retrograde venous occlusion for the treatment of a cavernous leak, the clinical results were correlated with cavernosometric flow measurements in 27 patients. In 15 patients, venous occlusion led to a reduction of the maintenance flow: in patients who showed improvement there was an average reduction of 30 ml/min, in those without improvement or deterioration it averaged 0.3 or 13 ml/min respectively. In 7 patients there was increased flow (up to +21 ml/min). One of these patients showed improved erectile function; the remaining 6 showed no change as was also the case in 5 other patients who had no change in cavernosometric measurements. Our findings suggest a multifactorial cause of the venous leaks. PMID:8425078

Schild, H H; Müller, S C; Hermann, M; Kaltenborn, H; Kern, M

1993-01-01

391

An unusual side effect of Ibuprofen post dental therapy: increased erectile and libido activity.  

PubMed

Nonsteroidal anti-inflammatory drugs are the most commonly used medications for pain control in dentistry. The reported adverse effects include gastrointestinal and cardiovascular events, alterations in renal function, and effects on blood pressure, hepatic injury, and platelet inhibition which can lead to increased bleeding. This case report describes an unusual rare adverse event of the use of ibuprofen for pain control post restorative treatment. A 26-year-old, otherwise healthy Saudi male reported an unusual side effect of increased libido and erectile function post use of ibuprofen. The medical and laboratory tests have failed to identify a link between this rare adverse event and either underlying conditions or possibly related etiology. This case represented a puzzling challenge with no clear explanation. PMID:25628494

Kujan, Omar; Raheel, Syed Ahmed; Azzeghaiby, Saleh; Alqahtani, Fahad Hussain; Alshehri, Mohammed; Taifour, Shahama

2014-01-01

392

An Unusual Side Effect of Ibuprofen Post Dental Therapy: Increased Erectile and Libido Activity  

PubMed Central

Nonsteroidal anti-inflammatory drugs are the most commonly used medications for pain control in dentistry. The reported adverse effects include gastrointestinal and cardiovascular events, alterations in renal function, and effects on blood pressure, hepatic injury, and platelet inhibition which can lead to increased bleeding. This case report describes an unusual rare adverse event of the use of ibuprofen for pain control post restorative treatment. A 26-year-old, otherwise healthy Saudi male reported an unusual side effect of increased libido and erectile function post use of ibuprofen. The medical and laboratory tests have failed to identify a link between this rare adverse event and either underlying conditions or possibly related etiology. This case represented a puzzling challenge with no clear explanation.

Kujan, Omar; Raheel, Syed Ahmed; Azzeghaiby, Saleh; Alqahtani, Fahad Hussain; Alshehri, Mohammed; Taifour, Shahama

2014-01-01

393

Modifications of Erectile Tissue Components in the Penis during the Fetal Period  

PubMed Central

Background The penile erectile tissue has a complex microscopic anatomy with important functions in the mechanism of penile erection. The knowledge of such structures is necessary for understanding the normal physiology of the adult penis. Therefore, it is important to know the changes of these penile structures during fetal development. This study aims to analyze the development of the main components of the erectile tissue, such as collagen, smooth muscle fibers and elastic system fibers, in human fetuses. Methodology/Principal Findings We studied the penises of 56 human fetuses aged 13 to 36 weeks post-conception (WPC). We used histochemical and immunohistochemical staining, as well as morphometric techniques to analyze the collagen, smooth muscle fibers and elastic system fibers in the corpus cavernosum and in the corpus spongiosum. These elements were identified and quantified as percentage by using the Image J software (NIH, Bethesda, USA). From 13 to 36 WPC, in the corpus cavernosum, the amount of collagen, smooth muscle fibers and elastic system fibers varied from 19.88% to 36.60%, from 4.39% to 29.76% and from 1.91% to 8.92%, respectively. In the corpus spongiosum, the amount of collagen, smooth muscle fibers and elastic system fibers varied from 34.65% to 45.89%, from 0.60% to 11.90% and from 3.22% to 11.93%, respectively. Conclusions We found strong correlation between the elements analyzed with fetal age, both in corpus cavernosum and corpus spongiosum. The growth rate of these elements was more intense during the second trimester (13 to 24 WPC) of gestation, both in corpus cavernosum and in corpus spongiosum. There is greater proportional amount of collagen in the corpus spongiosum than in corpus cavernosum during all fetal period. In the corpus spongiosum, there is about four times more collagen than smooth muscle fibers and elastic system fibers, during all fetal period studied. PMID:25170760

Gallo, Carla B. M.; Costa, Waldemar S.; Furriel, Angelica; Bastos, Ana L.; Sampaio, Francisco J. B.

2014-01-01

394

Swallowing dysfunction after critical illness.  

PubMed

Critical care practitioners must frequently make decisions about their patients' ability to swallow food, liquids, and pills. These decisions can be particularly difficult given the incompletely defined epidemiology, diagnostic criteria, and prognostic features of swallowing disorders in critically ill patients. Furthermore, the consequences of improper decisions-namely, aspiration, malnutrition, hunger, and thirst-can be devastating to patients and their families. This review outlines the problem of swallowing dysfunction in critically ill patients and then addresses the most clinically relevant questions that critical care practitioners face today. First, we review the epidemiology of swallowing dysfunction in critically ill patients. Next, we describe the different diagnostic tests for swallowing dysfunction and describe a general approach to the initial assessment for swallowing disorders. Finally, we explore the existing treatments for swallowing dysfunction. Given the burden of swallowing dysfunction in patients recovering from critical illness, enabling critical care practitioners to manage these disorders, while stimulating new investigation into their pathophysiology, diagnosis, and management, will enhance our care of critically ill patients. PMID:25451355

Macht, Madison; White, S David; Moss, Marc

2014-12-01

395

Men's experience with sexual dysfunction post-rectal cancer treatment: a qualitative study.  

PubMed

In an effort to address reports from men that their sex life is worse after treatment for rectal cancer, this qualitative study was designed to better understand their experience with sexual dysfunction following rectal cancer treatment, thus providing information on the adaptation of a psycho-educational sexual health intervention for male rectal cancer survivors and simultaneously investigating barriers and promoters that would influence their participation in a psycho-educational sexual health intervention. Thirteen male rectal cancer survivors who were treated at Memorial Sloan-Kettering Cancer Center (MSKCC) for rectal cancer participated (median time post-treatment was 6.4 years). Six survivors participated in individual semi-structured phone interviews, and seven others took part in focus groups. We performed standard procedures of qualitative thematic text analysis, which involved independent review of interview and focus group transcripts by several analysts followed by consensus meetings to identify key themes. Participants reported bowel dysfunction (N = 13, or 100%) and erectile dysfunction (N = 12, or 92%) as chief complaints. The participants thought a psychoeducational sexual health intervention post-surgery would be helpful because it would provide educational information regarding the etiology of their problems and treatments to improve their sexual health (N = 8, or 62%). Most participants' primary concern immediately after treatment was surviving their disease; improving sexual functioning seemed to become more important over time. Barriers to potentially participating in a psycho-educational sexual health intervention included geographical distance from MSKCC (N = 3, or 3/13) and the risk of embarrassment when discussing sexual issues (N = 5, or 5/13). Men reported that a psycho-educational sexual health intervention would be helpful to improve their sexual functioning post-treatment. Discussion of bowel issues and logistical concerns gave information on the psycho-educational sexual health intervention. PMID:23821133

Ball, Melinda; Nelson, Christian J; Shuk, Elyse; Starr, Tatiana D; Temple, Larissa; Jandorf, Lina; Schover, Leslie; Mulhall, John P; Woo, Heidi; Jennings, Sabrina; DuHamel, Katherine

2013-09-01

396

Examining Sexual Dysfunction in Non-Muscle-Invasive Bladder Cancer: Results of Cross-Sectional Mixed-Methods Research  

PubMed Central

Introduction More than 70,000 new cases of bladder cancer are diagnosed in the United States annually; with 75% being non-muscle-invasive (NMIBC). Research examining sexual dysfunction in bladder cancer survivors is limited, and previous studies have focused on cystectomy patients. Aims To evaluate the impact of sexual dysfunction on NMIBC survivors. Methods Mixed-methods data collection integrated a quantitative survey (Study 1; n = 117) and semi-structured qualitative interviews (Study 2; n = 26) from a non-overlapping sample of NMIBC survivors. We performed descriptive and classification and regression tree (CART) analyses of survey data and qualitative analysis of interviews. Main Outcome Measures Self-reported sexual activity, interest in sex, and physiologic symptoms (e.g., male erectile/ejaculatory difficulties, female vaginal dryness) over the previous 4 weeks; partner communication about sexuality; contamination concerns; illness intrusiveness. Results Participants in these studies averaged 65 years of age (mean and median) and were male (77%), white (91%), and married (75%). Survey (Study 1) results linked NMIBC treatment to sexual symptoms and relationship issues. Many participants reported sexual inactivity (38.8%). Sexually active participants reported erectile difficulties (60.0%), vaginal dryness (62.5%), and worry about contaminating partner with treatment agents (23.2%). While almost one-half reported the usefulness of talking with partners about sexual function, only one-fifth of participants reported sharing all concerns with their partners. CART analysis supported the importance of communication. One-half of interviewees (Study 2) reported sexual dysfunction. Two-thirds reported negative impacts on their relationships, including perceived loss of intimacy and divorce; over one-third were sexually inactive for fear of contaminating their partner or spreading NMIBC. Conclusions Survivors' sexual symptoms may result from NMIBC, comorbidities, or both. These results inform literature and practice by raising awareness about the frequency of symptoms and the impact on NMIBC survivors' intimate relationships. Further work is needed to design symptom management education programs to dispel misinformation about contamination post-treatment and improve quality of life. Kowalkowski MA, Chandrashekar A, Amiel GE, Lerner SP, Wittmann DA, Latini DM, and Goltz HH. Examining sexual dysfunction in non-muscle-invasive bladder cancer: Results of cross-sectional mixed-methods research. Sex Med 2014;2:141–151. PMID:25356311

Kowalkowski, Marc A; Chandrashekar, Aravind; Amiel, Gilad E; Lerner, Seth P; Wittmann, Daniela A; Latini, David M; Goltz, Heather